Document:

EXHIBIT 4.2

                     Amended and Restated Stock Plan of 2003

     Article III, Section 3.2, will be amended and restated to read, in its
entirety, as follows:

     "3.2 Annual Increase in Shares. In accordance with the terms of
     the Plan prior to its amendment and restatement, the aggregate
     number of Options, SARs, Stock Units and Restricted Shares that
     may be awarded under the Plan was increased by 250,000 Common
     Shares as of January 1, 2004. As of January 31 of each year,
     commencing with the year 2005, there shall be an automatic
     increase in the aggregate number of Common Shares reserved for
     issuance under the Plan in an amount equal to the number of
     Common Shares issued by reason of Awards being granted, exercised
     or settled, as applicable, during the immediately preceding
     fiscal year. "

     In addition, the following clarifying changes will be made to the 2003
Stock Plan:

     The title of the plan will be changed to "Medical Nutrition USA, Inc.
Amended and Restated 2003 Omnibus Equity Incentive Plan.

     In the first sentence of Article I, the word "initially" will be inserted
immediately prior to the word "adopted".

     Finally, Article XX will be revised to reflect the date that the Board
adopted the Amended and Restated 2003 Omnibus Equity Incentive Plan.

     The following summary of certain principal features of the 2003 Stock Plan
is qualified in its entirety by the complete text of the 2003 Stock Plan, as
amended and restated, a copy of which is attached hereto as Exhibit "B".
Capitalized terms used herein and not otherwise defined herein shall have the
meaning ascribed to them in the 2003 Stock Plan.

     Administration. The 2003 Stock Plan is administered by the Compensation
Committee of the Board. Subject to the express provisions of the 2003 Stock
Plan, the administrator has broad authority to administer and interpret the 2003
Stock Plan as it deems necessary and appropriate. This authority includes, but
is not limited to, selecting award recipients, establishing award terms and
conditions, adopting procedures and regulations governing awards, and making all
other determinations necessary or advisable for the administration of the 2003
Stock Plan.

     Authorized and Available Shares. 1,000,000 Common Shares were originally
available for awards under the 2003 Stock Plan. The 2003 Stock Plan initially
provided that the number of Common Shares available for awards under the plan
would be increased by 250,000 Common Shares as of January 1 of each year. If
Proposal 2 is approved, in lieu of such automatic increases of 250,000 Common
Shares, the number of Common Shares reserved for issuance under such plan will
be increased automatically every year by the number of Common Shares issued by
reason of awards being granted, exercised or settled, as applicable, during the
prior year.

     Change of Control. Upon a change of control event (as defined in the 2003
Stock Plan), any award will become immediately vested and/or exercisable, unless
the administrator determines to the contrary. Generally speaking, a change of
control event will be triggered under the 2003 Stock Plan: (a) in connection
with certain mergers or consolidations of the Company with or into another
entity where the Company's shareholders before the transaction own less than 50%
of the surviving entity; (b) if a majority of the Board changes over a period of
two years or less; or (c) upon a sale of all or substantially all of the
Company's assets if a change in ownership of more than 50% of the Company's

                                       E-2
<PAGE>

outstanding voting securities occurs. The administrator of the 2003 Stock Plan
may also provide for alternative settlements of awards, the assumption or
substitution of awards or other adjustments of awards in connection with a
change of control or other reorganization of the Company.

     Plan Amendment, Termination and Term. The Board may amend, suspend or
discontinue the 2003 Stock Plan at any time, but no such action will affect any
outstanding award in any manner materially adverse to a participant without the
consent of the participant. Plan amendments will generally not be submitted to
shareholders for their approval unless such approval is required by applicable
law. The 2003 Stock Plan will remain in existence as to all outstanding awards
until such awards are exercised or terminated. The maximum term of options,
stock appreciation rights and other rights to acquire common stock under the
2003 Stock Plan is ten years after the initial date of award, subject to
provisions for further deferred payment in certain circumstances. No award can
be granted more than ten years after adoption of the 2003 Stock Plan by the
Board.

     Awards. Awards under the 2003 Stock Plan may be given to the Company's
employees, outside directors and consultants. Awards under the 2003 Stock Plan
may be in the form of: (a) incentive stock options; (b) non-qualified stock
options; (c) stock appreciation rights; or (d) restricted stock. Awards may be
granted individually or in combination with other awards. Certain types of
stock-based performance awards under the 2003 Stock Plan will depend upon the
extent to which performance goals set by the administrator are met during the
performance period. Awards under the 2003 Stock Plan generally will be
nontransferable, subject to exceptions such as a transfer to a family member or
to a trust, as authorized by the administrator. Non-qualified stock options and
other awards may be granted at prices below the fair market value of the common
stock on the date of grant. However, non-qualified stock options may not be
granted at prices below 85% of the fair market value on the date of grant.
Restricted stock awards can be issued for nominal or the minimum lawful
consideration. Incentive stock options must have an exercise price that is at
least equal to the fair market value of the common stock, or 110% of fair market
value of the common stock for any owner of more than 10% of the Company's common
stock, on the date of grant. These and other awards may also be issued solely or
in part for services. Each outside director that joins the Board will receive a
one-time grant of a nonstatutory stock option to purchase 12,000 Common Shares.
In addition, upon the conclusion of each annual meeting of the Company's
shareholders, each outside director who will continue serving as a member of the
Board thereafter will receive a nonstatutory stock option to purchase 5,000
Common Shares, except that no such grant to an outside director will be made in
the same calendar year as the year in which such director receive the grant of
12,000 Common Shares discussed above.

     Federal Tax Consequences. Generally, awards under the 2003 Stock Plan that
are includable in the income of the recipient at the time of exercise, vesting
or payment, such as non-qualified stock options, stock appreciation rights and
restricted stock awards, are deductible by the Company, and awards that are not
required to be included in the income of the recipient, such as incentive stock
options, are not deductible by the Company. Generally speaking, Section 162(m)
of the Internal Revenue Code of 1986, as amended (the "Code"), provides that a
public company may not deduct compensation, except for compensation that is
commission or performance-based paid to its chief executive officer or to any of
its four other highest compensated officers to the extent that the compensation
paid to such person exceeds $1,000,000 in a tax year. In addition, the Company
may not be able to deduct certain compensation attributable to the acceleration
of payment and/or vesting of awards in connection with a change in control event
should that compensation exceed certain threshold limits under Section 280G of
the Code.

     Non-Exclusive Plan. The 2003 Stock Plan is not exclusive. The Company may
grant stock and performance incentives or other compensation, in stock or cash,
under other plans or authority.

                                       E-3EXHIBIT 4.3

                           MEDICAL NUTRITION USA, INC.
                       2003 OMNIBUS EQUITY INCENTIVE PLAN

                          NOTICE OF STOCK OPTION GRANT

     You have been granted the following option to purchase shares of the Common
Stock of Medical Nutrition USA, Inc. (the "Company"):

     Name of Optionee:

     Total Number of Shares:

     Type of Option:                    <<ISO>> Incentive Stock Option
                                        <<NSO>> Non-Statutory Stock Option

     Exercise Price Per Share:

     Date of Grant:

     Vesting Commencement Date:

     Vesting Schedule:                  This option becomes exercisable with
                                        respect to the following: options shall
                                        vest over three years at the rate of
                                        one-third (33 1/3%) per year so long as
                                        the optionee shall remain an employee of
                                        the Company.

     Expiration Date:                   This option expires earlier if your
                                        Service terminates earlier, as described
                                        in the Stock Option Agreement.

     You and the Company agree that this option is granted under and governed by
the terms and conditions of the 2003 Omnibus Equity Incentive Plan (the "Plan")
and the Stock Option Agreement, both of which are attached to and made a part of
this document.

     You further agree that the Company may deliver by email all documents
relating to the Plan or this option (including, without limitation, prospectuses
required by the Securities and Exchange Commission) and all other documents that
the Company is required to deliver to its security holders (including, without
limitation, annual reports and proxy statements). You also agree that the
Company may deliver these documents by posting them on a web site maintained by
the Company or by a third party under contract with the Company. If the Company
posts these documents on a web site, it will notify you by email.

OPTIONEE:                               MEDICAL NUTRITION USA, INC.

                                        By:
----------------------------------         -------------------------------------
                                        Title: Chairman, Chief Executive Officer
----------------------------------             ---------------------------------

                                       E-4
<PAGE>

                           Medical Nutrition USA, Inc.
                       2003 Omnibus Equity Incentive Plan

                             Stock Option Agreement

Tax Treatment       This option is intended to be an incentive stock option
                    under section 422 of the Internal Revenue Code or a
                    nonstatutory stock option, as provided in the Notice of
                    Stock Option Grant.

Vesting             This option becomes exercisable in installments, as shown in
                    the Notice of Stock Option Grant. In addition, this option
                    becomes exercisable in full if either of the following
                    events occurs:

                    o   Your Service terminates because of retirement at or
                    after age 70, total and permanent disability, or death, or

                    o   The Company is subject to a "Change in Control" (as
                    defined in the Plan) before your Service terminates,.

                    This option will in no event become exercisable for
                    additional shares after your Service has terminated for any
                    reason.

Term                This option expires in any event at the close of business at
                    Company headquarters on the day before the 10th anniversary
                    of the Date of Grant, as shown in the Notice of Stock Option
                    Grant. (It will expire earlier if your Service terminates,
                    as described below.)

Regular             If your Service terminates for any reason except death or
Termination         total and permanent disability, then this option will expire
                    at the close of business at Company headquarters on the date
                    three months after your termination date. The Company
                    determines when your Service terminates for this purpose.

Death               If you die before your Service terminates, then this option
                    will expire at the close of business at Company headquarters
                    on the date 12 months after the date of death.

Disability          If your Service terminates because of your total and
                    permanent disability, then this option will expire at the
                    close of business at Company headquarters on the date 12
                    months after your termination date.

                    For all purposes under this Agreement, "total and permanent
                    disability" means that you are unable to engage in any
                    substantial gainful activity by reason of any medically
                    determinable physical or mental impairment which can be
                    expected to result in death or which has lasted, or can be
                    expected to last, for a continuous period of not less than
                    one year.

Leaves of           For purposes of this option, your Service does not terminate
Absence and         when you go on a military leave, a sick leave or another
Part-Time Work      bona fide leave of absence, if the leave was approved by the
                    Company in writing and if continued crediting of Service is
                    required by the terms of the leave or by applicable law. But
                    your Service terminates when the approved leave ends, unless
                    you immediately return to active work.

                                       E-5
<PAGE>

                    If you go on a leave of absence, then the vesting schedule
                    specified in the Notice of Stock Option Grant may be
                    adjusted in accordance with the Company's leave of absence
                    policy or the terms of your leave. If you commence working
                    on a part-time basis, then the vesting schedule specified in
                    the Notice of Stock Option Grant may be adjusted in
                    accordance with the Company's part-time work policy or the
                    terms of an agreement between you and the Company pertaining
                    to your part-time schedule.

Restrictions on     The Company will not permit anyone to exercise this option
Exercise            if the issuance of shares at that time would violate any law
                    or regulation.

Notice of Exercise  When you wish to exercise this option, you must notify the
                    Company by filing the proper "Notice of Exercise" form at
                    the address given on the form. Your notice must specify how
                    many shares you wish to purchase. Your notice must also
                    specify how your shares should be registered. The notice
                    will be effective when the Company receives it.

                    If another person wants to exercise this option after it has
                    been transferred to him or her, that person must prove to
                    the Company's satisfaction that he or she is entitled to
                    exercise this option. That person must also complete the
                    proper "Notice of Exercise" form (as described above) and
                    pay the exercise price (as described below).

Form of Payment     When you submit your notice of exercise, you must include
                    payment of the option exercise price for the shares that you
                    are purchasing. Payment may be made in one (or a combination
                    of two or more) of the following forms:

                    o   Your personal check, a cashier's check or a money order.

                    o   Certificates for shares of Company stock that you own,
                    along with any forms needed to effect a transfer of those
                    shares to the Company. The value of the shares, determined
                    as of the effective date of the option exercise, will be
                    applied to the option exercise price. Instead of
                    surrendering shares of Company stock, you may attest to the
                    ownership of those shares on a form provided by the Company
                    and have the same number of shares subtracted from the
                    option shares issued to you. However, you may not surrender,
                    or attest to the ownership of, shares of Company stock in
                    payment of the exercise price if your action would cause the
                    Company to recognize compensation expense (or additional
                    compensation expense) with respect to this option for
                    financial reporting purposes.

                    o   Irrevocable directions to a securities broker approved
                    by the Company to sell all or part of your option shares and
                    to deliver to the Company from the sale proceeds an amount
                    sufficient to pay the option exercise price and any
                    withholding taxes. (The balance of the sale proceeds, if
                    any, will be delivered to you.) The directions must be given
                    by signing a special "Notice of Exercise" form provided by
                    the Company.

                                       E-6
<PAGE>

Withholding         You will not be allowed to exercise this option unless you
Taxes and Stock     make arrangements acceptable to the Company to pay any
Withholding         withholding taxes that may be due as a result of the option
                    exercise. With the Company's consent, these arrangements may
                    include withholding shares of Company stock that otherwise
                    would be issued to you when you exercise this option. The
                    value of these shares, determined as of the effective date
                    of the option exercise, will be applied to the withholding
                    taxes.

Restrictions        You agree not to sell any option shares at a time when
on Resale           applicable laws, Company policies or an agreement between
                    the Company and its underwriters prohibit a sale. This
                    restriction will apply as long as your Service continues and
                    for such period of time after the termination of your
                    Service as the Company may specify.

Transfer of         In general, only you may exercise this option prior to your
Option              death. You may not transfer or assign this option, except as
                    provided below. For instance, you may not sell this option
                    or use it as security for a loan. If you attempt to do any
                    of these things, this option will immediately become
                    invalid. You may, however, dispose of this option in your
                    will or in a beneficiary designation.

                    However, if this option is designated as a nonstatutory
                    stock option in the Notice of Stock Option Grant, then the
                    "Committee" (as defined in the Plan) may, in its sole
                    discretion, allow you to transfer this option as a gift to
                    one or more family members. For purposes of this Agreement,
                    "family member" means a child, stepchild, grandchild,
                    parent, stepparent, grandparent, spouse, former spouse,
                    sibling, niece, nephew, mother-in-law, father-in-law,
                    son-in-law, daughter-in-law, brother-in-law or sister-in-law
                    (including adoptive relationships), any individual sharing
                    your household (other than a tenant or employee), a trust in
                    which one or more of these individuals have more than 50% of
                    the beneficial interest, a foundation in which you or one or
                    more of these persons control the management of assets, and
                    any entity in which you or one or more of these persons own
                    more than 50% of the voting interest.

                    In addition, if this option is designated as a nonstatutory
                    stock option in the Notice of Stock Option Grant, then the
                    Committee may, in its sole discretion, allow you to transfer
                    this option to your spouse or former spouse pursuant to a
                    domestic relations order in settlement of marital property
                    rights.

                    The Committee will allow you to transfer this option only if
                    both you and the transferee(s) execute the forms prescribed
                    by the Committee, which include the consent of the
                    transferee(s) to be bound by this Agreement.

Retention Rights    Your option or this Agreement does not give you the right to
                    be retained by the Company or a subsidiary of the Company in
                    any capacity. The Company and its subsidiaries reserve the
                    right to terminate your Service at any time, with or without
                    cause.

                                       E-7
<PAGE>

Stockholder         You (or your estate, heirs or transferee) have no rights as
Rights              a stockholder of the Company until you (or your estate,
                    heirs or transferee) have exercised this option by giving
                    the required notice to the Company and paying the exercise
                    price. No adjustments are made for dividends or other rights
                    if the applicable record date occurs before this option is
                    exercised, except as described in the Plan.

Adjustments         In the event of a stock split, a stock dividend or a similar
                    change in Company stock, the number of shares covered by
                    this option and the exercise price per share may be adjusted
                    pursuant to the Plan.

Applicable Law      This Agreement will be interpreted and enforced under the
                    laws of the State of Delaware (without regard to their
                    choice-of-law provisions).

The Plan and        The text of the Plan is incorporated in this Agreement by
Other Agreements    reference. This Agreement and the Plan constitute the entire
                    understanding between you and the Company regarding this
                    option. Any prior agreements, commitments or negotiations
                    concerning this option are superseded. This Agreement may be
                    amended only by another written agreement between the
                    parties.

      BY SIGNING THE COVER SHEET OF THIS AGREEMENT, YOU AGREE TO ALL OF THE
              TERMS AND CONDITIONS DESCRIBED ABOVE AND IN THE PLAN.

                                       E-8

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00104-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00104-of-00352.parquet"}]]