Category Archives: Your Health

Strength in Numbers: A resolution for those of us over 55

By Neil Short, certified strength and conditioning specialist and and creator of ‘Be Strong Be Free’

Neil short photo
Neil Short, a Casper attorney and strength-training proponent, will write about positive aging in his weekly column, “Strength in Numbers.” (Photo courtesy of Neil Short)

Here is a resolution for all of us over 55:  Commit to a life of Positive Aging.  This is our life-long resolution, not merely a New Year’s Resolution.

New Year’s Resolutions tend to focus on subjects like weight loss and learning a new language.  New Year’s Resolutions are all too often made only to be broken, and quit quickly at that.  When a resolution (weight loss) is broken, the negative activity (eating poorly) becomes much worse.  Everyone knows that New Year’s Resolutions usually fail.

Rather than making a doomed – to – fail resolution for the New Year, those of us 55 and older need to make a life plan to take responsibility for our lives and make the next years the best they can possibly be.

Does that sound just too grand and broad to be real and effective?  It is not.  A positive life plan starts with an attitude that puts you in charge of how you will age and flourish versus allowing yourself to wither.  Choose active aging rather than allow aging to be a form of disability.  Decide that you want to remain active to the fullest degree possible and then do what needs to be done.

In this column, which will appear monthly on The Pulse, I will explore topics that contribute to a healthy, happy and productive life at any age. The basic tenents are the same, no matter if you are 20 or 70. But I will devote this space to those of us who, in the words of Dylan Thomas, will “not go gentle into that good night.”

Certainly you must eat well to have any hope of being the best you can be.  Of course you must engage in exercise centered on strength training to give you the boost and ability to live a full life.  But there is one more dynamic of positive aging that you must buy into to make your senior years full and rewarding.

A key ingredient is committing to a purpose or a cause that forces you outside of your personal universe.  Find meaning in your life beyond your family and your home projects.  To be the best possible version of you, step out of your comfort zone and contribute to the broader community.  Opportunities abound. Work with a church group; volunteer in a meaningful way with one of the many fine non-profit organizations in our community.  Expend yourself and expand yourself.  The community will benefit, but even more important, you will be the better for it.

Here is your resolution then: commit to a life of positive aging that includes contributing your time, energy, and talents to a worthy cause.

Expand your personal universe by making aging a positive process.  Eat well, exercise enthusiastically, and become engaged in the community.  Everything else will fall into place.

Bicep Curls

Neil Short demonstrates this good starter exercise which can be done with weighted objects found around your house – like two filled water bottles. Find more exercises and strength-training tips at Never start any exercise program without first consulting your healthcare provider.


neil short mugNeil Short, 66, of Casper, is a certified strength and conditioning specialist and a USA Weightlifting Level 1 certified coach. As he approached age 60, he sought to discover why some seniors recover from health problems, but others do not, and  why some people power into their senior years while others allow aging to become a form of disability.  The answer became very clear: strength training.

He is the creator of “Be Strong Be Free,” a home-based strength-training program to help you stay active into your 80s and 90s. Learn more at His “Strength in Numbers” column appears monthly on The Pulse.



New car seat inspection starting January 2014

On a windy Saturday in January, Safe Kids Central Wyoming held the first free car seat inspection at the new location – White’s Mountain Motors on East Yellowstone Highway. Moving the car seat inspections to White’s Mountain Motors is in alignment with our General Motors sponsor. General Motors has been a national sponsor for Safe Kids USA for over 16 years. The Buckle Up program has grown into the most comprehensive child passenger safety program in the nation. Measurement of the program is lives saved and injuries prevented. Since this program was started the number of deaths has been cut by a third, and the number of injuries have been cut in half today.
Even with the wind howling outside the service area, 10 vehicles showed up for the volunteer child passenger safety technicians to inspect 12 car seats to ensure they were installed correctly. Three car seats/booster seats were changed out to provide the correct equipment to the children that attended the event.

Child Passenger Safety technicians checking a car seat for a parent and child.
Child Passenger Safety technicians checking a car seat for a parent and child.

Safe Kids was very fortunate to have White’s Mountain Motors donate the removal of the old Safe Kids van graphics, along with purchasing and installing the new graphics. The graphics are the new Safe Kids Worldwide logos and decons.

The new van graphics displayed in front of White’s Mountain Motors on Sat. Jan. 11. Nice bright colors, shapes and new logos are apparent.
The new van graphics displayed in front of White’s Mountain Motors on Sat. Jan. 11. Nice bright colors, shapes and new logos are apparent.

Free Car Seat Inspections

Safe kids holds free car seat inspections on the second Saturday of each month from 10 a.m. to noon at Whites Mountain Motors, 2400 E Yellowstone Highway in Casper.

Healthy Snack: Cranberry Compote

Cranberry CompoteRecipe submitted by Ann Davin,RN, BSN, Certified Diabetes Educator

Preparation tip: The compote can be made a week ahead with no loss of flavor or freshness and depending on how you choose to serve it, it’s a healthy option for the New Year.

Delicious warm, cold or at room temperature serve with meat, poultry, pancakes, cottage cheese or yogurt; as an appetizer, condiment, dessert or between-meal snack.

Servings: 20


2/3 cup            water
3/4 cup            sugar substitute (Truvia etc.)
3                      medium or large firm, ripe pears, peeled and cut into ½ -inch pieces
12                    dried apricots, each cut into 6 pieces
1                      cinnamon stick
2                      seedless oranges, peeled, sectioned, and cut into ½ -inch pieces
6 cups              (2-12-ounce bag) cranberries
¼ teaspoon      nutmeg


  1. In a large saucepan, bring the water and sugar to a boil, stirring the mixture occasionally.
  2. Stir in the pears and apricots, reduce the heat, and simmer the fruit in the uncovered pan for 5 minutes. Add cinnamon stick.
  3. Stir in the oranges, and continue simmering the fruit in the uncovered pan for 2 minutes.
  4. Stir in the cranberries, and cook them over medium heat in the uncovered pan for 5 minutes, stirring the compote occasionally.

Per serving:
Calories 74, Fat >1 g, Carbohydrate 18 g, Sodium 2 mg, Potassium 304 mg
Recipe adapted from Jane Brody’s Good Food Gourmet cookbook

New Years Celebration Appetizer: Jean Eppler’s Cranberries Gone Wild Dip

Cranberry dipHere’s a wonderful, unusual dip recipe.  It has the tartness of cranberries, with the zest of jalapeno and cilantro.  It’s an amazing surprise on the appetizer table.  I replaced the 1.5 cups sugar with about 3/4 cup sugar substitute.  I skipped the cream cheese, which lowered the calories considerably. Try it on celery!

Time: 15 minutes prep + 4 hours refrigeration


12 ounce package fresh cranberries
1 bunch green onions, chopped
1/4 cup cilantro, chopped
1 small jalapeno pepper
1  ¼  cup sugar
¼ heaping teaspoon cumin
2 tablespoons fresh lime juice
Dash kosher salt
2, 8-ounce packages whipped cream cheese (use a mixer to whip the cheese just before serving)
Chips (or veggies such as celery)


  1. 005Chop cranberries in a food processor.
  2. Cut up your green onion, cilantro and jalapeno pepper into small pieces.
  3. Mix all ingredients (except cream cheese and chips) in a bowl, cover and store in the fridge for at least four hours. The sugar needs some time to soak into the cranberries and break up their bitter taste.
  4. When you are ready to serve, spread cream cheese on a platter.
  5. Pour cranberry mixture over the cream cheese.
  6. Serve with chips, celery or your favorite dippable ingredients.

Per serving (1 tablespoon on 4 chips):
Calories 47, Fat 2 g, Carbohydrate 6 g, Potassium 63 mg

Recipe adapted from Jean Eppler of Fargo, N.D.

Mary TvedtMary Tvedt is a certified diabetes educator and has managed the Diabetes Care Center at Wyoming Medical Center for the past seven years. She has a bachelor’s degree in foods and human nutrition with a minor in child development and family science from North Dakota State University. If you have concerns about diabetes talk to your doctor. To learn more about services at the Diabetes Care Center, call (307) 577-2592. 

Holiday Appetizer: Party Shrimp with Cilantro Dip

The pulse Dec 2013 075

This appetizer is a healthy choice to add a little spice to your holiday celebration. The leftover cilantro dip also goes well with your eggs for breakfast the next morning.

Party Shrimp with Cilantro Dip      

Makes: 16
Serving Size: About 4 shrimp, 1 tablespoon dip
Preparation Time: 20 minutes
Cooking Time: 5 minutes


Cilantro Dip

6                                  garlic cloves, mincedThe pulse Dec 2013 051
3/4       cup                  minced cilantro
1/2       small               green bell pepper, seeded, cored, and diced (about 1/2 cup)
1          teaspoon         ground cumin
1/4       teaspoon         kosher salt
1/4       teaspoon         red pepper flakes
3          tablespoons     red wine vinegar
1/3       cup                  olive oil


The pulse Dec 2013 056

2          pounds              peeled and deveined fresh shrimp, tails on
1          tablespoon      ground cumin
1          tablespoon      sweet paprika
1 1/2    teaspoons        ground coriander
1/2       teaspoon         garlic powder
1/2       teaspoon         hot or mild chili powder
1/2       teaspoon         cayenne pepper
1/4       teaspoon         kosher salt
1/4       teaspoon         ground black pepper
2          tablespoons     vegetable oil


  1. The pulse Dec 2013 052In a small food processor, mix the garlic, cilantro, green pepper, cumin, salt and red pepper flakes, pausing to scrape the sides. Add the vinegar and oil, and puree until smooth. Spoon the dip into a small serving bowl; set aside (chill in the refrigerator if not serving right away).
  2. In a large bowl, combine the shrimp, cumin, paprika, coriander, garlic powder, chili powder, cayenne pepper, salt and black pepper.
  3. In a large skillet or wok, heat the oil over medium-high heat. Add the shrimp and sauté for 5 to 8 minutes, until the shrimp turn pink and are no longer translucent. If you need to cook the shrimp in two batches, cook them for about 3 to 5 minutes per batch, until the shrimp are pink. Add the shrimp to a serving bowl.
  4. To serve: Spoon 1 Tablespoon dip into each of 16 shot glasses, and place three or four shrimp around the lip of the glass.

Per serving: Calories 120, Fat 7 g (Sat. Fat 0.9 g), Carbohydrate 1 g (Fiber 0 g, Sugars 0 g), Cholesterol 90 mg, Sodium 205 mg, Potassium 150 mg, Protein 13 g, Phosphorus 130 mg Exchanges: Lean Meat 2, Fat 0.5

Recipe adapted from Diabetes Forecast

Mary TvedtMary Tvedt is a certified diabetes educator and has managed the Diabetes Care Center at Wyoming Medical Center for the past seven years. She has a bachelor’s degree in foods and human nutrition with a minor in child development and family science from North Dakota State University. If you have concerns about diabetes talk to your doctor. To learn more about services at the Diabetes Care Center, call (307) 577-2592. 

Survive. Don’t Drive: In case of a heart attack, dial 911

Dr. Adrian Fluture reminds people to call 911 at the first signs of a heart attack. WMC doctors and staff can administer the best and fastest treatment when patients trust our EMS system, rather than driving to the hospitals themselves. (Photo by Dan Cepeda Photography)

It seems like common sense: At the first signs of heart attack, call 911. Do not lie down to see if the symptoms pass. Do not ask a friend or loved one to drive you to the hospital. Above all else, don’t think you can drive to the hospital yourself.

Americans wait an average of 2 hours after the first symptoms appear before deciding to do something about them, said cardiologist Dr. Adrian Fluture, Director of Regional Myocardial Infarction Care at Wyoming Medical Center. Only about 60 percent of those patients use EMS services, instead trying to make it to the hospital on their own.  Natrona County’s numbers are even worse. Here, only 30 percent of people who suspect heart attacks call 911.

That can be a deadly decision.

Heart attacks require immediate medical treatment. When a patient calls 911, Wyoming Medical Center shaves an average of 10 to 11 minutes off door-to-balloon time – the time from when a patient arrives at the emergency room to the time a balloon is inflated in the blocked vessel. The shorter the time, the more heart tissue doctors can save.

“Data shows that of the people who die from (heart) rhythm disturbances, most of them die within the first one hour of onset. Rhythm disturbances can be so bad that it can kill you within a couple or three minutes,” Fluture said. “You need to trust the system. Dial 911. Every minute a person delays medical treatment increases the likelihood of damage or even death.”

At the first signs of heart attack, call 911. Never drive yourself to the hospital or have someone else drive you.  Here are three reasons why:

1.       You may crash your car.

If you suffer a heart rhythm disturbance on the drive, you will likely crash. Worse, you may crash into another car or run over pedestrians.

“The thing I tell my patients is they may kill a mom with kids coming from school. Just be responsible,” Fluture said. “These are unpredictable things. You cannot say, ‘I just have a chest pain. I know I’m going to be fine until I reach the hospital.’ You can never guarantee that.”

2.       Cardiac resuscitation requires a team effort.

Even if a loved one is trained in cardiac resuscitation, one person is not enough. He needs help to arrive as quickly as possible, and calling 911 is the fastest way to get it. If a loved one decides to drive you to the hospital and you go into cardiac arrest, he can’t do anything for you while he’s behind the wheel.

Ambulances are mobile emergency medical clinics. When paramedics reach you, they can treat low blood pressure, administer IVs and aspirin, remove clothing and prep you for immediate admission to the hospital. If you go into cardiac arrest, paramedics are trained with defibrillators and can resuscitate you – at home or en route to the hospital. Casper Fire/EMS crews, which may arrive on emergency scenes before anyone else, also carry and are trained on defibrillators.

“The earlier you get these things done, the higher the chance the patient will survive if heart rhythm disturbance happens,” Fluture said.

3.       Time means muscle.

Treatment is started more quickly for patients who call 911. That means less chance for damage to heart tissue.

Natrona County’s fire crews and WMC’s ambulance crews have all been trained to start the first phase of treatment in suspected heart attacks. Upon arriving on scene, they will perform an EKG and send the results to the hospital right then. Hospital doctors will read the results and, if you are indeed suffering a heart attack, will prepare the Cath Lab team and forward the results to the cardiologist’s personal cell phone. The cardiologist can respond to the hospital while you are en route.

“Everything that we need to do at the hospital is already prepared when the patient is rolling in by ambulance. The whole time to treatment will be much shorter,” Fluture said.

Our heart program is among the best in the country, but you have to trust the medical professionals to take care of you. The American Heart Association’s Mission: Lifeline protocol recommends a 90 minute door-to-balloon time. Wyoming Medical Center averages 41 minutes, putting us in the top 90th percentile of American hospitals. But we can only save patients and provide the best outcomes when they get to us as quickly and as safely as possible.

 Heart attack symptoms: ‘From belt to teeth’

Warning signs of a heart attack can be hard to identify. They may start slowly, presenting as mild pain and discomfort, and may develop over days or weeks. They can feel similar to symptoms of other ailments, including heart burn, making them easy to discount.

Dr. Fluture recommends that you carefully weigh any pain or discomfort from “from belt to teeth” if you think you might be suffering a heart attack. Play it safe. If there is any doubt, call 911.

The more of the following symptoms present, the greater the likelihood of heart attack:

* Any pain, tightness, heaviness, pressure or squeezing in the chest. It may even feel like heart burn or a generalized apprehension or uncomfortable feeling.

* Pressure or pain spreading to the neck, jaw, left shoulder or both shoulders. You may feel tingling or numbness in the left arm and forearm, spreading to the inside of the arm. It may migrate to between the shoulder blades or, occasionally, to the back or spine.

* Feelings of fullness, pain or indigestion in the stomach.

* Shortness of breath or cold sweating with no good explanation.

adrian fluture

Dr. Adrian Fluture specializes in cardiology, interventional cardiology and vascular/endovascular medicine at Wyoming Cardiopulmonary, 1230 E. First St. in Casper. 

He is board certified in internal medicine, cardiovascular disease, interventional cardiology, nuclear cardiology, echocardiography and vascular medicine; and CT Angiography. He is also Director of Regional Myocardial Infarction Care at Wyoming Medical Center. For more information or referrals, call (307) 266-3174. 



Flu season is here: H1N1 nothing to sneeze at, but not out of the ordinary

Swine Influenca (H1N1) Virus

Wyoming Medical Center has seen a few cases of the dreaded H1N1 influenza virus this month, but it’s nothing to get excited about, said Dr. Mark Dowell, medical director of infection control at WMC.

H1N1 (also called swine flu) got a lot of media attention in 2009 because it hadn’t been seen in United States for many years and, as a result, the population was more susceptible. Young adults, who typically fend off most flus, fell ill. It caused more than 100 deaths in non-immunized pregnant women. Ever since, H1N1 has been one of three strains included in the influenza vaccine.

“H1N1 is just one of the many influenza viruses that are circulating right now internationally. It is no different really than most of the other strains of flu that go around every year,” said Dowell, who is also the Natrona County Health Officer. “It just is a little more aggressive in some people and it has hung around longer year to year than other strains. And it really doesn’t do too well in pregnant women.

“But it’s not a superstrain of virus. It’s another strain of virus.”

Flu cases at Wyoming Medical Center are still fairly sporadic, but they signal the start of Natrona County’s flu season. Cases will likely peak in 4 to 6 weeks, before tapering off again, Dowell said. If the season follows the typical pattern, cases will straggle in through March or April.

Here’s what you need to know to get ready for the worst season of the year – flu season:

Is it a cold or the flu?

Influenza, including H1N1, will make you sicker than you normally get. It sometimes presents with a cough but more usually with a 100-degree-or-so fever, headache  and tremendous muscle and joint pain. A stuffed-up nose is typically not a sign of the flu.

“You will often say, ‘This is as sick as I’ve ever been in my life,’” Dowell said. “I have had influenza as a teenager, and believe me, you will not forget it.”

Is it serious?

It can be. About 36,000 people a year die in this country from influenza. It is typically most dangerous to the very young, the very old or people with weakened immune systems – people with heart or kidney disease or cancers, for example. Complications can include flu pneumonia or developing bacterial pneumonia on top of your flu.

But, in most healthy people, the flu can be fought off at home.

“We don’t want to put patients with influenza in the hospital if we can help it because it tends to spread by droplet. The majority of people never get hospitalized for influenza. The treatment works if you start it early when you recognize the disease, otherwise it does nothing,” Dowell said. “The complications that occur usually mainly occur in those that are least healthy.”

How can I prevent it?

Get the vaccination, plain and simple. The CDC recommends that everyone six months and older get a flu shot, particularly people who are very young or very old or who may suffer from other chronic illnesses. Pregnant women should also get it since they have two lives at stake.

H1N1 can still seem like a big, bad monster because it’s been around for just a few years. “And since, a lot of times, only 30 to 50 percent of the population gets immunized , there is a whole population that is still susceptible. Because of that, it spreads,” Dowell said.

In the elderly, the flu shot may protect 50 percent of the time. But 50 percent is 50 percent, Dowell said. If you’re not willing to get the shot, be diligent about washing your hands and using hand gel. Use common sense. Flu is spread through fluids, so avoid fluids secreted by infected people.

But I’ve heard the shot will give me the flu?

The flu shot uses a dead virus. It cannot infect you. Symptoms you might experience afterward are caused by your immune response and only about 7 percent of people even get a fever from the shot, Dowell said.  The nasal vaccine does contain a live virus, so only choose this option if you have a fairly good immune system.

“Here at Wyoming Medical Center, we have more than 99 percent of our employees immunized against flu. We do not want our employees bringing influenza into our sick patients,” Dowell said. “We have done this for several years. We are very proud of it, and our employees just go for it.”

Ok, I’m convinced. But do I still have time to get the shot and be protected?

Yes. Get it now.

The shot lasts four to six months but is strongest after two to four weeks. So, you will likely be protected when the Natrona County season peaks in the next month or so.

As a general rule, people in Wyoming should not get their flu shots any earlier than October or November, despite the signs in supermarket parking lots. Our flu seasons typically come later than other parts of the country. Talk to your health provider.


Dr. Mark Dowell is an infectious diseases physician at Wyoming Medical Center and the Natrona County Health Officer.

Dr. Mark Dowell is an infectious disease specialist with Wyoming Medical Center and Rocky Mountain Infectious Diseases, 1450 E. A St. He is also the Natrona County health officer and is board certified in infectious disease and internal medicine. Reach his office at (307) 234-8700.

Couple, married 36 years, renews vows at Wyoming Medical Center

Bob and Marie Richter hold onto one another after renewing their vows on their 36th wedding anniversary Tuesday at Wyoming Medical Center in Casper. Bob has battled esophageal cancer since June, enduring two major surgeries, chemotherapy and radiation, and a tracheotomy, and will soon undergo another major surgery which will restore his ability to speak. ‘Stay close. Love them all you can,’ Marie says. ‘You don’t know when it will be last, and I’m not ready for last.’ (Casper Star-Tribune photo by Ryan Dorgan)

If you do nothing else today, take the time to read this story from Casper Star-Tribune reporter Patrick Simonaitis. “Through sickness and health” tells about Thermopolis couple Marie and Bob Richter who have been driving to Casper weekly since June in a fight against Bob’s esophageal cancer. Tuesday, the couple renewed their vows in Bob’s hospital room at Wyoming Medical Center.

“We’ve had a great 36 years. We’re going to have 36 more,” Richter told the Star-Tribune.

The Richters have stayed at the Masterson Place since the summer, driving home to Thermopolis on weekends. The Pulse first met Marie just before Thanksgiving when she attended a potluck for guests of Masterson Place — a home away from home for out-of-town patients of Wyoming Medical Center and Rocky Mountain Oncology.

“Each week, they give us the same room. It feels like we’ve come home whenever we get here,” Marie told us then.

Last week, though, Bob took  a turn for the worse. Doctors didn’t expect him to make it, but he hung on for another day and then another. Marie decided to surprise her husband with the renewal ceremony on Tuesday night, the couple’s 36th wedding anniversary, according to the Star-Tribune.

“I felt this was the best anniversary to repeat our vows because I didn’t know if I’d get to keep him or not,” Richter told the paper.

The whole story is worth a read, especially now with less than a week until Christmas.

For more

* Read the entire Star-Tribune article, “Through sickness and health: During a battle for life, a couple renews vows.”

* Read how the Masterson Place becomes a home away from home for many out-of-town patients in “The Turkey Chef: How cancer helped Casper man rediscover the joy of food.”  

About the Masterson Place

The Masterson Place serves thousands of patients every year. At a cost of $40 per night with both short- and long-term rooms, it is a comfortable refuge for those who need it most. Each room has a small eating area, microwave and refrigerator. Through contributions, the Wyoming Medical Center Foundation continues to make significant upgrades to the Masterson Place each year. For reservations or more information, contact the Masterson Place at (307) 237-5933 or visit our website.

To make a donation, contact the Wyoming Medical Center Foundation:

1233 E. Second St.
Casper, WY 82601
(307) 577-2973

Holiday Recipe Makeover: Coconut Macaroons

What fun is a hcoconut-macaroonsoliday party without a little something sweet? With just 21 calories per serving, this recipe for coconut macaroons means you don’t have to skip the family cookie exchange.

I modified my mother’s macaroon recipe for this lighter fare.

Remember, the trick to sticking to a healthier eating plan during the holidays is not to avoid your favorite foods. The key is to enjoy them in moderation.

Coconut Macaroons

4 large egg whites
½ tsp. cream of tartar
¼ tsp. salt
1 c. sugar
¾ c. flaked sweetened coconut

1. Preheat oven to 300 degrees.
2. In a large bowl, beat eggs, cream of tartar and salt with a mixer at high speed until soft peaks form.
3. Add sugar one tablespoon at a time, beating until stiff peaks form.
4. Fold in coconut.
5. Cover baking sheets with parchment paper. Drop coconut mixture by level tablespoons onto baking sheets.
6. Bake for 40 minutes or until dry. Cool on pans on wire racks.

Add Some Zing!
Melt 4 ounces (115 grams) of semi-sweet or bittersweet chocolate with ½-tsp. shortening in the microwave. Let it cool a little and then dip the bottom of your macaroons. Refrigerate for 15 to 30 minutes to let the chocolate harden. This adds 10 calories, 1 gram of fat and 2 carbohydrates to each macaroon.

Makes 54 cookies.

Nutritional information (per cookie): 21 calories, 0 g fat, 0 g protein, 4 g carbohydrates, 17 mg sodium, 0 g fiber

See the below instructional video on how to make these cookies, featuring me and my daughter, Mandy.

Mary TvedtMary Tvedt is a certified diabetes educator and has managed the Diabetes Care Center at Wyoming Medical Center for the past seven years. She has a bachelor’s degree in foods and human nutrition with a minor in child development and family science from North Dakota State University. If you have concerns about diabetes talk to your doctor. To learn more about services at the Diabetes Care Center, call (307) 577-2592. 

Decoding diabetes: 11 easy snack ideas with 200 calories or less


If you are living with diabetes or have been diagnosed with prediabetes, you’ve likely heard about the virtues of healthful eating and maintaining a healthy weight.

It’s often easier said than done.

Healthful eating takes planning and a well thought out grocery list. It may also mean cutting down – not cutting out – on some of your favorite foods. Don’t deprive yourself.

Aim for three meals and one to two snacks per day. Think of snacks as mini-meals that contribute nutrient-rich foods. You can fit snack calories into your day without over-spending your calorie budget. The Academy of Nutrition and Dietetics offers the following tips to make snacking work for – not against – your healthful eating plan.

  • Choose nutrient-rich foods from the grains, fruit, vegetable, dairy and protein food groups. Snacks can boost your energy between meals and supply essential vitamins.
  • Snack only when you’re hungry. Skip the urge to nibble when you’re bored, frustrated or stressed. Feed the urge to do something by walking the dog or working in the garden.
  • Keep portion control in mind. Have a single-serve container of yogurt or put a small serving of nuts in a bowl. Eating directly from a multiple-serving package can lead to overeating.
  • Plan snacks ahead of time. Keep a variety of nutritious ready-to-eat supplies on hand, such as whole-grain crackers and low-fat cheese.

Keep it interesting with these 11 snack ideas with 200 calories or less. Get creative by swapping out different fruits, vegetables and grains to give yourself even more options.

  1. One tablespoon peanut butter spread on slices of a medium apple
  2. One cup tomato soup with five whole-grain crackers
  3. Three cups air-popped popcorn sprinkled with three tablespoons grated parmesan cheese
  4. Tri-color veggie snack: 6 baby carrots, 10 sugar snap peas (or green pepper strips), 6 cherry tomatoes and 2 tablespoons reduced-fat ranch dressing for dipping
  5. Small baked potato topped with salsa and 1 ounce low-fat cheese
  6. Toaster waffle topped with ½ cup blueberries and 2 tablespoons low-fat yogurt
  7. Six whole-wheat crackers and one slice low-fat Colby cheese
  8. Fruit smoothie: Blend 1 cup fat-free milk, ½ cup frozen strawberries and ½ a banana
  9.  One 6-inch fl our tortilla with ¼ cup black beans and 2 tablespoons fresh salsa
  10.  Quick-to-fix salad: 2 cups mixed greens with ½ cup mandarin oranges, 1 tablespoon sliced almonds and 2 tablespoons reduced-fat dressing
  11. Mini-sandwich: Whole-grain dinner roll with 1 slice deli turkey, 1 slice low-fat cheese and mustard

Mary TvedtMary Tvedt is a certified diabetes educator and has managed the Diabetes Care Center at Wyoming Medical Center for the past seven years. She has a bachelor’s degree in foods and human nutrition with a minor in child development and family science from North Dakota State University. If you have concerns about diabetes talk to your doctor. To learn more about services at the Diabetes Care Center, call (307) 577-2592. 

Decoding Diabetes is a weekly series focusing on education, prevention and tips for living with the disease. Find it on The Pulse each Thursday. Past stories include:

Dec. 7: Seven steps to prevention

Nov. 22: A case for regular screenings

Nov. 14: What you should know for World Diabetes Day