Holiday spreads are often loaded with tradition — and, traditionally, too much salt, fat and calories. But you can keep your cooking festive without forgoing flavor. Make recipes more nutritious and lower in fat by reducing high-fat ingredients or substituting healthier ingredients.

To reduce sodium ■ When making stuffing, swap the salt for some rosemary. ■ Season potatoes with garlic, onion, paprika or sage

instead of salt. ■ Use fresh or frozen veggies rather than canned.

(Canned vegetables pack a lot of sodium.) ■ To spice up a main dish of lean meats or poultry, con-

sider adding bay leaves, lemons, rosemary or thyme. ■ Add some kick to sauces with a dash of paprika, basil or

dry mustard. ■ Lighten the sodium load of your favorite recipes by using

unsalted varieties of broths, sauces and nuts.

Cut fat and calories ■ Reduce the amount of fat in baked products by a quarter

to a third. For example, if a cookie, quick bread or muffin recipe calls for 1 cup of oil, use ²∕³ cup instead.

■ Use plain low-fat or nonfat yogurt for sour cream.

Simple swaps for healthy holiday meals

In touch Healthy EndeavorsSM1

Fall 2010

Inside

■ Substitute olive, canola, corn or peanut oil for solid fats such as shortening, lard and butter.

■ Substitute skim milk or 1 percent milk instead of whole milk or half-and-half.

■ Cook with nonstick pans to reduce the amount of oil needed. Using a cooking oil spray in place of oil and butter provides further fat savings.

■ Use fewer egg yolks by substituting egg whites for one or more of the yolks. Egg whites are fat- and cholesterol-free. Or use a fat- and cholesterol-free egg substitute.

Save on sugar ■ Reduce sugar by a quarter to a third in baked goods and

desserts. Add cardamom, cinnamon, nutmeg or vanilla to enhance the impression of sweetness.

■ Use a sugar substitute instead of real sugar.

Dark chocolate brownie recipeTurn to the back page for a brownie recipe from the kitchen of our own Cathy Chapman, Healthy Endeavors team lead.

Bust exercise excuses 2Diabetes myths 3

Heart attack action plan 4Low-cost healthy living 5Recognize depression 6

Avoid cold and flu germs 7

2 In touch

Solutions:1. Good news: You don’t have to revisit gym class. Studies show that lifestyle activities are just as effective as struc-tured exercise programs in improving fitness. So walk the dog, do yard work, run up and down the stairs, or dance to your favorite CD. It all counts as exercise.2. If you can’t find 30 minutes in a row, break it up. Three 10-minute activities are just as effective. Or scrub the bathroom for 15 minutes. Now you’ve already met half your exercise goal for the day.

1. ___ I hate aerobics . And weight lifting. And anything else that feels like gym class.

2. ___ I don’t have time to exercise .

3. ___ I’m too tired to exercise.

4. ___ I’m not at risk for heart disease, so I don’t need to exercise.

5. ___ I spend my whole day running errands and trying to keep up with my two young children. I don’t need to exercise.

3. Yes, it’s hard to get out of that chair. But if you do exercise regularly, you’ll actually feel less tired and have more energy. Studies show you’ll sleep better, too. 4. Actually, by not exercising, you are at risk for heart disease . An inactive lifestyle also increases your risk for diabetes and high blood pressure.5. Possibly. But is most of that errand time spent in the car? And what about your stress level? Exercise helps you feel better mentally as well as physically.

Bust your exercise excuses

Regular exercise — 30 minutes a day of moderate activity, four to six days a week — can help you feel better and live longer. Yet more than 60 percent of American adults don’t meet that goal. In fact, one out of four aren’t active at all. What’s stopping you from exercising? Mark the excuses below that apply to you. Then follow the corresponding solutions.

Women, have you had your breast cancer screening?Take these steps to detect breast cancer early, when it’s most treatable:■ Are you 40 or older? Women ages 40 and older should have a mammogram every year.■ Keep up with clinical breast exams.

Women ages 20 to 39 should have a clinical breast exam every three years. Women ages 40 and older need this exam yearly. Clinical breast exams or breast self-exams do not replace mammograms — both are important screening tools.

Q: What does “limiting” sugar mean? Can I have dessert?A: Not only is sugar not to blame for causing diabetes, it also isn’t completely off-limits after your diagnosis. Most days, it’s best to pile your plate high with vegetables, whole grains and other healthy choices. But on special occasions, you can have a serving of cake or pie. Just swap it for other high-carbohydrate foods, like bread and pasta, in a meal.

Q: Does having diabetes make me more likely to catch a cold?A: There’s no proof that people with diabetes are more prone to the sniffles. However, even minor illnesses can make your blood sugar harder to control and cause problems from very high blood sugar levels. If you become ill with influenza or pneumonia, diabetes can also increase your risk of having a more severe illness with complications. To stay healthy, talk with your doctor about flu and pneumonia vaccines, recommends the U.S. Department of Health and Human Services.

Ask the doctor: Debunking diabetes myths

Fall 2010 3

Kim Walsh, M.D., M.P.H.Medical Director

Schedule diabetes checkupsIf you have diabetes, regular care can help prevent serious diabetes-related complications. Make sure you get these tests:■ Schedule an annual dilated eye examination to check

for vision changes associated with diabetes.■ Have an Hb A1c test at your doctor’s office at least twice

a year to monitor your average blood sugar level.

Diabetes and heart health: How they’re connected

Diabetes, or high blood sugar, carries a lot of “clout” in the body. It can influence a wide range of organs from your eyes, kidneys and heart — not for the better, but for the worse. In fact, one of the key concerns for people with diabetes is keeping their blood sugar under control to reduce their risks for complications, such as heart disease.

A higher risk for heart problemsPeople with diabetes are two to four times likelier than people without diabetes to have heart disease.

Why do people with diabetes have higher heart risks? Diabetes can cause disease of the blood vessels, including the blood vessels of the heart. In addi-tion, people with type 2 diabetes may tend to be obese and to have high cholesterol and blood pressure. These conditions can also affect the health of the heart and its blood vessels.

Keeping it under controlIf you have diabetes, you can take steps to protect your heart. Eat a healthy diet, exercise and don’t use tobacco. Also, have your blood pres-sure and cholesterol checked at least once a year.

Need help managing diabetes?Call a nurse health coach today. It's free! 1-888-392-3506.

4 In touch

If you think you are having a heart attack, don’t let more than five minutes pass. Treatments, including clot-bust-ing drugs, can save your life. But to be most effective, these treatments must be given within one hour after symp-toms begin. That’s why experts advise calling 911 within five minutes of expe-riencing symptoms. Emergency medical personnel can start treating you immediately, even before you get to the hospital.

Save your heartThe longer the blood supply to the heart is disrupted, the more damaged the heart becomes. A damaged heart can make it difficult to do everyday activities, such as bathing or walking to the mailbox. According to a recent

study in the American Journal of Cardiology, heart attack patients had a 16 percent greater risk for impaired heart function for every hour they delayed getting to the hospital.

Recognize the signsThe first step to getting the fastest treatment for a heart attack is to know the symptoms:

■ Discomfort or pain in the center of the chest that lasts for several min-utes or comes and goes

■ Pain or discomfort in the jaw, arms, back, stomach or neck

■ Some people — especially women — may experience other symptoms, such as shortness of breath, light-headedness, nausea, vomiting or a cold sweat

MInuteS MAtter during a heart attack

Your heart health action planLiving a healthier life doesn’t require a major overhaul. A few simple steps can go a long way toward improving your health. If you’re taking medications, take them as prescribed. Get refills on time so you never miss a dose. And see your doctor regularly. Talk with your doctor to develop a healthy- living plan that’s right for you. You also can call 1-888-392-3506 to speak with a nurse health coach.

Have you had your cholesterol checked in the past 12 months?If you have heart disease or diabetes, you need a yearly cholesterol test. Healthy cholesterol levels lower your risk for heart disease and stroke.■ If you have heart disease, your

LDL ("bad") cholesterol should be less than 70.

■ If you have diabetes, your LDL cholesterol level should be less than 100.

Have you had a heart attack?Follow-up care is important in your recovery from heart attack and to prevent another attack.■ Take your medicine as pre-

scribed. Don’t stop taking your medicine unless your doctor instructs you to lower the dose and stop, or else you may become very sick.

■ Make sure you see your doc-tor for follow-up appoint-ments. Even if your condition is stable, see your doctor once a year for a checkup.

Fall 2010 5

Making positive choices in your every-day life about exercising, eating and smoking can help you feel better and stay healthier. And you don’t need to spend lots of money to make changes that will pay off.

No gym membership requiredWalking is one of the best exercises for people with a chronic condition. Plus, it’s free, requires no special equipment or gym membership and you can do it at home. Here’s your action plan:

■ Ask your doctor about safe exercise. ■ Start walking around your house. ■ Walk daily for a few minutes at a

time, resting in between. Try to walk longer and a little further each day.

Eating right doesn’t have to be priceyGood nutrition helps you maintain a healthy weight and gives you the vita-mins and minerals needed to fight off infection. But you don’t have to invest in pricey diets or health foods. Here are some healthy choices that won’t empty your wallet:

■ Skip sodas, chips, cookies and other junk foods. You’re just wasting

money on empty calories. ■ Eat nutrient-rich foods. Fruits, vege-

tables, whole grains and low-fat dairy products give you nutritional bang for your buck.

■ Bring on the beans. As a cheap and versatile vegetable that does dou-ble duty as a protein, beans deserve a regular place at your table. When using canned beans, be sure to drain well and rinse with water to decrease the amount of sodium.

Go smoke-free to fatten your walletThe number one strategy for managing asthma or COPD is to quit smoking. It will help you breathe better, live longer and save you money.

After all, smoking is expensive! Buying one pack per day for one year costs at least $1,460.

Do you have a COPD action plan?A COPD action plan tells you exactly what to do when your symptoms act up. It’s a written document created by you and your doctor. It lists symptoms and tells you what to do.

You can get an action plan form by going to lungusa.org/lung-disease/copd. Click on “COPD Management Tools,” then “My COPD Action/Management Plan.” Why not ask your doctor to fill it out with you at your next visit? Having a written plan will give you the green light for peace of mind.

Watch videosLook for our video online in January at fepblue.org for more tips on eating right.

Low-costwaysto live healthy

Reach your health goalsA nurse health coach can help you set and reach your goals to get fit, quit smoking or cure stress. Call 1-888-392-3506. It's free!

Ordinary life can be depressing at times. But depression that lasts more than a few weeks or that seriously hampers your ability to cope with everyday life is called clinical depres-sion. It is an illness, not an attitude. And it can improve with proper diagnosis and treatment.

A number of antidepressant medi-cations are effective and nonaddictive. They restore balance to brain chemis-try. And they don’t use tranquilizers or other potentially habit-forming drugs.

For many, the best treatment course combines medication with psychiatric or other talk therapy. The medication eases symptoms and restores everyday functioning. The talk therapy helps resolve social concerns.

When should you seek help?If any of these symptoms are persistent or interfere with normal behavior or activities, talk with your doctor:

■ Chronic low mood or hopelessness ■ Loss of interest or pleasure in friends,

family, hobbies, work or sex ■ Insomnia or sleeping too much ■ Self-blaming for past events

■ Difficulty concentrating ■ Food cravings or loss of appetite ■ Unintentional weight change ■ Thoughts of suicide or death ■ Excessive crying or feeling weepy ■ Feeling worse in the morning ■ Nagging anxiety or irritability ■ Chronic physical pain

Depression can seem overwhelming. But taking the small step to seek professional help can be a giant step toward recovery.

DePreSSIOn: Get help to get better

6 In touch

Stand up for yourself (and your health)The holidays are filled with temptations. How do you handle relatives who want you to try their fattening dessert? That coworker who asks you to help with a project even though you’re already overloaded? Here are some ideas.

■ In front of a mirror or with a willing friend, rehearse handling sticky situations. Practice what you will say, how you will stand and the  gestures you might use.

■ Maintain direct eye contact with the person you are talking to. Keep a level tone of voice.

■ Use “I” language, such as “I think,” “I want,” “I know,” “I believe,” “I need” or “I feel.”

■ Let people know ahead of time if you cannot take on new obli-gations. Simply say, “I’m sorry but I cannot take on extra responsibilities right now.”

■ Make small concessions that won’t compromise your health. Rather than having a whole piece of your mom’s pie, try a bite. Then tell her it’s delicious but that you’re full from dinner.

Do you take antidepressants?If you have recently been asked to take antidepressant medication by your doctor, follow these steps to get the best results:■ Follow your doctor’s orders and make sure to take your medication regularly, as instructed.■ Get your refills on time. Missing doses can make your medication less effective.■ Go to your follow-up appointments with your doctor. Tell your doctor about any side effects you may be experiencing.

Your doctor may adjust your dose or suggest that you try another medication.■ Once you’ve been taking your medication for a long time, see your doctor regularly. Continue taking your medication

as prescribed — don’t stop taking it unless your doctor says it’s OK to taper down the dose and then stop.

Leena Mehta

Manager

Blue Cross and Blue Shield of North Carolina, through the BCBS Federal Employee Program, provides the Healthy EndeavorsSM1 Program for your convenience and is not liable in any way for the goods or services received. BCBSNC reserves the right to discontinue or change this program at any time. 1 May not be available to members of all policies. Check with your benefits administrator to determine your eligibility. An independent licensee of the Blue Cross and Blue Shield Association. ® SM Marks of the Blue Cross and Blue Shield Association. SM1 Mark of Blue Cross and Blue Shield of North Carolina.

The information is intended to educate readers about subjects pertinent to their health, not as a substitute for consultation with a personal physician. ©2010 Printed in USA.

Healthy Endeavors members will continue to receive this magazine for two years.

Intouch

roll up your sleeve for a flu shotThe beginning of October through mid-November is the time to get your annual flu vaccination. While the vaccine is rec-ommended for nearly everyone, certain groups are at higher risk for complica-tions from the flu, including people with:

■ Asthma ■ COPD ■ Diabetes ■ Heart disease

Flu shots can prevent most complica-tions — and save lives.

Last year’s flu shot will not protect you against this year’s flu. The protective effects of the flu vaccine on your immune system do not last from one season to the next. To keep up with ever-changing flu viruses, researchers must formulate a new vaccine every year.

1. Which of these is the main way colds and flu are spread?

A Droplets from an infected person’s cough or sneeze move through the air to the mouth or nose of people nearby

b Droplets on a desk, doorknob or other surface are touched by an uninfected person who touches his or her mouth, nose or eyes

C Someone shares a glass used by a person with a cold or flu

D All of the above

2. If you have a cold or flu, which of these steps can best help stop the spread of germs?

A Coughing or sneezing into a handkerchief

b Covering your mouth and nose with your hand

C Coughing or sneezing into a tissue and then throwing it away

D All the above

3. To avoid infection, when should you wash your hands?

A Before eating or preparing food b After touching a sick person C After using the bathroom D All the above

4. How long do you have to wash your hands to kill germs?

A 15 to 20 seconds b 10 to 12 seconds C Five to seven seconds D One to three seconds

5. Alcohol-based gel sanitizers can also kill germs. How should they be used?

A Apply them, then rub your hands until the gel dries

b Get your hands wet, then apply the gel

C Apply the gel, then rinse it off D Any of the above

Quiz: Avoid germs during cold and flu season

A healthy immune system stands between our bodies and infection from bacteria and viruses. During cold and flu season, it’s especially important to keep the immune sys-tem in shape. Here’s how:

■ Hit the hay. New research shows that lack of sleep leaves you more vulnerable to viruses. Aim for seven to eight hours a night.

■ Keep moving. Regular physical activity helps your body fight

infection. Experts recommend two-and-a-half to five hours of moderate exercise weekly.

■ Take it easy. Stress weakens your ability to ward off disease. Try a relaxation technique like medita-tion, which research shows can help keep your immune system strong.

■ Also don't forget the other secret weapon to prevent colds: Wash your hands frequently during the day.

Answers1. D — All of the above. Some viruses and bacteria can live two hours or

longer on hard surfaces, including restaurant tables, railings and phones.2. C — Coughing or sneezing into a tissue and then throwing it away. If you

cover your mouth and nose with your hands, be sure to wash your hands.3. D — All the above. Also wash your hands after touching animals, animal

waste and trash.4. A — 15 to 20 seconds. Washing your hands while singing the “Happy

Birthday” song twice takes about 20 seconds. Use soap and warm water.5. A — Apply them, then rub your hands until the gel dries.

Your secret weapons to prevent colds

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of NCHealthy Endeavors In touchP.O. Box 2291Durham, NC 27702-2291

Getting help from a health coach (a real nurse) is as easy as 1-2-3 — and free Here’s how simple it is to work with your own coach:

1 Call us at 1-888-392-3506. Health coaching starts with an assessment that includes questions about your health. 2 You and your dedicated health coach — a registered nurse — choose goals for you to work on to improve your health. 3 Your health coach provides educational materials and support to help you reach your goals. We’d love to help you!

5003M

Dark Chocolate Brownies1 stick trans fat-free marga-

rine or 1/2 cup canola oil2 cups 60% cacao dark

chocolate chips3/4 cup agave nectar1/2 cup unsweetened

applesauce

11/4 cups white wheat flour or whole wheat flour

1/2 tsp. baking soda1 tsp. of vanilla1 whole egg2 egg whites1/2 cup raw walnut pieces

Melt the margarine and 1 cup of the chocolate chips in a medium-sized pan over low heat. Stir to melt and remove from heat and let cool for a few minutes. Combine the flour and baking soda in a small bowl. In a separate bowl combine the other cup of chocolate chips with the walnut pieces.

Add the applesauce and the agave nectar to the cooled chocolate mixture. Add the vanilla and the eggs to the mixture and beat well. Slowly add the flour with baking soda mixture, stirring gently.

Add the chocolate chips and walnut pieces. Bake for 18 to 20 minutes at 350 degrees. Cool and cut into squares.

Recipe by Cathy Chapman, Healthy Endeavors team lead