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NATURAL SUPPORT FOR

HIGH CHOLESTEROL HELPFUL ADVICE ON

METABOLIC SYNDROME SPOTLIGHT ON

SALMO & PENTICTON FOOD GROUP BASICS

COMPANY’S COMING RECIPE

PEOPLES DRUG MART • PEOPLES PHARMACY

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People First

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February 2014.

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Features & Cover Articles 4 7 HIGH CHOLESTEROL

Peoples Pharmacist Ian Lloyd discusses the dangers of high cholesterol and offers advice on natural supplement support.

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HEALTHY SAVINGS Great selection of quality health and wellness products from Peoples Pharmacy.

9

5

Natural health products that promote healthy cholesterol levels.

THAI HOT & SOUR SOUP

A look at Salmo and Penticiton, two B.C. communities that Peoples is proud to be a member of.

6

Darlene Booth provides helpful advice on understanding the basics of Canada’s food guide.

15

SPOTLIGHT ON OUR COMMUNITIES

CARDIO SUPPORT

FOOD GROUP BASICS

Brand new feature recipe From Company’s Coming Vegetarian Recipes.

METABOLIC SYNDROME Read about this condition that affects approximately one quarter of all Canadians.

Heart Health 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.

HIGH CHOLESTEROL

Ian Lloyd Peoples Pharmacist

There are many things that you can do to help What is the big deal about cholesterol? It is dislower your cholesterol without leaving your home. cussed on the news, at dinner parties and especially Don't smoke; smoking can lower HDL cholesterol. at your Doctors office. Why is everyone so concerned Getting regular exercise will help you lose weight, about their cholesterol? The answer is simple: high both of these health changes can lower cholesterol. cholesterol is a major risk factor for heart disease. To With approval from your Doctor, try to get at least 30 further complicate matters, there is both good and minutes of physical aerobic activity 5 times a week. bad cholesterol. This month, I shall try and explain all What exactly is physical aerobic about cholesterol and how it activity? An easy way to recogCholesterol plays an imcan effect your health. nize it is that it should raise your There are two main types of portant role in your health. heart rate, make you breathe cholesterol, low-density lipoproYour body uses it to make heavier, but not so much that tein (LDL) and high-density sex hormones, vitamin D, your can't maintain a conversalipoprotein (HDL). The LDL, or and help nerves function tion. This might include brisk bad cholesterol, carries cholesproperly. walking, cycling or ballroom terol throughout your body to dancing. Drink alcohol in modthe cells that need it. Cholesterol eration. This recommendation is a controversial one. plays an important role in your health. Your body Studies have shown that moderate consumption of uses it to make sex hormones, vitamin D, and help alcoholic beverages can reduce the risk of developing nerves function properly. The problem with LDL, is certain diseases. Conversely, too much alcohol can that if you have too much, it just keeps floating raise your risk for developing these same diseases. It around. After a while, these LDL pieces get smaller seems that one drink a day for women and two and are more likely to enter the walls of blood vesdrinks a day for men appears to be optimal. It is unsels. Deposits of bad cholesterol particles are called wise to recommend people start drinking to improve plaques. Eventually, these plaques can build up and their health, because the evidence is not that connarrow the space in blood vessels leading to impaired vincing. So continue to imbibe, in moderation, if it is blood flow. This is referred to as atherosclerosis, which something you already enjoy. is a major risk factor for heart disease.

Your diet can also effect your cholesterol, but not In contrast HDL, or good cholesterol, travels the way you think. The American Heart Association around your body and picks up extra cholesterol. It wrote, “Saturated fats and trans fats are the main dithen takes the extra cholesterol back to the liver for etary factors in raising blood cholesterol.� Saturated disposal. Generally, the more 'good' cholesterol you fats generally come from animal products, palm and have, the less 'bad' cholesterol is present in your coconut oils. Trans fats mainly come from processed arteries.

Continued On Page 11

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Supplements For Cardiovascular Health HealthCheck Cholesterol Test Complete test for detecting elevated blood cholesterol levels in just 3 minutes.

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peoplesdrugmart.com People First 5

METABOLIC SYNDROME A person has metabolic syndrome when they have a combination of 3 or more certain health risks. These health risks include: • high blood pressure • high blood sugar levels • excess body weight • low levels of good cholesterol (HDL) • high levels of triglycerides (a type of fat found in the blood) Each of these factors alone can increase a person's risk of developing diabetes, heart disease, and stroke. However, the risk is much higher when these factors are found in combination.

Approximately one-quarter of Canadians have this condition, although the rate is higher for certain groups of people. For example, people of First Nations and South Asian descent have higher rates of metabolic syndrome than Caucasians.

Other major risk factors that may lead to the development of metabolic syndrome include: • age (the risk of metabolic syndrome increases as you get older) • a family history of type 2 diabetes • other medical conditions including high blood pressure, heart or blood vessel disease, and polycystic ovarian syndrome (a condition where a woman's body produces too much male hormones) Causes Metabolic syndrome is believed to develop due to insulin resistance. Insulin is a hormone that is produced by the pancreas (an organ located near stomach). It helps blood sugar enter cells, where it 6 People First Join us on

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is used for energy. With insulin resistance, the body fails to recognize the insulin that is produced, causing the sugar to accumulate in the blood instead of being absorbed into other cells. Because blood sugar levels remain high, the pancreas keeps producing more and more insulin, leading to high insulin levels. While blood sugar levels are not high enough to be classified as diabetes, they do increase the risk of developing serious health problems.

Scientists are not certain why insulin resistance develops but they believe it may be partly inherited. They do know, however, that being overweight and inactive contributes to the development of metabolic syndrome.

Symptoms and Complications In general, few people have any noticeable signs or symptoms. However, the main characteristics of metabolic syndrome are: • excess body weight (usually around the stomach) • high blood pressure • low level of good cholesterol in the blood • high level of triglycerides (fats) in the blood • resistance to insulin (high blood sugar) Although you may not notice any changes in the way you feel, having metabolic syndrome dramatically increases the risk of serious health problems including diabetes, heart disease, and stroke. In fact, the more health risks you have, the more likely you are to develop these conditions.

Making the Diagnosis In order to diagnose your condition, your doctor Continued On Page 8

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peoplesdrugmart.com People First 7

Metabolic Syndrome...Continued From Page 6

will likely ask about your medical history, perform a physical examination, and analyze your blood.

If you have 3 out of 5 of the following health risks, it is likely that you have metabolic syndrome: • excess body weight (waist circumference greater than 102 cm (40 inches) for men and greater than 88 cm (35 inches) for women • high blood pressure - 130/85 mm Hg or higher • high levels of triglycerides (blood fats) - 1.7 mmol/L or higher • low levels of "good" cholesterol (HDL) - less than 1.03 mmol/L for men and less than 1.29 mmol/L for women •high levels of fasting blood sugar (glucose) 5.6 mmol/L or higher Treatment and Prevention The goal of treating metabolic syndrome is to prevent the development of diabetes, heart disease, and stroke. Your doctor will first suggest lifestyle modifications such as exercising for 30 minutes most days of the week. One study showed that individuals who are physically active (30 minutes of activity at least once per week) have half the risk of developing metabolic syndrome than those who are inactive. Your doctor may also suggest eating a healthy diet to promote weight loss and normal

blood cholesterol and fat levels.

If lifestyle modification alone does not improve your health risks, your doctor may prescribe one or more of the following medications: • weight loss medications (e.g., orlistat*) • insulin sensitizers (e.g., metformin, rosiglitazone) to help lower blood glucose and insulin levels • acetylsalicylic acid (ASA) to reduce risk of heart disease • blood pressure-lowering medications • medications to decrease "bad" cholesterol (LDL) and increase "good" cholesterol (HDL) Leading a healthy lifestyle now can reduce your risk of developing the health risks associated with metabolic syndrome as you get older. Effective prevention includes eating a healthy diet by following Canada's Food Guide and exercising for 150 minutes every week. Seeing your doctor for routine check ups and checking your blood glucose levels, blood pressure, blood cholesterol, and weight will help you monitor your health.

All material © 1996-2014 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

Focus On CoQ10 Supports Cardiovascular Health Coenzyme Q10 (CoQ10) is a naturally occurring compound found throughout all cells in the body. This nutrient is essential for producing the energy that cells require to function effectively. The cells of the heart are particularly abundant in CoQ10 to help satisfy the demand for energy to keep the heart beating and efficiently circulating blood throughout the body.

Research has shown that use of statins (cholesterol-lowering medications) can deplete CoQ10 levels in the body. However, since CoQ10 plays an important role in maintaining normal functioning of the heart, depletion of this nutrient may cause a number of cardiovascular health concerns. Supplementation with CoQ10 in combination with long-term statin therapy can help to prevent depletion of this essential nutrient. Talk to a Peoples Pharmacist about the benefits of CoQ10.

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Spotlight

On Our Communities

Salmo Salmo is a beautiful village situated high in the Selkirk Mountains in the Kootenay region.

Salmo offers a vibrant art community and challenging and fun recreational activities year round.

Salmo has a fascinating gold rush and logging history that is celebrated in their famous stone murals. Logging has continued to flourish over the years and continues today as a mainstay for many Salmo residents.

Photos courtesy PictureBC

1000 was donated to the Salmo Valley Fund. The Salmo Valley Fund's purpose is to promote philanthropic activities in the Salmo community with a goal of building a viable and sustainable endowment. Left to right: Chris Borgstad, Store Manager, Tracey Davies, Pharmacist & Store Owner, Duncan Mackay, Pharmacist & Store Owner, Micheal VanWijk, Committee Member, and Maureen Berk, Salmo Community Services, Executive Director

Penticton Penticton is ideally located in the heart of wine country in the Okanagan Valley, bordered to the north and south by two beautiful fresh water lakes and surrounded mountains. The city has a semi-arid climate and receives more than 2,000 hours of sunshine per year making it ideal for growing almost anything, playing on the more than 20 acres of golden sandy beaches, hiking and biking on trails and skiing fresh powder on blue-bird sunny days in the winter.

Photo courtesy Mellisa Barnes/Tourism Penticton

Photo courtesy PictureBC

Peoples Drug Mart Healthy Communities Fund donated 1000 to the Pathways Addiction Resource Centre (PARC). PARC promotes the well-being of people affected by, or at risk of developing alcohol, drug or related problems in the Penticton area. Left to right: Brent Atkinson, Pharmacist & Store Owner, Jeanni Jones, Pathways Agency Director, Anthony Rage, Pharmacist & Store Owner.

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 HFC is funded by the owner operators of Peoples Drug Mart and from the proceeds of the annual Peoples Drug Mart Golf Event. peoplesdrugmart.com People First

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Going On A Trip?

Peoples has everything; from travel-size essentials to travel vaccinations - find everything you need for a healthy and safe trip.

Travel Vaccination Service Most Peoples locations conveniently administer travel vaccinations on-site.

Medications for Allergy, Stomach Relief, First Aid & Pain Relief A prepared traveller is a safe traveller.

Travel-size Toiletries Bring along your daily essentials.

Join us on facebook and enter our prize draw!

Win A Maybelline, L’Oreal and Fructis prize package www.facebook.com/peoplesdrugmart

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PEOPLES PHARMACISTS

Ian Lloyd...Continued From Page 4

foods, look for the phrase “partially hydrogenated vegetable oils.� Other diet observation studies noted that people who ate more fish, tended to have lower cholesterol and a lower risk of heart disease. At first people thought that it must be the fish oils that are reducing their cholesterol. Taking extra fish oils will not lower your cholesterol; however, they will reduce your body's triglyceride levels. Elevated triglyceride levels are also a risk factor for heart disease. Another theory is that people who ate more fish actually ate less red meat and other animal products. It might not be what you are eating, but what you are not.

Cinnamon is not normally associated with cholesterol reduction. It is more likely that patients will ask about this spice's ability to help improve glycemic status. In one small study, involving 60 people, doses of 6g of cinnamon daily helped reduce LDL cholesterol by 27% and total cholesterol by 26%. Six grams of cinnamon is not that much, it's about one teaspoon. This could easily be sprinkled on cereal or oatmeal in the morning, provided you like the taste of cinnamon. It is important to use the correct kind of cinnamon as there are two main varieties. The type of cinnamon used in this study was Cinnamomum cassia. This spice is generally safe to use, but you should check with your Doctor or Peoples Pharmacist before use. Higher doses of cinnamon can sometimes lower blood sugar and complicate the treatment of diabetes.

Dietary fibre is one of the most overlooked options to help lower cholesterol. One study found that 3.4 g of psyllium taken three times a day lowered LDL by 20%. Fibre works due to its ability to bind to cholesterol in the gut, correct? Not necessarily. There is evidence that the metabolism of fibre may lead to the products, propionate (a short-chain fatty acid) and alpha-tocotrienol (similar to vitamin E), both of which can prevent your body from making its own supply of cholesterol. Taking lots of extra fibre can cause stomach related side effects such as gas, bloating and indigestion. If you wish to increase your intake of fibre, start with small amounts and work your way up from there. Lots of fibre can also interfere with the absorption of certain medications, ask your Peoples Pharmacist for more information.

Plant phytosterols/stanols are also mentioned when people are concerned about their cholesterol.

Helping People Live Better Lives

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 health service.

Paul Sherman

Pharmacist & Partner, Kitimat

New Pharmacy!

We Can Help With Travel Health.

When traveling abroad, plan ahead and talk to a Peoples Pharmacist. We can help with travel vaccinations and recommend medications for stomach troubles and motion sickness. Talk to a Peoples Pharmacist for advice on staying healthy while you travel.

Derek Langer

Pharmacy Manager, Courtenay

We Can Help With The B.C. Smoking Cessation Program.

Free nicotine replacement therapy is available to B.C. residents covered by Pharmacare. For information on how to enroll, talk to a Peoples Pharmacist.

Al Asaria

Pharmacist & Owner, Burnaby

Ian Lloyd...Continued on Page 13

peoplesdrugmart.com People First 11

Earn reward points on almost everything* you buy at Peoples.

It Pays To Shop At Peoples

* Some exceptions apply, please see store for details

Are your medications working effectively for you?

Medication Review Service The Peoples Drug Mart medication review service was created to ensure medication therapy is appropriate and effective for those taking multiple medications. Your Peoples Pharmacist will ensure all your medications are compatible with each other and working optimally.

Medication review includes: • Detailed analysis of all medications (prescription and over-the-counter), vitamins and supplements, to ensure safe and effective use. • In-depth consultation to improve health outcomes by helping resolve any issues that may have arisen due to your medications.

A Peoples Drug Mart medication review provides an opportunity for you to sit down one-on-one with your Peoples Pharmacist to help identify and resolve common medication-related issues, so you can get the most benefit from your medication. This medication review can help you better understand your medication therapy, and ensure that medications are being taken as prescribed.

Speak to a Peoples Pharmacist about scheduling a free medication review.

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Ian Lloyd...Continued From Page 11

Phytosterols are a plant product that is chemically similar to cholesterol and is thought to prevent cholesterol absorption. A recent study found that 1.8g/d of esterified plant sterols/stanols helped reduce bad cholesterol by 9.2% and total cholesterol by 7.4%.

Other articles have noted a 10-11% reduction in bad cholesterol levels. Both Health Canada and the US FDA permit food product labeling to reflect this plant sterols ability to reduce cholesterol and subsequent risk of cardiovascular disease. Side effects are minor and stomach related. No significant drug interactions have been noted.

Garlic comes to the forefront whenever high cholesterol is mentioned. There is a bit of controversy concerning garlic’s ability to reduce cholesterol.

Some studies have shown its effectiveness in lowering cholesterol (sometimes as much as 20%), while others have shown no benefit. One important study, which appeared in the Annals of Internal Medicine, found that garlic lowered total serum cholesterol levels by about 9%. The equivalent dose used was ½ to 1 clove (2-4gm) of garlic per day. At these doses stomach upset and odour can be a problem. If you are taking medications to thin the blood, like warfarin or higher doses of aspirin, garlic may make your blood too thin. Check with your Peoples Pharmacist if garlic supplements are right for you.

This is certainly a lot to digest, but there are many natural options to help reduce cholesterol. Many of these suggestions can be incorporated in one’s lifestyle, without even purchasing a supplement; increasing fibre intake, adding cinnamon, getting regular exercise and avoiding 'convenience' foods. Many convenience products have little nutritional value anyways; think about having an apple instead. Don’t be fooled by the ‘low-fat’ food phenomenon, which I feel can be a real problem. In many cases, these products are lower in fat but they have similar amounts of calories as their regular fat counterparts.

Most of the fat calories are often replaced with sugar; high-fructose corn syrup and/or sucrose (50% fructose) to be exact. So you may not be any better off.

So watch those labels, but better yet avoid processed foods. Your heart will thank you for it.

Written By Ian Lloyd, Pharmacist & Chartered Herbalist, Peoples Pharmacy

PEOPLES PHARMACISTS Helping People Live Better Lives

We Can Help With Environmentally Safe Medication Disposal.

By bringing your expired medications to Peoples for environmentally responsible disposal, you are removing the risk of accidental poisonings, potential abuse, resulting from keeping unused and expired pharmaceuticals in the home.

Jessica Phillips

Pharmacist, Campbell River

We Can Help With Medication Compounding.

Medication compounding allows pharmacists to create custom medications to suit your specific health needs. Talk to a Peoples Pharmacist about medication compounding.

Mario Bruno Bossio

Pharmacy Manager, Victoria

We Can Help With Medication Reviews.

Medication reviews are in-depth consultations that improve health outcomes by helping resolve common medication related issues.

If you are on multiple medications, a medication review can help you get the most benefit from your medication therapy.

Anthony Rage

Pharmacist & Owner, Penticton

peoplesdrugmart.com People First 13

Darlene Booth

FOOD GROUP BASICS

R.H.N B.S.W.

We keep hearing that optimal health is best supported by a ing whole grains rather than overly processed or refined grains balanced diet, but defining what a balanced diet is can be ex- has been shown to lower risk of many degenerative conditions. tremely confusing. One diet does not fit for all people and for My personal caution with grains is that they are concentrated each book professing what constitutes a healthy diet, there is an- calorie sources and one should become familiar with serving other philosophy that seems to directly contradict it. One com- sizes in regard to personal energy needs. Gluten free grains are mon factor that most healthy eating plans can agree on is that we another choice that some people find beneficial as well. need a wide variety of wholesome, high quality foods to truly Milk and milk alternatives supply calcium and vitamin D for flourish. Whether you are vegan, paleo, vegetarian, fruitarian, strong bones. If you do not get along with lactose and casein there raw foodist or a gold medal meat and potatoes kind of aficionado, are wonderful dairy alternatives available in most supermarkets an understanding of the basic food these days. You can choose from great tastgroups from a healthy perspective can ing rice, almond, soy or coconut beverages, help you reach your dietary goals.

Fruits and vegetables are alternative cheese products and frozen Canada’s Food Guide (CFG) defines dessert products. If they are not fortified, some of Mother Nature’s you may want to get your calcium and vita4 major food group categories that make up the basis of a healthy diet. best medicine when it min D in supplement form. The CFG recThese are: fruits and vegetables, grain ommends 2-4 servings daily for children, comes to preventing products, milk and alternatives and 3-4 servings for teens and 2-3 servings for meat and alternatives. Oils and fats are adults. Choose low fat dairy products if you disease. recommended in limited amounts and are watching calories. Cultured milk prodanything that lives outside the four ucts like yogurt and kefir also supply main groups should used sparingly in a healthy regimen. (Yes beneficial probiotics, which support digestive and immune funcit is true that chocolate has been recently deemed a health food tions. but it should not form the mainstay of our menu planning). Our Meat and alternatives provide our protein, which is a building needs from each group will vary with age, activity levels block for pretty much every cell in our body. Proteins are involved and individual/cultural relationships to specific foods. in our immune system, enzymes, hormones, bloodstream and Fruits and vegetables are some of Mother Nature’s best med- building strong tissues. Get your protein from lean meats, fish, icine when it comes to preventing disease. They are full of vita- poultry, eggs, beans, legumes, nuts, seeds and tofu products. Almins, minerals and fibre; they are also relatively low in calories. ways choose the least processed sources you can find. The CFG The CFG recommends 4-6 servings daily for children and 7-10 recommends 1-2 servings daily for children and 2-3 servings for servings for teens and adults. The best way to advantage pro- teens and adults and 2 servings per week should be fish. duce is to try to eat a rainbow; this means to vary your fruit Canada’s Food Guide is a pretty good starting off point for choices often and fill your plate with a few colourful vegetables everyone who wants to familiarize with the food groups and adopt each meal. I prefer seasonal fresh produce when available but a healthy balanced diet. Keep in mind that we live in a world frozen or canned can be convenient and healthy alternatives if where portion distortion has supersized our concept of serving they are not overly processed with salt, fat or sugar. Be adven- sizes. At first glance at the CFG, one might think that 6 servings turous with your vegetables and try something new each week. of grains is excessive but if you understand that a serving of cooked This helps to ensure we don’t get stuck in the same trace pasta is only 1/2 cup, you will begin to see how easy it is to meet nutrient rut all the time. this quota. We also need to listen closely to our own body and let Grain products come in many wholesome forms such as it guide us to our own optimal diet. To learn more, get your free whole wheat, quinoa, brown rice, oats, rye, spelt, kamut, ama- copy of Canada’s Food Guide by following this link: ranth, corn meal and barley. The CFG recommends 3-6 servings http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/order-comdaily for children and 6-8 servings for teens and adults. Choos- mander/index-eng.php. Good Health to You!

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Thai Hot & Sour Soup A pleasing light soup with plenty of vegetables and a nice chili heat. Cut veggies on an angle for a pretty look. Substitute fresh shiitake and oyster mushrooms for the brown mushrooms for a slightly different taste.

Cooking oil 2 tsp.

Sliced fresh brown 4 cups (or white) mushrooms Garlic clove, minced 1 (or 1/4 tsp., 1 mL, powder) Prepared vegetable broth 6 cups Thinly sliced carrot 1 cup Thinly sliced celery 1 cup Finely chopped fresh hot chili pepper 1 tsp. (see Tip below) Finely grated ginger root 1 tbsp. (or 3/4 tsp., 4 mL, ground ginger) Lemon grass paste 1 tbsp. (or 1 tbsp., 15 mL finely chopped lemon grass bulb) Snow peas, trimmed and halved 1 cup Package of firm tofu 1/2 (12.75 oz., 350 g), cut into 1/2 inch (12 mm) pieces Lime juice 3 tbsp.

Cornstarch 2 tbsp.

Soy sauce 2 tbsp.

Granulated sugar 1 tbsp.

Sliced green onion 1/4 cup Chopped fresh basil 2 tbsp.

Thai Hot & Sour Soup

10 mL 1L 1 1.5 L 250 mL 250 mL 5 mL 15 mL 15 mL 250 mL 1/2 45 mL 30 mL 30 mL 15 mL 60 mL 30 mL

Heat cooking oil in large saucepan or Dutch oven on medium. Add mushrooms and garlic. Cook for about 10 minutes, stirring occasionally, until mushrooms are browned. Add next 6 ingredients. Bring to a boil. Reduce heat to medium-low. Simmer, covered, for about 5 minutes, stirring occasionally, until vegetables are tender-crisp. Add snow peas and tofu. Bring to a boil.

Stir next 4 ingredients in small bowl until smooth. Add to vegetable mixture. Heat and stir for about 1 minute until boiling and thickened.

Sprinkle green onion and basil on individual servings. Makes about 9 1/4 cups (2.3 L).

1 cup (250 mL): 80 Calories; 3 g Total Fat (0.5 g Mono, 0 g Poly, 0 g Sat); 0 mg Cholesterol; 10 g Carbohydrate; trace Fibre; 4 g Protein; 630 mg Sodium TIP: Hot peppers contain capsaicin in the seeds and ribs. Removing the seeds and ribs will reduce the heat. Wear rubber gloves when handling hot peppers and avoid touching your eyes.

Wash your hands well afterwards.

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Reprinted from Vegetarian Recipes© Company's Coming Publishing Limited

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