Check out the new Prevention Site

There is a new website for the Montana Cardiovascular Disease and Diabetes Prevention Program. The site still offers the Blog and lots of other resources, there are more recipes for you to try and enjoy.

Find us at www.mtprevention.org

Survival for The Season of Food Temptations and Stress

Trick or treat? We are entering the holiday season. You know, that time of year when you wake up each morning and hit the ground, running, like a little hamster on the little treadmill, going 90 miles an hour and getting nowhere fast. We go from Halloween to Thanksgiving and then the biggest stressor of all, Christmas. Baking, tight finances, gift buying and wrapping, shipping gifts in time for those who you will not see and dare I mention the stress and agony of those family gatherings.

While it is still early in the month, let’s take a BIG DEEP BREATH, exhale and repeat. Now, pull yourself together and let’s get ready to take some pre-emptive strikes against potential pitfalls.

You have my solemn oath, the sun will still rise, and the sun will still set whether you do it all or not. You have my permission not to do it all and to say “no”. I have learned the art of saying “no”. I still have friends and family. If they truly love you and care about you, they will understand that you are not a robot and I do believe in my heart that they will be glad you are taking a stand as it then gives them permission to follow in your footsteps with a deep sigh of relief.

I encourage you to sit down, now, while the pressure is only in your head, and make a list.
· Write down what you know you must do.
· Write down what you would like not to do.
· What can you delegate?
· Be realistic and honest with yourself and you will see there are things you can easily cross off the must do list.

Halloween: Beware those mini candy bars. A nibble here, a nibble there and voila-5 pounds packed back on.

How to avoid Halloween pitfalls:
· Buy candy you do not like.
· Don’t buy candy early in the month.
· Don’t buy more than you think you need. It is OK to run out of candy, turn off the lights, and hide in the basement.
· Pay attention to the weather forecast. Cold, rain, snow=fewer kids.
· Bring leftover candy to work. After you turn out the porch light for the evening, bring the candy straight to your car and put it in the backseat or trunk to avoid temptation in the morning.
· Finally, as heartbreaking as it may seem, and again, you have my permission—THROW AWAY THE LEFTOVER CANDY.

Thanksgiving and Christmas dinners if you invited guests over:
· Ask everyone to bring a dish. Make sure you have a variety, not 5 bowls of mashed potatoes.
· Don’t sabotage your newly lost weight, ASK FOR WHAT YOU NEED. Nothing wrong with telling your sister-in-law you are watching your fat intake and can she please use chicken broth in the mashed potato recipe instead of 2 sticks of butter. The recipes can be found on cans of chicken broth.
· Yep, the food is mighty tasty but you don’t have to take a full serving either. Try a small spoonful and don’t deprive yourself. There are all sorts of ways to cut back and not gain back in a weekend what you took 8 weeks to lose.
· Talk to your lifestyle coach to gear up for holidays.

A Thanksgiving tradition in my home: we go for a walk after dinner, before dessert. The dogs like it too and it is a nice way for people to mingle and visit. It’s a chance for everyone to get caught up on the past year. I bet others appreciate it too. So will the dog. Just remember to tell your guests to bring some good walking shoes with them.

Desserts: I admittedly have a sweet tooth and adore desserts. How to avoid the pitfalls of overindulgence: Small tastes to satisfy the desire. I like both pecan and pumpkin pie. I have a small sliver of each. Fat free whipped cream can defray some fat and calories. Have a cup of herbal tea to help fill you up.

· Confidential to you: a slice of pumpkin pie does not count as a serving of vegetable or fruit. A slice of pecan pie does not count as your small handful of nuts as a protein source.

Lots of tempting leftovers? Send leftovers home with guests. Keep some for yourself, that’s part of the holiday fun, but a half-gallon of mashed potatoes leftover in the fridge will only be temptation.

For some good tips on what a healthy eating plate looks like: www.hsph.harvard.edu/nutritionsource

Holiday frenzy survival techniques:
· Simplify.
· Now is a good time to sit down and work up a holiday budget for gifts, for your holiday meal plans.
· Make up your menu and then see who of your guests can help with the cooking. This also gives you ample time to find recipes that will not sabotage your progress and share it with the willing cooks.
· Refer to the list you made as to what things you must do and what things you can eliminate from doing. Finances are tight for many people. Is it necessary to buy your 15 nieces and nephews a gift? Get the group together and have everyone pick a name out of a hat and buy 1 gift for 1 person.
· Step outside of yourself; donate what you would spend on gifts to your local battered women’s shelter, to the local animal shelter or the charity of your choice. The rewards you reap from giving to others less fortunate are many. It cuts down on the stress of shopping.
· If you must shop, take advantage of internet offers. Saves gas and time too.
· Ask your lifestyle coach for help with recipes or check out the prevention blog site http://www.mtdpp.blogspot.com/ for tasty recipes.

“In three words I can sum up everything I’ve learned about life: it goes on.”
Robert Frost

All American Chili

“All American Chili” for the Slow Cooker Adapted from www.cookinglight.com
Yield: 8 servings (serving size: 1 1/4 cups chili and 1 tablespoon cheese)
Ingredients
• 1½ pounds ground wild game or beef (your choice, they all work)
• 2 cups chopped onion
• 1 cup chopped green bell pepper
• 8 garlic cloves, minced
• 1 jalapeño pepper, chopped (optional, leave out for a mild chili)
• 2 tablespoons chili powder
• 2 tablespoons brown sugar
• 1 tablespoon ground cumin
• 3 tablespoons tomato paste
• 1 teaspoon dried oregano
• 1/2 teaspoon freshly ground black pepper
• 1/4 teaspoon salt
• 2 bay leaves
• 1 1/4 cups Merlot or other fruity red wine (optional)
• 2 (28-ounce) cans whole tomatoes, undrained and coarsely chopped
• 2 (15-ounce) cans kidney beans, drained
• 1/2 cup (2 ounces) shredded reduced-fat sharp cheddar cheese

Preparation:
In a large sauté pan, combine ground meat, onion, and the next 4 ingredients (onion through jalapeño) to pan; cook 8 minutes or until browned, stirring to crumble.

Add chili powder and the next 7 ingredients (chili powder through bay leaves)*, and cook for 1 minute, stirring constantly.

In a large slow cooker, combine meat mixture with wine, tomatoes, and kidney beans; cover and cook on low for 6 hours or high for 4 hours.

Uncover and discard the bay leaves.

Sprinkle each serving with cheddar cheese, as desired.

*Don’t have all the seasonings or short on time? Just use a low-sodium chili seasoning packet instead.

Note: Like most chilis, this version tastes even better the next day. Leftovers can be put in single-serving containers and frozen (cool completely first!), to be used for a quick lunch later, at work or at home.

Nutritional Information:
Calories: 375
Fat: 4-12g (depending on the suet you use to process your ground meat)
Protein: 28.9g
Carbohydrate: 33.7g
Fiber: 8.2g
Cholesterol: 59mg
Iron: 5mg
Sodium: 969mg (if you choose low-sodium canned tomatoes and beans, this will be significantly less)
Calcium: 165mg

For more wild game recipes:
http://somhelp.blogspot.com/2010/08/hunters-challenge-recipes.html

Plan Ahead

I like to plan ahead. I was one of those kids who did their homework on Friday afternoon so my weekend was free and clear. Worked for me, I got to watch Walt Disney on Sunday night since my homework was done. Where I am going with all of this is-winter is coming. Yes, it is still August as I write but I see leaves beginning to turn. Those in the know say it will be an early winter, sheesh, and it was a late start to summer. I hope everyone is enjoying each and every waking moment of summer, it has been glorious. I also hope you are enjoying the bounties of summer-fresh fruit, REAL tomatoes, it is really hard to eat a winter tomato after enjoying a farm fresh one. But I digress.

Are you a hunter? Did you know the recommendation is to start getting into shape at least 6 weeks prior to going out hunting? Rifle season for elk and deer opens October 22, 2011. http://fwp.mt.gov/hunting/seasons/ The State employee wellness program offers Hunter’s Challenge, there’s lots of good information, even if you are not a State employee. http://benefits.mt.gov/hunterfitness.mcpx

Montana is ranked #1 in having the most hunters per capita in the nation. There’s more to preparing for a hunting trip than your tags, ammo, warm clothes and tents. Think about your health and getting into shape for this upcoming hunting season.

Every year you hear of some poor soul who was out hunting and dropped dead, it’s called Buck Fever. Here is what happens:
“Buck fever is the adrenaline pumping excitement a hunter may experience when they spot a buck in the woods. The study showed that the heart rate of some hunters would almost double simply upon seeing a buck, even though the hunters were standing still. The study also noted that the common practice of dragging a dead deer, often for considerable distances, proved to be exceptionally stressful on the heart”. By David K. Ashpole, MD, FACC, Wisconsin Heart & Vascular Clinics, S.C.

· Know the warning signs of heart attack and stroke
· Call 9-1-1

Heart Attack Warning Signs
· Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes. It can feel like uncomfortable pressure, squeezing, fullness or pain.
· Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
· Shortness of breath. May occur with or without chest discomfort.
· Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness.
· If you are having symptoms and are out of cell phone service range chew an adult sized aspirin (for heart attack only) and see a medical provider ASAP

Stroke Warning Signs
· Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.· Sudden confusion, trouble speaking or understanding.
· Sudden trouble seeing in one or both eyes.
· Sudden trouble walking, dizziness, loss of balance or coordination.
· Sudden, severe headache with no known cause.

Some tips for healthy hunting (from William Beaumont Hospital, Royal Oak, MI)
· Don’t drink alcohol or smoke the day before or during hunting.
· Don’t eat a heavy meal before hunting.
· Spend time prior to hunting raising fitness level by walking or aerobic exercise.
· People with heart disease should not drag a deer or elk.
· Those with high blood pressure, high cholesterol or other risk factors should consult a doctor before hunting.
· Seek medical help if heart attack warning signs come on while hunting (dizziness, chest pain, heart palpitations).

Regular exercise benefits your heart, back and overall health, both physical and emotional.
· Maintain a healthy diet and weight. Talk to your lifestyle coach for guidance if you are planning on hunting.
· Warm up before exercising or other physical activities.
· Quit smoking, it impairs your blood flow resulting in oxygen and nutrient deprivation to spinal tissues. Montana Quit Line 1-800 QUIT NOW

Plan ahead. I am referring to physical activity in winter and inclement weather. Why? In a follow up survey with prevention program graduates, winter weather was noted as a barrier to physical activity. I imagine people in Phoenix would list summer heat as a barrier to physical activity as well, I see their point, which is worse, heat exhaustion or falling on ice and breaking a bone? Not sure. I suppose heat exhaustion could at least put your mind in a form of delirium which might be rather pleasant for some while a broken bone is just plain painful.

Hunter or not, hunting is over in November and then we still have 7 months of winter in Montana.

Think about your plans on achieving your 150+ minutes of physical activity this winter. Your lifestyle coach is a wonderful resource for ideas.
· Organize a group to meet regularly for exercise and moral support.
· Smaller communities may not have health clubs or recreation or community centers but I am willing to bet there is a house of worship with a nice community room or a local school with a gymnasium, a library with a meeting space. I am also willing to bet that those facilities may be open to allowing a group to meet for activity, especially if you open it up to members of the community. Tap into local resources. And what a great opportunity to make new friends also interested in a healthy lifestyle.
· There is usually someone in your community who is happy to offer their expertise in teaching yoga, Zumba, Pilates, aerobics or lead a walking group for all levels of walkers.
· Have room in your house for a piece of exercise equipment THAT YOU WILL USE? Check the local thrift shop, Thrifty Nickel, yard sales or bulletin boards at the market for used exercise equipment. Swap out with friends, maybe you are bored with your treadmill and your friend is tired of the elliptical trainer, you can trade back again later on.

In the meantime, enjoy these summer evenings.

“Summer is a promissory note signed in June, its long days spent and gone before you know it, and due to be repaid next January.” Hal Borland, American Author

Pan-Cooked Summer Squash with Tomatoes and Basil

From the New York Times
By MARTHA ROSE SHULMAN
This Provençal summer dish is delightful as a starter or as a side dish with fish, chicken or cooked grains.

Yield: Serves four to six.

2 tablespoons extra virgin olive oil
1 1/2 pounds medium or small zucchini or other summer squash, thinly sliced or diced (depending on what shape squash you use)
2 garlic cloves, minced
1 pound ripe tomatoes, grated on the large holes of a box grater, or peeled, seeded and diced
Salt and freshly ground pepper
1 to 2 tablespoons chopped or slivered fresh basil (to taste)

1. Heat 1 tablespoon of the olive oil over medium-high heat in a wide, heavy skillet. Add the zucchini. Cook, stirring or shaking the pan, until the zucchini is lightly seared and beginning to soften, three to five minutes. Remove from the pan, and set aside.

2. Add the remaining olive oil to the pan, then the garlic. Cook, stirring, just until fragrant -- less than 30 seconds. Stir in the tomatoes. Cook, stirring, until the tomatoes have begun to cook down, about five minutes. Return the zucchini to the pan, add salt and pepper to taste, and reduce the heat to medium. Cook, stirring often, until the zucchini is tender and translucent and the tomatoes have cooked down to a fragrant sauce. Stir in the basil, and taste and adjust seasonings. Remove from the heat and serve hot, or allow to cool and serve at room temperature.


Advance preparation: You can make this a day or two ahead of time. Keep refrigerated, and reheat gently on top of the stove. The dish is also good cold, doused with a little lemon juice.

Nutritional information per serving (four servings): 111 calories; 1 gram saturated fat; 1 gram polyunsaturated fat; 5 grams monounsaturated fat; 0 milligrams cholesterol; 10 grams carbohydrates; 3 grams dietary fiber; 20 milligrams sodium (does not include salt to taste), 3 grams protein
Nutritional information per serving (six servings): 74 calories; 1 gram saturated fat; 1 gram polyunsaturated fat; 3 grams monounsaturated fat; 0 milligrams cholesterol; 7 grams carbohydrates; 2 grams dietary fiber; 13 milligrams sodium (does not include salt to taste), 2 grams protein

Asking for What You Need

You want me to WHAT? That’s OK, I will sit silently and suffer, stew, fume, boil over, punch someone in the face.

Why is it so many of us have such a difficult time stating our needs? And, why does the recipient of said request look at us like we just landed in an alien craft during dinner?

There are things in my life that I am willing to negotiate on, others not so much. Where is it written that one person has the power over another? Why shouldn’t we ask for what we need, (OK, within reason, I really don’t need a shiny red sports car). Some people have no problem speaking out and standing up for themselves while others would sooner curl up and die (great name for a hair salon except you have to spell die dye). I am being silly, it’s Friday afternoon.

Ok, you say, “I get it” but “how do I go about it”?
· Self-confidence
· Self-esteem
· Be assertive-we tend to confuse assertive with aggressive. “The basic difference between being assertive and being aggressive is how our words and behavior affect the rights and well being of others.” Sharon Anthony Bower.
· Don’t think that by asserting yourself you are being rude, unless of course you get in someone’s face about it in which case you are being rather aggressive.

Start small. Practice saying no in the mirror. Look yourself in the eyes and say NO, it is difficult but can be helpful. Next, try it on the dog. If it works on the dog you have it mastered.

Once you have graduated from saying no in the mirror and to the dog, take what you learned in your Lifestyle Balance class, session 10, #2 “ASK FOR WHAT YOU WANT. BE FIRM AND FRIENDLY”, it’s in your notebook. This is a great place to start asking for what you need. Don’t be shy. My motto is “I am the customer and paying for this with my hard earned money”, if your money is not hard earned, is your company hiring? Call me! But seriously, call me, no really… OK, it is Monday and I am still being silly.

Back to my “I am the customer” comparison, would you pay good money for a pair of shoes that are too small? Your circulation is being cut off and they pinch like a vise grip. I know I wouldn’t do that. So why would you order a meal that isn’t what you want? For you Baby Boomers out there and maybe some younger whipper snappers who are into good movies, I take you to the scene in Jack Nicholson’s “Five Easy Pieces” where he is ordering a sandwich in a coffee shop. Here it is on You Tube, it is a classic. He surely was not shy to make his request known. http://www.youtube.com/watch?v=6wtfNE4z6a8 Enjoy. Please note: I do not advocate taking your arm and clearing the table.

Without getting caught up in Psych 401 and beyond, many of us learn to not ask for what we need. We are intimidated by others, afraid to speak up.
· I grew up in a home where I would be asked what I want and I would say I want the red one and immediately heard, no you don’t, you want the blue one. Well, I am stubborn so I usually got nothing!
· Group mentality. If everyone else asks for vanilla but I want strawberry what will they think of me. Lack of self-confidence, self-esteem—OMG, all this because I want strawberry and not vanilla? You bet.

When you feel invalidated-your opinion, your needs are not valued, then some people will stop speaking up, feeling like it is a losing battle to speak their peace. Others move 3000 miles away from home.

http://www.helpguide.org/mental/stress_management_relief_coping.htm I am highlighting some great ideas from this website, you can read it in its entirety and it’s actually about managing stress.

· Learn how to say NO –know you limits and stick to them.
· Communicate your feelings in an open and respectful way.
· Be more assertive; don’t take a back seat in your life.

To help you gain self confidence take some private time to sit down and list your accomplishments, things you are proud of, large or small. Ask your friends for their input, too. When you are making your own list I ask this of you-remove yourself from being you and look at yourself from the outside as your friend might look at you-I guarantee you won’t be so harsh on yourself. Write things down as though you were writing about your dear friend.

When you are speaking to someone:
· Stand up straight,
· Look them in the eye
· Keep your head up
· Speak clearly

You will exude confidence, take a deep breath and speak up.

Here’s a good article on Assertiveness: http://www.mayoclinic.com/health/assertive/SR00042

“Assertiveness is giving yourself permission to speak up, to say no when you need to, to be proud and confident in who you are and in your abilities” http://www.solveyourproblem.com/assertiveness/index.shtml

“The most difficult thing is the decision to act, the rest is merely tenacity. The fears are paper tigers. You can do anything you decide to do. You can act to change and control your life; and the procedure, the process is its own reward.” Amelia Earhart

Rice Noodles with Zucchini, Tomatoes and Fresh Mint

I had a recipe all typed up using the bounty of summer vegetables available in your gardens and at local farmer's markets. Lo and behold, the recipe calculator I use is not functioning as I go to post. I read, I searched, I conquered--I hope you enjoy this recipe that sounds delicious.

This is from Recipes for Health. Martha Rose Shulman presents food that is vibrant and light, full of nutrients but by no means ascetic, fun to cook and to eat.

Yield: Serves four.

1 to 2 garlic cloves (to taste), minced
1 pound zucchini, cut in 1/4-inch dice
1 pound tomatoes, peeled, seeded* and cut in 1/4-inch dice, or 1 14-ounce can diced tomatoes, partially drained
Salt and freshly ground pepper to taste
7 to 8 ounces thin rice sticks or 3 cup dry whole wheat pasta
3 to 4 tablespoons chopped fresh mint
1/4 cup freshly grated Parmesan or pecorino or crumbled feta (optional)

* To seed the tomatoes, cut the tomatoes in half along the equator, place a strainer over a bowl and seed the tomatoes into the strainer. Rub the gelatinous seed pods against the strainer to extract flavorful juice, and discard the seeds.

1. Bring a large pot of water to a boil. *Follow cooking time for pasta if usingMeanwhile, place the rice sticks in a large bowl, and cover with hot water. Let sit 20 minutes, until pliable. Drain and cut the noodles in half, into roughly 6- to 8-inch lengths, with kitchen scissors. If using whole wheat pasta, skip this step.

2. While the rice sticks are soaking, heat 1 tablespoon of the olive oil over medium heat in a wide, heavy skillet, and add the garlic. Cook, stirring, until fragrant, about 30 seconds, and add the zucchini. Cook, stirring, until the zucchini begins to soften and the skin becomes bright green, about three minutes. Add the tomatoes with juice and salt and pepper to taste. Cook, stirring often, for 6 to 10 minutes until the zucchini is tender and the tomatoes have begun to break down. Remove from the heat, taste and adjust seasonings, and set aside.

3. When the water comes to a boil, salt moderately and add the rice sticks. Boil one minute and drain. *Follow cooking time for pasta if using.Toss with the zucchini and tomato mixture, the remaining olive oil and the mint. Serve, passing the cheese for people to sprinkle on at the table.

Advance preparation: The zucchini-tomato mixture can be cooked several hours ahead and reheated. If it seems dry, add a little pasta cooking water. The soaked noodles will keep for three or four days in the refrigerator.

Nutritional information per serving: 289 calories; 7 grams fat; 1 gram saturated fat; 0 milligrams cholesterol; 49 grams carbohydrates; 4 grams dietary fiber (7 grams if using brown rice noodles); 17 milligrams sodium (does not include salt added during preparation); 6 grams protein