People Health Magazine September 2019 Volume 16,, Number 8

PEOPLES Health Helping People Live Better Lives

TRAVEL VACCINATIONS

FEVER DRUG TALK AND YOUR CHILD HELPFUL ADVICE ON

TERRACE & SOOKE SPOTLIGHT ON

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PEOPLES Health

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September 2015

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Features & Cover Articles 4 7 TRAVEL VACCINATIONS

COLD & FLU

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If you are heading away for a tropical winter holiday, pharmacist Ian Lloyd provides helpful advice on travel health.

Save on a wide selection of cold and flu products from Peoples Pharmacy.

Its important to have open dialogue regarding drugs and Darlene Booth offers insights on creating open communication with your children.

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HEALTHY SAVINGS Great savings on travel products for a safe and healthy trip.

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DRUG TALK & YOUR CHILD

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SPOTLIGHT ON OUR COMMUNITIES A look at Terrace and Sooke, two B.C. communities that Peoples is proud to be a member of.

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BLUEBERRY HALIBUT

Brand new feature recipe From Company’s Coming 400-calorie Mains.

FEVER Read about causes of fever, making the diagnosis, treatment and prevention.

Healthy Choices Page 5

PEOPLES DRUG MART • PEOPLES PHARMACY Community owned and operated pharmacies, proudly serving British Columbians since 1976. Peoples Pharmacists are truly committed to helping people live better lives by providing trusted and personal health care.

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TRAVEL VACCINATIONS

You can never plan for every possibility when you go on vacation. This is part of the joy of traveling; seeing new things, having new experiences and basking in the unknown. It is impossible to prepare for everything when you are away from home.

Airlines will not allow you an infinite amount of luggage. One of the easiest and most important ways to protect your health when away from home is to ensure your vaccinations are up to date. I can not think of anything more scary than being in a foreign country with a preventable infectious disease. Most likely things will be fine, but you might waste valuable sight-seeing time in bed. This month I shall mention the most important vaccines and health tips that can hopefully make your travels less eventful.

At home we are protected from certain diseases by the principle of herd immunity. Essentially, this means that if a significant amount of those around you are vaccinated or immune to a disease, you are most likely protected. When diseases are spread from person to person, a vaccinated person will stop the spread of the disease. This has been the primary goal of wide spread vaccination public health policy. Suppose for whatever reason, your body has no immunity to measles. At home this is not a problem, almost everyone around you is immune to this disease. However if you travel to a foreign land where no one has been vaccinated, you might be at risk if there is an outbreak of measles. This is why getting vaccinated before traveling is a good idea.

If you have any questions about vaccinations or medications needed for traveling, the best person to 4 PEOPLES Health

Ian Lloyd Pharmacist

ask is your Peoples Pharmacist. They may have knowledge about the items you might need for a safe journey. They might also have information about where to find a travel medicine clinic. These clinics specialize in what medications and vaccinations you will need during your travels. You have spent so much time insuring your plane ticket and luggage, why not take the time to insure your body?

Perhaps the simplest vaccine to get is your yearly influenza vaccine. While influenza is only a minor inconvenience for most people, it can be particularly troublesome for people who are traveling. At home, you are able to rest and fight off the infection from the comfort of your couch. While on vacation, you might not have that luxury. And who wants of spend their vacation time in bed? If you have significant nasal congestion, it can make air travel painful. The excessive mucus production might block your eustachian tube; a small passage connecting your middle ear and throat. This tube is responsible for maintaining normal air pressure in the middle ear. If this tube gets plugged, you can experience a build up of air pressure in your ear as the airplane climbs or descends. This can cause a serious amount of ear pain. While you are in getting your flu shot ask about a pneumonia vaccine.

It is recommended that seniors get a pneumonia vaccine every five years. There is also a new pneumonia vaccine that might last a lifetime. Ask your Peoples Pharmacist if the new vaccine Prevnar 13 is right for you.

Continued On Page 11

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Your Source For Travel Vaccinations

Going Away For The Winter?

Some immunizations for international travel require a series of vaccinations that are administered over a 2-3 month period.

Make Peoples Your First Destination For Travel Health Most Peoples locations conveniently administer travel vaccinations on-site. Talk to a People Pharmacist if you're travelling to a tropical destination and discuss the following common illnesses: cholera, hepatitis A, hepatitis B malaria, traveller's diarrhea typhoid fever Talk to a Peoples Pharmacist who can advise you on the medications, vaccinations and health supplies that you'll need for a safe and healthy trip.

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HELPFUL INFORMATION ON FEVER

Although normal body temperatures can vary throughout the day, the average adult normal body temperature when taken by mouth with a thermometer is 37NC 9 .6NF . The normal rectal temperature is approximately 0.5VC 1VF higher than the oral mouth temperature, while the temperature under the armpit axillary is slightly lower than the oral temperature.

Temperature readings taken rectally are considered more reliable than oral readings, particularly in the case of children and adults who are mouth-breathers. Ear temperature measurements are not accurate in small children and are not recommended for children less than 2 years of age.

Recommendations for temperature measuring techniAues vary according to age. For infants and children up to 2 years old, rectal temperatures give the most accurate reading. A thermometer at the armpit can help identify whether or not a fever is present. For children 2 to 5 years old, rectal, ear, or armpit temperatures are acceptable. For children older than 5, oral temperatures are the main method, while ear and armpit are also acceptable.

Fever strips are not recommended because those temperature readings have not been found to be as accurate as other methods.

When someone has a fever the body raises the normal body temperature as measured orally above 37.5NC 99.5NF to try to kill bacteria or viruses in the body. A rectal temperature above 38VC 100.4VF or an underarm temperature above 37.3VC 99.1VF is also considered a fever.

Fever is actually the body's natural way of defending 6 PEOPLES Health Join us on

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itself from invaders like viruses and bacteria, because many of them can't survive in the body due to the high temperature caused by a fever. High body temperatures also signal infection-fighting cells of the immune system such as phagocytes, neutrophils, and lymphocytes to come to the body's defence and help fight off infections. The degree of temperature increase doesn't necessarily correspond to the severity of the illness. The fever response tends to be greater in children than in adults.

Causes Fever can be caused by factors outside or inside the body. Microorganisms, including bacteria and parasites, can produce chemical poisons. Both the microorganism and the poisons cause the white blood cells called monocytes to produce substances called pyrogens. It's the pyrogens that actually cause the fever.

The body also produces pyrogens in response to infection, inflammation, cancer, or an allergy. Illnesses in which the body's immune system attacks its own tissues called an autoimmune disease , such as rheumatoid arthritis, can also cause fever. Too much exercise in hot weather, overexposure to sunlight, or some medications can cause a fever that is a medical emergency. In these situations, get immediate medical attention.

Symptoms and Complications When the body is fighting an in:ury or infection the hypothalamus a part of the brain sets the body temperature at a higher level. The body compensates for this by moving blood away from the skin so the amount of heat lost through the skin Continued On Page

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Fever...Continued From Page 6

is reduced.

The muscles might repeatedly contract to keep the body warm, which causes shivering. When the blood that is warmed up to the new temperature reaches the hypothalamus, these symptoms usually stop, and just the fever remains. When the body's thermostat is set back to its normal temperature, it moves the blood back to the skin and excess heat is lost through sweating. Sometimes chills occur when this happens.

The body's temperature may go up and then either return to normal or stay up. Seniors, very young people, and people addicted to alcohol may lose body heat when they're fighting a major infection.

About 3% of all children between 18 months and 3 years of age will have a seizure when they have a high fever. About one-third of children who have previously had febrile seizures (seizures caused by fever) will have another seizure when they have a fever. However, these seizures do not appear to cause long-term effects.

Making the Diagnosis In most cases, fever can be managed without seeing a doctor. When deciding whether to call the doctor or not, it's better to look at all of your or your child's symptoms, because the degree of fever doesn't tell you how sick someone is.

Consult a doctor or get immediate medical attention if: • a child below the age of 6 months has a fever • a child has a fever that lasts more than 3 days • a child or adult with a history of cancer, AIDS, or other serious illness such as heart disease or diabetes has a fever • a child or adult has a fever after returning from international travel • fever is accompanied by: - behaviour changes - excessive fussiness or irritability - headache, stiff neck, confusion - localized pain, redness, or swelling - persistent vomiting or diarrhea - rash - shaking chills and burning or pain with urination - shortness of breath and cough - unresponsiveness or limpness When a child has a fever, trust your parental instincts. Take your child to the doctor or get immediate medical attention if there is something about their behaviour or appearance that worries you.

If you see your doctor about a fever, they will take a medical history - asking about symptoms, Continued On Page 10

Focus On Vitamin B Complex Aids Metabolism & Nervous System Function The 11 members of what's known as the vitamin B complex are critical nutrients for metabolism and nervous system function. Although each B vitamin has a unique role, they work together as coenzymes to metabolize food and to provide energy. B vitamins help synthesize brain chemicals that control mood and nerves. The B vitamins support the nervous system, skin, eyes, liver, and mucous membranes, and enhance energy, muscle tone and gastrointestinal health.

Many of us don't get enough B vitamins, deficiencies in folic acid, B12, and B6 are especially common.

Ensuring that your diet contains plenty of B-rich foods -- dark-green vegetables, protein from animal sources, and whole grains - is important.

Talk to a Peoples Pharmacist about the benefits of B vitamin supplements.

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Spotlight

On Our Communities

Terrace First Nations people have lived in this area for thousands of years. Their rich history and culture still thrives today, and visitors to Terrace have many chances to discover it for themselves. For a memorable experience, visit the First Nations communities closest to the city - the Kitselas and Kitsumkalum, both Tsimshian tribes.

From mild to wild, Terrace provides yearround adventure. Explore one of the many spectacular hiking and biking trails or experience the thrill of incredible climbing routes.

Anglers around the world say the Terrace area is one of the best fishing locations anywhere.

Some of the most exciting sport fishing in B.C. is on the Skeena River.

Photos Courtesy Province of BC

Sooke Sooke is a picturesque, seaside town situated on the dynamic south-western shores of Vancouver Island. Sooke boasts worldrenowned accommodations, restaurants, galleries and shops, as well as provincial parks, unspoiled rainforests, tranquil beaches Q a destination well worth the short trip from Victoria: British Columbia’s capital city.

Named for its early inhabitants, the T’Souke First Nation, Sooke was a thriving settlement of the Coast Salish Indians. For hundreds of years the T’Sou-ke First Nation lived undisturbed off the land, until in 1 90 Spanish explorer Manuel ,uimper PdiscoveredS this coastal hidden treasure.

Photos courtesy Province of BC

1000 was donated to the Sooke Family Resource Society. The Society provides prenatal education, children’s programs, youth outreach, and parenting education. More specifically, the funds will be directed to the counselling services the SFRS provides for those dealing with mental health issues such as depression, anxiety, trauma, grief, and family conflict. Cheque presentation: Nicky Logins, SFRS Executive Director, (left) and Ron Kumar, Sooke Peoples Drug Mart owner (right).

The Peoples Drug Mart Healthy Communities Fund (HCF) is a community support program that provides financial assistance to health related organizations in Peoples Drug Mart communities. The HCF is funded by the owner operators of Peoples Drug Mart and from the proceeds of the Peoples Drug Mart corporate fundraising. peoplesdrugmart.com People First

Fe er...Continued From Page

prior diseases, medications, and recent travels. 0sually, it's easy to find a specific cause for a fever. If a specific cause can't be identified, additional tests may be performed.

Your doctor may want to know the following about a fever: R how long the fever has lasted R if the fever is worsening or getting better R if there are chills or other symptoms (e.g., headache, cough) R if the fever is going up and down R if it came on suddenly After asking detailed questions, your doctor will also perform a physical examination to look for an infection or signs of a disease. Your doctor may check the blood for white blood cells, and may check the urine or sputum. Other tests that may be done include 3rays and ultrasound.

Treatment and Prevention Here are a feG things to do for relief until the fever 2reaks R drink plenty of fluids (e.g., water, juices, broth or oral hydration solution) to compensate for fluid loss from sweating R get plenty of rest R make sure there are no extra blankets or clothing on the body, to help lower the body temperature (to prevent shivering and a subsequent rise in body temperature, do not remove all clothing) Sponge baths with lukewarm water or alcohol are not recommended because they can cause shivering and alcohol can be absorbed through the skin.

A fever causes the body to use more oxygen. Thus, people who have difficulty getting more oxygen into

their blood, such as heart and lung patients, should be treated for a fever as soon as one develops.

Antipyretics Ghich are medications that fight fever are used to help people Gith a fever to feel more comforta2le. Acetaminophen* and ibuprofen are frequently used. ASA (acetylsalicylic acid) is given only to adults because it can cause Reye's syndrome, a disease that causes liver and brain damage in children. Acetaminophen or ibuprofen is generally given to children who are uncomfortable because of a fever. These are considered very safe and effective when used as recommended. Since fever is part of the body's natural defense against infection, the goal of using these medications is to improve overall comfort, not to reach a normal body temperature.

When using these medications, the dose should be based on the child's weight rather than age. To ensure an accurate dose is given, use a medication cup or oral syringe to give the liquid forms of the medication. Keep all medication out of the reach of children. If a bacterial infection is the suspected cause of a fever, your doctor will likely prescribe antibiotics.

If a medication is causing the fever, the medication will be stopped and other treatments may be used as well. If heat exhaustion is causing a fever, immediate medical attention is necessary, as the body temperature needs to be reduced quickly and medications typically used to reduce fever are not effective. *All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., TylenolT). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist. All material U 199 -2014 MediResource Inc. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

PEOPLES PHARMACISTS

Ian Lloyd...Continued From Page 4

Cholera and travelers diarrhea are two stomach bugs that can really ruin a vacation. Cholera is caused by an infection of the bacteria Vibrio cholerae. This unpleasant bacteria is found in contaminated water and food. Travelers diarrhea goes by many names, some are unspeakable, but health care professionals call it enterotoxigenic E. coli.

This bug is also found in unsanitary water and contaminated food. Symptoms for both diseases are similar: fever, watery diarrhea, vomiting, stomach pain and fatigue. With adequate rehydration, people usually recover in 3-4 days. The key phrase here is 3-4 days, that is a lot of vacation time lost.

You will also not want to be too far from a bathroom during this time. Luckily, there is an oral vaccine that your can get without a prescription from your Peoples Pharmacist that is effective against cholera and travelers diarrhea. It is called Dukoral and only needs to be taken a few weeks before your trip.

It seems all traveling diseases affect your stomach; typhoid is no exception. Typhoid is caused by ingesting food or water contaminated with the bacteria Salmonella Typhi. The symptoms of typhoid are slightly different from other stomach bugs you might pickup. Typhoid causes a high fever, stomach pains, fatigue, headaches and a rash of flat, rose-coloured spots. Luckily there is an oral vaccine that can protect you from the typhoid causing bacteria. Ask your Peoples Pharmacist for more information. Another important thing to remember about avoiding stomach bugs while traveling is to be aware of what you put in your mouth. Don't forget the old phrase: Boil it, Peel it, Cook it or Forget it. Also be wary of using tap water to brush your teeth or washing your face.

Avoidance works well with vaccination.

Hepatitis A is a viral disease that you can get by traveling abroad or staying at home. Hepatitis A is caused by a viral infection that leads to liver inflammation. Again it is usually transmitted by ingesting contaminated food or water. Symptoms include nausea, fever, yellow skin or eyes, diarrhea and lack of appetite. People can fight this infection off without treatment, but these symptoms can sometimes persist for up to nine months. This is an infection that you can catch at home. In 2011, there was an outbreak of hepatitis A on Vancouver Island that af-

Helping People Live Better Lives

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We Can Help You Live A Better Life.

Peoples Pharmacists have years of training - not only about your medications, but also about the conditions they treat. Talk to a Peoples Pharmacist, their role is changing to help you better manage your health.

Jay Ross

Pharmacist & Owner, Trail

Ian Lloyd...Continued on Page 13

peoplesdrugmart.com PEOPLES Health 11

Hey Traveller!

Ask your healthcare provider if TWINRIX is right for you. 速

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Many common travel activities can put you at risk for hepatitis A and B.

Help keep hepatitis A and B out of your travel plans.

Visit Twinrix.ca.

Twinrix速 is a combined hepatitis A and hepatitis B vaccine used in adults, adolescents, children and infants to prevent hepatitis A and hepatitis B diseases. Twinrix速 does not protect against hepatitis C or E nor does it treat hepatitis A or B infections. 100% protection cannot be guaranteed and booster doses may be required. Very commonly (more than 10% of doses) reported adverse events in adults were pain or discomfort, redness at the injection site, headache and tiredness. Common (between 1% and 10% of doses) adverse events were swelling at the injection site, diarrhea, nausea and vomiting and generally feeling unwell.

Allergic reaction may also occur. Full product information can be found on Twinrix.ca.

TWINRIX is a registered trademark of GSK Biologicals SA, used under license by GSK Inc. 息2015 GlaxoSmithKline Inc. All rights reserved.

00641 01/15

Ian Lloyd...Continued From Page 11

fected over 90 people. Normally, the Vancouver Island Health Authority sees about one or two cases a week. Luckily this disease is preventable with a short course of injectable vaccinations.

A related liver disease is caused by the hepatitis B virus. This is not normally a concern with traveling because it is spread through sexual contact or infected blood products. Symptoms and disease progression are very similar to hepatitis A. It is often mentioned with travel because there is a combination hepatitis A and B vaccine. If you are going to get vaccinated, you might as well get vaccinated for both diseases. Ask your Peoples Pharmacist if the combination hepatitis vaccine Twinrix is right for you.

Other possible vaccinations needed for travel are often linked together: tetanus, diphtheria and pertussis (whooping cough). Tetanus is caused by the bacteria Clostridium tetani, diphtheria by Corynebacterium diphtheriae and pertussis by Bordetella pertussis. Some of these infections are potentially fatal while others are not. Most of us have been vaccinated against these diseases, but protection only lasts about 5-10 years. Also, vaccination is not routine in certain areas of the developing world.

Another major concern with traveling is the possibility that you might catch a virus on a long plane ride. One major barrier against catching a cold or flu is a moist nasal passage. The air in a plane is often dry and can dry out your nose. This can make you more susceptible to catching a 'bug'. Here are a few simple ways to help keep your nose moist. Whenever your nose feels dry, use a saline nasal spray to help rehydrate your nasal passages. Another idea is to use some sort of ointment or nasal gel. Drinking lots of water during the flight is also a good idea.

This is by no means a complete list of vaccinations or medications that you will need while traveling. Ask your Peoples Pharmacist for more information about the medications you might need on your travels. You might also wish to visit a travel medicine clinic before you leave. With a little planning, your well deserved vacation can be truly relaxing.

PEOPLES PHARMACISTS Helping People Live Better Lives

We Can Help With Shingles Vaccinations.

About 1 in 3 people will get shingles in their lifetime.

Select Peoples locations offer convenient on-site shingles vaccinations that can prevent or reduce the severity of shingles.

Duncan Mackay

Pharmacist & Owner, Salmo

We Can Help Reduce Everyday Strain On Your Busy Legs.

Select Peoples Drug Mart and Peoples Pharmacy locations offer compression stocking and fitting services, which help treat painful venous leg disorders.

Check with your local Peoples for this service.

Paul Sherman

Pharmacist & Owner, Kitimat

We Can Help With Travel Vaccinations.

Make Peoples your first destination for travel health. Most Peoples locations provide convenient on-site vaccination services so you can have a worry free and safe vacation.

Vladi Stevanovic

Pharmacist & Owner, Victoria Written By Ian Lloyd, Pharmacist & Chartered Herbalist

peoplesdrugmart.com PEOPLES Health 13

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DRUG TALK AND YOUR CHILD

Just say NOS might be a time-honoured effective strategy for two-year-olds when dealing with everything in life, but it has yet to prove itself in the campaign for a healthy drug free society. Drug use has become integrated into much of mainstream culture and children are absorbing media induced prodrug culture from early childhood onward. By the time the teen years roll around, peer pressure combined with a natural propensity towards establishing autonomy increases the risk that drug use could become a part of their life. Indeed, it is best for the conversation about drug use to begin in early childhood and factual information should intersect with health promoting values around their physical and mental well-being.

The preschool years are not the appropriate time to introduce drug specific facts but they are ripe with opportunities to model and establish healthy lifestyle basics. These foundational years are when much of your child’s sense of personal self worth will begin to form. Help them connect to how good they feel when they eat well, get enough sleep and take good care of their body. This is a good time to begin discussing things that can hurt their body like cigarettes, some common household products and taking medicine that is not meant for them. Bring in awareness around effective coping skills to help them navigate the quagmire of emotions that life will present. Be on alert for the spontaneous teachable moments and take advantage of them whenever you can.

As they enter the early grade school years, children are introduced to concepts and ideas that may differ greatly from their own familial experience of the world. Peers begin to influence decisions on activities and appearance. These are the years to strengthen family culture and talk openly about how you feel about drug use. They may not be able to link a future diagnosis of COPD with cigarette smoking but they can certainly understand that it makes your clothes smell awful and gives you bad breath. If they value good grades, sports and other physical activities let them know how drugs and alcohol can affect performance. Model, teach, and use every opportunity to encourage your child to dialogue with you about their perceptions and experiences. Help them distinguish and

1

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arlene Booth R.H.N., B.S.W.

hone healthy relationships with their peers and be there to support the process when needed.

Before you know it, your child has entered into the often-tumultuous pre-teen and teen years. By now your child should have a clear concept of house rules and natural consequences.

This goes hand in hand with having respect for their own person as well as the family environment. Brainstorm ways for them to save face while not giving in to peer pressure and help your child find their own voice amongst the cacophony of the crowd. When talking to your teen about drugs it is best to minimize the fear tactics and keep the information present and personal. Teens are often so focused on their external appearance that it is almost an obsession. The sooner they can link proper nutrition and exercise with looking and feeling their personal best the better. Appearance is one area where the peer pressure to fit in can actually work in parental favour. Of course it can slide the other way if the child wishes to form an identity around the drug culture.

Open-minded communication is essential and the best tool you can have in your parenting toolkit. Be approachable and let your child know that their voice is valued and heard no matter what the topic is. There is more to be gained in a two-way conversation than a finger-wagging lecture. Today’s youth are more than aware of where most parents stand on the subject of drug use; what they are really trying to define is who they are in relation to you and the rest of the world.

Research has shown that the earlier a person is introduced to drugs the more at risk they are for addiction. Neuroscience and epigenetics are starting to correlate biological and environmental influences that can inhibit optimal brain development in youth. While recreational use of drugs and alcohol are often celebrated in mainstream culture we have to remember they can cause permanent, irreversible damage to a developing brain. The bottom line when parenting is to help ensure your child is able to develop into their full potential and the challenge lays in helping them value the same outcome enough to choose a drug free path.

Good Health to You.

Blueberry Halibut Thick-cut halibut splashed with flavours of sage and white balsamic, topped with a refreshing blueberry yogurt and crisp graham crackers.

Blueberry Halibut

1 tsp (5 mL) blueberry vinegar (or white balsamic vinegar) 1 ⁄2 tsp (2 mL) chopped fresh sage 1 ⁄4 tsp (1 mL) no-salt seasoning 1 ⁄4 tsp (1 mL) pepper 2 × 6 oz (170 g) halibut fillets (centre cut), patted dry ⁄3 cup (75 mL) Greek yogurt ⁄4 cup (60 mL) fresh (or frozen, thawed) blueberries, chopped 1 1/2 Tbsp (22 mL) liquid honey 1 Tbsp (15 mL) lemon juice 1 1

2 tsp (10 mL) canola oil 2 Tbsp (30 mL) graham cracker crumbs On a large plate mix together first 4 ingredients to make a marinade. Add fillets to plate and rub entirely with marinade. Allow to sit at room temperature for 10 minutes.

Combine next 4 ingredients in small bowl. Mix loosely to create a marbled look. Set aside.

Heat large heavy-bottomed pan over high (see Tip). Add canola oil. Heat for 1 minute.

Gently place each fillet in pan. Slightly reduce heat and cook for 2 to 3 minutes, until browned. Carefully flip fillets and brown other side, another 2 to 3 minutes. Then place entire pan in 400°F (200°C) oven for 8 minutes, or until fish is cooked medium-well.

Remove from oven. Tent with foil. Let stand for 5 minutes.

To serve, spread a spoonful of blueberry yogurt over top of each fillet. Top with graham cracker crumbs. Serves 2 1 serving: 360 Calories; 13 g Total Fat (4 g Mono, 2.5 g Poly, 3.5 g Sat); 65 mg Cholesterol; 23 g Carbohydrate (1 g Fibre, 17 g Sugar); 37 g Protein; 170 mg Sodium Tip: Use a non-stick or well-seasoned pan to avoid the fish sticking to it. Use gentle hands when flipping fillets to avoid breaking them.

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Reprinted from 400-calorie Mains Company's Coming Publishing Limited

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