PROGRESSEditorial by Laura Del Guerra, RD, CDEWorking with clients each month o�ers a unique window into the process of progress. Just like no two people are alike neither is the process of change and progress towards a goal. Progress is de�ned as movement forward or toward a place OR the process of improving or developing something over a period of time. Both of these de�nitions are applicable to the improvements in individual health over the course of the year in the Take Control program. For some, progress occurs quickly while for others it occurs more subtly. It is much easier to see progress occurring with things rather than people. When working on any type of project it is easy to see the steps we have taken, remember where we have been, and what the �nished project will look like. I wish it were this easy when making progress towards a healthier life. Often times clients get stuck, unable to see (or maybe acknowledge) the progress made. This is especially easy to do with yourself – as humans we possess a unique ability to discount our accomplishments and have learned from childhood not to ‘brag or boast.’ One of the most exciting aspects of being a health coach is watching progress take place. Once the seed of progress takes hold, It can be a force all its own. This month’s Person of the Month feature is such a story. Kim’s journey has neither been short nor easy but it is one of great accomplishment.Often progress begins as an idea. I had a client last week who set a goal of running a 5K later this spring. With training ideas (see our article on completing your �rst 5K), a little coaching, and determi-nation I have little doubt that her goal will be achieved. Several of our Take Control participants have achieved amazing health related goals – ones that make the health coaches as excited as the partici-pant!Finally making progress can be as simple as incorporating new foods and recipes into our usual meals. Marya’s article on functional foods and the accompanying recipes may nudge you into moving farther ahead with your nutrition goals.Whatever goals you are working towards remember that each step forward counts as progress. For many this process is not as quick as we would like it to be and leads us to stop moving forward. If you �nd yourself in this situation try taking the long view. What were things like a week, month, or year ago? Are you in the same place? If the answer is ‘no’ that’s progress! Keep moving forward. If things are the same, it may be time to dig in, set your sights lower and do one small thing to move forward. Let us know what progress looks like to you. Join our discussion on Facebook. Your thoughts may be just what someone needs to take the next step.

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IN CONTROL!TRANSFORMATION, GRACE, & THE NEW ME!PERSON OF THE MONTH: KIM S.By Shannon Jones, Health Coach and Exercise SpecialistThis past year I have been inspired by Kim and her life changing weight loss journey. Her perspective has made all the di�erence in achieving her goals and making achievements over the long haul. I am excited to share how she took steps to transform herself and become the person she wanted to be. (continued on page 2)

APRIL 2014 EDITION

KIDS DIABETES CAMPREGISTRATION OPENS

MARCH 24!Save the Date–Registration for Camp Montana will open on March 24! Check out this website for updated information on Camp 2014, taking place July 20-25, 2014 in Fishtail, Montana for kids ages 8-17. The primary objective of Camp Montana is to provide a safe, fun, traditional experience, and attention to the medical needs of each camper is always a priority. Each camper has the opportunity to learn and practice valuable diabetes self-management techniques under medical supervision. 

UPCOMING SAFE ATSCHOOL EVENTS

On April 24, 2014 there will be two Safe at School Workshops - one in Billings, and one in Bozeman. Come to this free workshop and learn about your child's rights and how to keep your child with diabetes Safe at School. RSVP at www.diabetes.org/montana. Please contact Kirsten Weatherford at kweatherford@diabetes.org to learn more.

UPCOMING MONTANA RACES Saturday, June 14, 2014Heart and Sole Run: 10k, 5k, and 2-mile Health Walk in Billings www.heartandsolerace.org Governor’s Cup–marathon, half marathon, 10K, 5K, 1M Fun Run in Helena www.govcupmt.comSunday, June 15, 2014 Prison Break - Fun run, 5k &10k in Deer Lodge (Info call 846-1191)July 12, 2014 Missoula 5K -in Missoula www.runwildmissoula.orgSeptember 20, 2014 The Color Run-The Happiest 5K on the Planet in Missoula www.thecolorrun.com/Missoula*For all the up to date race info on running or walking in Montana go to www.runmt.com

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IN CONTROL!(continued from page 1) What made you decide to join Take Control’s Lifestyle Manage-ment program?I decided to join the program because I had previously been a part of the Wellweight/Wellheart program through MUS, and the program ended before I could �nish. I originally joined because I had just begun my journey of becoming a healthier person. The timing was right and there was no way I was going to pass up the opportunity for having gym membership reimbursements, reimbursement for a personal trainer, and the information I needed to be successful.What were your reasons/motivation for wanting to make changes regarding your health?I felt awful. I was lethargic, achy and considered to be morbidly obese. I wanted to be able to keep up with my kids and the rest of the family, doing the kinds of things we like to do. I was also scared that my high C-Reactive Protein (CRP) levels might indicate some type of disease. As I learned about the body, prevention became a new motivator for me.What have been the biggest challenges and accomplishments in your health since you started? What do you feel was your biggest obstacle?My biggest challenges: Taking things one day at a time and learning to have the grace to make mistakes and get back to where I needed to be in terms of behavior/habits. My biggest obstacle has been �guring out which foods my body is most sensitive to and doesn’t handle well.My biggest accomplishment: I would like to say that it has been the weight loss I’ve experienced, but it really is more than that. I’ve changed who I am, how I cope with things, and how I view the relationship between my body, food and exercise. A bumpy road is OK and that each day is a new day. Each choice is a new choice.What helped you stay motivated? The scale used to be what motivated me. I was tied to it for a long time. Seeing continuous weight loss was very motivating. From there, it changed to how I felt. Eating the right kinds of foods became more important than the scale. How I feel (less achy and tired) has become one of my biggest motivators . I also used a personal trainer to help motivate me. It is psycho-logically motivating and it I feel it keeps me focused on the right things. My personal trainer is a good �t for me and he has become like family! While I know I can work out on my own, this is something I plan to continue for as long as I can a�ord it.What have you gained through this process?I feel as though I have gained a whole di�erent me. I’ve been able to discard some of the pieces of myself that I picked up along the way- the ones that weren’t really who I was, but changed who I became. I’ve learned

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to relax and enjoy life as it comes. My entire outlook has changed and I feel as though I am the perfect combination of my younger self and my wisdom.What di�erences do you see in yourself and the impact it has had on your health and life?Everything is di�erent. My size and shape are di�erent. I’m happier. I have more energy. My CRP levels are now at a normal level, I’m no longer in the obese category. Life. Is. Great!What advice or encouragement would you give others in our program? Take it day by day. Make room for the things you normally avoid because you are afraid to deal with them. Have respect for yourself to feel what comes from those experiences, the grace that is needed with yourself to work through whatever comes of those experiences, and try to �nd a way to learn from each of new thing without expectations as to how things will turn out. Visualize who you want to be and put one foot in front of the other.

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TIPS FOR TAKING YOURMEDICATIONS THE RIGHT WAYBy Danielle Sebastian, PharmD, BCPSIt’s very important for you to take your medicines the right way. This means taking the right dose of each medicine the right number of times every day. It also means following any special directions, such as taking a medicine with food, on an empty stomach, or at bedtime.Taking your medicines the right way can help you stay as healthy as possible. For example, taking your full course of medicine for an infection will help you get completely cured. Taking your blood pressure medicine the right way will help prevent heart attacks and strokes in the long run. Taking your diabetes medicine the right way will help prevent problems with your eyes, kidneys, and nerves as years pass.Ask yourself a few questions:Do you know the names of all of your medicines? Yes NoDo you know what each of your medicines is for? Yes NoDo you know how to take all your medicines? Yes NoDo you think you need all the medicines you are taking? Yes No If you answered “No” to any of the questions above, you might not be getting the most bene�t from your medicines.Do you ever forget to take your medicine? Yes NoWhen you feel better do you sometimes stop taking your medicine? Yes NoIf you think your medicine is making you feel worse, do you sometimes stop taking it? Yes NoIf you answered “Yes” to any of the questions above, you might not be getting the most bene�t from your medicines.There are a lot of reasons why it might be hard for you to take your medicines the right way. Be open and honest with your pharmacist or health care provider about any problems you have taking your medicines. They want to help you. They can work with you so you get the most bene�t from your medicines. Below are some “road blocks” that might come up, and some useful tips to help you get past them.The schedule for taking my medicines is complicated:• Ask if there are medicines you can take just once or twice a day to replace any that you take three or four times a day.• Ask if there are any pills you can take that combine two or more of your medicines.• Ask if any of the medicines you take can be stopped.

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I forget to take my medicines:• Ask for help matching your medicine schedule with your daily routines, such as eating meals and going to bed.• Use a pill organizer.• Try using technology, such as a reminder alarm or “app” on your smart phone (see below for some reminder apps for your phone)• Ask if your pharmacy or the company who makes your medicine has any special programs to help you remember. I have trouble paying for my medicines: • Ask if there are options that cost less, such as generics.• Ask if there are any programs or discount cards that will help you pay for your medicines.I don’t like the side e�ects from my medicines:• Ask how long the side effects will last. Some side effects go away after you’ve been taking a medicine for a few weeks or so.• Ask what you can do to prevent the side effects or make them easier to deal with.• Ask if there is a similar medicine that won’t have the side effect you don’t like.• If you have an allergic reaction or a very bad side effect, seek medical attention right away.DO NOT stop taking any of your meds on your own. Always speak with your health care provider and/or pharmacist about ANY problems you’re having. Then together you can make sure your meds are the best ones for you.Phone Reminder AppsThe following were rated highest in a study conducted by Pharmacists.Medication adherence smartphone applications (apps) and alerts:• MyMedSchedule (for iPhone and Android) http://www.mymedschedule.com/• MyMeds (for iPhone and Android) http://about.my-meds.com/• RxmindME (for iPhone) https://itunes.apple.com/us/app/ rxmindmeprescription-medicine/id379864173?mt=8Short Message Service (SMS) text messaging services:• OnTimeRx http://www.ontimerx.com/reminders/services.html• RememberItNow http://rememberitnow.com/index.phpReferences:• PL Detail-Document, Tips for Sticking With Your Meds. Pharmacist’s Letter/Prescriber’s Letter. November 2013.• PL Detail-Document, Medication Adherence Toolbox. Pharmacist’s Letter/Prescriber’s Letter. December 2013.• Type 2 Diabetes Exams and Tests. Retrieved March 12, 2014, from http://www.nlm.nih.gov/medlineplus/ency/article/000313.htm

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WHERE IS THE JAMMERBUS THIS MONTH?

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TWO MEDICINEBefore the Going-to-the-Sun Road was constructed, Two Medicine was a primary destination for travelers arriving by train. After spending a night at Glacier Park Lodge, visitors climbed on horseback to travel to Two Medicine for a night in one of several rustic chalets or canvas tipis built by the Great Northern Railway. From Two Medicine, a system of backcountry tent camps and chalets within the park allowed adventurous visitors to live in Glacier's wild interior.Backpackers and day hikers �nd this area rich in scenery, providing those willing to travel by foot into the mountains with a true wilderness experience. Tenderfeet can also venture o� the roads and into the wild with a casual boat tour on Two Medicine Lake. Today, Two Medicine has become a somewhat o�-the-beaten-path discovery for most park visitors. Once discovered however it's easy to see why many people consider this their favorite part of Glacier National Park. Amazing vistas, extensive trails, crashing waterfalls, and sparkling lakes await.

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TakeCONTR L Eat Well. Stay Active. Reduce Your Risks.

FUNCTIONAL FOODSBy Marya Bruning, RDIn 2011, Americans spent 4.4% of their food budgets – including groceries, alcohol, and restaurant meals – on functional foods. Around that same time, we collectively spent 1.5% of our food dollars on vegetables and legumes. Judging by these numbers, it would seem that we value functional foods three times as much as vegetables and dried beans. But what exactly are functional foods? Do they deserve such a signi�cant portion of our budget? Simply put, functional foods are those with something added over and above what’s naturally found in the food. Old-fashioned examples are vitamin D-forti�ed milk and iodized salt. In the �rst half of the last century, public health o�cials regulated the addition of key vitamins and minerals to staple foods to prevent widespread de�ciency diseases like rickets and goiter. You can spot modern functional foods by their packaging and advertising. For example, you may have noticed one brand of margarine that claims it will lower your cholesterol levels in two weeks (if you eat ¼ cup of margarine every day) thanks to an ingredient called plant stanol esters. One brand of orange juice with added calcium and vitamin D promises to “refresh yourself down to the bone.” Cartoonish cereal boxes loudly display their whole grain credentials and tout health bene�ts like preventing heart disease, cancer, and diabetes. American grocery shoppers have a tough job to do. We want to buy foods that are healthy. Food companies want to sell as much as possible (who wouldn’t?), and so they appeal to our desire for health by adding extra nutrients to their products and then letting us know about it with attention-grabbing packages. The only problem is that no one is checking to make sure that health claims on food packages are true. The Food and Drug Administration stopped trying to control unsupported health claims after it lost a series of lawsuits over free speech. So, what’s the average shopper to do? Should we trust that if we select the enhanced margarine, orange juice, and cereal, we’ll be spared from heart attacks, osteoporo-sis, and other dreaded diseases? When independent health researchers do carefully controlled studies on the bene�ts of modern functional food, the results are disappointing. Time and again, researchers �nd that when a nutrient is isolated from a whole food and inserted into another food, the nutrient becomes less functional. This makes a lot of sense when we consider that whole foods are complex biological systems containing tens of thousands of chemicals. Singling out just one nutrient and expecting great results is like gluing a racecar bumper sticker onto your bike and expecting to win NASCAR. My advice is to stick with good old-fashioned foods that our grandmothers would recognize. Thousands of years of human experience demonstrate that when most of our nutrition comes from plants – fruits, vegetables, whole grains, nuts, seeds, and legumes – along with dairy, �sh, game, and meat, our bodies get what they need to take care of appetite, energy balance, digestion, blood pressure, choles-terol, blood sugar, and so on. In the words of one Take Control participant, “I’d rather give my money to the farmer than the pharmacist.” I agree. And I’d rather buy whole foods from the farmer than just a few spare parts.

BROILED SALMON WITH CITRUS YOGURT SAUCEMakes 4 to 6 servingsActive time 20 minTotal time 35 minINGREDIENTSFor salmon• 1 (3-lb) piece salmon fillet with skin (1 inch thick at thickest part; preferably center cut)• 3/8 teaspoon salt• 1/4 teaspoon black pepperFor sauce• 1 cup low-fat plain Greek yogurt or plain whole-milk yogurt (see cooks' note, below)• 2 tablespoons extra-virgin olive oil• 2 tablespoons water• 1 teaspoon finely grated fresh lime zest• 1 tablespoon fresh lime juice• 1/2 teaspoon finely grated fresh orange zest• 1 teaspoon fresh orange juice• 3/4 teaspoon salt• 1/4 to 1/2 teaspoon mild honey (to taste)• Special equipment: pliers (preferably needle nose)• Accompaniment: lime wedgesPreparation—Preheat broiler. Line rack of broiler pan with foil and lightly oil foil with some olive oil. Pat �sh dry and check for bones by running your hand over �sh from thinnest to thickest end. Remove any bones with pliers. Sprinkle �sh with salt and pepper, then broil 4 inches from heat 7 minutes. Cover �sh loosely with foil and continue broiling until just cooked through, 7 to 9 minutes more. While salmon broils, whisk together all sauce ingredients in a bowl until combined. Serve salmon with sauce.Kat’s Commentary: I really liked the broiling technique used in this dish. I enjoy citrus so next time I’m doubling the lime and orange zest. Functional Food Smoothie (serves two)Ingredients: Juice from one Meyer lemon ½ cup frozen blueberries½ cup fresh spinach ¼ cup frozen or fresh strawberries¼ cup pecans 1 frozen banana½ cup water you can add 2 tablespoons honeymore or less water dependson your preferenceDirections: Mix all ingredients, in a high powered blender. Blend until smooth and creamy. I use a nutria bullet blender.

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SPRING INTO RUNNING, YOUR FIRST 5KBy Shannon Jones, Exercise Specialist and Health CoachIt’s springtime which means longer days and warmer weather. This can help launch your motivation to be more physically active. Let spring-time's rejuvenation inspire you to try something new like walking or running a 5K! Looking for "the best way" to start this journey? All running programs for beginners start with walking then progress to running. Some say the di�erence between walking and running isn’t speed or biomechanics. It’s fortitude. Shannon’s Running Tips 4 All: • WE are all individuals. What works for some may not be right for you. • Start with buying the right shoes. That does not mean the most expensive. Before you purchase, search for a shoe that �ts you properly and is designed for the surface you'll run on most often. If running is new to you, I highly recommend you stop at local running- specialty store sta�ed by veteran runners and shoe experts. These professionals will �t you by watching your gait and posture to guide you before your purchase. Remember all exercise shoes have a lifespan. To prevent injury, plan on replacing your running shoes after about 350 to 500 miles of wear. Once you �nd a shoe that �ts, you will know what brand to buy in the future.

• Make a plan. I recommend you check out the training resources below. Find a route to start your program and �nd your pace. Make it comfortable to avoid getting overly fatigued and discouraged, or even injured. Listen to yourself. You should be able to talk some while you're running, not hyperventilating or conversely be able to belt out your favorite tune. Experiment, �nd what works for you. • Include warm up and cool down time. Warm up by walking or jogging slowly to ease your body into the movement. I recommend at least a 5 minute warm-up. When you �nish, don’t just stop suddenly. Instead cool down gradually with a slow jog or walk. The best time for stretching is after your workout when your muscles are warm and pliable.• Most of all have fun, and enjoy the journey!

Great Training Resources• The Galloway run-walk-run method- http://www.je�galloway.com/training/run-walk/• Cool Running-Couch-to-5K ® Running Plan- http://www.coolrunning.com/engine/2/2_3/181.shtml