Thanksgiving brings warm memories of loved ones sitting around the dining room table. Gratitude and happiness are rich in the air as plates are filled with seasonal favorites. While health may not be at top of mind during a meal that is often considered indulgent, there are several superfoods that are true Thanksgiving classics. While the focus may be on the big meal, it’s still important to nourish your body throughout the day. Many people try to “save” calories for a holiday meal, which can decrease energy, negatively impact blood sugar, and increase the risk of overeating later. Why not start the morning with a satisfying whole grain option? Nothing But the Truth Overnight Oats & Chia is a new brand from Hy-Vee that’s a great superfood start to your day! With 6 grams of fiber and 5 grams of protein per serving, enjoy either mixed berry or chocolate varieties. Pair your oats with a coffee that’s infused with superfoods like Lion's Mane mushrooms to support focus, energy, and gut health. Four Sigmatic is a unique brand of organic Arabica coffee infused with functional mushrooms & adaptogens. With breakfast covered, read on to find out which foods to include on this year’s Thanksgiving menu! Cranberries This small, but mighty fruit packs a punch when it comes to nutrition! Cranberries are high in antioxidants, and they can help prevent urinary tract infections (UTIs) by keeping bacteria from sticking to the urinary tract lining. These berries provide the greatest benefit for UTIs when consumed as unsweetened cranberry juice, though if you’re looking for a fun beverage to serve alongside your Thanksgiving meal, the recipe below for Virgin Cranberry Cream Smash is sure to be a hit! Pairing cranberries with Too Good & Co. Coffee Creamer makes for a delicious combination, and you will feel good knowing you’re getting 40% less sugar than the leading coffee creamers. The clean label offers no artificial sweeteners, flavors, gums, oils or preservatives. Brussels Sprouts Similar to cranberries, don’t let size fool you! Brussels sprouts are also loaded with antioxidants that can protect our cells from damage. Brussels sprouts are full of fiber which can help keep cholesterol levels in check. Thanks to their spike in popularity over the past several years, there are many delicious recipes available if you’re looking for inspiration. For an easy side dish, look no further than Air-Fried Brussels Sprouts. In just 20 minutes, these Brussels sprouts will have a crisp, golden-brown outer shell with tender leaves inside. Pick smaller Brussels sprouts and avoid overcooking to prevent bitterness. Sweet Potatoes While a casserole full of brown sugar, butter, and marshmallows may come to mind when you think of sweet potatoes at Thanksgiving, there are so many other ways to prepare this superfood. For a delicious combination of ingredients and just the right amount of sweet, try this Roasted Sweet Potato Salad with Tahini Maple Dressing. Sweet potatoes get their orange color from beta-carotene which the body converts to vitamin A. The body relies on this vitamin for optimal eye health, proper immune function, and healthy skin. Additionally, sweet potatoes are a fiber-rich complex carbohydrate which gets digested slower and helps to stabilize blood sugar. Turnips Turnips are nutrient-dense vegetables that only contain about 35 calories per cup and offer many nutrients, including vitamin C, fiber, potassium, and manganese. This makes it an ideal food for weight management. In addition to the root, turnips contain edible greens. Many people throw away this part of the plant, though there are a lot of benefits to eating them as well! Calcium, folate, and vitamins A, C, and K are just a few of the nutrients hidden inside. For a unique twist on classic mashed potatoes, try Root Vegetable Mashed Potatoes, which are sure to please the crowd! Pecans This Thanksgiving ingredient shines at the dessert table, though pecans can also be used in a variety of salads or as a crust on meat or fish. If sweet sounds the best, for a lighter dessert option, try Apple Pecan Nachos! The medley of fruits tastes great alongside crisp pecans and chocolate drizzle. Pecans offer a good serving of heart-healthy fat, which can help lower bad LDL cholesterol. When eaten in moderation, the combination of healthy fats, fiber, and protein helps to promote satiety and reduce cravings. Equally nutritious and delicious, it’s easy to see that these superfoods certainly do have a seat at the Thanksgiving table! Of course, it’s important to note that nourishing your body is all about balance. You will have some days and meals that are more decadent, and that’s OK! Enjoy time with the people you love and savor those family recipes that have been passed down for generations. Consider throwing one new recipe into the mix this year, and maybe it will become a new tradition. If you’re looking for more ways to incorporate these fall superfoods into your diet or have other nutrition questions, schedule a complimentary Discovery Session today by contacting our Discovery Call Center via email [email protected] or calling (515) 695-3121. Your local Hy-Vee Registered Dietitian is excited to help create a nutrition plan that works for you. Virgin Cranberry Cream Smash Here’s a sweet and tart non-alcoholic cocktail – perfect for the holiday season Adapted from: https://www.hy-vee.com/discover/recipes/cranberry-coconut-smash Servings: 4 All you need: ½ C fresh cranberries 8 oz sugar-free ginger ale 16 oz Hy-Vee cranberry juice 8 oz Too Good & Co. Coffee Creamer (Sweet Cream, Roasted Vanilla or Lavender) Rosemary sprigs All you do:
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October is full of delicious treats, from Halloween candy and pumpkin-spiced goodies to caramel apples and cozy fall desserts. While it’s absolutely OK to enjoy these festive flavors, too much added sugar can lead to energy crashes, mood swings and overall drowsiness. With a few smart swaps and mindful habits, you can savor the season without overloading on sugar and still feel your best every day. Here are some easy tips to keep added sugars at bay this October. 1. Choose Real Fruit Over Candy: Fruit naturally satisfies sweet cravings and provides vitamins, fiber, and hydration. Mangos are a great option. They’re naturally sweet, packed with more than 20 vitamins and minerals, and makes a delicious, satisfying snack. Try festive fall-inspired ideas like:
To help stabilize blood sugar and stay full longer, pair fruit with a little protein or healthy fat, like nut butter or cheese. 2. Rethink Seasonal Drinks: Fall favorites like pumpkin spice lattes and sweetened ciders are festive, but they can be loaded with added sugars that sneak into your day without you realizing it. Thankfully, there are plenty of ways to enjoy the season’s flavors without overdoing it on sugar. Try these alternatives:
3. Plan Smartly for Candy: Instead of an all-or-nothing approach, help your family enjoy treats mindfully:
With these ideas, sweets remain a treat, not a daily habit. 4. Prepare Balanced Snacks Ahead of Time: Having ready-to-go, lower sugar snacks makes it easier to avoid reaching for candy when hunger strikes. Some favorites include:
5. Stay Hydrated to Curb Sugar Cravings: Sometimes thirst is mistaken for hunger or sugar cravings. Staying well-hydrated helps keep energy levels stable and reduces unnecessary snacking. Try Liquid I.V. Sugar-Free Energy to deliver hydration with essential electrolytes, without any added sugars. It’s an easy, delicious way to stay balanced during the sweetest season of the year. The Key Takeaway: October is a time for celebration and seasonal treats, but with a little planning and smart swaps, you can enjoy the best of fall flavors without the sugar crash. Focus on real foods, hydration and balance to make this month energizing and enjoyable. Contact your Hy-Vee Registered Dietitian by visiting www.hy-vee.com/health. Chili-Lime Spiced Mango Serves 1 All You Need:
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 by Tara Sallee MS, RD, LD Whether you’re hitting the trails for a fall bike ride, sweating on the treadmill, or battling cold and flu season, you may need an extra boost of electrolytes to keep your body in balance. Electrolytes are minerals that help your body work properly. They keep you hydrated, support your nerves and muscles, help control blood pressure, balance pH, and move nutrients where they need to go. Read on to learn more about the different electrolytes, how they keep us going, and when you may benefit from an extra dose! Electrolytes defined and when to get more There are seven main electrolytes, and each of these minerals has a specific role that allows the body to function at its optimal level. Sodium, magnesium, potassium and calcium contain a positive charge while chloride, phosphate and bicarbonate are negatively charged. The body is typically made up of 60 to 70% water, which means electrolytes are present in nearly all fluids and cells. When you are well-hydrated and consuming a balanced diet, your body can regulate electrolyte levels. You need more electrolytes when you sweat a lot or lose fluids due to intense physical activity, hot environmental conditions, or illness. Sodium While sodium is often discussed as a mineral to limit, it plays an important role in rehydration. Sodium regulates fluid balance by supporting water retention and distribution. Additionally, it aids in nerve impulses, muscle contractions and blood pressure control. Sodium is used as a preservative and can be found in most processed foods. Table salt, pickles and broth are just a few dietary sources of sodium. It is also a common ingredient in functional hydration products. Magnesium This important mineral is used for muscle and nerve functioning including maintaining a normal heart rhythm, supporting sleep and aiding proper digestion. Magnesium is used in many reactions that allow our body to turn the food that we eat into energy. If you’re looking to increase your magnesium intake, three great options include pumpkin seeds, chia seeds and quinoa. Potassium Like magnesium, potassium is also key for a proper heart rhythm. Low potassium can lead to cramping, especially in the legs, due to potassium’s ability to support muscle contractions. Bananas are an easy, quick source of this mineral, though potatoes, avocados and spinach all contain even more potassium per serving. Calcium Building strong bones and teeth is one of calcium’s primary roles. As we age, bone mass declines and our body becomes less efficient at absorbing calcium from the food we eat, which is why it’s so important to consume adequate calcium. Similar to the other positively charged electrolytes, calcium also plays a role in muscle contractions and nerve functioning. Dairy foods, including milk, cheese and yogurt all offer a good dose of this mineral. Plant-based milk is often fortified with calcium as well. Chloride Alongside sodium, chloride helps keep fluids balanced throughout the body. It also allows the body to maintain its natural pH level. Table salt is 60% chloride by weight, which means processed foods are high in this mineral. Fish, chicken and seaweed are a few whole foods that provide chloride. Phosphate With calcium, phosphate also helps maintain strong bones and teeth. Additionally, it is critical for proper storage and metabolism of nutrients as well as cell structure. Animal sources of phosphate, such as meat, fish and dairy products are easier for the body to absorb than plant options. This means your body requires more phosphate if you are primarily eating plant-based foods. Nuts, seeds, legumes and whole grains are all good unprocessed, plant phosphate choices. Bicarbonate This final electrolyte works with the lungs and kidneys to achieve pH balance. Some of the carbon dioxide we make is recycled into bicarbonate, which allows the body’s acid-base level to be maintained. Baking soda contains bicarbonate, though most of this nutrient is manufactured and regulated by our body. What if I need more? From mangos to hydration drinks Many nutrient-dense foods are full of electrolytes such as fruits, vegetables, nuts, and grains. In particular, fruits have high water content. Mangos, for example, are 83% water and contain more than 20 vitamins and minerals, making them a perfect hydration boost! Try the mango smoothie recipe below, which is packed with electrolytes. When you need to restore levels quickly, an electrolyte solution product may be the best option. Liquid I.V. utilizes a unique Cellular Transport Technology to enhance rapid absorption of water and other key ingredients into the bloodstream. Their sugar-free varieties are perfect for those looking to minimize added sugar. They’re sweetened with allulose, a natural occurring sugar, and rely on the amino acids L-Alanine and L-Glutamine to enhance water absorption when glucose is not present. Oftentimes when we need an electrolyte boost, we would also benefit from an extra kick of energy. Liquid I.V. just launched their new Sugar-Free Energy Multiplier for just this reason. Two fun flavors (strawberry kiwi and blackberry lemonade) contain natural caffeine and electrolytes. For a delicious, restorative drink in this new Liquid I.V. product line, try the strawberry kiwi pink drink recipe found below! Our body is well-equipped to regulate our electrolyte levels, but when we lose a lot of fluid, we do need to replace what was lost. If you’re looking for help identifying other foods containing electrolytes or knowing when you should consume an electrolyte replacement product, schedule a complimentary Discovery Session today by contacting our Discovery Call Center via email [email protected] or calling (515) 695-3121. Strawberry Kiwi Pink Drinks Skip those long drive-thru lines with our pink drink recipe. We added electrolyte packets and fresh fruit to help hydrate and restore electrolytes. All you need: 32 oz water 1 (13.5-oz) can Hy-Vee unsweetened light coconut milk 2 C strawberries ½ C Hy-Vee no sugar added white grape juice 4 packets Liquid I.V. Strawberry Kiwi Sugar-Free Energy Multiplier 1 C freeze-dried strawberries All you do:
 Photo credit: Hy-Vee Missouri autism specialists say White House assertions on cause, treatment need more researchby Steph Quinn, Missouri Independent David Tomber-Young, 9, of St. Louis, has always been musical and expressive. According to his mom, Lizzy Tomber, he can sing the theme song to his current favorite movie, “K-Pop Demon Hunters,” from memory, including the parts in Korean. And when he watches movies, he has a knack for imitating the actors’ facial expressions. But David, who along with his three younger brothers has been diagnosed with autism, struggles with some aspects of verbal communication, like answering open-ended questions and talking about the past. Tomber said David has had “really huge progress” since he began taking a medication prescribed by his doctor in May: leucovorin. “Before, you would really have to be like, number one or number two, and kind of give him a couple of choices,” Tomber said. “Right now, he’s talking more at school and, I think, talking about what he did last weekend or what he wants to do tomorrow.” Leucovorin was at the center of statements by President Donald Trump and top federal health officials on Sept. 22 about the causes and treatment of autism spectrum disorder. Officials endorsed the use of leucovorin, which is used to treat side effects of chemotherapy, as an autism therapy. They also asserted a link between autism and pregnant mothers’ use of acetaminophen – the active ingredient in the pain and fever reducer Tylenol. Specialists across Missouri urged caution around the claims from the White House last week, advising parents to consult their doctors and underlining the complexity of factors that influence autism. Doctors said that scientific research on Tylenol and autism is inconclusive, while noting the importance of treating maternal fevers and pain. “Your specific health care needs are best addressed with your physician,” said Dr. Benjamin Black, medical director at the Thompson Center for Autism and Neurodevelopment at the University of Missouri. “You want to appropriately treat illnesses and fevers during pregnancy, and whatever that needs to look like in your pregnancy is a discussion to have with your care provider.” Leucovorin is a form of vitamin B9 that limited studies have suggested can boost verbal communication in individuals with autism. The “hypothesis,” said Dr. Gregory Cejas, co-director of the Washington University Autism Clinical Center, is that some people with autism have an autoimmune reaction that prevents the uptake of folate in the brain – and that leucovorin can help. “I think what we don’t know,” Cejas said, “is that a true hypothesis? So we have to test that more. We have to, I think, do bigger studies on those things.” Tomber said that while she thinks leucovorin, along with speech therapy and his teachers’ support, has helped David, it isn’t a “miracle drug.” Two of Tomber’s younger sons, who are mostly nonverbal, tried leucovorin and stopped due to possible side effects. “They’re obviously frustrated that they can’t communicate, that they can’t get their point across,” Tomber said. “If I can give them a tool to do that better, of course I’m going to do it.”
‘We don’t want to put blame on our families’Jenny Shank, of St. Louis, said Trump’s assertions pulled her back to her self-doubt in the early days of her now 17-year-old daughter’s diagnosis with autism. Trump urged pregnant women to endure pain and “fight like hell not to take” Tylenol, except in cases of high fever. “As a woman, I think you go back so many times,” Shank said. “Even though you’re so grateful for your child and you wouldn’t change them, you still go back and you think, ‘Was it this? Was it that?’” Cejas said that as researchers work to learn more about autism, it’s important not to “put blame on our families.” “I think a lot of parents ask me, ‘Is it something that I did?’” Cejas said. “And my usual answer is no, there’s nothing that you did specifically. There is no way to predict anything that you did in your pregnancy or otherwise that led to this point.” Michelle Trupiano, executive director of Beacon Reproductive Health Network, formerly the Missouri Family Health Council, said misinformation, including around Tylenol, sows uncertainty and distrust. “It just causes confusion for folks that is going to trickle down into continued confusion for patients over who they can trust, who they can go to for accurate information,” Trupiano said.” Zachary Moser, administrator at the Dent County Health Center in rural southwest Missouri, said his office doesn’t plan to make any changes following the president’s remarks on Tylenol. Moser, who is also a pharmacist, said a letter published Monday by the Commissioner of Food and Drugs offered a “reasonable” and “substantially different” message from Trump. “It just uses the common sense principles that we use in medicine all the time,” Moser said. “Use the lowest dose for the shortest amount of time as possible. That applies to everything we do.” The letter ended by describing acetaminophen as “the safest over-the-counter alternative in pregnancy” to aspirin or ibuprofen, which “have well-documented adverse impacts on the fetus.” As of Friday, Moser saw some chatter about Tylenol online but had not yet been approached by many in his community for guidance on taking the medication.
‘No single medical treatment’Black, the medical director from the Thompson Center, said that because autism can’t be traced to any single cause or pathway in the brain, “no single medical treatment will be the answer for all patients and families.” Though leucovorin appears to present minimal risk, Black said, there are no safety studies specific to patients with autism, and tests for the type of folate deficiency the drug may treat can be expensive or rely on scant data. For now, Black said he is taking “a relatively cautious approach” to leucovorin. Shank said that she will likely ask her daughter’s doctor about leucovorin. She wishes she could take away some of her daughter’s struggles, but she isn’t looking for a cure. “I don’t think that autism is something that needs to be cured,” she said. Looking back on her family’s journey, Shank said she wants parents of children with autism to feel empowered to reach out to other families, because “most other families, they get it, they understand.” “Go out of your comfort zone to fight for your child and advocate for them and create opportunities for them,” Shank said, “and give them the tools they need to succeed.” YOU MAKE OUR WORK POSSIBLE.
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Missouri Independent is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence. Contact Editor Jason Hancock for questions: [email protected].
by Tara Sallee MS, RD, LD, Hy-Vee Corporate Dietician Aging is inevitable, no matter your stage of life. While it’s a topic many prefer to avoid, September is National Aging Awareness Month, offering the perfect opportunity to shift our mindset, not to look ahead with dread, but with curiosity better understand and caring for our bodies. With the right preparation, we can support our bodies to feel strong, resilient and energized throughout the years. Some of the top concerns for aging adults include bone density, skin integrity and immune function, all of which are heavily influenced by nutrition. Bone Health: Osteoporosis is the gradual loss of bone density. While calcium is essential for bone health, it’s only effective when absorbed properly. That’s where vitamin D comes in, playing a vital role in calcium absorption. Without enough vitamin D, calcium can’t do its job, no matter how much you consume. You can get vitamin D primarily from sun exposure, but also from eggs, cold-water fish, fortified cereals like Cheerios, and fortified milks. Other nutrients that support bone health include magnesium and amino acids, which are found in protein-rich foods. Skin Health: As we age, skin tends to lose structure, gets wrinkles and takes longer to heal. Nutrients that support skin integrity and repair include collagen, antioxidants, and polyphenols. Antioxidants and polyphenols are natural compounds that help protect your cells, and they’re especially abundant in grapes, berries, veggies, and tea. Collagen is made from specific amino acids found in protein. To support both skin and bone health, try to include a source of protein at each meal and snack. Quick options include cottage cheese, Chomps beef sticks, and granola or cereal with protein added, such as Cheerios Protein cereal. Immune Support: A strong immune system becomes even more important as we age. Nutrients that help support immunity include vitamins E, D, and C, zinc, probiotics, omega-3s, and, again, protein. One of the best ways to support your immune system through food is to eat a colorful, varied diet. Fruits and vegetables are packed with immune-boosting vitamins and antioxidants, and including a mix of these foods daily helps guard against deficiencies. Whatever your age, it’s never too early or late to support your body with good nutrition. Talk to your Hy-Vee dietitian to learn more about the foods and habits that help you age well and feel your best. Schedule a complimentary Discovery Session today by contacting our Discovery Call Center via email [email protected] or calling (515) 695-3121. If you’re looking for a fun way to add some variety and color to your day, try this copycat protein box recipe the next time you are on the go!  Copy-Cat Starbucks Protein Box (makes 3 protein boxes)
All you need: 6-count bag of Chomplings 6 hard-boiled eggs, split length-wise 1.5 cups red grapes Handful of favorite gluten-free crackers 18 slices of sharp cheddar cheese All you do: 1. First, cut all your ingredients that need to be sliced to fit into your chosen containers, like your hard-boiled eggs. 2. Place grapes into one compartment of your container. 3. Add hard-boiled eggs to their own compartment. 4. Combine crackers and cheese with two unwrapped Chomplings into the largest compartment. 5. Enjoy within two to three days! Recipe modified from: https://chomps.com/blogs/recipes/starbucks-copy-cat-protein-boxes The information is not intended as medical advice. Please consult a medical professional for individual advice. This content was made possible with the sponsored support of our sponsors Chomps, Cheerios and Grapes from California. by Tara Sallee MS, RD, LD, Hy-Vee Corporate Dietician September is National Family Meals Month, which makes it an excellent time to prioritize eating with your loved ones. As we get back into routines and schedules start filling up, time is often limited, though family meals don’t need to be complicated to provide countless benefits. To take one task off the to-do list, your Hy-Vee dietitians are excited to introduce our free updated digital cookbook. With over 60 recipes included, you no longer need to sift through multiple sources to find meal options that are easy to prep, nutritious, and sure to be a hit with your entire crew. Click here to download the Hy-Vee Dietitians Healthier Made Easier cookbook. Family Meal Benefits: When meals are eaten as a family, plates tend to be healthier and more balanced. Furthermore, eating habits and preferences learned at a young age are often carried on into adulthood. A review of more than fifty studies with over 200,000 participants reveals a significant relationship between frequent family meals and better nutritional health. The connection was present in both younger and older children and across countries and socioeconomic groups.1 It is common for parents to focus on their children’s meals without taking time for themselves. Preparing a dish for the entire family ensures everyone is fueling nutritiously, and it may even encourage children to try something new if they see their parents eating it too. Beyond nutritional gains, family meals strengthen relationships and household dynamics. Oftentimes, everyone goes their separate ways for much of the day. Sitting down with your family either before heading out the door or after returning home allows individuals to stay connected with what’s going on in each other’s lives. Studies have found an association between family meals and improved family functioning. This leads to greater connectedness, communication, expressiveness, and problem-solving.2 While conversations at the table may be more lighthearted, this frequent and open dialogue encourages children to keep their parents in the loop. These trusting relationships can promote positive mental health and reduce risky behaviors. Research shows that frequent family meals are associated with reduced disordered eating, alcohol and substance use, violence, and feelings of depression or thoughts of suicide in adolescents.3 Time at the table may seem routine, though these precious moments allow each person to know that they are loved and an integral member of the family. How to Implement: When most people think of family meals, they immediately envision a dinner that took hours to prepare. Have no fear; this is not the only way to dine as a family! Whichever meal works best is the right time to eat together. It can truly be as simple as pouring bowls of cereal, adding low-fat milk, and talking about the upcoming day. For some families, weekends may be an easier time to align schedules, though these days are typically just as packed with commitments. Thankfully, there are plenty of recipes that involve minimal cooking, such as salads, wraps and tacos, that still hit many of the food groups. Adding a side of fresh fruit is a simple way to balance the plate and tacks on very little prep. Sometimes, family meals require even more creativity, yet that doesn’t mean you won’t get the perks. If everyone finds themselves in different locations at midday, why not pack your lunches together the night before. You are still able to talk with one another and each family member will have healthful choices to stay nourished until returning home. Bento-style lunches have gained popularity thanks to their help with creating quick, balanced, and portion-controlled meals. Your family meal may be having breakfast with friends, calling a cousin and eating lunch over Facetime, or bringing your family to Hy-Vee for a balanced supper that’s prepared for you. Everyone’s meals will look a little different, and that’s okay. Combining a favorite dish with a dash of each personality is the perfect recipe for laughter, storytelling, and memory making! We’re making mealtime even more exciting this September. Download your copy of the Hy-Vee Dietitian’s Healthier Made Cookbook and you’ll be entered for a chance to win 1 of 5, $100 Hy-Vee Gift Cards! For official contest rules, visit: Hy-Vee Dietitians Family Favorites Cookbook Giveaway Sweepstakes Cauliflower Nachos These nachos offer a healthy twist on a classic favorite! They are filling enough to serve as a main dish or the perfect addition to your appetizer line-up. Thanks to the variety of toppings and textures, your family won’t even miss the chips! From Hy-Vee Dietitian’s Healthier Made Easier Cookbook All you need: 2 Tbsp avocado oil ½ tsp chili powder ½ tsp ground cumin ½ tsp onion powder 5 cups cauliflower florets, cut into ½-inch slices 1 Roma tomato, diced ¼ cup fresh cilantro, chopped 2 tablespoons pickled jalapeño peppers 2 Tbsp red onion, minced Pinch of salt ½ cup fat-free refried beans ¾ cup shredded Mexican cheese blend 1 avocado, diced ½ cup cabbage, finely shredded All you do:
The information is not intended as medical advice. Please consult a medical professional for individual advice.  ‘We are sweating’: Missouri kindergarten vaccination rates fall below immunity thresholdby Annelise Hanshaw, Missouri Independent The percentage of kindergarten students in Missouri vaccinated against diseases like measles and whooping cough is dropping each year as more parents turn in non-medical exemptions prior to their child’s first day of school. Only 90% of Missouri kindergarten students were immunized against measles, mumps and rubella last year, according to the Missouri Department of Health and Senior Services. That’s down from 94.6% five years prior. Some counties have rates nearing 75%. According to the CDC and World Health Organization, a community needs a vaccination rate of at least 95% to be adequately protected from measles outbreaks. “We are sweating,” Dr. Laura Morris, a University of Missouri Health Care family medicine physician and liaison to the CDC’s Advisory Committee on Immunization Practices, told The Independent. “There are a couple of diseases that are very infectious that require really high rates of vaccination to provide herd immunity.” Missouri exceeds the national average of non-medical exemptions. According to the U.S. Centers for Disease Control and Prevention, 5% of Missouri kindergarteners had non-medical exemptions on file last school year, compared to a nationwide rate of 3.4%.
This percentage, which has been on a steady incline since the 2020-21 school year, is troubling public health experts who say vaccination rates are dipping below safe levels. “The number of children in a particular school that might be vulnerable or unvaccinated, it’s going to vary by community,” Morris said. “There are definitely some places and communities where there are a lot more unvaccinated kiddos, and then there are some communities where the rate might be 97% or even higher.” Morris added: “It is going to be a bit of a firestorm if those infections get into some of those places.” As vaccination rates drop, measles is popping up at levels not seen since 1992. Seven cases of the disease have been confirmed in Missouri this year — five of which occurred in Cedar County, which has one of the lowest vaccination rates in the state with 74.4% of kindergarteners vaccinated against measles. It is not just the MMR vaccine worrying health providers. The percentage of kindergarten-aged children with updated DTP vaccines (which protects against diphtheria, tetanus and pertussis) has declined over the past 10 years from 96% to 90% in Missouri. This is much steeper than the national drop, which went from 94.3% in the 2014-15 school year to 92.1% last year. Rachel Hassani, director of education and engagement for the Missouri Rural Health Association, told The Independent that family hesitancy as well as access issues are contributing to the declining vaccination rates. “Across the board, access to care is more limited in rural Missouri. Access to specialists, pediatricians, things like that is far more challenging,” she said. “And these workforce issues are really growing.”
Marvia Jones, director of the Kansas City Health Department, told The Independent that the city has been working to make vaccines more easily available. The health department has extended office hours to be convenient for working parents and scheduled more informational events in the community. The result is a strong level of vaccination in the majority of the city, but Jones is noticing lower rates in suburban areas like the Northland. “It is more of a hesitance issue,” she said. “A lot of misinformation and some of the political issues have been added to the discussions around public health vaccination in the past three to five years.” The trend of lower vaccination rates and more religious exemptions in Missouri begins around the 2020-21 school year, which is when the COVID-19 vaccine was released. That year, only 2.4% of Missouri kindergarteners had a religious exemption from vaccination — less than half the rate of the 2024-25 school year. “It has been just a big backslide in terms of the misinformation and inaccurate information,” Morris said. “It has become so prevalent to see so many things that are completely inaccurate.” She has seen misinformation about COVID-19 vaccines spill into patient concerns about regularly scheduled vaccinations. Health officials hope ease of access and proper education will help reverse the trend. But Missouri and the United States as a whole is also facing newfound systemic issues. Cuts in the U.S. Department of Health and Human Services has trickled down to Missouri programs. This spring, the Missouri Immunization Coalition shuttered after losing federal funding, and the Missouri Rural Health Association lost a $1 million grant intended to study immunizations in rural health clinics, as reported by St. Louis Public Radio. And in June, U.S. Health Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist, replaced all 17 members of the Advisory Committee on Immunization Practices, a group that guides the CDC on vaccine policy. Morris, a non-voting liaison to the committee, is still serving in an advisory role. “The process of where those (vaccine) recommendations come from has been subverted over the last couple of months, and that (group) is no longer a source that has the same merit and the same kind of evidence-based background that it previously did,” she said. Kansas City joined a lawsuit challenging the federal cuts to public health programs. The state has taken no such action. Since 2021, Missouri lawmakers have spoken against COVID-19 vaccine mandates, filing bills annually that seek to make such mandates illegal. “It’s hard to know which direction things go. Does our state have less of an appreciation and trust of public health, so it funds it at lower levels? Or because of the low levels of funding, do people see us and respect us as an authority on these matters less?” Jones said. “It is an interesting kind of conundrum.” Missouri ranks last in per-capita funding of public health, at $7 per person, according to the State Health Access Data Assistance Center. “We need lawmakers and certainly our medical community to be evidence-driven,” Jones said. “And to not stray away from tried and true public health interventions due to any political leanings.” This story has been updated at 3:46 p.m. Tuesday to clarify Dr. Laura Morris’s position with the CDC’s Advisory Committee on Immunization Practices. Keep Missouri Journalism FreeAs a nonprofit newsroom, our articles are free for everyone to access. Readers like you make that possible. Can you help sustain our watchdog reporting today?
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Missouri Independent is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence. Contact Editor Jason Hancock for questions: [email protected]. (StatePoint) There is an epidemic of loneliness affecting boys and young men in America. The fascination with recent shows like Netflix’s “Adolescence,” Jonathan Haidt’s “The Anxious Generation,” and the return of the online “Ice Bucket Challenge” spotlight this youth mental health crisis in important ways that have reached millions. It is no secret how the mental health crisis has impacted boys and young men, making the conversation more important than ever. Meanwhile, statistics show that large numbers of boys and young men are feeling driftless and alienated; and so-called AI “aggro-rithms” are filling the void by increasingly driving them toward misogynistic and anti-democratic content online. Traditional gender roles have resulted in boys and young men often being left out of the mental health conversation and care, despite being at particularly high risk for poor mental health outcomes. They are the least likely to seek mental health support and are four times more likely to die by suicide than women in the United States. “Supporting boys in addressing mental health challenges begins with ensuring that they have the role models to learn how to build healthy relationships, ultimately leading them to take healthier actions, and create safer communities for all,” says Brian O’Connor, vice president at Futures Without Violence, a national non-profit. For nearly 40 years, Futures Without Violence has pioneered programs and resources for advocates, policymakers and other professionals to foster safe, healthy communities. Through its Engaging Men programming, the organization is working to mitigate online dangers for boys and men, addressing the mental health crisis among them by connecting them with trusted mentors, and is supporting them to engage in healthier relationships. One of their efforts is a program called Team: Changing Minds (T:CM), which launched three years ago after a $5 million grant through Harry’s Open Mind Initiative. Training already-embedded adults in the lives of kids, like sports coaches, teachers, mentors and community leaders, to recognize early signs of mental health challenges, the program leverages existing relationships and trust to connect boys and young men to necessary support. With the support of founding investor Harry’s, and partners FUTURES, Big Brothers Big Sisters of America, and the National Council for Mental Wellbeing, T:CM has trained over 80,000 adults to-date and is on track to reach over 1 million youth within the next year. Anyone can be a mental health support for the boys and men in their life. Here are four simple, everyday actions family members, friends and coaches can take right away: 1. Ask questions. Don’t be afraid to ask simple questions that show concern. If there are specific changes you’ve noticed, mention them. This can be as simple as, “You’ve been less talkative lately, is there anything you’d like to talk about?” 2. Listen to understand (not to respond) with empathy. If you’ve shown the young people in your life that you’re someone who really hears them, they may be more likely to talk to you when they are having a rough time. 3. Ask for help. You're not a therapist, and you aren’t expected to have all the answers. Lean on experts (such as school counselors or your child’s pediatrician) and brainstorm others you can call in to be part of the support team. You’re an important piece of this puzzle, but you never have to do this alone. 4. If you or someone you know needs help, call the Suicide and Crisis Lifeline by just dialing 988. To become a Team Changing Minds responder, visit teamchangingminds.org. To learn more about the mental health crisis affecting men and boys, visit futureswithoutviolence.org. “Focusing on everyday actions to empower boys and young men to step into the simple things they can do as leaders, allies and change-makers is the goal, ” says O’Connor. KANSAS CITY – Community Blood Center (CBC) has declared a blood emergency in Kansas City and the surrounding area as the region’s blood supply drops below a 2-day inventory, far below the 7-day supply needed to meet hospital and patient needs. While all blood types are urgently needed, the shortage is especially severe for types O-negative and O-positive, which are vital for emergency situations and trauma care. “We urgently need the community’s help to rebuild the blood supply and prevent this situation from becoming more dire,” Chelsea Tibbetts, Executive Director at Community Blood Center said. “Donating blood is one of the most impactful ways to support our healthcare system and save lives.” Summer has brought an expected decline in donations, driven by vacations, school breaks, and intense heat waves that have kept donors indoors. Combined with increased trauma cases, the impact on the local blood supply has been severe. “Every time you hear a siren or see a helicopter overhead, there’s a chance that patient will need blood,”Tibbetts said. “We need to make sure it’s on the shelves before they ever get to the hospital.” Kansas City’s hospitals aren’t alone in this crisis. Blood shortages are a growing concern nationwide. But the solution is local, and immediate. CBC is calling on community members to step up now and ensure blood is available for those who need it. Dr. Douglas Rivard, DO, Executive Vice President and Physician-in-Chief at Children’s Mercy, emphasized the urgency: “A reliable blood supply is essential to the care we provide every day, from surgeries and cancer treatments to unexpected emergencies and lifesaving procedures. Every donation directly supports the children and families who count on us, and it’s one of the most powerful ways our community can help ensure every child gets the care they need.” How You Can Help:
In light of recent updates to FDA guidance, more people than ever may now be eligible to give. Blood donors can donate every 56 days, and platelet donors can give up to twice per month. To view current eligibility guidelines or make an appointment, visit savealifenow.org or call 877.468.6844. by Tara Sallee MS, RD, LD, Hy-Vee Corporate Dietician The warmer months often bring busier schedules and more commitments. It’s also the perfect time to focus on health and good nutrition. Packed with heart-healthy fats, fiber, vitamins and minerals, avocados are a true nutrition powerhouse and a great inclusion for your summer meal plans. This unique fruit is high in monounsaturated fat which helps keep your cholesterol levels in check and allows the body to absorb fat-soluble vitamins A, D, E and K. Just one-third of a medium-sized avocado provides three grams of fiber, a nutrient most Americans fall short on, and more potassium than a banana. Avocado toast has exploded over the past several years and guacamole has long been a staple recipe, though there are so many other options for this versatile fruit. Let’s explore a few fun ways to enjoy your Hy-Vee Dietitian’s Picks of the Month: California Avocados and Chosen Foods avocado products. Five updated ways to eat avocados:
In order to make these new uses a success, it’s important to master the art of determining avocado ripeness. First, look at the outside color. Haas avocado skin turns from dark green to a purple or almost black hue once ripe. Next, place the fruit in your palm. A ripe avocado should yield slightly to gentle pressure; avoid too much force to prevent bruising. Lastly, remove the stem cap. If it comes off easily and reveals green, the avocado is ripe and ready to eat. If the stem cap does not release effortlessly, the fruit is not yet ripe. Looking to speed up the ripening process? Simply place avocados in a paper bag at room temperature with an apple or banana. On the other hand, store ripe avocados in the refrigerator to slow down spoilage if you need a couple of extra days to get through your stash. Find more tips from California Avocados here: How to Choose a Ripe Avocado. Since California Avocados are grown right in our country, there is a shorter distance between you and the orchard. This both means a reduced risk of damage during transit and minimized carbon emissions during shipping. With their adaptability, countless nutritional benefits and sustainability, it’s easy to see why dietitians can’t get enough of this tasty fruit! Stock up on California Avocados and Chosen Foods avocado products on your next shopping trip and head to the kitchen for some delicious experimenting. BLT Avocados All you need:
All you do:
Recipe Source: https://www.hy-vee.com/discover/recipes/blt-avocados by Tara Sallee MS, RD, LD, Hy-Vee Corporate Dietitian Let’s face it – life can feel like a never-ending to-do list. Between work deadlines, family responsibilities and everything in between, stress has practically become a lifestyle. But here’s the good news: you don’t have to just get through it. The foods you eat can do more than fuel your day – they can help you feel better, sleep better, think more clearly and recover faster from stress. Here’s how you can go from simply surviving to truly thriving:
Go from frazzled to flourishing by making intentional choices and tuning into what your body truly needs. Implementing these feel-good strategies can also help you create a foundation for greater calm, clarity and strength. So, the next time stress starts creeping in, head to the kitchen. Your healing journey might just begin with your next bite. Salmon, Citrus, and Avocado Stress Relief Bowl Servings: 8 All You Need:
Recipe Adapted from Hy-Vee: https://www.hy-vee.com/discover/recipes/salmon,-beet,-citrus-and-avocado-protein-bowl (StatePoint) Two in five U.S. adults identify as family caregivers, but there is a lack of support for them nationwide, according to new research from Edward Jones in partnership with Morning Consult and Age Wave. With 46% of Americans expected to become caregivers in the future, this research sought to better understand their concerns and challenges, and uncover ways to support them.
How caregivers are navigating their finances, emotions and careers Top financial concerns caregivers face include rising costs and inflation (56%) and inadequate retirement savings (42%). In fact, 95% of caregivers have some level of financial concern for their retirement, and 51% must cut back on personal spending because of their caregiving responsibilities, according to the study. In addition to financial challenges, many caregivers cited caregiving as a significant emotional responsibility, leaving them stressed, burned out, and unable to prioritize their own health. Most caregivers (72%) are willing to sacrifice their own financial security to ensure proper care for their loved ones. This sometimes includes such measures as stepping away from their jobs entirely, reducing work hours, taking on debt and dipping into their own retirement savings. Despite these challenges, 80% of caregivers say their role has strengthened their relationships with loved ones, with the large majority reporting feelings of personal fulfillment and gratitude from those in their care. “Caregivers often bear great financial burdens and sacrifice their own well-being to care for children and elder family members,” says Ken Dychtwald, founder and CEO of Age Wave. “The vital role of family caregivers in our care systems and society demands greater recognition, resources and relief, especially as America’s population continues to live longer with more chronic conditions and the need for caregiving grows.” Support, education and resources for caregivers is crucial. Fifty-seven percent have not sought professional advice for caregiving-related financial guidance, yet 93% of those who work with a financial advisor report feeling more confident about their financial future. “Financial advisors are an important element of a caregiver’s support system,” says Ken Cella, principal and head of external affairs at Edward Jones. “They can give caregivers a complete picture of their finances, enabling them to navigate the complex realities of care while planning for multiple long-term financial and life goals.” Policies that help caregivers have bipartisan support Currently, 68% of Americans, regardless of political affiliation, say the public sector is not doing enough to support caregivers, a sentiment felt more strongly among those caring for elderly adults and special-needs adults. The research found that the majority of Americans support enacting federal legislation that would aid caregivers, such as expanded retirement account contributions for caregivers, and additional “catch-up” contributions for caregivers. Additionally, 74% say they believe employers should offer benefits such as financial support or flexible work arrangements for employees with caregiving responsibilities, reflecting a growing demand for supportive workplace policies. “In the face of rising living costs and a looming retirement crisis, supporting caregivers through national and employment policies is an investment in economic stability, public health and the well-being of both caregivers and those they are caring for,” says Cella. “As a firm, we are proud to advocate on behalf of caregivers by backing policies that will build lasting financial strength for our clients, colleagues, communities and society.” Caregivers have a lot to navigate emotionally, financially and logistically. But support, education and resources can help them meet the challenges. Missouri, Kansas saw combined drug, alcohol, suicide deaths decline in recent researchDeaths caused by drugs, alcohol and suicide dropped in Missouri and Kansas in 2023, thanks in part to investment in mental health services and data tracking from government agencies, a new report found. The data analysis from Trust for America’s Health found that Missouri and Kansas tracked nationwide trends when it comes to deaths induced by alcohol, drug overdose or suicide. Nationwide, more than 200,000 deaths in 2023 can be attributed to alcohol, drug overdoses or suicide, a 4% decrease from 2022. The report defines alcohol-induced deaths as those caused by alcohol poisoning, liver failure or other adverse effects related to alcohol. Drug overdoses include opioids, synthetic opioids, cocaine and other psychostimulants. Overall, the combined rates of injury deaths fell 8% in Kansas from 2022 to 2023, with 56.7 deaths per 100,000 people. In Missouri, injury death rates fell 10% to 62.4 per 100,000. Kansas was one of five states in 2023 that saw alcohol-related deaths increase, growing 1% from 2022 to 15.7 deaths per 100,000 people. Separately, recently released preliminary data from the Centers for Disease Control (CDC) shows the drop in deaths caused by alcohol, drug overdose or suicide continued in 2024. For resources for mental health or substance use crisis, call, text or chat with the 988 Suicide and Crisis Lifeline. The progress is encouraging but feeble, the report’s authors said during a media briefing. More investment in data collection, tracking and health care that is specific to each community’s needs is crucial in order for rates to keep falling, they said. Recent funding and workforce cuts at the CDC and the Substance Abuse and Mental Health Services Administration (SAMHSA) threaten the progress that is being made, said Dr. Nadine Gracia, the president and CEO of Trust for America’s Health and the former director of the office of minority health at the Department of Health and Human Services. “Among the tools that led to these reductions in overdose deaths are improved data systems that allow local officials to track drug misuse trends and direct resources where they’re needed most, as well as the availability of overdose reversal medications like naloxone,” Gracia said. How Missouri and Kansas fared with injury deaths in 2023Rates for all injury deaths dropped in Missouri and Kansas, aside from Kansas’ slight increase in alcohol-related deaths, in 2023. In Missouri, alcohol-related deaths fell 10% from 2022 to 2023, to 11.2 deaths per 100,000 people. Nationally, alcohol-related deaths dropped 7%, to 12.6 deaths per 100,000. Kansas and Missouri both outperformed national progress when it came to drug overdose deaths. Nationally, drug overdose rates fell 4% to 31.3 deaths for every 100,000 people. The rate decreased 14% in Kansas to 22.8 deaths, and fell 12% in Missouri to 17.1 deaths. Kansas outpaced Missouri when it came to reductions in overdoses related to opioids and synthetic opioids. In Kansas, opioid overdose deaths fell 18% from 2022 to 2023, while synthetic opioid overdose deaths fell 17%. In Missouri, opioid overdose deaths fell 8%, while synthetic opioid overdoses fell 7%. Both states also outperformed the nationwide rate when it comes to the decrease in deaths by suicide. Nationally, the rate fell less than 1%. In Kansas, deaths by suicide fell 5% at 19.6 deaths per 100,000 people, while Missouri saw a 6% reduction in deaths by suicide, at 18 deaths. But the data shows a need for more resources in both states when it comes to mental health, addiction treatment and suicide prevention efforts. The report ranked Kansas 35th when it comes to mental health treatment access, while Missouri was ranked 32nd. In Kansas, the data analysis found that 6% of residents over 18 reported serious mental illness in the last year. In Missouri, 7% of residents reported the same. The average therapy cost for a therapy appointment in Kansas was about $147, while it averaged $122 in Missouri. In both Kansas and Missouri, 76% of known residents with substance use disorder did not receive treatment for their addiction. And as public health strategies lean into harm reduction through education, peer support and other low-barrier forms of support, investments are being made in mobile crisis units that can treat patients or connect them with resources for their care. Currently, Kansas has no enhanced Medicaid reimbursement for any mobile crisis unit operating in the state, while Missouri has established a planning grant to put an enhanced Medicaid reimbursement in place. What experts recommend for the U.S. to continue its decline in drug, alcohol, suicide deathsThe report outlines a number of recommendations for Congress and state officials to keep the momentum going. The group called on Congress to restore the CDC’s workforce and to fund the CDC’s National Center for Injury Prevention and Control, which is a national data resource for health officials to track trends in their areas. The center also provides technical assistance and provides some funding for prevention programs across the country. Under President Trump’s current budget proposal, the Injury Center will be cut. “No other agency collects and analyzes injury data across emergency departments’ overdose deaths and suicide attempts at the level of detail and speed that CDC does, and no other agency deploys scientists at the request of local governments to provide on-the-ground support when new drug threats or suicide clusters emerge without the Injury Center,” said Sharon Gilmartin, the executive director of the Safe States Alliance. “Communities will lose access to a range of resources.” The report also recommended that the U.S. boost access to early prevention and support programs for those who may be struggling with addiction or their mental health, focus on youth programs for addressing substance misuse, promote harm reduction policies and support efforts that limit access to lethal means of suicide, like voluntary gun locks. “We’re seeing signs of progress, but that progress is not universal and it’s not guaranteed to continue,” said Dr. Susan Kansagra, the chief medical officer at the Association of State and Territorial Health Officials. “So now is the time to double down, renew our investment and commitment in funding the programs that support the health and well-being of communities across the nation.” This article first appeared on Beacon: Kansas City and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
With local blood supplies critically low heading into the summer months, Community Blood Center (CBC) is once again teaming up with the Kansas City Royals to host a blood drive at Kauffman Stadium on Wednesday, June 4th from 9:00 am – 3:00 pm. The local supply of types O-negative and B-negative currently sits at just a 1-2-day supply, well below the ideal inventory of 7 days, and donors are urgently needed. As a thank you for giving the lifesaving gift of blood donation, all who come to donate will receive a Royals T-shirt and two vouchers redeemable for tickets to a select 2025 Royals home game. This drive comes at a pivotal time: summer is historically one of the hardest seasons to maintain an adequate blood supply, as regular donors are distracted by vacations, school breaks, and outdoor activities. Meanwhile, hospitals often see a surge in trauma cases, from car accidents to outdoor injuries, many of which require immediate transfusions. In fact, nearly 1 in 4 trauma patients need blood as part of lifesaving treatment. Blood donors can give every 56 days, and platelet donors can give twice per month. The Food and Drug Administration (FDA) recently lifted several blood donor eligibility restrictions. To view current eligibility guidelines or make an appointment, visit savealifenow.org or call 877.468.6844. The drive will be held at Kauffman Stadium on Wednesday, June 4th from 9:00 am – 3:00 pm. Donors will park in Lot J and enter through Gate A. It only takes one hour to donate, and a single donation can save multiple lives. Roughly one in seven hospital admissions require a blood transfusion. Those in need include cancer patients, accident, burn, or trauma victims, newborn babies and their mothers, transplant recipients, surgery patients, chronically transfused patients suffering from sickle cell disease or thalassemia, and more. To make an appointment for this drive, donors can visit this link or call 877.468.6844. 
When you think of the Mediterranean diet, you likely envision a diet rich in colorful vegetables, fresh seafood, olive oil, and whole grains. But what about beef? While often overlooked, lean beef can still play a role in this heart-healthy eating pattern. The Mediterranean diet emphasizes an abundance of fruits, vegetables, whole grains, nuts, seeds, olive oil, and lean proteins, supporting long-term health by reducing risk factors for cardiovascular diseases, such as high cholesterol and high blood pressure.1,2 So, where does beef fit into a Mediterranean-style diet? While seafood and plant-based proteins often take center stage, lean beef can also be a nutritious addition. Beef provides essential nutrients, including iron, zinc, and B vitamins, which support muscle growth, energy production, metabolism and brain health.1,2 When enjoyed in moderation and paired with Mediterranean staples like vegetables, whole grains, and healthy fats, lean beef can be a delicious and satisfying part of a balanced diet. Here’s how to incorporate lean beef into a Mediterranean-style diet while keeping heart health in mind:
If you're looking for personalized guidance on creating a balanced meal plan that aligns with the Mediterranean diet, Hy-Vee's team of registered dietitians is here to help. Whether you're exploring heart-healthy eating, trying new recipes, or seeking expert advice on maximizing your grocery shopping, Hy-Vee dietitians can provide personalized tips and meal ideas tailored to your lifestyle and health goals. Additionally, Hy-Vee dietitians now accept insurance, allowing you to receive expert nutrition guidance with little to no out-of-pocket costs. Reach out to your local Hy-Vee registered dietitian or schedule a one-on-one appointment to begin your journey to better health today! https://www.hy-vee.com/healthnew/dietitians Mediterranean Beef Meatball Kabob Serves 4 All you need: 1 (1-lbs.) pkg. 93% Lean 7% Fat ground beef or leaner ¼ cup dry breadcrumbs 2 egg whites or 1 whole egg 2 tbsp chopped fresh parsley 2 tsp minced garlic 1 tsp ground cumin ½ tsp salt ¼ tsp pepper 2 tbsp water 4 flatbreads (such as naan, lavash or pita bread) Toppings: Chopped tomatoes, chopped cucumber, chopped red onion, chopped fresh parsley, Tzatziki sauce. All you do:
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