Indian Foods: AAPI's Guide To Nutrition, Health and Diabetes

Indian Foods: AAPI’s Guide To Health, Nutrition, and Diabetes

© American Association of Physicians of Indian Origin Photographs by Amish Thakkar; Cover page designed by Ranjita Misra

Indian Foods: AAPI’s Guide To Nutrition, Health and Diabetes

By The Subcommittee of the Public Health Committee of AAPI

Nirmala Abraham

Theja Mahalingaiah

Padmini Balagopal

Suraj Mathema

Rita (Shah) Batheja

Ranjita Misra

Nimesh Bhargava

Chhaya Patel

Sharmila Chatterjee

Sudha Raj

Keya Deshpande

Nirmala Ramasubramanian

Madhu Gadia

Janaki Sengupta

Karmeen Kulkarni

Geeta Sikand

Allied Publishers Private Limited New Delhi l Mumbai l Kolkata l Chennai l Nagpur Ahmedabad l Bangalore l Hyderabad l Lucknow

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2. Waist Circumference# Determine your waist circumference by placing a measuring tape snugly around your waist. It is a good indicator of your abdominal fat (another predictor of your risk for developing risk factors for heart disease and other diseases). This risk increases with a waist measurement of over 40 inches in men and over 35 inches in women # The table, Risks of Obesity-Associated Diseases by BMI and Waist Circumference, provides you with an idea of whether your BMI combined with your waist circumference increases your risk for developing obesity associated diseases or conditions.#

3. Other Risk Factors# Besides being overweight or obese, there are additional risk factors to consider.

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overweight (BMI of 25 to 29.9) and have two or more risk factors, the guidelines recommend weight loss. Even a small weight loss (just 10 percent of your current weight) will help to lower your risk of developing diseases associated with obesity. Patients who are overweight, but do not have a high waist measurement, and have less than 2 risk factors may need to prevent further weight gain rather than lose weight.## Talk to your doctor to see if you are at an increased risk and if you should lose weight. Your doctor will evaluate your BMI, waist measurement, and other risk factor for heart disease. People who are overweight or obese have a greater chance of developing high blood pressure, high blood cholesterol or other lipid disorders, type 2 diabetes, heart disease, stroke, and certain cancers. Even a small weight loss (just 10 percent less than current weight) will help to lower the risk of developing those diseases.

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FOOD GUIDE PYRAMID A Guide to Daily Food Choices

FATS,OILS, CONCENTRATED SWEETS USE SPARINGLY -j

, j

-i

;

-j

l

EGGS, FISH, NUTS AND DRY BEANS

I I I I

(2 • 3 SERVINGS)

,1

Low-fat \ DAIRY· MILK,

\

milk

YOGHURT,

products \

(2 - 3 SERVINGS)

meats,

like

\

Nuts,

milk,

I

Fish,

Curds,

Poultry

Paneer,

\ Sweetened

etc.

Cheese,

\ Coloured

Dhal, , Legumes'

~

\

I I Egg, I Yolks, I Fried

MEAT, POULTRY,

Fish, ,I

\

I Curds,

Ice-

Egg,

Imllk

cream

Whites'

I LESS OFTEN-

USE

I I I I I I

VEGETABLES Drumstick,

(3 - 5 SERVINGS)

Carrots, Tomatos, Cabbage, Radish,

,

\

LESS OFTEN

-USE

\ Pickled or

Apple, . Orange,

fried

Pear

Vegetables

Plums,

In oil,

Sapota,

Cucumber,

I I ,

Fried

Grapes,

Karela, Capsicum,

I

bhaJllas

Mangoes,

etc.

Pineapple

Cauliflower, , Spinach,

Gourds, Brin/a,,!

,

Mushrooms,

\ Fruit based \ sweetened drinks, , preserves and \ desserts ,(Aam papad) etc.

o

,, ,

\ \

I USE WITH

USE

CONTROLLED FAT ! DhokJa

Blsslbele

I I

Dhamsak

Pongal

Poha

Vegetables; Uppuma ; Yams; ! Pulao

Rica; Rice flakes Sookhl rotl; Colocasia; Pasta; Plantain, Idll; Root

Sev; Khlchdl ; Sweet Peas; , Blriyanl White or sweet Potato,' Khadl; Kootu, Dhal chutney

I

Khandvl

USE SPARINGLY

,

,

Tlkkl, Purls,

I

Dosal,

. pradalt!an,

PUluogarl

,

Fried

Panl-purl,.

Aloo Dum

\

vadams,

Muttlya

I Pappads,

AVlyal

I BhuJllya, Boondl, Vadai, \ Uthappam,

I I

Golgappa, Masal Dosal, Rumall rotl,

I Chakkaral pongal, etc.

\

STARCHES· Cereals, Rice, Breads, Pasta, Starchy Vegetables (6-11 servings) Note: FOODS ARE BEST USED WHEN COOKED TO BE HEART-HEALTHY (I.e. controlled fats, sugars and salt) Watch portions I Adapled from Iha USDA Food Pyramid and The Ethnic and Raglonai Food Pracllces on the indian - PakJalJlnl Cuisine by Ihe Am. Dlel Assoclallon and lhe Am. Dlabellc Asaoc/allon, 1996

48

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68

Ykkgbk .^kg Ykkgbk Aùk +ÉÄ\kK}kTkvlK^k (¢lSkAù FkWkmr Zkn‘P) (1 lcbbkk bkkP Ck|kYk ÉkkvKmTkä 8 Ck|kYk ^kbkk PQkk 100 Avù\k@mHki RvPk cw!) @vCkn\k@ UTkm@ : 1 ¢kwgbk maugaI- / TkI-, haÐT D,aga : 1(10/pa]MD,) YkofCkVú\km Aùk Yk‘BkTk 1 ¢kwgbk (—1 ^kbkk Aùk lcbbkk) bkkbkvHk : 1 ¢kwgbk 1% UTkm@ : 1 ¢kwgbk 3å bk†WHkZkkf lWkTkk ^kbkk Avù (1 lcbbkk 5 Ck|kYk AùkWkkvrck£M}vKä 2 Ck|kYk ÉkkvKmTk PQkk 25 Avù\k@m RvPk cw) c@mYkvQkm Aùm UlÅkZkkf 1Ö2 AùU c@m Vúl\kZkk 1Ö2 AùU WkTR CkkvXkm .^kg Voú\k CkkvXkm 1Ö2 AùU Aù+o 1Ö2 AùU WkyCk\k 1Ö2 AùU KYkkK@ 1Ö2 AùU l#kYk\kk lYkFkr 1Ö2 AùU bkVvúR Yko\kmä YkofCkkä zXkMm 1Ö2 AùU 4å Vú\k (JÉÉxÉäEòä ʱÉB iÉlÉ Ê½þººÉä PWRm\k ckvPv @cPv cy) (1 lcbbkk 15 Ck|kYk AùkWkkvrck£M}vK PQkk 60 Avù\k@m RvPk cw) Avù\kk : 1Ö2 AùU bkvWkä bkgP@k : 1 (GkvKk) WkMjm Tkk#kUPm 1Ö2 AùU P@WkoHkk PQkk Bk@WkoHkk 1 AùU GkvKk ¢kYk : 1Ö2 PkHkk ¢YkêR 1Ö2 AùU 5å RoSk .^kg RoSk ʨɱÉÉ =i{ÉÉnù (1 lcbbkk 12 Ck|kYk AùkWkkvcr k£M}Kv 8 Ck|kYk ÉkkvKmTkä 1 bkv 5 Ck|kYk ^kbkk PQkk 90-150 Avù\k@m RvPk cw) \kbbkm Zkk Rcm : 1 AùU 1-10 UTkm@ : 1 ¢kwgbk 6å ^kbkk .^kg Pv\kZkn‘P (1 lcbbkk 5 Ck|kYk ^kbkk PQkk 45 Avù\k@m RvPk cw) Pv\k 1 FkYYkFk (FkkZk^kk\km) bkoBkv bkvYk Aùk WkmHk 2 WkMjm FkYYkFk Yk‘BkTk Zkk ¨ÉÉMÉÇÊ®úxÉ : 1 FkYYkFk (FkkZk^kk\km) *

Yk‘BkTk Zkk Dkm Aùm WkHkkZk Hkwbkv Aùm HkwPoTk Aùk Pv\k Aùk ¤UZkkvCk Aù@Tkk Fkklc.‹ P\kv XkkvHkTk Aùk ¢lSkAù ¤UZkkvCk Tkc{ Aù@Tkk Fkklc.‹ * Pv\kä TkYkAù PQkk FkmTkm Aùk ¤UZkkvCk AùYk bkv AùYk Aù@Tkk Fkklc.‹ .‘bkFkxHk l\kbK Vúk@ Ykm\k ¶\kklTkgCk (1995) ¢kw@ ¢vQkTkmA bkm@mHki ¢kvTk R £TMmZkTk UklAùbPkTkm EÚòʺÉxÉ ¢Ykv@mAùTk Mk£rK ¢#kkv#km.#kTk .gM ¢Ykv@mATk MkZkkWkvKmbk ¢#kkv#kmv.bkTk (1996) ¨ÉÉäb÷xÉÇ ¤ªÉÚÊ]õ¶É º´ÉɺlªÉ Ê´É ¤ÉÒ¨ÉÉ®úÒ ¨Éå iÉä®ú½þ´ÉÉÄ ºÉƺ´ÉÉ®úhÉ ºÉ±ÉÉnù ¶ÉÒ±ºÉ, ½þ¨É +Éä±ÉVÉ VÉä +Éè®ú ¶ÉÉ<{É ½þ¨É ʱɪÉä ´Éä ¡äòʤɮú Eò¨{ÉäxÉÒ (1994)

69

YknIkv ¢UTkkv Sm`]roQ>g Aùkv lTkZkglÇkP Aù@Tkv Avù l\kZkv ‘Zkk BkkTkk Fkklc.? .l#kZkTk .^kg Xkk@PmZk XkkvHkTk Avù Wkk@v Ykx bkoFkTkk.f .^kg lTkRvr#k (¢UTkv Mk‘K@ Zkk XkkvHkTk AùPkr U@kYk#kr Aùm bk\kkc bkv \kx) ¢kUAvù Mk‘K@ .^kg bkcl^k#kvakekkx Avù ¢Tknbkk@ b^klTkZkkvlHkP ¢kck@ Aùk TkYkoTkk

ZkkvCkkÖ¢XZkkbk : ¢TZk xÉä¨ÉÒ EòÉ¨É : XkkvHkTkÖBkk< bkYkoc

bkYkZk: bkYkZk: XkkvHkTk Aùk XkkCk AùkWkkvcr k£M}Kv (Ck|kYk)

Ék|kKv mTk (Ck|kYk)

Fk@Wkm (Ck|kYk) Avù\kkv@m

Eò±Éä´ÉÉ YkSZk bknWkc YkSZkk/ XkkvHkTk

YkSZkk/ @kP Aùk XkkvHkTk

@kP Aùk +±{ÉɽþÉ®ú Anù\k 28-30 Ck|kYk [ 1 ¢kwg#k; 8 ¢kwg#k [ 1 AùUä 3 FkYklFkZkkf [ 1 FkYYkFk; 2 FkYYkFk [ 1 ¢kwg#k Padmini Balagopal, MsS. B.Ed., RD.CDE

English version Reviewed by

Hindi Translation done by Vanita Manchanda, MS.RD.

Wahida Karmally, MS.RD.CDE Karmeen Kulkarni, MS.RD.CDE

70

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1

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2

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}ÚÁOÚ ÛÂVÚ×ßÚ (OæึÄÇ¥ßÚ )§ (JM¥Úß ®ÛÄß N 2 VÛÃM ®æãÃÞnÞ«é (protein), 5 VÛÃM OÛ·æà%ÞÔæçsæÃÞmé (CHO) ÈÚß}Úß¡ 25 OÛÀÄÂVÚ×Úß (calories) ÔÚÒÁÚß }ÚÁÚOÛ N ÈæßM}ÚÀ¥Ú ÑæàÞ®Úâý° N 1/2 @×Ú}æ¾Úß ¶loÄß #N ÔæÑÚ ÔÚßÁÚßØOÛ¿ß N 1/2 @×Ú}æ¾Úß ¶loÄß OæàÞÑÚßVÚsæu, OÛƱڴ´ÇÈÚÅé N 1/2 @×Ú}æ¾Úß ¶loÄß N OÚßM¶×ÚOÛ¿ß/ÑæàÞÁæOÛ¿ß N 1/2 @×Ú}æ¾Úß ¶loÄß ¶¥Ú«æÞOÛ¿ß N 1/2 @×Ú}æ¾Úß ¶loÄß N mæàÈÚáÛÀmæà N 1/2 @×Ú}æ¾Úß ¶loÄß ¥æàsÚu ÈæßyÒ«ÚOÛ¿ß N 1/2 @×Ú}æ¾Úß ¶loÄß N ¸Ø ÈÚßàÄMW N 1/2 @×Ú}æ¾Úß ¶loÄß «ÚßVæXOÛ¿ß, ·æMsæOÛ¿ß N 1/2 @×Ú}æ¾Úß ¶loÄß N }ÚÁÚOÛ ÑÚÅÛsé N 1 @×Ú}æ¾Úß ¶loÄß

4.

ÔÚyß|V×Ú ßÚ (ÉÉ¨Ú @×Ú}VÚ ×Ú ÆÚ )Ç (JM¥Úß ®ÛÄß N 15 VÛÃM OÛ·æà%ÞÔæçsæÃÞmé (CHO) ÈÚß}Úß¡ 60 OÛÀÄÂVÚ×Úß (calories) ·Û×æÔÚyß| N 1/2 @×Ú}æ¾Úß ¶loÄß ÑæÞ¶ß, ÈÚßàÑÚM¸ N 1 (_OÚQ¥Úß) ¥ÚàsÚu ®æÞÁé ÔÚyß| N 1/2 OÚÄÇMVÚt/ OÚÁÚ¶àd N 1 @×Ú}æ¾Úß ¶loÄß ÈÚáÛÉ«ÚÔÚyß| N 1/2 @×Ú}æ¾Úß ¶loÄß ®æÞÁ×æÚ N 1/2 @×Ú}æ¾Úß ¶loÄß OÛÀ«é ÈÚáÛt¥Ú ÔÚyß| N 1/2 _OÚQ OÛÀ«é

5.

ÔÛÄß ÈÚß~¡}ÁÚ Ú AÔÛÁÚ (JM¥Úß ®ÛÄß N 8 VÛÃM ®æãÃÞnÞ«é (protein), 1-5 VÛÃM Oæà¶ß¹ (fat), 12 VÛÃM OÛ·æà%ÞÔæçsæÃÞmé (CHO), ÈÚß}Úß¡ 90-150 OÛÀÄÂVÚ×Úß (calories)) ÔÛÄß (OæูÄÇ¥Ú/ÑÚÊÄ°Oæู«Ú/®Úã~%Oæู«Ú) N @×Ú}æ¾Úß ¶mæoÄß ÈÚßfgVæ ÈÚß}Úß¡ ÈæàÑÚÁÚß N 1 @×Ú}æ¾Úß ¶loÄß 1% ®Ú¬ÞÁéN 1 @×Ú}æ¾Úß ¶loÄß

6.

Gzæ| ÈÚß~¡}ÁÚ Ú Oæู«Ú ®Ú¥Û¢Ú%VÚ×ßÚ (JM¥Úß ®ÛÄß N 5 VÛÃM Oæà¶ß¹ (fat) ÈÚß}Úß¡ 45 OÛÀÄÂVÚ×Úß (calories) @sÚßVæ Gzæ| N 1 ^ÚÈÚß^Ú N }æMW«ÚOÛ¿ß (ÔæÁ榥Úߧ) N 2 mæÞ¶Åé ^ÚÈÚß^Ú ¸ÞdVÚ×Úß N 1 mæÞ¶Åé ^ÚÈÚß^Ú N ÈÚáÛd%«é / ÈÚ«ÚÑÚ°~ }Ú߮ڰ N 1 mæÞ¶Åé ^ÚÈÚß^Ú • ÑÛ¨Ú´ÀÈÛ¥ÚÎÚßo @«éÑÛÀ^ÚßÁæÞmæsé Oæู«Ú Gzæ| (AÆÈé Gzæ| }ÚÁÚÔÚ¥Úߧ) ¶ØÒ N ÑÛÀ^ÚßÁæÞmæsé Oæู«Ú (}Ú߮ڰ, ·æz¾ |æ ßÚ M}ÚÔÈÚ ´âÚ ) ¶ØOæ OÚtÈæß ÈÚáÛt. OÚÂ¥Ú ~Mt¾Úß«ÚßAVÛVÚ ~«Úß-ÈÚ´â ¥«Ú ßÚ - }Ú¯°Ò. • Gzæ,| D®Úýâ °, ÈÚß}Úß¡ ÑÚOQÚ Áæ¾ßÚ «Úß- A¥ÚÎßÚ o OÚtÈæß ¶×ÚÒ.

Adapted from Exchange List for Meal Planning (1995) and the Ethnic Seies on the Indian - Pakistani Cuisine by American Diet Association and American Diabetes Association (1996); Modern Nutrition in Health & Disease, XIIth Ed. Ed. By Shils, M.Olson, J.A. & Shike, M. Lea & Febiger Co. (1994)

3

«Ú«-Ú ÈÚߨÚßÈæßÞÔÚ (sÚ¾áÚ Û¸ÞnÑé) SÛ¾ÚßÅæ¾ßÚ «Úß- ÔÚ}àæ Þn¾ÚßÆÇsÄÚ ß «Û«æÞ«Úß ~«Ú-·æÞOÚß? ¦«Ú®ÃÚ ~ AÔÛÁÚ¥Ú ¶×ÚO¾ æ ßÚ ¾æàÞd«æ¾ßÚ ®Úno¾ßÚ ÈÚáÛ¥Ú ¾æàÞVÚ/ ÈÛÀ¾ÚáÛÈÚß N B¬-}ÚÁÚ ¥æç¬OÚ OÛ¾Úß%OÚÃÈßÚ VÚ×ßÚ N AÔÛÁÚ/ @×Ú}æ

El/AÔÛÁÚ VÚßM®Úâ´

ÑÚÈßÚ ¾Úß N ÑÚÈßÚ ¾Úß N OÛ·æà%ÞÔæçsæÃÞmé (CHO)

®æãÃÞnÞ«é

Oæà¶ß¹

OÛÀÄÂVÚ×Úß

(protein)

(fat)

(calories)

±ÚÄÔÛÁÚ

ÈÚߨڴÀ·æ×ÚW«Ú ±ÚÄÔÛÁÚ

ÈÚߨÛÀÔ-Ú ¥Ú El

ÑÚMeæ¾Úß D®ÚÔÛÁÚ

ÁÛ~þÚß El

ÁÛ~þÚß D®ÚÔÛÁÚ

GÅÛÇ ÑæÞÂ

@×Ú}æVÚ×Úß N

8

L«éÓ = @×Ú}æ¾Úß ¶loÄß ; 3 nÞ ^ÚÈÚß^æ = 1 mæÞ¶Åé ^ÚÈÚß^Ú ; }æàOÚ N 28-30 VÛÃM = 1 L«éÓ

BY Padmini Balagopal, MS, B.Ed, RD, CDE

2

mæÞ¶Åé ^ÚÈÚß^Ú =

1

L«éÓ

Reviewed by Wahida Karmally, MS, RD, CDE Karmeen Kulkarni, MS,RD,CDE

Translated By : H.N. Nagaraja and D. S. Shankar Columbus, Ohio, USA July 2002

4

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Padmini Balgopal, MS.B.Ed., RD.CDE Telugu Translation by : A. Narasimha Reddy, MD, FACG, FACP

4

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· 6 Kjy; 8 lk;sHtiu jz;zHP / ghdq;fs; vd;gJ xU ehSf;F tof;fkhf gupe;Jiuf;fg;gLk; msthFk;. Rj;jkhd> rhjhuz jz;zHP rpwe;jjhFk;. ~fhgpd;| vd;w tp\g;nghUs; mlq;fpa fhgp> NjePH Nghd;w ghdq;fis mjpfkhfg; gUFtij jtpHf;fTk;.. · jtpHf;f Kbahj epiyapy>; cq;fs; kUj;Jtuplk; fye;jhNyhrpjj ; gpdN; g kJ ghdj;ij mUe;jNtz;Lk;.

EPpSXjûRl Tô§dÏm úYß £X AmNeLs:

·md;whlk; Fiwe;jJ 20 fpuhk; msT ehHr;rj;J clypy; NruNtz;Lk;. NjhYld; $ba KO gaW> jhdpa tiffs;> mtiu tiffs; kw;Wk; gr;irf; fha;fwpfs; ehHr;rj;J epiwe;jitfshFk;. ·gy ~Jupj| czT tiffs;> mjpf nfhOg;G> cg;G kw;Wk; / my;yJ rHf;fiu epiwe;jitaha; cs;sd. ,JNghd;w czT tiffis mbf;fb gad;gLj;Jtijf; Fiwj;Jf;nfhs;sTk; my;yJ jtpHf;fTk;. · cq;fSf;F mjpf ,uj;j mOj;jk; ,Uf;Fkhdhy;> cg;G gad;gLj;JtijAk;> tof;fkhd rpg;]f ; s; kw;Wk; CWfha;fs; Nghd;w cg;G NrHe;j czTg; nghUl;fisg; gad;gLj;JtijAk; Fiwj;Jf; nfhs;sTk;. ·gy itl;lkpd; rj;J kw;Wk; fdpkr;rj;J khj;jpiufs; kw;Wk; lhdpf;Ffs; cl;nfhs;tJ Fwpj;J cq;fs; kUj;Jtuplk; fye;J NgrTk;. xt;thik ,Ue;jhy; ,J fl;lhak; nra;aNtz;ba xd;whFk;. ·,uj;jj;jpy; nfhOg;G msit jtwhky; gupNrhjpj;Jg; ghHf;fTk;.

NodLûW úSôûVd LhÓlTÓjR ØVt£ úUtùLôsL! EeL[ôp Nô§dL Ø¥Ùm!!

79

G]Õ NodLûW úSôûVd LhÓlTÓjÕYRtÏ Sôu Guù]u] EiQXôm? ngaH : fNyhupfs; / xU ehisf;F :

,d;iwa Njjp : jw;Nghija vil:

gy;NtW Mjhuq;fisr; NrHe;j czTg; nghUl;fis xd;WNrHj;J xU ruptpfpj czitj; jahupf;fyhk;. cq;fs; tho;fi ; fKiwf;Nfw;wthW cq;fs; nrhe;j czTj;jpl;lk; mikj;Jf;nfhs;sg;gLjy; Ntz;Lk;. xt;nthU Ntis cztpYk; xt;nthU czTj;njhFg;gpd; gupkhwy; msit cq;fs; czTj;jpl;lk; Nahrid toq;Fk;. gy;NtW czTj; njhFg;Gfs; kw;Wk; xt;nthU czTj; njhFg;gpYk; toq;fg;glf;$ba gupkhwy; mstpd; vLj;Jf;fhl;Lfs; gpd;tUkhW! (,e;j kjpg;gL P fs; Njhuhakhdit vd;gij ftdj;jpy; nfhs;sTk;)

1 . Rô²VeLs/TVßLs/UôÜfNjÕs[ LônL±Ls (nfhOg;Ngh my;yJ vz;nzNah NrHf;fg;glhky;) (1 gupkhwy ;(serving) czT> 15 fpuhk; khTr;rj;J> 3 fpuhk; Gujk; kw;Wk; 80 fNyhupfis mspf;fpwJ) nuhl;b : 1 Jz;L nea;As;s rg;ghj;jp : 1-6|| mfyk; muprp NrhW : 1/3 Nfhg;ig NfhJik> Nrhsk;> Xl;]>; cUisf;fpoq;F:1/2 Nfhg;ig Nrhsg;nghup : 3 Nfhg;ig thiof;fha; / gl;lhzp : 1/2 Nfhg;ig mtpay; : 1/2 Nfhg;ig mty; : 1/2 Nfhg;ig rhk;ghH : 1/2 Nfhg;ig gaW/jhdpaq;fs; : 1/2 Nfhg;ig(120 fNyhup) rikj;j E}Ly;];/uit:1/2Nfhg;ig ,l;yp : 1 ehd; nuhl;b : ¼ 8|| X2|| muprp khT : 2 Nkirf;fuz;b NfhJik khT : 2½ Nkirf;fuz;b

2 . UôªNm Utßm UôªNj§tÏl T§Xô] EQÜLs -kpf nky; y paJ (1 gupkhwy; czT> 7 fpuhk; Gujk;> 0-1 fpuhk; nfhOg;G kw;Wk; 35 fNyhupfis toq;FfpwJ) Nfhopf;fwp> thd;Nfhopf;fwp (Njhyw;w nts;is khkprk;) : 1 mTd;]; ^dh jz;zU P ld;> Fiwe;j nfhOg;G ghy;fl;b : 1 mTd;]; jl;ilahd kPd; : 1 mTd;]; nte;j gUg;G* : ½ Nfhg;ig Kl;ilapd; nts;isf;fU : 2 ,uhy; : 1 mTd;]; *(Vwf;Fiwa 15 fpuhk; CHO (rHf;fiur; Fiwe;j nfhOg;G NjhG : 3 mTd;]; rj;Jk;) 120 fNyhupfisAk; toq;FfpwJ)

UôªNm Utßm UôªNj§tÏl T§Xô] Uôtß EQÜLsþùUp­VÕ (1 gupkhwy; czT> 7 fpuhk; Gujk;> 3 fpuhk; nfhOg;Gr; rj;J ; 55 fNyhupfis mspf;fpwJ) Nfhop> thd;Nfhopf;fwp (Njhyw;w khkprk;) : 1 mTd;]; vz;nzapy; nghupj;j kPd:; 1mTd;]; nky;ypa nfhOg;Gs;s Ml;Lf;fwp> gd;wpf;fwp> khl;Lf;fwp : 1 mTd;]; fhl;Nl[; ghyhilf; fl;b : ¼ Nfhg;ig 3 fpuhk; my;yJ mjw;F Fiwe;j nfhOg;Gs;s ghyhilf;fl;b : 1 mTd;];

UôªNm Utßm UôªNj§tÏl T§Xô] Uôtß EQÜLsþªRUô] ùLôÝl×Pu (1 gupkhwy; czT> 7 fpuhk; Gujk;> 5 fpuhk; nfhOg;Gr; rj;J kw;Wk;; 75 fNyhupfis mspf;fpwJ) Kl;il : 1 upf;Nfhl;lh ghyhilf;fl;b : ¼ Nfhg;ig NjhG : 4 mTd;]; nlk;ng`; (Tempeh) (,e;NjhNdrpa Guj czT) : ¼ Nfhg;ig

tWj;j kPd; : 1 mTd;]; Ml;L khkprk; (tWj;j khHngYk;G) : 1 mTd;]; Nrhah ghy;

: 1 Nfhg;ig

80

UôªNm Utßm UôªNj§tÏl T§Xô] Uôtß EQÜLsþA§L ùLôÝl×Pu (1 gupkhwy; czT> 7 fpuhk; Gujk;> 8 fpuhk; nfhOg;Gr; rj;J kw;Wk; 100 fNyhupfis mspf;fpwJ) rhjhuz ghyhilf;fl;b : 1 mTd;]; epyf;fliy ntz;nza; : 1 mTd;]; (+ xU nfhOg;G gjpYzT) rhN][; : 1 mTd;];

Nfhop / thd;Nfhopf; fwp `hl; lhf; : 1 (10/ lb) 1 % gd;dHP : 1 mTd;];

3, LônL±Ls (ùLôÝl× úNodLlTPôRÕ) (1 gupkhwy; czT> 5 fpuhk; rHf;fiu khTr;rj;J> 2 fpuhk; Gujk; kw;Wk; 25 fNyhupfis mspf;fpwJ) gr;irf;fi P u> nte;jaf; fPiu : ½ Nfhg;ig Kl;ilf;Nfh];> fhypgpstH : ½ Nfhg;ig fj;jupf;fha; : ½ Nfhg;ig> jf;fhsp : ½ Nfhg;ig KUq;iff;fha;> ntz;ilf;fha; : ½ Nfhg;ig Nryl; (salat) : ½ Nfhg;ig

gr;ir mtiuf;fha; : ½ Nfhg;ig Riuf;fha; : ½ Nfhg;ig Flkpsfha; : ½ Nfhg;ig nts;is Ks;sq;fp> ngq;fðH fj;jupf;fha; : ½ Nfhg;ig

4, TZ YûLLs: (T¬Uô\p A[Ü UôßTÓm) (1 gupkhwy; czT> 15 fpuhk; rHf;fiu khTr;rj;J> 60 fNyhupfis mspff ; pwJ) thiog;gok; : ½ Nfhg;ig Mg;gps;> MuQ;R : 1 (rpwpaJ) Ngupf;fha; ngupaJ : ½ Nfhg;ig jHg+rzp : 1 Nfhg;ig khk;gok; : ½ Nfhg;ig nfha;ahg;gok; : ½ Nfhg;ig lg;ghtpy; milf;fg;gl;l gotif : ½ Nfhg;ig

5. Tôp Utßm Tôp ùTôÚhLs (1 gupkhwy; czT> 12 fpuhk; rHf;fiu khTr;rj;J> 8 fpuhk; Gujr; rj;J 1-5 fpuhk; nfhOg;Gr; rj;J> 90-150 fNyhupfis mspf;fpwJ) ntz;nza; vLf;fhj / ntz;nza; vLj;j / Fiwe;j nfhOg;Gs;s ghy; : 1 Nfhg;ig NkhH kw;Wk; japH (ntz;izaw;w my;yJ ntz;izAs;sit) : 1 mTd;]; 1% gd;dHP : 1 mTd;];

6. ùLôÝl×Ls Utßm GiùQnLs (1 gupkhwy; czT> 5 fpuhk; nfhOg;Gr;rj;J kw;Wk; 45 fNyhupfis mspf;fpwJ) rikay; vz;nza; : 1 Njf;fuz;b Ke;jpup> ghjhk; nfhl;ilfs; my;yJ gUg;Gfs; : 1 Nkirf;fuz;b

Njq;fha; JUty; : 2 Nkirf;fuz;b nfhOg;gw;w ntz;nza; : 1 Njf;fuz;b

*

nfhOg;G epuk;gpa ntz;iza; kw;Wk; nea; Nghd;wtw;wpw;Fg; gjpyhf nfhOg;G ,y;yhj Mypt; vz;nza; Nghd;w vz;nza;fisg; gad;gLj;jg; gofTk;.

*

tWj;j czT tiffis mbf;fb gad;gLj;Jtijj; jtpHf;fTk;.

*

vz;nza;fs;> cg;G kw;Wk; rHf;fiu gad;gLj;Jtijf; Fiwj;Jf;nfhs;sTk;.

mnkupf;f cztpay; rq;fk; kw;Wk; mnkupf;f ePupopT Neha; ghJfhg;G rq;fj;jhy; (1996) ,e;jpa-ghfp];jhdpa rikay; Kiw Fwpj;J jahupf;fg;gl;l czTj;jpl;lk; (1995) kw;Wk; ,dtop fl;LiufspypUe;J vLf;fg;gl;lJ. \py;]>; vk;. Xy;rd;> J.A. & \pfh MfpNahuhy; vOjp vk;. yP & /nggp[H fk;ngdp epWtdj;jhy; ntspaplg;gl;l khlHd; epa+l;up\d; ,d; n`y;j; & brPr]; (1994) XIIItJ gjpg;G.

81

G]Õ NodLûW úSôûVd LhÓlTÓjÕYRtÏ Sôu Guù]u] EiQXôm? Mrpa-,e; j pa rikay; Kiw Fwpj; j jfty; f Sk; > topfhl; b newpKiwfSk; (jq;fs; kUj;JtH kw;Wk; cztpay; ty;Yeupd; mwpTiug;gb gad;gLj;jTk;) (cq; f s; kUj; J tH kw; W k; cztpay; ty; Y eupd; mwpTiuf; N fw; g nray; g Lj; j Ntz; b a xU jdpegH czTj; jpl; l j; j pw; f hd khjpupg; gbtk; ) Nahfhrdk; / gapw;rp : kw;w xOq;FKiwg; gapw;rpfs; :

czT/ve; j tif

msT

fhy Neuk; : fhy Neuk; :

khT

G uj k ; (fpuhk;)

nfhOg; G fNyhupfs; (fpuhk;) (fpuhk;)

fhiy czT Kw;gfy; czT kjpa czT

gpw;gfy; czT ,uT czT

,uTr; rpw;Wz;b nkhj; j k; CHO = fhHNghi`l;Nul;> gms = fpuhk;fs; oz = mTd;]>; tsp = NjePH fuz;b> Tbsp = Nkirf;fuz;b ckd = Ntfitj;j 28-30 fpuhk; = 1 mTd;]>; 8 mTd;]; = 1 Nfhg;ig 3 Njf;fuz;b = 1 Nkirf;fuz;b> 2 Nkirf;fuz;b = 1 mTd;];

Padmini Balagopal, MS.BEd., RD.CDE Tamil translation done by Suguna Lakshmi Narayanan, MS.RD

82

English version Reviewed by Wahida Karmally, MS.RD.CDE Karmeen Kulkarni, MS.RD.CDE

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Bkkv @ kA Zkkv C Zk @mPkv @kg S k^kkTkm @mPk: VOkCkk^kv\kk HnRk HnRk ALkv]Ykkg UkkvakA PkP^kkv ^kDkk@v Uk|YkkOkYkkg ckvZk Gvå #kkAkXkkÆ QkkvMk UkkOkmYkkg WkkV^kkTkkå WkkVv\kk #kkAXkkÆ PkQkk XkkPkYkkgQkm UkkOkm MkNm Tk TkkBk^knå @mVk¥Tk A@v\kk TkkbPkkä ^kSkk@v YkmLk^kk]kv Av ^kSkk@v Fk@Wkm^kk]m (Dkmä Pkv\k) ^kkTkCkm¢kv ¢kvGm Bkk^kkTkm ¢Qk^kk PkvTkkQkm Ro@ @cv^kkTkng QkkvMgn QkkvMgn lR^kbkYkkg bkYkZkbk@ 5-6 ^kBkPk Bkk^knåg

Fkkv B Bkn g UkkOkm ¢Tkv Uk| ^ kkcm ^kSkk@v \kv ^ kn g ? R@@kvH 6-8 C\kkbk bkkRn ¢Tkv FkkvBBkn UkkOkm Ukm^knåg UkkOkm bkkwQkm ^kSkk@v bkk
#k@m@Tkv ¢bk@ A@^kk^kk]m ¢TZk WkkWkPkkv ? R@@kvH 20 Ck|kYk HvK\kkv @vbkk^kk]kv Bkkv@kA (Vk£Wk@) \kv^kkvå ¢kBkng ¢TkkHä ^kKkOkk FkOkkä PkQkk #kkAXkkÆ YkkgQkm ^kSkk@v Uk|YkkOkYkkg @vbkk (Vk£Wk@) Yk]vå DkOkm PkwZkk@ ^kkTkCkm¢kv (VkbK VnM) Ykkg BkkgMä YkmKng PkQkk Fk@Wkm ^kSkk@v Uk|YkkOkYkkg ckvZk Gvå ¢k^km ^kkTkCkm¢kvQkm Ro@ @cv^kng ¢Qk^kk Wkcng Tkc{ Bkk^knåg W\kM Uk|bv k@ ^kSkk@v @cvPkng ckvZk Pkkv YkmLng Tkc{ Hv^kng Bkk^knåg ¢QkkOkkä UkkUkM ¢Tkv WkKkKkOkm ^kvV@Qkm Ro@ @cv^knåg Akv¥ Bkkv@kA Uk|PZkv ¢v\kÆr ckvZk Pkkv ^kmKkYkmTkTkm Ckkv]m¢kv YkkKv PkYkk@k MkvAK@Tkv Bkkbk UkoG^knåg

MkZkkWkvKmbk AkWkoYkkg \k¥ #kAkZk Gv! AkWkoYkkg \kkv ! PkYkv Hæ@ Pkv A@m #k 83

MZkkWkv K mbk QkZkv \ k ^ZklAPkQkm #kn g Bkk¥ #kAkZk? (PkYkk@k MkvAK@ PkQkk MkZkvKm#kmZkTkTkm RvBk@vBk TkmFkv ^kkUk@^kkTkm YkklcPkm PkQkk YkkCkrR#krTk)

TkkYk: ¢vA lR^kbkYkkg Bkk^kkTkm Aw\kv@m:

¢kHTkm Pkk@mBk : ¢kHTkng ^kHTk :

bkYkPkkv\k ¢kck@Ykkg TkmFkvTkk DkKAkvTkkv bkYkk^kv#k QkkZk Gvå PkYkk@m @cvOkm-A@Okm Uk|YkkOkvä MkZkvKm#kmZkTk UkkbkvQkm bkYkHkv Av bk^kk@vå WkUkkv@v ¢Tkv bkkgHv #kng #kng Bkk^kkTkng ^kSkk DkKAkvYkkgQkm QkkvMkv QkkvMkv ¢kck@ \kv^kkvå R@vA DkKAYkkgQkm ¢vA bk^kk‘CkTkkv RkBk\kkv TkmFkv Uk|YkkOkv Gv (TkkvSg k A@kv RkBk\kk Pk@mAv):

1å¢TkkH FkOkk ^kKkOkk bKkFkmr #kkAXkkÆ (Dkm PkQkk Pkv \ k ^kCk@): 1å¢TkkHÖFkOkk FkOkkÖ^kKkOkk ^kKkOkkÖbKkFkmr (1 bk^kk‘Ck ¢vK\kv \kCkXkCk 1Uk Ck|kYk AkWkkvcr k£M}Kv ä 3 Ck|kYk Uk|kKv mTkä 80 Av\kv@m) Wk|Mv : 1 b\kk¥bk bknAm @kvK\km : 1-6'"' " Ckkv] XkkPk : 1Ö3 AUk Sk§ä YkAk¥ä WkKkKk : 1Ö2 AUk (¢kv@bk ) UkkvUkAkTkr 3 AUk ^kKkOkkä AkFkk Av]kä 1Ö2 AUk Ukky¢k : 1Ö2 AUk ¢k^kmZk\k : 1Ö2 AUk bkgXkk@ : 1Ö2 AUk ALkv]ÖRk] : 1Ö2 AUk (120 Av\kv@m) #kgDkv\km AkgÆ £M\km : 1 ¢Tkv bUkCkvKm 1Ö2 AUk TkkTk : 1Ö4 8""ø2"" FkkvBkkTkm \kkvK : 2 FkYkFkk Sk§Tkkv \kkvK : 2-1Ö2 FkYkFkk

2åYkkg åYkkg b k - Fk@Wkm l^kTkkTkn g :

(1 bk^kk‘Ck ¢vK\kv 7 Ck|kYk Uk|kKv mTkä 0-1 Ck|kYk Fk@Wkm ¢Tkv 35 Av\kv@m) FkmATkÖKAmr (FkkYkMm l^kTkkTkng bkVvR Ykkgbk) : 1 ¢kwbg k KnTkk (UkkOkmYkkg) V\kk£TM@ YkkG\km : 1 ¢kwbg k \kkv VvK FkmH-1 ¢kwbg k ,MkTkkv VAPk bkVvR XkkCk : 2 #k|mYUk : 1 ¢kwbg k Rk]* : 1Ö2 AUk (@kgSkv\km) (*15 Ck|kYk AkWkkvcr k£M}Kv ) PkkvVn (UkTkm@) \kkv VvK : 3 ¢kwbg k (¢Tkv \kCkXkCk 120 Av\kv@m Yk]v Gvå)

Ykkg b k-Qkkv M m Fk@Wkm^kk]n g : (1 bk^kk‘Ck ¢vK\kv 7 Ck|kYk Uk|kKv mTkä 3 Ck|kYk VvK ¢Tkv 55 Av\kv@m) FkmATk-KAmr (FkkYkMm l^kTkkTkng Mk¥ Ykkgbk) : 1 ¢kwbg k KTkk Pkv\kYkkg : 1 ¢kwbg k \kvYWkä UkkvAär Wkm< (Fk@Wkm ^kCk@Tkkv)-1 ¢kwbg k Fkm<-3 Ck|kYk ¢Qk^kk ¢kvGm-1 ¢kwbg k Fk@Wkm^kk]kv AkvKH v FkmI : 1Ö4 AUk

Ykkg b k-YkSZkYk FkcWkm^kk]n g : (1 bk^kk‘Ck ¢vK\kv 7 Ck|kYk Uk|kKv mTkä 5 Ck|kYk Fk@Wkm ¢Tkv 75 Av\kv@m) ¥Mng - 1 PkWkv\km YkkgG\km : 1 ¢kwbg k @mAkvKk FkmI- 1Ö4 AUk \kvYWk (@mBk @kvbKä Ck|k§TM)-1 ¢kwbg k bkkvZkkWkmTkTkkv RoSk-1 AUk PkkvV-n 4 ¢kwbg k KwYkkv-1Ö4 AUk

84

¢lPk#kZk Fk@Wkm ^kk]n g : (1 bk^kk‘Ck [ 7 Ck|kYk Uk|kKw mTkä 8 Ck|kYk Fk@Wkm ¢Tkv 100 Av\kv@m) FkmI (@vCZkn\k@) : 1 ¢kwbg k FkmATkÖKAmr ckvK MkvCk 1(10 ÖUkk§TM) UkmTkK WkK@ : 1 ¢kwbg k (+1 Fk@WkmTkkv ¢vAbkvTH) bkkvbkvH : 1 ¢kwbg k 1% UkTkm@ : 1 ¢kwbg k

3å#kkA XkkÆ (Pkv \ kä Dkm ^kCk@Tkk) (1 bk^kk‘Ck [ 5 Ck|kYk AkWkkvcr k¥M}Kv ä 2 Ck|kYk Uk|kKv mTk ¢Tkv 25 Av\kv@m) YkvQkmTkk XkkÆ : 1/2 AUk ^kKkOkk : 1/2 AUk CkmbkkvWkm : 1/2 AUk AkvWkmä V\kk^k@ : 1/2 AUk @{CkOkk : 1/2 AUkä KYkvKk : 1/2 AUk Ykkv@k : 1/2 AUk bkVvR YkoBkkä bk@Ck^kkTkm #k{Ckä Xk{Mk : 1/2 AUk (Zk^kZk^k) bkv\kM : 1/2 AUk

4åV] (1 bk^kk‘Ck [ 15 Ck|kYk AkWkkvcr k¥M}Kv ¢Tkv 50 Av\kv@m) Av]kg : 1/2 AUk bkV@HTkä Tkk@gCkm : 1 (TkkTkk) Fkm\kWkkvä A\k{Ck@ : 1 AUk YkkvKgn Ukv@ : 1/2 AUk ¢kgWkkv : 1/2 TkkTkkv HkYkV] : 1/2 AUk AvTM VUk - 1/2 AUk (TkkTkk)

5åRo S kä Rc{ £PZkklR (1 bk^kk‘Ck [ 12 Ck|kYk AkWkkvcr k¥M}Kv ä 8 Ck|kYk Uk|kKw mTkä 1-5 Ck|kYk Fk@Wkm ¢Tkv 90-150 Av\kv@m) RoSk (ckv\kä bAmYkä \kkv VvK) : 1 AUk Gk#kä Rc{ : 1 AUk(@kvTM ¢kv@ whole) 1% UkTkm@ : 1 ¢kwbg k

6åFk@Wkmä Dkmä Pkv \ k (1 bk^kk‘Ck [ 5 Ck|kYk Fk@Wkm ¢Tkv 25 Av\kv@m) Pkv\k-1 FkYkFkm (GmOkv\kn) AkvUk
*bkvFZkn@vKvM Fk@Wkm-YkkBkOk ¢Tkv DkmTkk WkR\kvä ¢TkbkvFZkn@vKvM Fk@Wkm ¢kv\km^kTkng Pkv\k ^kkUk@^kng ^kSkk@v lcPkk^kc Gvå TkUkv\km ^kkTkCkm¢v ¢PkmbkZk Tk bkvDkå *Dkmä Yk{Ln ¢Tkv BkkgM ¢kvGm ^kkUk@kv ¢vMvUKvM VkvYk ¢vMbkFkvTH \kmbK Vkv@ Ykm\k U\kkTk{Ck (1995) ¢vTM Sk ¢vQkTkmA bkm@mI ¢kvTk Sk £TMmZkTk UkkAmbPkkTkm AnImTkä WkkZk ¢Ykv@mATk MkZkvWkvKmA ¢#kkv#kmZkvbkTk ¢Tkv ¢Ykvl@ATk MkZkkWkvKmA ¢vbkkv#kmZkvbkTk (1996); YkkvMTr k TZknKm} #kTk £Tk cv\Qk ¢vTM Mmbkmbkä 13Ykm ¢vMm#kTkä FkvKmKvM WkkZk bkm\bkä ¢vYk ¢kv\k#kTkä Hvå¢vå ¢vTM #kk¥Aä ¢vYk\kmå ¢Tkv VvWkmCk@ AgUkTkm (1994)

85

MkZkkWkv K mbk QkZkv \ k ^ZklAPkQkm #kn g Bkk¥ #kAkZk? Xkk@PkmZk Bkkv@kA YkkKv bkoFkTkk (PkYkk@k MkvAK@ PkQkk MkZkvKm#kmZkTkTkm RvBk@vBk TkmFkv ^kkUk@^kkTkm YkklcPkm PkQkk YkkCkrR#krTk) Mkv A Kbkr ¢Tkv MkZkv K m#kmZkTk ÿk@k ¢kUkTkm ^ZklAPkCkPk Hæ@mZkkPk Ykn H Wk Wkk^kv \ k ¢kck@ Uk| k v C k| k Yk Vkv Y kr T kkv TkYko T kk

ZkkvCk-^ZkkZkkYk (¢vAbk@bkk¥I): RwlTkA AkZkr¿Yk : Bkkv@kA

AvK\k\kng (bk^kk‘Ck)

bkYkZk: bkYkZk: AkWkkvrck¥M}vK (Ck|kYk)

Uk| k v K mTk (Ck|kYk)

Fk@Wkm (Ck|kYk)

Av\kv@m

bk^kk@v TkkbPkkv WkUkkv@v

TkkbPkkv bkkgHv

TkkbPkkv KkvK\k Ck|kYk [ MS. 1 ¢kwB.Ed., gbk; 8 ¢kwRD.CDE gbk [ 1 AUkä 3 FkYkFkm [ 1 FkYkFkkv; 2 FkYkFkk [ 1 ¢kwgbk Padmini28-30 Balagopal, Gujarati Translated by Rita (Shah) Batheja, MS.RD.CD.N. Bharat Shah, MD. English version Reviewed by

Wahida Karmally, MS.RD.CDE Karmeen Kulkarni, MS.RD.CDE

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Clinical Preventive Services for Normal-Risk Adults Screening Blood Pressure, Height and Weight: Periodically, 18 years and older. Cholesterol: Men, Every 5 years (and more frequently if at risk or abnormal), 35 years and older Women, Every 5 years (and more frequently if at risk or abnormal), 45 years and older. Diabetes: Periodically, adults with hypertension or hyperlipidemia. Pap Smear: Women, Every 1 to 3 Years, 18-65 years. Mammography: Every 1 to 2 Years, 40 years and older. Colorectal cancer: Periodically, 50 years and older with Stool Guiac &/or sigmoidoscopy or colonoscopy. Osteoporosis: Women, routinely, > 65 years or > 60 years at increased risk for fractures. Alcohol Use: Periodically, 18 years and older. Vision, Hearing: Periodically, 65 years and older. PSA Screening: In Men Periodically

Immunization Tetanus-Diphtheria (Td): Every 10 Years, 18 years and older. Varicella (VZV): Susceptible only Two doses, 18 years and older. Measles, Mumps, Rubella (MMR): Women of childbearing age-One dose, 18-50 years. Pneumococcal: One dose, 65 years and older. Influenza: Yearly, 50 years and older.

Chemoprevention Discuss aspirin to prevent cardiovascular events: Men, Periodically, 40 years and older. Women, Periodically, 50 years and older. Discuss breast cancer chemoprevention with women at high risk. Counseling Calcium Intake: Women, Periodically, 18 years and older. Folic Acid: Women of childbearing age, 18-50 years. Tobacco cessation, drug and alcohol use, STDs and HIV, nutrition, physical activity, sun exposure, oral health, injury prevention, and poly-pharmacy: Periodically, ≥18 years. Upper age limits should be individualized for each patient.

Weight Normal body mass index (weight (kg)/height (sq. meters) for Indian Americans is <23 Waist circumference <90 cm or 36 inches (men); < 80 cm or 32 inches (women) ! ! "#$!"%&'&($)*(!)($*!"%+,$),&---!

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Diabetes Numbers At-a-Glance† (For Nonpregnant Adults)

Criteria for Diagnosis of Pre-diabetes > 110 – < 126 mg/dl (Fasting plasma glucose) Impaired glucose tolerance (IGT) > 140 – < 200 mg/dl (2-hr 75g OGTT) Impaired fasting glucose (IFG)

Criteria for Diagnosis of Diabetes Random plasma glucose > 200 mg/dl* with symptoms (polyuria, polydypsia, and unexplained weight loss) Fasting plasma glucose > 126 mg/dl* 2-hr plasma glucose > 200 mg/dl* after 75g OGTT *Repeat to confirm on subsequent day

Treatment Goals for the ABCs of Diabetes††

A1C < 7 % Preprandial plasma glucose 90 – 130 mg/dl Peak postprandial plasma glucose < 180 mg/dl

Blood pressure (mmHg) Systolic Diastolic Hypertension definition >140 and/or >90 Treatment goal <130 and <80

Cholesterol – Lipid Profile (mg/dl) LDL Cholesterol < 100 HDL Cholesterol Men > 40 Women >50 Triglycerides < 150 † American Diabetes Association Clinical Practice

Recommendations, Diabetes Care 26 (Suppl.1): S33-S50, 2003. †† NDEP promotes control of the ABCs of diabetes and use of the term A1C for Hemoglobin A1c.

Diabetes Management Schedule At each regular diabetes visit: • • • • •

Measure weight and blood pressure. Inspect feet. Review self-monitoring glucose record. Review/adjust medications. Recommend regular use of aspirin for CVD prevention. • Review self-management skills, dietary needs, and physical activity. • Determine Medicare benefits eligibility for medical nutrition therapy and diabetes self-management education. • Counsel on smoking cessation and alcohol use.

Twice a year: • Obtain A1C in patients meeting treatment goals with stable glycemia (quarterly if not). • Refer for dental exam.

Annually: • Obtain fasting lipid profile (less often if normal). • Obtain serum creatinine and urinalysis for protein and microalbumin. • Refer for dilated eye exam. • Perform comprehensive foot exam. • Administer influenza vaccination.

Usually only once: • Administer pneumococcal vaccination.

To order NDEP materials for your practice, call 1-800-438-5383 or visit our web site at www.ndep.nih.gov The National Diabetes Education Program (NDEP) is a partnership of the National Institutes of Health, the Centers for Disease Control and Prevention, and over 200 partner organizations. NIH Publication No. NDEP-12, Revised February 2003