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Time To Quit Smoking The Benefits Of Omega Fatty Acids Save On Health & Wellness Products Company’s Coming Recipe
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People15 First
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Dr. Hister looks at how to take charge of your health by building a trusting realtionship with your health team.
contents Good Fat
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Smoking Cessation Peoples Pharmacist Ian Lloyd on how to break the smoking habit and live a healthier life.
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Great Health Buys Helping people live better lives with quality health products.
Butt Out Live a healthier life by quitting smoking. Read about the options available at Peoples Pharmacies on page 6.
Vitamins & Supplements Save on a wide selection of quality nutritional supplements from Peoples Pharmacy.
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Read an informative article on the many health benefits of Omega 3 fatty acids, a good fat for your body.
The Pharmacist, Doctor And Patient Relationship
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Pharmacist Recommended Helpful advice on children’s fever and health news on how baked fish may ward of Alzheimer’s.
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35th Anniversary Prize Draw Winner See the lucky person that won the Apple prize package.
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Omega Fatty Acids Darlene Booth talks about the good fats in your diet and how they can improve your health.
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Wild Gumbo Soup Brand new feature recipe From Company’s Coming Healthy Recipe Makeovers.
Helping People Live Better Lives
Managing Menopause Pharmacists Know how I know for certain that I’m getting pretty old much more quickly than I want to be aging? It’s simple, really: because my pharmacist has become my very best friend. And lest you think I’m kidding, rest assured that I’m completely serious when I say that because if you judge a BFF (for those without a teenager at home to help translate that reference, that’s text talk for “best friend forever”) by how often you see them and by how often you solicit their advice about matters that are of vital importance to you (who should be the Canucks regular goalie? Do you turn off the TV when Don Cherry comes on or do you just mute it till he’s done, and so on), my pharmacist is not only my number one BFF, but also my BFF number 2 and BFF number 3. But the even more curious thing is this: as the days pass (all too quickly, alas), I am becoming ever more determined to spend even more time with my BFF (in fact, if my wife were to allow it, I would even contemplate adopting my pharmacist, or at least having him sleep over several nights a week) because as a typical baby boomer getting on in years (which does, of course, still beat the only known alternative), I am (very reluctantly) finding it necessary to take more and more medications every year (for the curious among you, it’s for my GERD, my high blood pressure, my abnormal cholesterol levels, and several other less complicated conditions), and that’s a problem that I’m trying to get as much help with as I can. Why is it a problem to be taking more and more medications every year? For a start, many of the drugs they give you these days are not the drugs they gave
your mother or father way back when because quite simply, many current medications are significantly more powerful than the medications they used to give out just a few decades back. For a very common example of what I mean, just consider how we treat a problem like gastric acid reflux these days. Back when I was an intern, the only medications we had for “stomach ulcers” (that was just about the only diagnosis we had for all gastric complaints) were one or two antacids and a very restrictive diet, what we used to call the “milk, rice and Maalox” treatment (an interesting aside: most patients hated this regime so much that they refused to stick to it, which is why we interns sometimes found pizza boxes hidden under ulcer patients’ beds, clear evidence that despite what their specialist had ordered them to do, these patients had brought in takeout pizzas from delivery services near the hospital). Nowadays, not only do we have several different forms of antacids, we also have medications to “coat” the upper gastrointestinal lining, as well as several different drugs to reduce stomach acid output including such “milder” ones as cimetidine (Tagamet) and ranitidine (2antac) and very powerful ones (proton pump inhibitors or PPIs) such as omeprazole (Losec) and (the one I’m on) esomeprazole (Nexium), a drug that virtually eliminates stomach acid output, which is both a good and bad thing. It’s a very good thing in that Nexium has certainly reduced my reflux symptoms dramatically and made my life much more pleasant, but it’s also a bad thing in that not only is it very hard to discontinue a drug like Nexium (when you try to discontinue a PPI, your Continued On Page 11
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Ian Lloyd
Pharmacist, Peoples Pharmacy
Smoking Cessation Smoking cessation is a timely topic, especially around the beginning of the New Year. We make resolutions to change our routines, start the good and stop the bad. This is a great idea, but the timing may be wrong. Before, and after, the New Year can be a stressful time. There are holiday bills to pay, people to visit, parties to attend, and so on. So pick another day: February 1st, January 15th, or the second Monday after New Year's Eve. Pick any day and stick to it. If you are truly committed to quitting, here are a few tips that can help. Tell as many people as you can about your plan. If you announce it to everyone, there will be more people to cheer you on and more people that will catch you if you cheat. Reward yourself. Quitting smoking is difficult and should be rewarded. Choose something indulgent; a fancy dinner out, a vacation, a new stereo, or even a new car. Think of the many reasons why you should stop smoking, then write them down. During the tough times, this will remind you why you are quitting. To understand why smoking is addictive and how drugs can help you quit, you should learn more about nicotine. Nicotine is the most addictive substance found in cigarettes. There are believed to be others, but nicotine is the most prominent. .pon inhalation of cigarette smoke, nicotine can reach the brain in about 10 seconds. Its effects can last about 1-2 minutes. Drugs with a rapid onset and a 6 People First peoplesdrugmart.com
short duration of action tend to have the highest potential for abuse. Other drugs that share nicotine’s quick acting nature include crack cocaine and heroin. What does nicotine do once it enters the brain? Nicotine causes a rapid release of a brain chemical called dopamine. One of dopamine’s primary roles in the brain is to facilitate the sensation of pleasure. Dopamine also enables us to remember specific pleasures. This 5remembering’ is why people can become addicted to other 5pleasurable’ activities, such as eating, shopping, sex, etc. But these things are not as readily available as smoking; so the 5pleasure memory’ can be re-enforced over and over and over again. This is also thought to be the reason why people crave cigarettes even after they have quit for a year or more. This year there is a provincial program that can help you quit smoking. The B.C. government will help pay for the non prescription and prescription medications to help you quit smoking. Every calendar year, eligible BC residents can obtain a 12 weeks supply of nicotine patches and nicotine chewing gum. There is no cost for the patches nor the chewing gum. Talk to your Doctor or Peoples Pharmacist to see if nicotine replacement therapy is right for you. Then call 8-1-1 (B.C.'s health information phone number) and ask to speak to a “QuitNow CareCoach.” Your CareCoach will provide you with an authorization number for your supply of eiContinued On Page 8
Healthy Solutions Start Here Nicorette understands that all smokers are different; that’s why we offer the widest range of nicotine replacement products to help you quit smoking in the way that is best for you.
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Ian Lloyd...Continued From Page 6
ther nicotine patches or gum. Once you have your number, you can either pick up the nicotine replacement products at any Pharmacy or have them mailed to your home. That's it: make the phone call, visit a Pharmacy and quit smoking. It has never been easier. The B.C. government may also pay for smoking cessation prescription medications. Just visit your Doctor for a prescription and then have it filled at a Pharmacy. You do not have to call 8-1-1 for authorization. You might qualify for medication coverage if you are a resident of a residential care facility (Plan B), on income assistance (Plan C), or have Plan G coverage. People who have reached their yearly deductible with Fair Pharmacare might also qualify for coverage. Talk to your Peoples Pharmacist to learn if you might qualify for no cost smoking cessation medications. There are two prescription medications that could be covered by Pharmacare: bupropion (Zyban®) and varenicline (Champix®). Originally used to treat depression, Zyban works by blocking the breakdown of dopamine in the brain. This increased, and more constant, level of dopamine in the brain helps to reduce the cravings associated with low levels of dopamine. Many people find that after a few weeks on Zyban, the cravings for ciga-
rettes slowly subside. While quite effective, Zyban is not for everyone. People who are taking other antidepressant medications or have a history of seizures should talk to their Doctor before taking this drug. It should also not be taken with alcohol, because of the increased risk of having a seizure. The most common side effects include; nausea, insomnia, an irregular heartbeat or a skin rash. Speak with your Doctor or Peoples Pharmacist for more information about Zyban. The newest medication to help you quit smoking is varenicline (Champix®). Champix works differently from Zyban. Champix acts like nicotine in the brain and also blocks the rapid dopamine release caused by cigarette smoking. After about 8 days your nicotine cravings should decrease and you should be ready to quit smoking. Therapy is usually continued for 12 weeks. People with depression or other mental health issues should use this medication with caution. Side effects include nausea, sleep problems and stomach upset. Speak with your Doctor or Peoples Pharmacist for more information about Champix. What these patches, gums and drugs do is to help you rid your body of the nicotine addiction. With this addiction under control, the only thing left to do is to rid yourself of the habit. There are alContinued On Page 10
Don’t Play A Guessing Game With Your Daily Medications Peoples Drug Mart and Peoples Pharmacy offer a medication compliance program called “Med Manager.” The Med Manager is a medication compliance card that conveniently organizes your medications for a full week and helps you easily identify what medications are to be taken at what time of the day. Talk to your Peoples Pharmacist about the convenient Med Manager program.
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pharmacist recommended Health & Wellness Information From Your Peoples Pharmacist
Children’s Fever A fever is an abnormally high body temperature. Most of the time this is a normal response to infection. However, just because your child has a slight fever does not necessarily mean that he or she is seriously ill. (Generally, if your child feels well enough to do so, he or she can still go to school or child care). Keep in mind that your child can also be sick and have a temperature that is normal or below normal. Normal body temperature is 37°C (98.6°F) when measured orally, although there can be slight differences in temperature between children. Normal body temperature may even vary slightly — by 0.5°C to 1°C (1°F to 2°F) — depending on how and when it is measured. It is typically lower in the middle of the night. A child may have a higher body temperature: • round mid-afternoon • in hot weather • during active play or exercise • when crying • while wearing warm clothing You can do a quick check for fever by using your cheek to feel if your child’s forehead is hot. However, you should use a thermometer for an
accurate temperature reading. To treat a fever, follow these basic guidelines: • Give your child plenty of liquids. • Maintain a comfortable room temperature. • Dress your child in light cotton clothing. Keep bedclothes to a minimum. • Wet a sponge or cloth with lukewarm water and wipe your child’s face gently. • Do not use baths or alcohol rubs to cool down your child. • If your child is uncomfortable or the fever is high, use acetaminophen (Biomedic brand,Tempra or Tylenol) or ibuprofen (Biomedic, Motrin or Advil). Do not exceed recommended doses. Important: Children and teenagers should not take ASA (Aspirin) or “baby” Aspirin when they have a fever. Giving ASA to children with fever has been linked to Reye’s syndrome, a serious disease. This basic information on fever but is not a substitute for professional medical advice. Talk to your doctor or go to a hospital emergency department if you have concerns about your child’s health.
health news Non-Fried Fish Might Help Ward Off Alzheimers Eating baked or broiled fish as little as once a week may boost brain health and lower the risk for mild cognitive impairment and Alzheimer's disease, new brain scan research suggests. The study authors found that eating baked and broiled fish -- but not fried -- helps to preserve gray matter neurons, strengthening them in areas of the brain deemed critical to memory and cognition. The study noted that people who eat baked or broiled fish had larger brains and they had larger brain cells in areas of the brain responsible for memory and learning. And the reason that's important is that these brain areas are at high risk for Alzheimer's disease." In those people with larger brain volume, the risk for Alzheimer's and mild cognitive impairment went down by fivefold within five years following the brain scans that were conducted. Millions have Alzheimer's disease, an incurable, age-related disorder that slowly destroys memory and thinking and lan-
guage skills. Older adults with mild cognitive impairment have less severe memory loss than those with Alzheimer's but often go on to develop the disease. To assess the impact of fish on cognitive health, the authors focused on 260 mentally healthy elderly individuals. The study team observed that people who ate baked or broiled fish weekly displayed better so-called "working memory," enabling them to more effectively execute routine tasks. But fish and chips lovers, take note: No cranial benefit was evident with respect to consumption of fried fish. The team cautioned that while eating baked and broiled fish appears to exert some cognitive benefit, other lifestyle and socioeconomic factors may play a role. For now, the connection must be viewed as an association, rather than a cause-and-effect.One has to wonder if there are other factors associated with fish consumption that they didn't measure that might be protective, possibly, people who eat fish exercise more, or eat less total calories. peoplesdrugmart.com People First 9
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ways certain things that you associate with smoking. Some people only smoke at the bar. Others may smoke after dinner, in the car or while watching TV. If people do not change their lifestyle to avoid these associations, they will likely begin smoking again. So the other half of successfully quitting smoking is changing your routine, or 'breaking the habit'? If you smoke after a meal, go for a walk instead. If you smoke while watching TV, chew carrot sticks instead. Only you can be creative enough to break your own habit. For more information about and help with quitting smoking, check out the many internet websites that offer ideas. Quitnow.ca is a great website operated by the BC Lung Association. Every nicotine replacement manufacturer has a website with excellent resources to help you quite smoking. Google their websites. Type in “Champix”, “Habitrol” or “Thrive Gum” to find great websites dedicated to helping you quit smoking.
Another problem encountered by people who have quit smoking is the temptation to restart. Don't fool yourself; this possibility is very real, even after a year or more. You must remind yourself frequently, "I am a non-smoker.” If you ever find yourself at a moment of weakness, leave or go for a walk. Never say, "I'll just have one." This is the main reason why people start smoking again. Set a date to quit smoking. You will thank yourself later, perhaps with a new car. You think I'm exaggerating; do the math yourself. Smoking one pack of cigarettes a day can cost about 300 every month. Isn't that close to a car payment? After a year, you can fly yourself to a Mexican resort for an all-inclusive week of pampering. This is just one more reason to quit. Written By Ian Lloyd, Pharmacist & Chartered Herbalist, Peoples Pharmacy
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Dr. Hister...Continued From Page 4
stomach responds with a strong and very uncomfortable rebound in acid production, a sort of cry of “Hey, dude, I want you back on that stuff – NOW!”); and it’s also potentially a bad thing because stomach acid has important functions. For example, stomach acid helps us absorb nutrients from our diet so no surprise that in studies, people on PPIs have been found to have higher rates of fracture than people not on those drugs, an effect most likely due to the fact that a PPI can interfere with the absorption of calcium and other bone-necessary nutrients. Stomach acid also helps fight off some infections so that people on these strong acid reducers have been found to have higher rates of all sorts of significant infections like pneumonia. On top of that, though, over the last few decades, we’ve also discovered lots of vitally important information about how all medications interact with at least some other drugs and some of those interactions can be very serious, even deadly (warfarin, for example, is a commonly-prescribed drug to prevent clotting, and so is ASA or Aspirin, and needless to say, one has to be very careful about combining the two), not to mention that we’ve also discovered that for many drugs, it makes a big difference in effectiveness as to how and when an individual takes those drugs. Some drugs, for example, are better taken in the morning, some at night; some drugs should be taken on an empty stomach, some are better taken with food; for some drugs, specific foods interfere with how they work (for example, grapefruit juice, which is otherwise delicious, can interfere and interact with a very long list of drugs including such common ones as statins and some high blood pressure pills), and so on, and the more we research those important variables, the more complicated this issue becomes. Just over the last few months, for example, I’ve seen two excellent studies that concluded that many people with high blood pressure are better off taking their drugs at night instead of earlier in the day (it’s all to do with when blood pressure is highest, which, for a lot of people, is overnight), although I have to very quickly add that absolutely no one should change their drug-taking routine on their own without consulting their doctor first.
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Dr. Hister...Continued on Page 13
peoplesdrugmart.com People First 11
35th Anniversary Prize Draw Winner Congratulations to Kim Harrington, Victoria,B.C. on being the grand prize winner of Peoples Drug Mart’s 35th Anniversary prize draw for an Apple prize package. Kim won an iMac computer, an iPad and an iPhone. Naz Rayani, owner of four Peoples Drug Marts and Peoples Pharmacies in Fairfield, Shelbourne and Cadboro Bay, congratulates Kim on winning this great prize package. Thank you to all customers for entering the prize draw and for helping us celebrate 35 years of helping people live better lives.
Compare&Save! Biomedic is a Peoples family brand that offer unbeatable value! Biomedic offers national brand quality at great low prices. Trust the Biomedic brand for all your health needs.
Don’t Leave Home Without Our Help We can help you take the right precautions • Traveller’s Diarrhea • Hepatitis • Maleria • Cholera • Dengue Fever
Vaccination Services Certain Peoples Pharmacists can provide shots for the seasonal flu or for travel vaccinations. Talk to your Peoples Pharmacist and ask if they provide this health service.
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Dr. Hister...Continued From Page 11
Now you might at first think that as an experienced physician, I would know all there is to know about the drugs I take, and in fact, I do know a lot about drugs (why do you think I spend so much time reading studies? It’s largely to find out more about the stuff that affects me). But you can never know all you need to know, and besides, there’s the world of studies and then there’s the real world, and often things that seem straightforward to researchers conducting studies on how drugs work don’t end up being nearly as straightforward when people in the real world take the same drugs. I have never, for example, heard of a drug that worked nearly as well post-marketing as it seemed to do in the studies that led to its being allowed on the market. Even more worrisome, though, far too often, the side effects of many drugs – and worse, their important complications - are not nearly as prominently discussed or detailed in pre-marketing studies they should have been, which is why over the last couple of decades, at least a dozen very popular drugs were withdrawn from use because of problems that became much more evident in the real world than they had been in the pre-marketing studies. All of which is to say that because pharmacists spend so much time talking to the public about their observations and experiences with the medications they have to take, they learn many “practical” and many not always-evident things about how drugs work in the real world, which is why, despite my knowledge, still spend lots of time with my pharmacist discussing my options for treatment. And so should you, I strongly suggest. Your pharmacist is a terrific resource for drug information, and often, in fact, an easier resource to access than your busy family doctor, so do yourself a real favour and avail yourself of that service. You don’t, of course, have to do as I do and buy him flowers every few weeks, but you know, it doesn’t hurt if you do.
Dr. Art Hister can be heard on CKNW and other Corus Radio Network stations on House Calls on Saturdays at 10 AM, as well as seen on Global TV news on Saturday mornings at 9:20.
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Omega 3 Fatty Acids When it comes to the nutritional category of superfoods, we often think of exotic, nutritionally dense foods like blue green algae, wheat grass juice, acai berries and bee pollen. While these are wonderful additions to a healthy diet, they aren’t always that easy to find on your neighbourhood supermarket shelf. Many of the common nutritional superstars are often overlooked; one of these stars is salmon. Not only is this fish an excellent source of healthy protein, vitamin D and selenium, it is an excellent dietary source for omega-3 fatty acids. Omega-3 fatty acids belong to the family of essential fatty acids 3EFA4; this means that they cannot be manufactured by the body and must be obtained from the food we eat. .nfortunately, much of the standard western diet is imbalanced and fails to provide the optimum levels of omega-3 fatty acids needed for good health. This can lead to many health problems and conditions such as dry skin, mood swings, fatigue, and heart disease. Suffice to say that omega-3 fatty acids are a good fat; they are classified as a polyunsaturated fat 3P.FA4 and salmon is a particularly good source for DHA 3Docosahexaenoic acid4 and EPA 3eicosapentaenoic acid4; these two long chain fatty acids are more potent and easier to assimilate than ALA (alphalinolenic acid), which is a short chain fatty acid found in nonanimal food sources like flaxseed. Don’t get me wrong though, ALA is a beneficial omega-3, but it doesn’t carry quite the same punch as the DHA and EPA found in salmon. It seems that the omega-3 connection is essential for optimal health in so many areas including: 1. Brain power – Omega-3’s may help with mood regulation, especially for people who suffer from depression. Studies also suggest that omega-3’s play a role in neural transmitter formation and may lower the risk of memory loss, dementia and Alzheimer’s in seniors. Some studies correlate omega-3 deficiency during pregnancy to lower IQ’s in some school age children. 2. Heart health – 4 decades ago, researchers studied the indigenous population in Greenland who ate a high fat diet but were not prone to heart disease. They linked this to the consumption of omega-3 fatty acids found in the fish they were
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eating. Other studies have since found that these fatty acids support heart health on many levels including lowering risk for heart attack, stroke, arrhythmia and high blood pressure. 3. Prevention – I am a firm believer in a preventative approach to health. Omega-3 fatty acids have been linked to improved immune system function as well as contributing to a decreased risk for colorectal, breast and prostate cancer. As with all preventative measures, there is no magic bullet; success usually proves to be a combination of a number of diet and lifestyle factors. . Anti-aging – If you wish to preserve your eyesight and retain that youthful glow, then include 2 or 3 servings of salmon to your diet plan each week. Omega-3’s lock moisture into the skin, help prevent collagen breakdown, reduce blemishes and keep hair shiny. They are good news too when it comes to age related macular degeneration and dry eye syndrome. 5. Joint health – Fish oils have two benefits for stiff and achy joints; they help keep them lubricated and also help reduce inflammatory responses. This is also good news for our 4legged friends. Supplementing your pet’s diet with fish oil can add more shine to their coat and a bounce in their step. Farmed salmon versus wild salmon; this is a big debate for sure. There are numerous voices condemning farmed salmon based on a lower protein higher fat ratio and an increase in toxins and contaminate levels. There are others that suggest this is now changing in the fish farming industry and that farmed fish are not such an unhealthy choice after all. Personally, I always advocate for the highest quality food whenever possible and find wild salmon more preferable on my palate than farmed. Canned wild Alaskan salmon is a versatile food and an affordable option over fresh; use it in salads, soups, casseroles, fish cakes, dips and sandwiches. There are overarching concerns around environmental contamination of the ocean, which poses a subsequent risk associated with consuming fish in general. Some fish seem to be worse than others when it comes to mercury levels and PCB’s but the general consensus seems to be that the benefits of adding 2 – 3 servings of salmon to your weekly menu far outweighs the risks. Good Health to You!
bo Soupthat Wild Gulom vely earthy flavour
Wild rice has a e t soup apart from th sets this thick low-fa ce d also helps to redu traditional gumbo-an arly half. overall calories by ne
1 tbsp. 15 mL Canola oil 11⁄2 cups 375 mL Chopped celery 11⁄2 cups 375 mL er Chopped green pepp 11⁄2 cups 375 mL Chopped onion 2 2 Garlic cloves, minced er) wd (or 1/2 tsp., 2 mL po 5 mL 1 tsp. Dried oregano 5 mL tsp. 1 1 Dried thyme ⁄2 tsp. 2 mL 1 Dry mustard ⁄4 tsp. 1 mL Pepper cups 1.5 L 6 h ot Prepared vegetable br d) okra, 2 cups 500 mL Sliced fresh (or frozen, thawe 1 3 ⁄2 inch (12 mm) thick 175 mL ⁄4 cup Diced kielbasa n sausage)2 (or other spiced cooked lea 150 mL ⁄3 cup Wild rice 2 2 Bay leaves 500 mL ps cu 2 breast Chopped cooked chicken to 250 mL p cu 1 Chopped seeded toma 15 mL . sp 1 tb Hot pepper sauce
t 8 ingredients. n on medium-high. Add nex Heat canola oil in Dutch ove ing occasionally, until onion is softened. s, stirr t to medium-low. Cook for about 8 minute Bring to a boil. Reduce hea Add next 5 ingredients. 40 minutes until rice is tender. Remove and ut Simmer, covered, for abo about 5 minutes discard bay leaves. s. Stir. Cook, covered, for Add remaining 3 ingredient about 10 cups (2.5 L). kes until heated through. Ma ver Results Healthy Recipe Makeo 281 Calories; 13.6 g Total Fat (1.1 g Sat); ): mL 0 (25 cup 1 E: OR BEF 677 g Sodium Fat (2.0 g Mono, ): 150 Calories; 4 g Total Carbohydrate; g AFTER: 1 cup (250 mL 15 ol; ster ole 35 mg Ch 1.0 g Poly, 1.0 g Sat); ium Sod mg 458 ; tein Pro 3 g Fibre; 14 g
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Wild Gumbo Soup Healthy Recipe Makeovers Cookbooks are available at participating
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