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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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According to the NHLBI guidelines, assessment of excess weight involves using three key
measures:
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The BMI is a measure of your weight relative to your height and waist circumference measures
abdominal fat. Combining these with information about your additional risk factors yields your
risk for developing obesity-associated diseases.
!I#
What is Your Risk?##
1. Body Mass Index (BMI)#
BMI is a reliable indicator of total body fat, which is related to the risk of disease and death. The
score is valid for both men and women but it does have some limits. The limits are:#
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Use the BMI calculator <http://www.nhlbisupport.com/bmi/bmicalc.htm> or tables to
estimate your total body fat. The BMI score in the following shows how to rate the weight
status.
FOR INDIANS Normal BMI is <23
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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,
<bmi_dis.htm> 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.
Risk Factors
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4. Assessment#
For people who are considered obese (BMI greater than or equal to 30) or those who are
!!#
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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http://www.diabetes.org/main/application/commercewf
http://www.diabetesnet.com/
http://www.aadenet.org/
http://www.joslin.harvard.edu/education/library/index.shtml
http://www.eatright.org/
http://ndep.nih.gov/get-info/dpi.htm
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DIABETES CAN BE MANAGED! TAKE CONTROL! YOU CAN DO IT!!
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A sample format for an Individualized Meal Plan
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• bk†WHkZkkx Aùkv AùYk UkTkm Ykx SÉ¤ÉÔªÉ UAùkTkk Fkklc.‹ Fkk^k\k PQkk bk†WHkZkkx Aùkv UAùkPv bkYkZk ¤TkAùk UkTkm Tkc{ VvúAùTkk
Fkklc.‹
• ¢lSkAù ^kbkkZkn‘Pä TkYkAùmTkä VúkbK VnúMä PQkk HZkkRk ÉkkvbkvbK XkkvHkTk Aùk AùYk bkv AùYk ¤UZkkvCk
Aù@Tkk Fkklc.‹
• lTkSkkrl@P bkYkZk U@ QkkvMjk-QkkvMjk Aù@Avù Aù£r Wkk@ BkkTkk Fkklc.‹
¢lSkAù YkkÇkk Ykx UvZk URkQkr ¢kw@ #kná Hk\k Ê{ÉªÉå
• lRTk Ykx AùYk bkv AùYk G: bkv ¢kL lCk\kkbk UvZk Hk\kÖUkTkm UmTkk Fkklc.‹ bkkRk UkTkm bkWkbkv ¢FGk
@cPk cw‹ FkkZkä AùktVúm PQkk AvùVúmTkZkn‘P P@\k URkQkkv‰ Aùk AùYk bkv AùYk ¤UZkkvCk Aù@Tkk Fkklc.‹
• ¢UTkv Mk‘K@ Avù U@kYk#kr Avù lWkTkk #k@kWk Aùk bkv^kTk Tk Aù@x‹
b^kkbQZk bkYWk†TSkP ¢TZk HkkTkAùkl@Zkkf
• lRTk Ykx 50 Ck|kYk @v#kvRk@ XkkvHkTk BkkTkk Fkklc.‹ lG\kAvù bklcP ¢Ækä WkmTbkä PQkk bk†WHkZkkx Ykx ¢lSkAù @v#kk ckvPk cw‹
• WkkHkik@ Ykx ÉkFkl\kP VúkbK VnúM BkkTkv Ykx ^kbkkä TkYkAù PQkk FkmTkm Aùm ¢lSkAùPk ckvPm cw‹ £bkl\k. £TkAùk AùYk bkv AùYk
¤UZkkvCk Aù@Tkk Fkklc.‹
• ¢lSkAù @‘PFkkU Aùm lWkYkk@m Ykx TkYkAù ¢kw@ TkYkAùmTk BkkTkk Hkwbkv lAù lFk¶bk ¢kw@ ¢kFkk@ Aùk AùYk ¤UZkkvCk Aù@Tkk Fkklc.‹
• ¢UTkv Mk‘K@ bkv UoG Aù@ cm Yk\Kml^kKlYkTk~bk ¢kw@ Yk\Km lYkTk@\k +xÉÖ{ÉÚ®úEòÉä Aùk £bPvYkk\k Aù@Tkk Fkklc.‹ lAùbkm +É{ÉEäò
JÉÚxÉ Eäò SÉ¤ÉÔ ºiÉ®ú xÉä¨ÉÒ VÉÉÆSÉ Eò®ú ±ÉäxÉÉ
S>m`]roQ>g Aùkv lTkZkglÇkP lAùZkk Hkk bkAùPk cw‹ lTkZkgÇkOk Aù@xä +É{ÉEäò ¤ÉºÉ EòÒ ¤ÉÉiÉ cy‹
67
S>m`]roQ>g Aùkv lTkZkglÇkP Aù@Tkv Avù l\kZkv ‘Zkk BkkTkk Fkklc.?
TkkYk:
Eèò±ÉÉä®úÒÖlRTk:
lRTkkgAù :
^kHkTk :
bkgPnl\kP ¢kck@ WkTkkTkv Avù l\k. XkkvHkTk Ykx l^kl#kì P’^kkx Aùk bkYkkZkkvHkTk ckvTkk Fkklc.‹ ¢kUAùk ^Zk†‘PCkP BkkTk-UkTk ¢kUAvù
@cTk-bkcTk Avù NgCk Avù ¢Tknbkk@ ckvTkk Fkklc.‹ XkkvHkTk ZkkvHkTkk Aùkv lTkYTkl\klBkP XkkCkkx Ykx l^kXkklHkP lAùZkk Hkk bkAùPk cw‹
lTkYTkl\klBkP ¤Rkc@Okkx Avù çk@k ½þ¨É ºÉ¨ÉZÉ ºÉHäò ½èþ cw lAù l^klXkTTk P@c Avù XkkvHkTk bkYkockx Ykx bkv AùkwTk bkk XkkvHkTk lAùbk bkYkZk
Aù@Tkk Fkklc.‹ (SZkkTk @cv lAù Zkv YkkÇkkZkx \kCkXkCk cy)
1å Rk\kxÖVúl\kZkkfÖbKkFkrZkn‘P bk†WHkZkkf (FkWkmr ¢kw@ Pv\k @lcP)
(1 XkkvHkTk Aùk .Aù XkkCk \kCkXkCk 15 Ck|kYk AùkWkkvrck£M}vK 3 Ck|kYk ÉkkvKmTk .^kg 80 Avù\k@mHki)
MWk\k @kvKm 1 KnAùMjk
bkoBkm FkUkPm 1-6ï FkkwMjm)
Fkk^k\k 1Ö3 AùU
Ckvcofä ¢kvK~bkä ¢k\ko 1Ö2 AùU
XknTkv cn. YkAù£r Avù RkTkv 3 AùU
AùÃkk Avù\kkÖYkK@ : ¢kSkk AùU
.vl^k\k : 1Ö2 AùU
Ukvck 1Ö2 AùU
bkkYWk@ : 1Ö2 AùU
JÉä¨É/¡ò±ÉÒ 1Ö2 AùU (120 Awù\k@mHki)
PwZkk@ bkvlYkZkkg TZkoM\kvbkÖbkoHkm : 1Ö2 AùU
£K\km : 1 TkkTk : 1/4 8ïø2ï
Fkk^k\k Aùk ¢kKk : 2 WkMjk FkYYkFk
Ckvcof Aùk ¢kKk : 2½ WkMjm FkYYkFk
2å Ykkgbk .^kg Ykkgbk Aùk +ÉÄ±]õ®úxÉäÊ]õ´É (¢lP AùYk FkWkmr Zkn‘P)
(1 lcbbkk bkkP Ck|kYk ÉkkvKmTkä 0-1 Ck|kYk FkWkmr PQkk 35 Avù\k@mHki RvPk cw!)
YknCkmr KAùmr (’^kFkk@lcP bkVvúR Ykkgbk):1 ¢kwgbk
AùYk ^kbkk ^kk\kk UTkm@ : 1 ¢kwgbk
KoTkk .^kg $\kk£TM@ YkFGm UkTkm Ykx 1 ¢kwgbk
Rk\k : 1Ö2 AùU UAùm cn£r
Rkv ¢OMkx Aùk bkVvúR lcbbkk
(Zkc Rk\k \kCkXkCk 15 Ck|kYk AùkWkkvrck£M}vK~bk PQkk
l#k@YU (ÉkkvTbk) : 1 ¢kwgbk
120 Avù\k@mHki RvPm cw)
AùYkFkWkmr ^kk\kk KkvVoú 3 ¢kwgbk
Ykkgbk .^kg Ykkgbk Aùk +ÉÄ±]õ®úxÉäÊ]õ´É (AùYk FkWkmr Zkn‘P)
(1 lcbbkk bkkP Ck|kYk ÉkkvKmTkä 3 Ck|kYk ^kbkk PQkk 55 Avù\k@mHki RvPk cw!)
YknCkmr KAùmr (’^kFkk@lcP MkAùr KkgCk Ykkgbk): 1 ¢kwgbk
KoTkk YkFGm Pv\k Ykx : 1 ¢kwgbk
AùkvKvHki Fkmbk 1Ö4 AùU UTkm@
lHkbkYkx PmTk Ck|kYk PAù ^kbkk ckv : 1 ¢kwgbk
Ykkgbk .^kg Ykkgbk Aùk +ÉÄ±]õ®úxÉäÊ]õ´É (YkSZkYk FkWkmr Zkn‘P)
1 ¢gMk : 1
l@AùkvKk FkmHk : 1Ö4 AùU
KkvVoú : 4 ¢kwgbk KvYVú 1Ö4 AùU
bkkvZkkWkmTk Aùk RoSk : 1 AùU
P\km cn£r YkFGm 1 ¢kwgbk XkvMj Aùk Ykkgbk (XknTkm cn£r l@WWk AùmYkm) 1 ¢kwgbk
68
Ykkgbk .^kg Ykkgbk Aùk +ÉÄ\kK}kTkvlK^k (¢lSkAù FkWkmr Zkn‘P)
@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 Ê±ÉB 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 Ê¨É±ÉÉ =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 EÚòÊºÉxÉ
¢Ykv@mAùTk Mk£rK ¢#kkv#km.#kTk .gM ¢Ykv@mATk MkZkkWkvKmbk ¢#kkv#kmv.bkTk (1996)
¨ÉÉäb÷xÉÇ ¤ªÉÚÊ]õ¶É º´ÉÉºlªÉ Ê´É ¤ÉÒ¨ÉÉ®úÒ ¨Éå iÉä®ú½þ´ÉÉÄ ºÉÆº´ÉÉ®úhÉ ºÉ±ÉÉnù ¶ÉÒ±ºÉ, ½þ¨É +Éä±ÉVÉ VÉä +Éè®ú ¶ÉÉ<{É ½þ¨É Ê±ÉªÉä ´Éä ¡äòÊ¤É®ú
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 +±{ÉÉ½þÉ®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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2.
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(JM¥Úß ®ÛÄß N 7 VÛÃM ®æãÃÞnÞ«é,(protein) 0-1 VÛÃM Oæà¶ß¹ (fat) ÈÚß}Úß¡ 35 OÛÀÄÂVÚ×ßÚ (calories)
OæàÞØ, lP% (^ÚÈßÚ %ÉÄÇ¥Ú ¸×ÚÈáÚ ÛMÑÚ) N 1 L«éÓ
lßÀ«Û ÉßÞ«Úß (¬ÞÂ«ÚÆ)Ç , ^Ú®°Ú mæ ÉßÞ«Úß N 1 L«éÓ OÚtÈæß Oæà¸¹«Ú ·æÞÑé N 1 L«éÓ
ÈÚáÛmæo¾ßÚ ¸Ø¾Úß ºÛVÚ ÈÚáÛ}ÚÃ N 2
}æàVÚÂ ·æÞ×æ *N 1/2 @×Ú}¾
æ ßÚ ¶loÄß
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* (@M¥Ûdß 15 VÛÃM OÛ·æà%ÞÔæçsÃæ Þmé,
120 OÛÀÄÂ J¥ÚWÑÚß}Ú¥
¡ )æ
mæàÞ®Ú´â (ÑæàÞ¾Úß ·æÞÑéNOÚtÈæß Oæà¸¹«¥
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OÚtÈæß Oæà¸¹«Ú¥Úß
(JM¥Úß ®ÛÄß N 7 VÛÃM ®æãÃÞnÞ«é(protein), 3 VÛÃM Oæà¶ß¹ (fat) ÈÚß}Úß¡ 55 OÛÀÄÂVÚ×Úß
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OæàÞØ, lP% (^ÚÈßÚ %ÉÄÇ¥Ú OÚ®ýâÚ ° aÛ¾æß¾Úß ÈÚáÛMÑÚ) N 1 L«éÓ
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OÚßÂ, ÔÚM¦, ¥Ú«Ú¥Ú ÈÚáÛMÑÚN1 L«éÓÓ
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3 VÛÃM @¢ÚÈÛ OÚtÈæß Oæà¶ß¹ BÁÚßÈÚ ·æÞÑé : 1 L«éÓÓ
ÑÛ¨ÛÁÚy Oæà¸¹«Ú¥Úß
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ÈÚáÛmæo N 1 L«éÓ
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3.
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(JM¥Úß ®ÛÄß N 2 VÛÃM ®æãÃÞnÞ«é (protein), 5 VÛÃM OÛ·æà%ÞÔæçsæÃÞmé (CHO)
ÈÚß}Úß¡ 25 OÛÀÄÂVÚ×Úß (calories)
ÔÚÒÁÚß }ÚÁÚOÛÂ N ÈæßM}ÚÀ¥Ú ÑæàÞ®Úâý° N 1/2 @×Ú}æ¾Úß ¶loÄß #N ÔæÑÚÂ ÔÚßÁÚßØOÛ¿ß N
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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 (Oæà¸¹ÄÇ¥Ú/ÑÚÊÄ°Oæà¸¹«Ú/®Úã~%Oæà¸¹«Ú) N @×Ú}æ¾Úß ¶mæoÄß
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6.
Gzæ| ÈÚß~¡}ÁÚ Ú Oæà¸¹«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 (ÔæÁæ¦¥Úß§) N 2 mæÞ¶Åé ^ÚÈÚß^Ú
¸ÞdVÚ×Úß N 1 mæÞ¶Åé ^ÚÈÚß^Ú N ÈÚáÛd%Â«é / ÈÚ«ÚÑÚ°~ }Úß®Ú° N 1 mæÞ¶Åé ^ÚÈÚß^Ú
• ÑÛ¨Ú´ÀÈÛ¥ÚÎÚßo @«éÑÛÀ^ÚßÁæÞmæsé Oæà¸¹«Ú Gzæ| (AÆÈé Gzæ| }ÚÁÚÔÚ¥Úß§) ¶ØÒ N
ÑÛÀ^ÚßÁæÞmæsé Oæà¸¹«Ú (}Úß®Ú°, ·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 ÈÚß¨ÚßÈæßÞÔÚ (sÚ¾áÚ Û¸ÞnÑé) SÛ¾ÚßÅæ¾ßÚ «Úß- ÔÚ}àæ Þn¾ÚßÆÇsÄÚ ß «Û«æÞ«Úß ~«Ú-·æÞOÚß?
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ÑÚÈßÚ ¾Úß N
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(fat)
(calories)
±ÚÄÔÛÁÚ
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@×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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N][²T¶ úgRiV²ïR¶VM-I-NRPÉÓÁ
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1% xms¬dsõ-LìiM 1 K©«sV=
6. ©«sW®© ÌÁV ª«sVLji¸R¶VV úN]ª«so* xmsµy-LóRi-ª«sVVÌÁV
(INRPä Ë³ØgRi-ª«sVVÍÜ[ 5 úgS. úN]ª«so* ª«sVLji¸R¶VV 45 NSùÌÁ-LkiÌÁV DLi²R¶V-©«sV)
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3
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Ë³Ü[ÇÁ-©«sª«sVV A¥¦¦LRi
LRiNRPª«sVV (úgS.)
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xqsª«sV¸R¶V ª«sVV :
qsª«sV¸R¶V ª«sVV :
zmsLi²T¶ xmsµy-LóRi-ª«sVVÌÁV ª«sWLixqs-NRPX-»R½VòÌÁV úN]ª«so* xmsµy-LóRi-ª«sVVÌÁV
(úgS.)
(úgS.)
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NSùÌÁ-Lki£qs
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LSú¼½ Ë³Ü[ÇÁ-©«sª«sVV
LSú¼½ xmnsÌÁ-¥¦¦¦-LRiª«sVV
®ªsVV»R½ªò s« VV
1 K©«sV=-- = 30 úgSª«sVV-ÌÁV, 1 NRPxmsoö = 8 K©«sV=-ÌÁV, 1 Â¿ÁLi¿y i= 3 Â¿ÁLi¿y-ÌÁV,
2 Â¿ÁLi¿yÌÁV i= INRPä K©«sV=, INRPä Â¿ÁLi¿y i= 15 -sVÖdýÁ ÖdÁÈÁLýRiV
INRP ¿y¸º¶V Â¿ÁLi¿y i= 5 -sVÖdýÁ ÖdÁÈÁLýRiV
Karemeen Kulkarni, MS.RD.CDE
Padmini Balgopal, MS.B.Ed., RD.CDE
Telugu Translation by :
A. Narasimha Reddy, MD, FACG, FACP
4
G]Õ NodLûW úSôûVd LhÓlTÓjÕYRtÏ Sôu Guù]u] EiQXôm?
B£VþCk§V NûUVp Tt±V RLYpLÞm, Y¯Lôh¥ ùS±Øû\LÞm
(jq;fs; kUj;JtH kw;Wk; cztpay; ty;Yeupd; (Dietitian) mwpTiug;gb gad;gLj;jg;gl Ntz;baJ)
· rHf;fiu Neha; vd;gJ> cq;fs; cly; NghJkhd ,d;Rypd; cw;gj;jp nra;a ,ayhjNghJ
my; y J ,d; R ypd; Kiwahf gad; g Lj; j g; g lhkypUf; F k; N ghJ cz; l hFk; xU
epiyahFk;. ePqf
; s; cl;nfhs;Sk; cztpypUe;J cilj;njLf;fg;gl;l rHf;fiuahd
FSf; N fhrpypUe; J cq; f s; cly; rf; j p ngWtjw; F ,d; R ypd; cjTfpwJ.
,d;RypDf;Fk;> ,uj;jj;jpYs;s FSf;NfhRf;Fk; ,ilNaAs;s msTfs; ruptu
,y;yhky; ,Uf;Fkhdhy;> mJ cq;fs; ,uj;jj;jpy; mjpf FSf;Nfh]; (rHf;fiu)
msit (i`g;gH-f;isrPkpah) my;yJ ,uj;jj;jpy; Fiwe;j FSf;Nfh]; (rHf;fiu)
msit (i`g;NghfpisrPkpah) Vw;gLj;jyhk;.
· Muha;rr
; p %yk; fz;lwpe;j msT tpfpjg;gb ,uj;jj;jpy; rHf;fiuia fl;Lg;ghl;by;
itj;jpUf;fNtz;baJ kpfTk; Kf;fpakhFk;. cq;fs; fz;fs;> rpWePufq;fs;> ,uj;jf;
Foha;fs; kw;Wk; gpw clYWg;Gfspy; rpijT (rpf;fy;) Vw;glhky; jLg;gjw;F ,J
cjtKbAk; vd;gij Muha;rr
; p ep&gpj;Jf;fhl;bAs;sJ.
·cq;fs; kUj;Jtupd; topfhl;Ljypd;gb kUj;Jt Cl;lr;rj;JzT rpfpr;ir
Nkw;nfhs;tjd; topahf-mjhtJ> xU jdpegH czTj;jpl;lk>; (4k; gf;fj;ijg; ghHf;fTk;) Njitahd
clw;gapw;rp kw;Wk; kUe;Jfis itj;J rHf;fiu NehAk;> ,uj;jj;jpy; cs;s rHf;fiu msTk; fl;Lg;gLj;jg;gLk;.
·ePqf
; s; cz;Zk; czT> nkhj;j ntg;gf;$Wfs; (fNyhupfs;)> cq;fs; Ntiy> tho;fi
; f Kiw kw;Wk; cly;
vil Kjypad cq;fs; ,uj;jj;jpy; rHf;fiu msTfis epHzapf;fpd;wd. khTr;rj;Jfs; mlq;fpa czTfs;
,uj;jj;jpy; rHf;fiu msit mjpfupf;ff;$Lk;. nfhOg;Gr;rj;J kw;Wk; Gujk; epiwe;j gz;lq;fis msTf;F
mjpfkhf cz;lhYk;$l mJ cly; vilia ghjpf;Fk;.
·,uj;j mstpy; Vw;gLk; Vw;w ,wf;fq;fis ,d;Dk; ed;whfg; Gupe;Jnfhs;tjw;F cq;fs; czT kw;Wk;
,uj;jj;jpy; rHf;fiu msTfis md;whlk; gupNrhjpj;J> Fwpj;J itj;J ftdpj;J tuNtz;baJ mtrpakhFk;.
·(cq;fs; kUj;Jtuplk; fye;jhNyhrpj;j gpd;G) cq;fs; czTj;jpl;l KiwNahL NrHj;J ehs;NjhWk; clw;gapw;rp
nra;Ak; jpl;lj;ijAk; Vw;gLj;jpf;nfhs;sTk;.
·cq;fSf;F Vw;w czTg; nghUl;fs; vd;ndd;d vd;gijAk; mtw;wpy; cs;s rj;Jf;fspd; tpfpjq;fisAk;
ed;whf mwpe;Jnfhs;Sq;fs;. cq;fs; cztpay; ty;YeH ,jpy; cq;fSf;F cjTthH.
EQÜ RVô¬dÏm Utßm NûUdÏm Øû\Ls:
· gaWtif jhdpaq;fis Kisf;fl;b cz;lhy; rj;J mjpfupfF
; k;. ntt;NtW gaWtif jhdpaq;fis Kisf;fl;LtJ
vd;gJ kpf ,dpa NtiyAkhFk;.
· nfhQ;rk; jz;zi
P ug; gad;gLj;jp fha;fwpfis ePuhtpapy; Ntfitf;fTk;. muprp my;yJ fha;fwpfis rikf;Fk;NghJ
fQ;rp / Ntfitj;j jz;zi
P u tbf;fNtz;lhk;.
· kpfTk; mjpfg;gbahf gjg;gLj;jg;gl;l czT tiffis my;yJ nfhOg;G epiwe;j mjpf cg;G epiwe;j ~~Jupj||
czT tiffis Fiwj;Jf;nfhs;sTk; my;yJ jtpHf;fTk;.
· xNuabahf mjpf czit cl;nfhs;shky;> xU rPuhd ,ilntspfspy; rpwpa mstpy;;
rj;jhd czT tiffis cz;zg; gofNtz;Lk;.
¨û\V Ri½o Utßm Tô]eLs TÚLÜm:
· 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; $ba KO
gaW> jhdpa tiffs;> mtiu tiffs; kw;Wk; gr;irf; fha;fwpfs; ehHr;rj;J epiwe;jitfshFk;.
·gy ~Jupj| czT tiffs;> mjpf nfhOg;G> cg;G kw;Wk; / my;yJ rHf;fiu epiwe;jitaha; cs;sd. ,JNghd;w
czT tiffis mbf;fb gad;gLj;Jtijf; Fiwj;Jf;nfhs;sTk; my;yJ jtpHf;fTk;.
· cq;fSf;F mjpf ,uj;j mOj;jk; ,Uf;Fkhdhy;> cg;G gad;gLj;JtijAk;> tof;fkhd rpg;]f
; s; kw;Wk;
CWfha;fs; Nghd;w cg;G NrHe;j czTg; nghUl;fisg; gad;gLj;JtijAk; Fiwj;Jf; nfhs;sTk;.
·gy itl;lkpd; rj;J kw;Wk; fdpkr;rj;J khj;jpiufs; kw;Wk; lhdpf;Ffs; cl;nfhs;tJ Fwpj;J cq;fs; kUj;Jtuplk;
fye;J NgrTk;. xt;thik ,Ue;jhy; ,J fl;lhak; nra;aNtz;ba xd;whFk;.
·,uj;jj;jpy; nfhOg;G msit jtwhky; gupNrhjpj;Jg; ghHf;fTk;.
NodLûW úSôûVd LhÓlTÓjR ØVt£ úUtùLôsL! EeL[ôp Nô§dL Ø¥Ùm!!
79
ngaH :
fNyhupfs; / xU ehisf;F :
,d;iwa Njjp :
jw;Nghija vil:
gy;NtW Mjhuq;fisr; NrHe;j czTg; nghUl;fis xd;WNrHj;J xU ruptpfpj czitj; jahupf;fyhk;. cq;fs;
tho;fi
; fKiwf;Nfw;wthW cq;fs; nrhe;j czTj;jpl;lk; mikj;Jf;nfhs;sg;gLjy; Ntz;Lk;. xt;nthU Ntis
cztpYk; xt;nthU czTj;njhFg;gpd; gupkhwy; msit cq;fs; czTj;jpl;lk; Nahrid toq;Fk;. gy;NtW
czTj; njhFg;Gfs; kw;Wk; xt;nthU czTj; njhFg;gpYk; toq;fg;glf;$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
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
MkZkkWkv K mbk QkZkv \ k ^ZklAPkQkm #kn g Bkk¥ #kAkZk?
Xkk@PkmZk Bkkv@kA YkkKv bkoFkTkk
(PkYkk@k Mkv A K@ PkQkk MkZkv K m#kmZkTkTkm Rv B k@v B k TkmFkv ^kkUk@^kkTkm YkklcPkm PkQkk YkkCkr R #kr T k)
MkZkkWkvKmbk ¢Uko@Pkk £TbZkn\kmTkTkk Ak@Okv QkkZk Gvå £TbZkn\kmTk ¢kck@Ykkg \kmSkv\k #kAr@k (BkkgM)
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\kkvcmYkkg bkkA@Tkng Uk|YkkOk ^kSkm HkZk PkvTkv ck¥Uk@ C\kk¥bkvYkm¢k Acv Gv ¢Tkv DkKm HkZk PkvTkv
ck¥Ukkv C\kk¥bkvYkmZkk Acv Gvå
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(FkkvQkk UkkTkv)ä ^ZkkZkkYk PkQkk ¢kwakSkkvTkm Hæ@ @cv Gvå
Bkkv@kATkkv Uk|Ak@ (bKkFkrä Fk@Wkm)ä KkvK\k Av\k@mä Uk|^kplûkä PkQkk #k@m@Tkng ^kHTk bk^kvr §Uk@ \kkvcmYkkgTkm bkkA@Tkkv ¢kSkk@ Gvå
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RwlTkA TkkvSg k @kBk^km ¢PZkgPk Hæ@m Gvå
MkvAK@Tkm bk\kkc Uk|YkkOkv R@@kvH ^ZkkZkkYk A@^kkv Hæ@m Gvå
PkwZkk@ Bkkv@kATkk UkvAKv ¢Qk^kk MWWkk¢kvYkkg #kng #kng Gv Pkv HkOk^kk YkkKv PkvTkk §Uk@ \kCkkMv\kk \kvWk\kkv ^kkgFk^kkTkm Kv^k UkkM^km
Hæ@m Gvå ¢k WkkWkPkYkkg MkZkvKm#kmZkTk Hæ@m YkRR A@m #kAv Gvå
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
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¢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<gå ^kSkk@v
Uk|YkkOkYkkg ¢kä AkvVm PkQkk bkkvMkQkm Ro@ @cv^knåg
Rk< MkvAK@Tkm @Hk ckvZk Pkkv H \kv^kkvå
#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<g - 2 FkYkFkk
AkHnä ¢kBk@kvK ^kCkv@v Ykv^kkv ¢Tkv WkmH FkmXk]kTkk ^kCkv@Tv kk-1 FkYkFkkv
YkkHv@r mTk : 1 FkYkFkm (GmOkv\kn)
*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.
86
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)
!
!
"#$!"%&'&($)*(!)($*!"%+,$),&---!
87
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

to the entire book - American Association of Physicians of

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