Professional Documents
Culture Documents
APPI Guide To Health and Nutrition 2nd Edition
APPI Guide To Health and Nutrition 2nd Edition
Edited by
RANJITA MISRA
Professor & Research Director
Center for the Study of Health Disparities (CSHD)
Member, Intercollegiate Faculty of Nutrition
Texas A&M University
Contributors
Nirmala Abraham Theja Mahalingaiah
Padmini Balagopal Suraj Mathema
Rita (Shah) Batheja Ranjita Misra
Nimesh Bhargava Chhaya Patel
Sharmila Chatterjee Thakor G Patel
Madhu Gadia Sudha Raj
Wahida Karmally Nirmala Ramasubramanian
Keya Deshpande Karwankar Janaki Sengupta
Karmeen Kulkarni Geeta Sikand
i
Copyright © 2011 by AAPI
All rights reserved. Written permission must be secured from AAPI to use or reproduce any
part of this book.
Reviewers
Padmini Balagopal, Rita Batheja Wahida Karmally, Karmeen Kulkarni, Ranjita Misra,
Misra,
TG Patel,
Patel, Sudha
Sudha Raj and Nirmala Ramasubramanian
Published by
Sunil Sachdev
M/s. Allied Publishers Pvt. Ltd., 751, Anna Salai, Chennai – 600 002.
ii
Contents
Preface v
TG Patel, MD, MACP
Acknowledgements vii
TG Patel, MD, MACP
Forward ix
Ajeet Singhvi, MD, FACG
Chapter 1 Introduction 1
Dr. Sudha Raj, PhD, RD
Chapter 2 Epidemiology, Risks and complications of Diabetes 6
Dr. Ranjita Misra, PhD, CHES & TG Patel, MD, MACP
Chapter 3 Preventing Heart Disease in Asian Indians 11
Dr. Geeta Sikand, MA, RD, FADA, CDE, CLS
Chapter 4 Renal Diet 23
Chhaya Patel, MA, RD, CSR
Chapter 5 East Indian (Odia and Bengali) Cuisine 36
Dr. Ranjita Misra, PhD, CHES, FMALRC
Chapter 6 South Indian Cuisine 40
Nirmala Ramasubramanian, MS, RD, CDE
Chapter 7 Maharashtrian Cuisine 45
Keya Deshpande Karwankar, MS
Chapter 8 Gujarati Cuisine 48
Rita Batheja, MSc, RD, CDN
Chapter 9 North Indian Cuisine 52
Madhu Gadia, MS, RD, CDE
Chapter 10 Nepali Cuisine 56
Suraj Mathema, MS, RD, CDE
Chapter 11 Low Fat Cooking & How to Modify a recipe 60
Nimesh Bhargava, MS, RD, CNSD, MBA
Chapter 12 Choosing Healthy Snacks 71
Janaki Sengupta, MSc, RD, CDN, CDE
Chapter 13 Desserts of India 76
Sharmila Chatterjee, MSc, MS, RD, CDE
iii
Chapter 14 Managing your Menu in an Indian Restaurant 79
Karmeen Kulkarni, MS, RD, BC-ADM, CDE
Chapter 15 Carbohydrate counting for Indian Foods 81
Karmeen Kulkarni, MS, RD, BC-ADM, CDE
Chapter 16 Healthy Weight: Make it Your Lifestyle! Healthy Choices in Nutrition and 84
Physical Activity are Most Effective in Fighting Obesity
Dr. Wahida Karmally, DrPH, RD, CDE, CLS, FNLA
Chapter 17 Exchange Lists for Indians with Diabetes 88
Chhaya Patel MA, RD, CSR
Chapter 18 Selecting Foods from Different Food Groups in the Asian Cuisine 95
Padmini Balagopal, PhD, CDE, RD, IBCLC (lead author)
Chapter 19 Do Indian Spices and Condiments Have a Role
Role to Play in Preventive Health and 97
Therapeutics?
P. Balagopal, W. Karmally, K. Kulkarni, R. Misra and S. Raj
Chapter 20 Summary 106
Padmini Balagopal, PhD, RD, CDE, IBCLC
Appendix 1 Gestational Diabetes Sample Meal Plan 115
Sharmila Chatterjee, MSc, MS, RD, CDE
Appendix 2 Diabetes Numbers at a Glance 117
National Diabetes Education Program (NDEP)
Appendix 3 Diabetes Mellitus Pocket Reference Card 118
Developed by the Diabetes Committee of Indo-US Health Summit
Appendix 4 Clinical Preventive Services for Normal Risk Adults 120
Recommended by the U.S. Preventive Services Task Force
Appendix 5 Glossary 122
Theja Mahalingaiah, MA, RD & Nirmala Abraham, MS, RD
Appendix 6 What Can I Eat to Manage my Diabetes
English 128
Hindi 132
What Can I Eat to Manage my Diabetes (Regional Languages)
Bengali 136
Gujarati 140
Kannada 144
Malayalam 148
Marathi 152
Odia 156
Punjabi 160
Sindhi 164
Tamil 168
Telugu 172
iv
Preface
Indian Foods: AAPI’s Guide to Nutrition, Health & Diabetes is a labor of love by a group of dedicated
dietitians. This booklet has information which will guide Asian Indians and particularly Indian Americans
of Indian origin better manage and prevent diabetes, hypertension, obesity and hyperlipidemia. In addition,
this book can be used by physicians and other health care professionals who see patients in their clinic using
the Asian Indian cuisine.. I believe this book is a must have for all Indian Americans. It is available on the
American Association of Physicians of Indian Origin ((AAPI) website at www.aapiusa.org/resources.
www.aapiusa.org/resources This
revision is presented
esented to the Indian American ccommunity
ommunity and physicians as a community service on behalf of
AAPI. The reader will find that this edition has a few added chapters rs and appendices. The two new
chapters include “DoDo Indian Spices and Condiments Have a Role to Play in Preventive Health and
Therapeutics” & “Renal Diet.” It is our small effort to help our community take charge to prevent diabetes,
hyperlipidemia, and obesity and manage them if present.
v
vi
0
Acknowledgement
The revised edition of the book was done in a timely manner due to Dr. Ranjita Misra’s leadership and
coordinating efforts. We would also like to thank Padmini Balagopal as the coordinating editor for the first
edition and Rita (Shah) Batheja as co-chair for her invaluable help in bringing together an expert group of
contributors.
I want to personally thank the authors Nirmala Abraham, Padmini Balagopal, Rita Batheja, Sharmila
Chatterjee, Keya Deshpande, Madhu Gadia, Wahida Karmally, Karmeen Kulkarni, Theja Mahalingaiah,
Suraj Mathema, Ranjita Misra, Chhaya Patel, Sudha Raj, Nirmala Ramasubramanian, Janaki Sengupta and
Geeta Sikand. These authors took time out of their busy family life, academics and work to revise this
edition of the book. To date, this book is still one of the best resources on preventive health and disease
management on the Asian Indian cuisine presented in a simple and user friendly format. This book can be
downloaded in its entirety from the website www.aapiusa.org/resources/nutrition.aspx for use.
The reviewers Padmini Balagopal, Rita Batheja, Wahida Karmally
Karmally,, Karmeen Kulkarni, Ranjita Misra,
T.G.Patel, Sudha Raj and Nirmala Ramasubramanian have done a tremendous job in getting the reviews
back in time and in ensuring the accuracy of the material.
The Pocket Reference Card for diabetes was created by the Diabe tes Committee of the Indo-US Health
Diabetes
Summit, a new additions to this book. I want to thank Drs. Ritesh Gupta, Shashank Joshi, Anoop Misra,
T.G.Patel and Banshi Saboo, along with the advisors who helped revise this Pocket Reference Card. This
committee consists of Drs. Anuj Bhargava, Arvind Gupta, Neha Gupta, Shilpa Joshi, Sailesh Lodha, Mohan
Mallam, Sundar Mudaliar, Rakesh Parikh, V. Ranga, Jayesh B. Shah, Ronak Shah, Priya Sivaprakasan, and
Vijay Viswanathan. The Gestational Diabetes meal plan was create
created
d by Sharmila Chatterjee, another new
addition to this book. I want to thank Padmini Balagopal for creating “What Can I Eat to Manage my
Diabetes” and Wahida Karmally and Karmeen Karmally to review the document & the translators of the
regional languages (Bengali, Gujarati, Hindi, Kannada, Malayalam, Marathi, Odia, Punjabi, Sindhi, Tamil
and Telugu) Rajasri Chatterjee, Kaushik Chatterjee, Sharmila Chatterjee, Alokeraj Banerjee, Balwant
Suthar, Rita Batheja, Bharat Shah, Varun Japee, Vanita Manchanda, Uday Meghani, Varsha, Roshan Khaki,
Kavitha Simha, Sheela Krishnaswamy, Shaji Tewani, Alex Johnson, Vaishali Mohile, Deepa Inamdar, Anita
Mishra, GB Patnaik, Indu Jaiswal, Murali Sadani, Purshotam Sharangdhar, Sushila Sarangdhar, Suguna
Lakshmi Narayanan, Anuradha Sivasundar, A Narasimha Reddy, Latha Sashi, N Lakshmi, and P Janaki
Srinath.
Finally, I want to thank all the Indian Americans in the U.S. and Indians in India for helping us to assess
data on our community by participating in different research proje
projects.
cts. This book is a tribute to all Indian
Americans and Indians all over.
vii
viii
FORWARD BY AJEET R. SINGHVI, PRESIDENT AAPI
I am pleased to see the publication of the second edition of Indian foods: AAPI’s Guide to Nutrition,
Health and Diabetes. The first edition was hugely successful and this edition was overdue and is being
published at the right time.
Although there are over two thousand books on diabetes listed in the catalog of the Library of Congress
(2,218 at the last count), however, there is a paucity of literature that deals with the largest population at risk:
The Indian Population. The ancient Ayurvedic treatises by Sushruta and Charaka recommended diet as
treatment for diabetes more than two thousand years ago in India. This is as relevant today, if not more so,
as it was then. Further, it is not only of great value to Indians here in States but also to the general population
India – especially given the expansion of quick service restaur
restaurants
ants and the concomitant adoption of a diet of
highly processed, high calorie, high sugar, high fat, but low nutrient value foods.
It will be of special benefit to all to realize that the concept of diet as treatment is centuries old. Through this
concept, people will discover new and tasty foods that help manage or even reverse their diabetes and other
related conditions.
This publication is truly unique. The contributors include M.D.s, Ph.Ds, and Registered Dietitians. There is
a diet plan to suit every palate and for different ethnic groups and regions. The authors have taken into
account the changing environment, customs, and preferences and have made modifications to suit all the
segments of the population and all taste buds in the contemporary society.
This book makes us all proud. Health is wealth, and this book takes us a step forward in that direction. I am
sure it will be very useful to the reader. I personally congratulate Dr TG Patel, Dr. Ranjita Misra and their
entire team for this superb effort.
Sincerely,
ix
x
Chapter 1
Introduction
Sudha Raj, PhD, RD
Since 1965 more than 2 million Asian Indians have on all four frontiers share many common features
immigrated to the United States from the Asian sub- with regard to dietary habits and food practices
continent of India. Recent census report that their despite their unique cuisines.
numbers have increased from 1.6 million in 2000 to
2.7 million in 2007. The community continues to be Health problems and nutritional status of Asian
ranked the third largest Asian American group in Indians in the US
the United States after Chinese and Filipinos. Fifty Some of the important health problems faced by
percent of Asian Indians reside in the South and Asian Indian immigrants include chronic
West followed by 35% in the north-east and the degenerative diseases such as diabetes, hypertension,
remainder in the Mid-West. Large Asian Indian cardio-vascular disease and complications arising
communities are seen in the states of California, from any of these conditions. In fact, Asian Indian
Illinois, New Jersey, New York and Texas. The immigrants have a significantly higher risk of CVD
community consists of academic, medical and (cardiovascular disease) with heart disease rates
technical professionals, individuals who own and/or estimated to be one and one half to four times
work in commercial establishments and their greater than Whites. In addition to the genetic
dependents (spouses, children, siblings and elderly susceptibility in developing Type 2 diabetes and
parents who visit from India for extended periods of cardiovascular disease, risk factors such as abnormal
time). lipid levels, increased abdominal fat, diets high in
fat, saturated and trans-fats, simple carbohydrates
The Asian Indian community is diverse with regard
and sedentary lifestyles contribute to the
to the region of origin in India and the religions they
development of chronic diseases.
practice. India can be divided into four major
regions-North, South, East and West. Each region What can you do?
has its own distinctive language, dialects, customs
and food practices. Hinduism is the predominant Your nourishment does not depend on the selection
religion practiced by Asian Indians followed by of any one food. Instead it depends on the
Islam, Buddhism, Jainism, Sikhism, Zorastrianism, consistent and continuous selection of many
Christianity and Judaism. The followers of these different foods on a day to day basis. This book
different religions observe different dietary laws and gives you suggestions on how to plan your diet with
codes for fasting, and feasting thereby influencing Asian Indian cuisine with foods and tips that will
their eating patterns. Throughout history, the culture help to enhance your health.
and cuisines of India have been influenced by other
Purpose and organization of this booklet
civilizations such as the Moghuls, the British and
now the Americans. The neighboring nations of This book makes an attempt to present some tools
Pakistan, Nepal, Bhutan, Bangladesh and Sri Lanka for patients and the general public to help with
1
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
lifestyle changes in the prevention and treatment of the body’s metabolism. Insulin is required to assist
chronic diseases. Highlights of this book include: the cells in taking up the needed fuels from the
A brief description of two chronic degenerative blood.
diseases- Diabetes and Cardiovascular disease. Type 2 diabetes is characterized by high blood
A description of the different regional cuisines glucose and insulin resistance. This disease usually
of India. Within each region we provide begins after the second decade of life. However the
background information to illuminate the widespread changes in lifestyle and dietary practices
cultural context from which the ethnic foods has resulted in the appearance of this disease at a
and food habits have evolved, popular dishes, much younger age. In the initial stages the pancreas
meal patterns highlighting typical and modified produces insulin. The person may actually have
meal patterns for clients with chronic diseases, higher than average insulin levels but the cells are
tips for changes and suggestions for weekend not very responsive either because they have fewer
and party planning and tips on how to modify a number or malfunctioning receptors that are needed
high-fat recipe into a more heart-healthy one. for the insulin to exert its action. Consequently the
Every chapter talks about weekend eating as the blood glucose levels increase thereby stimulating the
two days of feasting and partying can undo pancreas to produce insulin. This exhausts the cells
many of the benefits of eating healthy and reduces their ability to function. Generalized
throughout the week. weight gain particularly in the abdominal region
aggravates the condition because the higher body fat
A description of common spices used in the necessitates higher insulin production. Age, genetics,
various cuisines and their health benefits. lifestyle and dietary factors promote the
A section on food exchanges that gives a list of development of the disease.
some of the common foods and selected food
items mentioned in the book as well as some of Symptoms of Diabetes include frequent urination,
the ingredients in this cuisine with its English excessive thirst, extreme hunger, unusual weight
equivalent. loss, increased fatigue, irritability and blurred vision.
Nutrition advice, tips and guidelines by Criteria for diagnosis
qualified professionals and reviewers in the field
of nutrition (you will find a brief write-up about Symptoms of diabetes together with casual (any
the writer at the end of each chapter). time of day) plasma glucose concentrations of >
200 mg/dl.
A Primer on Chronic Diseases in Asian Indians Fasting plasma glucose (At least 8 hours
following no caloric intake) > 126 /dl.
Diabetes
Two hour plasma glucose > 200 mg/dl during
Diabetes is a chronic disorder characterized by high an oral glucose tolerance test.
blood glucose and either insufficient or ineffective
insulin, depending on the type of diabetes. Criteria for Impaired Glucose levels
Type 1 diabetes also known as insulin dependent Fasting plasma glucose levels of > 110mg/dl –
diabetes or juvenile onset diabetes typically strikes 126 mg/dl or post-prandial glucose levels
around the ages of 8 to 12 years but can occur at any (2 hrs after meals) of > than 140 mg/dl during
age. The disease has a strong genetic link. The an oral glucose tolerance test can be considered
pancreas cannot synthesize insulin thereby altering to be in the Impaired blood glucose range.
2
Introduction
Body Mass Index and Waist circumference Protein intake is recommended at 10-20% of
caloric intake with a focus on plant based
A Body Mass Index of ≥23 and Waist sources such as lentils and beans, cereal lentil
circumference of >35.4” for men and 31.5” for combinations and the use of smaller portions of
women can put a person at risk for developing lean meats, poultry and fish.
diabetes if there is a genetic predisposition.
Total fat, saturated fat and cholesterol intakes
Blood Pressure - <120/80
must be tailored to meet individual
HbA1c - <6.5 requirements based on blood lipid profiles.
Focus on healthy fats rather than saturated fats
Complications of diabetes
and emphasize avoidance of trans-fats.
The accumulation of glucose in the blood leads to Diet should focus on the consumption of
acute and chronic complications. Therefore early, complex carbohydrates such as whole grains,
aggressive treatment to control blood glucose fruits and vegetables. Consistent and evenly
significantly reduces the risk of long term diabetes spaced carbohydrate intake throughout the day
related complic-ations. Diabetes related should be emphasized. In this respect
complications include diseases of the: carbohydrate counting and exchange lists
large blood vessels such as atherosclerosis provided in this book will help.
small blood vessels resulting in loss of kidney Current guidelines advise moderation of salt
function as seen in kidney diseases, retinal intake that is < 1500 mg. of sodium/day and no
degeneration and blindness. more than 2300 mg. of sodium/day.
nerves resulting in loss of sensation, increased
infections stemming from unnoticed injuries, Metabolic Syndrome
and gastrointestinal problems. Metabolic syndrome is a condition closely related to
Recommendations for Type1 insulin resistance. Abdominal obesity and insulin
resistance aggravate the disease along with
Nutrition is an important part of the treatment hypertension and abnormal lipid levels.
regimen. Nutritional therapy focuses on maintaining
optimal nutrition for growth and development in the Diagnostic criteria put out by the International
child, educating clients about portion sizes, Diabetes Federation include a waist circumference
modifying recipes, controlling blood glucose, of > 90 cms for men and 80 cms for women; a
preventing and treating related complications. Focus triglyceride level of >150 mg/dl; a HDL-cholesterol
is on meal intake patterns, consistency in level of < 40 mg/dl for men and <50 mg/dl for
carbohydrate intake to minimize glucose women; a blood pressure of > 130/85 mm HG and
fluctuations. a fasting plasma glucose of >100 mg/dl or previously
diagnosed type 2 Diabetes.
Recommendations for Type 2
Cardiovascular disease
The American Diabetes Association recomm-ends
that the distribution of calories between fats and More than 50% of cardiovascular disease
carbohydrates should be individual-ized according to occurrences arise from atherosclerosis.
the individual’s assessment and treatment plan. Atherosclerosis is a generic term used to describe
Calories should be prescribed to maintain a the thickening of the arteries caused by the
reasonable body weight ideal for the person’s formation and deposition of an atherosclerotic
age, sex and lifecycle needs. plaque. The plaque is a fatty fibrous growth that
3
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
4
Introduction
16. 4 Steps to Control Your Diabetes. For Life. 30. The Power to Control Diabetes is in Your
(in Hindi) Hands Community Outreach Kit
17. http://ndep.nih.gov/publications/PublicationDet 31. http://ndep.nih.gov/publications/OnlineVersion
ail.aspx?PubId=141 .aspx?NdepId=NDEP-44k
18. Take Care of Your Heart. Manage Your 32. Tips for Teens with Diabetes: Stay at a Healthy
Diabetes (in Gujarati) Weight
19. http://ndep.nih.gov/media/TCH_AsAm_flyer_ 33. http://ndep.nih.gov/media/Youth_Tips_Weight
Guj.pdf .pdf
20. Take Care of Your Heart. Manage Your 34. http://ndep.nih.gov/media/Youth_Tips_Weight
Diabetes (in Hindi) _BW.pdf
21. http://ndep.nih.gov/media/TCH_AsAm_flyer_ 35. Tips for Teens with Diabetes: Make Healthy
Hin.pdf
Food Choices
22. If You Have Diabetes, Know Your Blood Sugar
36. http://ndep.nih.gov/media/Youth_Tips_Eat.pdf
Numbers
37. It's Not Too Late to Prevent Diabetes
23. http://ndep.nih.gov/media/KnowNumbers_Eng.
pdf 38. http://ndep.nih.gov/media/nottoolate_tips.pdf
24. Tips to Help You Stay Healthy 39. Kanaya AM et al. Prevalence and correlates of
25. http://ndep.nih.gov/media/TipsFeel_Eng.pdf diabetes in South Asian Indians in the United
States: findings from the metabolic syndrome
26. Tips for Kids: How to Lower Your Risk for and atherosclerosis in South Asians living in
Type 2 Diabetes America study and the Multi-ethnic study of
27. http://ndep.nih.gov/media/kids-tips-lower- atherosclerosis. Metab. Syndro. Relat.
risk.pdf Disorders. Apr 8 (2): 157-64. 2010.
28. Diabetes Numbers at-a-Glance 40. Palaniappan L et al. Leading causes of mortality
29. http://ndep.nih.gov/media/NumAtGlance_Eng. of Asian Indians in California. Ethnic Dis. 20
pdf (1): 53-7 Winter 2010.
5
Chapter 2
6
Epidemiology, Risks, and Complications of Type 2 Diabetes Mellitus
to urban areas (8-14%) in India. Pre-diabetes rates educational level and income are primary factors for
are slightly higher than T2DM prevalence but follow elevated mortality of diabetic patients in rural India.
a similar pattern with urban prevalence significantly
greater than the rural populations. Although Studies on South Asians (includes Asian Indians,
prevalence of T2DM is lower than urban areas, Pakistanis, Bangladeshis, Sri Lankans, Nepalese,
rural Indians have higher glycosylated hemoglobin Maldives, and Bhutan) immigrants in the United
level (A1c) or poor control of the disease resulting in Kingdom, Canada, Australia, and Africa show a
higher complications and mortality. Community- higher prevalence of T2DM and CVD as well. In
based diabetes prevention program in a rural Indian the United States, the Diabetes among Indian
community also found rural youths, 10-18 years of Americans (DIA) national study showed prevalence
age, had higher level of pre-diabetes. Lack of rate of T2DM and pre-diabetes among immigrant
knowledge of T2DM and its associated Asian Indians as 17.4% and 33% respectively, higher
complications, access to care & medical services, low than other racial/ethnic groups in the United States.
Table 1: Prevalence of diabetes among rural Indians, urban Indians and Indian Americans
Number
Urban India Mean SD Mean SD < 8.0 ≥ 8.0
of cases
Self-reported Diagnosed
57 134.10 47.68 6.85 1.22 79.4% 20.6%
T2DM cases
Undiagnosed cases 12 152.17 43.52 7.11 0.69 83.4% 16.6%
Total number of respondent = 508; Prevalence of Diabetes = 13.6%;
Prevalence of Pre-diabetes = 23.4%
Number
Rural India Mean SD Mean SD < 8.0 ≥ 8.0
of cases
Self-reported Diagnosed
35 137.03 42.73 6.84 1.30 84.4% 15.6%
T2DM cases
Undiagnosed cases 13 235.77 185.36 7.28 1.35 80.6% 19.4%
Total number of respondents = 532; Prevalence of Diabetes = 9.02%;
Prevalence of Pre-diabetes = 13.1%
7
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
In the same study, comparison of rural Indians, pace. Mortality from CAD is twice in Indian
urban Indians and immigrant Asian Indians in the Americans than other racial/ethnic groups in the
US showed rural Indians had the lowest rate United States. The United Kingdom Prospective
followed by urban Indians and immigrants in the US Diabetes Study, showed for each 1% increase in
(Table 1). Despite a perception that they have high A1c, there was a 14% increase in incidence fatal or
socio-economic status and good access to health nonfatal myocardial infarction. Projections based on
care, US Asian Indians have marked variations in the Global Burden of Disease study have shown that
educational attainment, income, and wealth, and a by the year 2020, the overall burden of
significant number lack education and job skills. cardiovascular disease in India will surpass other
Recent immigrant cohorts comprise both highly regions of the world. There is no doubt that
educated professionals as well as individuals who significant reduction in diabetes related morbidity
lack education and job skills. The latter are mostly and mortality is feasible through effective
family members of earlier immigrants. educational and lifestyle interventions to reduce
smoking, promote regular exercise, monitor healthy
T2DM Complications: A focus on Diabetes and dietary habits and reading food labels, and manage
Cardiovascular Disease stress.
T2DM is one of the leading causes of morbidity and Epidemiology of Nutrition and Diabetes Mellitus:
mortality because of its role in the development of Etiology and Environmental Factors
optic, renal, neuropathic, and cardiovascular
disease. These complications, particularly There is considerable evidence to show as
cardiovascular disease (~50-75% of medical individuals migrate from resource poor rural settings
expenditures), are the major sources of expenses for to urban areas and westernized countries such as the
patients with T2DM [for more information, please United States and United Kingdom, the risk and
read the chapter on “Preventing Heart Disease in prevalence for T2DM rises. This increase is due to
Asian Indians” and “Cardiovascular disease” in the rapid acculturation associated with the migration.
introduction chapter]. In the United States, South Although the concept of acculturation originated
Asian Indians have the highest ethnic-specific within anthropology, in recent years it has assumed a
prevalence of CVD or coronary artery disease prominent role within epidemiology as a risk factor
(CAD), with age-specific mortality two to three times for chronic disease. The association between
higher than Caucasians. Results from the DIA study acculturation to a Western lifestyle and prevalence
indicate traditional risk factors such as hypertension of diabetes has been established in several Asian
(21%), obesity (49.8%) and hypercholesterolemia American subgroups due to changes in diet, obesity
(43.5%) may account for these high rates. Asian and other lifestyle factors modulating the prevalence
Indian immigrants have been found to have high of T2DM. Consumption of sugar-sweetened drinks
rates of vascular disease in the United States and increases the risk for obesity and predisposes to
other countries. The CAD prevalence in US Asian T2DM. Recent data suggests an increase in the
Indians is 6 and 4 times higher than Chinese and consumption of high fructose corn syrup and
other Asian Americans and associated with similarly association between obesity and T2DM in the US.
higher prevalence of risk factors among this ethnic Glycemic index, or GI, is a number between 0 and
group. For example, the prevalence of central 100 that reflects the effects of carbohydrates from
obesity, glucose intolerance, hypertension, high food on an individual’s glucose levels. Glycemic
triglyceride levels, and low levels of high density index is important for individuals with T2DM since
lipoprotein cholesterol (HDL)-- the five ‘axes of evil’ higher GI will increase sugar levels. Foods rich in
of metabolic syndrome-- is the highest among the dietary fiber might be protective and vegetarian diets
Asian Indians and continues to increase at a rapid tend to have less saturated fat and high dietary fiber.
8
Epidemiology, Risks, and Complications of Type 2 Diabetes Mellitus
Saturated fatty acids are positively related to fasting TG Patel, MD, MACP is an Associate Professor of
and postprandial glucose levels in normoglycemic Medicine at the Uniformed Services University of
Dutch men, the effect being independent of energy the Health Sciences, Bethesda, MD. Contact
intake and obesity. In the United States, studies information (571)213-
(571)213-5393 or thakorg@gmail.com.
thakorg@gmail.com.
show the relative risk of developing diabetes was
significantly reduced amongst those with the highest References
intake of vegetable fats and fiber. While light to 1. van Dieren S, Beulens JW, van der Schouw
moderate intake of alcohol is associated with YT, Grobbee DE , Neal B. The global burden
enhanced insulin sensitivity, smoking increases the of diabetes and its complications: an emerging
risk for T2DM. Intervention trials indicate diet and pandemic. Eur J Cardiovasc Prev Rehabil;17
exercise programs are associated with reduction Suppl 1:S3-8.
(nearly 60%) in the risk of progression of pre-
diabetes to T2DM. Diets restricted in saturated fatty 2. Wild S, Roglic G, Green A, Sicree R , King H.
Global prevalence of diabetes: estimates for the
acids and increased fiber content seems to be
year 2000 and projections for 2030. Diabetes
particularly successful in this context. Furthermore,
Care 2004;27:1047-53.
weight loss is beneficial and reduces the risk for
T2DM. 3. King H, Aubert RE , Herman WH. Global
burden of diabetes, 1995-2025: prevalence,
Conclusions numerical estimates, and projections. Diabetes
Care 1998;21:1414-31.
Asian Indians are disproportionately burdened by
T2DM and related complications. Increased genetic 4. Ramachandran A, Snehalatha C, Baskar AD,
susceptibility may be enhanced by environmental Mary S, Kumar CK, Selvam S et al. Temporal
changes in prevalence of diabetes and impaired
triggers such as physical inactivity, high calorie, fat,
glucose tolerance associated with lifestyle
and sugar intake, and obesity as individuals migrate
transition occurring in the rural population in
from rural areas to urban areas to Westernized India. Diabetologia 2004;47:860-5.
countries. Acculturation, defined as the process of
adopting the cultural traits and social patterns, and 5. Gupta R, Sarna M, Thanvi J, Sharma V , Gupta
western lifestyle are associated with unhealthy habits VP. Fasting glucose and cardiovascular risk
such as increased intake of dietary fat and saturated factors in an urban population. J Assoc
fat, lower consumption of fiber-rich and low Physicians India 2007;55:705-9.
glycemic index foods, and physical inactivity. These 6. Mohan V , Deepa R. Risk factors for coronary
unhealthy behaviors are associated with higher risk artery disease in Indians. J Assoc Physicians
and prevalence of T2DM and diabetes-related India 2004;52:95-7.
complications. 7. Misra R, Patel T, Kotha P, Raji A, Ganda O,
Banerji M et al. Prevalence of diabetes,
Ranjita Misra, PhD, CHES, CHES, FMALRC is a
metabolic syndrome, and cardiovascular risk
Professor and Research
Research Director, Center for the factors in US Asian Indians: results from a
Study of Health Disparities, at Texas A&M national study. J Diabetes Complications;
University. She is also a member of the 24:145-53.
Intercollegiate Faculty of Nutrition at TAMU and a
member of the Public Health Committee of AAPI. 8. Gupta R. Predictors of health among Indians in
Contact information (979) 845-
845-8726 or United States. India Association of North
ranjitamisra@gmail.com
ranjitamisra@gmail.com.
itamisra@gmail.com. Texas, Texas Indo American Physicians Society
Meeting. Dallas, TX,2000.
9
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
9. Rangaswamy P. Asian Indians in Chicago: 14. Fernandez ML. Acculturation and biomarkers
Growth and Change in a Model Minority. In: I. for type 2 diabetes in Latinos. J Nutr
M. G. H. P. Jones editor. Ethnic Chicago. 2007;137:871-2.
Chicago: Wm. B.Eerdmans Publishing Co; 15. Colditz GA, Manson JE, Stampfer MJ, Rosner
1995. B, Willett WC , Speizer FE. Diet and risk of
10. Wild SH, Laws A, Fortmann SP, Varady AN , clinical diabetes in women. Am J Clin Nutr
Byrne CD. Mortality from coronary heart 1992;55:1018-23.
disease and stroke for six ethnic groups in 16. Fung TT, Hu FB, Pereira MA, Liu S, Stampfer
California, 1985 to 1990. Ann Epidemiol MJ, Colditz GA et al. Whole-grain intake and
1995;5:432-9. the risk of type 2 diabetes: a prospective study
11. Enas EA, Garg A, Davidson MA, Nair VM, in men. Am J Clin Nutr 2002;76:535-40.
Huet BA , Yusuf S. Coronary heart disease and 17. Facchini F, Chen YD, Hollenbeck CB , Reaven
its risk factors in first-generation immigrant GM. Relationship between resistance to insulin-
Asian Indians to the United States of America. mediated glucose uptake, urinary uric acid
Indian Heart J 1996;48:343-53. clearance, and plasma uric acid concentration.
12. Enas A AS. Coronary Artery Disease In Asian Jama 1991;266:3008-11.
Indians: An Update And Review. The Internet 18. Balagopal, P., Kamalamma, N., Patel, T. G., &
Journal of Cardiology 2001;1. Misra, R. (2008). A community-based diabetes
13. Deedwania P, Singh V. Coronary artery disease prevention and management education
in South Asians: evolving strategies for program in a rural village in India. Diabetes
treatment and prevention. Indian Heart J Care, 31(6), 1097-1104.
2005;57:617-31.
10
Chapter 3
Preventing Heart Disease in Asian Indians: Diet
& Lifestyle Recommendations
Geeta Sikand, MA, RD, FADA, CDE, CLS
Prevention of heart disease among Asian Indians or Atherosclerosis begins with the deposition of
South Asians (includes Bangladesh, Nepal, Pakistan cholesterol filled cells in the inner wall of blood
and Sri Lanka) is a major concern. The occurrence vessels. Due to inflammation, a plaque is formed in
of heart disease among Asian Indians is significantly the blood vessels. A plaque is a thickened wall of
higher worldwide. According to a recent World the artery. A damaged plaque can cause a blood clot
Bank Report, heart disease is the leading cause of with very rapid narrowing or blockage of the artery.
death in Asian Indian adults (ages 15 to 69 years). A heart attack occurs when the blood flow to a part
All South Asian countries and India in particular are of the heart is blocked (often by a blood clot). Your
facing a “health crisis” with rising rates of heart diet and other lifestyle choices can affect your blood
disease, diabetes, obesity, unhealthy diet and low
cholesterol and triglyceride levels. The good news is
levels of physical activity. The report has also
that heart disease can be prevented and treated with
predicted that if the treatable risk factors e.g. excess
body weight, blood pressure and LDL cholesterol current knowledge. At the conclusion of this chapter
remain untreated; it could lead to a global epidemic a nutshell of six strategies geared towards how Asian
of heart disease in low and middle income Indian can adopt a heart-healthy diet will be
countries. provided. The same strategies will be helpful for the
treatment of high LDL, high triglycerides and the
By 2030 heart disease will emerge as the primary metabolic syndrome.
cause of death (36%) in India. A recent study of 52
countries showed that Asian Indians or South Risk Factors for Heart Disease
Asians suffer their first heart attack six years earlier
(53 years versus 59 years) than other countries Risk factors increase the chances of a person
worldwide. developing atherosclerosis and heart disease.
According to the National Cholesterol Education
Heart disease is also the leading cause of death in Program (NCEP) Adult Treatment Panel III
women in every major developed country e.g. US guidelines, the major risk factors for heart disease
and also in most emerging economies. The myth are:
that heart disease is only a “man’s disease” has been
debunked. Cigarette smoking
Diabetes mellitus (fasting plasma glucose equal
What is Heart Disease? to or greater than 126 mg/do
Heart disease refers to diseases of the heart and the Hypertension (Blood Pressure equal to or
blood vessels due to atherosclerosis. greater than 140/90 mmHg)
11
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
High LDL cholesterol (equal to or greater than overweight and diets high in fat and refined sugars.
100) Genetic factors also play a role in heart disease.
Low HDL cholesterol (men less than 40 mg/do, Target
Target Numbers for Asian Indians to Prevent Heart
women less than 50) Disease
Obesity (Body Mass Index greater than 25)
Non HDL-Cholesterol less than 130 mg/dl
Lack of physical activity (Total Cholesterol-HDL= Non HDL-
Family history of premature heart disease Cholesterol)
(presence of heart disease in male first-degree LDL-Cholesterol less than 100 mg/dl
relative less than 55 years & in female first-
degree relative less than 65 years) HDL-C greater than 40 mg/dl for males and
greater than 50 mg/dl for females
Age (men greater than 45 years; women greater
than 55 years) Blood pressure: less than140/80 mm
Waist Circumference: less than 35" for men and
Additional risk factors
less than 31" for women
Your physician will determine whether you need Target Numbers for Asian Indians with Heart
these additional tests.
Disease or Diabetes
1. Lipoprotein (a),
Non-HDL-Cholesterol less than100 mg/dl
2. Remnant lipoproteins
LDL-Cholesterol less than70 mg/dl
3. Small LDL particles
HDL-Cholesterol greater than 40 mg/dl for
4. Fibrinogen
males and greater than 50 mg/dl for females
5. High-sensitivity C-reactive protein (CRP)
HbA1c less than 6.5
6. Impaired fasting plasma glucose (110-125
mg/dl), Blood pressure: 120/80 mm if you are a
diabetic
7. Presence of subclinical atherosclerosis
(measured by exercise testing, carotid intimal- Waist Circumference: less than 35" for men and
medial thickness [CT scan], and/or coronary less than 31" for women
calcium [EBCT]. It is important to achieve the target numbers as
Presence of diabetes doubles the risk of heart noted above. If any of your numbers are abnormal,
disease in men and quadruples the risk in women. the information provided in this chapter will help
Lack of healthy dietary habits and a lack of physical you understand the role of a heart healthy diet and
activity along with overweight increase the risk of lifestyle in preventing heart disease. This chapter
heart disease, diabetes, high blood pressure and also provides six practical strategies geared towards
stroke. Asian Indians have a higher prevalence of the Asian Indian cuisine. It is also important to seek
high triglycerides, low high density lipoprotein (good your physician’s advice, take medications under
cholesterol) levels, glucose intolerance, and central medical supervision so as to reach your target
obesity. Metabolic syndrome or pre-diabetes is also numbers. A registered dietitian (RD) could also
common in Asian Indians. Some adults as well as partner with you to help you achieve your target
children are also at a higher risk for developing numbers. To find a registered dietitian (RD) in your
heart disease associated with high LDL cholesterol area: www.eatright.org Click on the “Find a
(bad cholesterol) and high triglycerides due to Nutrition Professional” link toward top of the page.
12
Preventing Heart Disease in Asian Indians: Diet & Lifestyle Recommendations
13
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
cooked vegetable, ½ cup vegetable juice; 1 Sodium: 1500 mg per day (read food labels,
medium fruit, ½ cup fresh fruit). prepare food with as little salt as possible).
Fish: 2 servings per week if religion permits What is the metabolic syndrome?
(1 serving= 4 oz cooked fish preferably fatty fish
e.g. salmon, mackerel, catfish). Metabolic syndrome is the primary cause of an
Legumes or lentils: Vegetarians: 5-7 times per increase in heart disease in Asian Indians.. The
week e.g. lentils, daal, rajma, channa and for American Heart Association and the National
non-vegetarians: at least 2 times per week (one Heart, Lung, and Blood Institute recommend that
serving= ½ cup cooked legumes or lentils) the metabolic syndrome be identified as the
presence of three or more of these components:
Whole grains: 3 servings per day choose from 1
slice whole grain bread, 1 oz dry whole grain 1. Central obesity measured by elevated waist
cereal, ½ cup cooked whole grain brown rice, circumference in Asian Indians: Waist
½ cup whole grain pasta, 1-6” chapati. circumference in Asian Indian Men: greater
than 35” Asian Indian Women: greater than
Fiber: 30 g daily (choose legumes, vegetables, 31”
fruits, whole grains, oats, rye, bran cereal,
berries, brown rice etc); 7 to 13 gm soluble fiber 2. High triglyceride: Equal to or greater than 150
e.g. whole oats, rye, barley. mg/dl
Nonfat Dairy Products: 2 to 3 servings per day 3. Reduced HDL (“good”) cholesterol:
(choose from 1 cup non fat or 1% milk, non-fat Men — Less than 40 mg/dl
yogurt, 1% buttermilk), Women — Less than 50 mg/dl
Fats & oils: 4 to 6 tsp daily (choose 4. High blood pressure: equal to or greater than
monounsaturated or polyunsaturated oils e.g. 130/85 mm Hg
canola, corn, olive, soybean, safflower oil) 5. High fasting glucose: 100 to 125 mg/dl ( pre-
Nuts and seeds: 2 to 4 times per week ( / cup
1
3
diabetes)
or 1 ½ oz nuts, avoid macadamia nuts and Other components of the metabolic syndrome
salted nuts, 2 tablespoon or ½ oz seeds). (insulin resistance and pro-thrombotic state) cannot
Sugar: limit to 5 servings week (1 serving= be identified by routine clinical evaluation.
1 tablespoon sugar, jelly or jam) However, in the presence of central obesity, they can
Saturated fat 7%/total energy intake ( fat on be assumed to be present to some degree.
meat or chicken skin, packaged desserts, whole Metabolic Syndrome Treatment Recommendations
milk, ice cream, butter, cheese, sour cream etc. by American Heart Association
Trans-fatty acids 0 grams (found in processed
foods e.g. cookies, chips, Indian savory snacks The primary goal of treating the metabolic
and fried foods). syndrome is to reduce the risk for heart disease and
type 2 diabetes. Combining a heart healthy diet
Cholesterol: limit to 200 mg daily (found in pattern and regular physical activity with even a
animal meats, organ meats, eggs, etc). small amount of weight loss (7-10%) in overweight
Alcohol: if you drink it is recommended you person can reverse the metabolic syndrome. The
limit to 1 serving per day (women) and 2 primary approach is to reduce the major risk factors
servings per day (men). (1 serving= 5 oz wine, for cardiovascular disease: stop smoking and reduce
12 oz beer, 1.5 oz of 80-proof spirits, or 1 oz of LDL cholesterol, blood pressure and glucose levels
100-proof spirits)) to the recommended levels by:
14
Preventing Heart Disease in Asian Indians: Diet & Lifestyle Recommendations
1. Weight loss to achieve a desirable body weight Blood levels of triglycerides are measured in the
(BMI less than 25 kg/m2) fasting state after a 12-
12-hour fast and no alcohol for
2. Increased physical activity, with a goal of at least 48 hours before the blood test.
30 minutes of moderate-intensity activity on
To lower triglycerides
most days of the week. Seek your physician’s
approval before starting your exercise program. The National Cholesterol Education Program Adult
3. Healthful eating habits that include reduced Treatment Panel III recommends:
intake of salt, saturated fat e.g. butter, ghee, 1. Weight loss of 7 to 10% of body weight should
coconut, coconut oil and coconut milk, palm be encouraged if indicated.
oil, fatty meats, Trans fat e.g. vanaspati (Dalda),
partially hydrogenated oils used in Indian 2. Avoid excessive intake of carbohydrate (not
savory snacks and dietary cholesterol e.g. egg more than 50% of calories) especially refined
yolks, meat, dairy. carbohydrates e.g. sugar and sweets
3. Choose fats wisely and lower the intake of fat to
What are triglycerides?
not more than 35% of calories in the diet.
Triglycerides are a type of fat found in the blood. If 4. Eat plenty of vegetables, fruits and whole grains,
triglycerides levels are high, they can increase the non-fat milk and non –fat dairy products,
risk of heart disease. Triglycerides are stored in the choose fatty fish, lean meat and lean meat
fat cells. When caloric intake is excessive, the alternatives e.g. tofu, soybeans lentils and
additional calories are converted into triglycerides legumes
(fat) and stored in fat cells. This is how the body
stores its body fat. Take your triglyceride number 5. Abstain or limit alcohol intake according to
seriously. Extremely high triglyceride (1000 or your doctor’s instructions
higher) can cause pancreatitis (inflammation of the 6. Include regular physical activity such as walking
pancreas). Several risk factors can increase the risk for a minimum of 30 minutes on most days of
for very high triglycerides: the week.
Overweight / obesity
Are fats & oils bad for a heart healthy diet?
Lack of exercise
All fats and oils are high in calories and can cause
High LDL( bad) cholesterol and low HDL
weight gain when excessive calories are consumed.
(good) cholesterol
However, some fats are good for heart health
Type 2 diabetes provided their calorie contribution does not cause
Certain medications weight gain. Fats are divided into 3 types based on
the main type of fat they contain.
Family history
1. Unsaturated fats
Table 1: National Cholesterol Education Program
(NCEP) cut points for normal to very high Unsaturated fats are liquid at room temperature and
triglyceride levels are generally considered “good fats” such as omega-
Normal Less than 150mg/dL 3 (marine and plant derived), monounsaturated and
polyunsaturated fats (omega-6).
Borderline-high 150-199 mg/dL
Marine derived Omega-3 fatty acids
High 200-499 mg/dL
Marine derived Omega-3 fatty acids found in fatty
Very High 500 mg/dL or higher fish e.g. salmon are considered as “good fats” for
15
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
two reasons. Firstly, they can lower the risk of heart Two to three grams/day of ALA may reduce risk of
disease and secondly lower triglycerides. Two heart disease. Good sources of ALA (plant omega
servings (3.5 oz each) of fatty fish per week are 3) are:
associated with a 30-40% reduced risk of death from Canola oil 1TBS = 0.94 g/serving
a heart attack or stroke in persons without heart
disease. Fatty fish are a good source of omega-3 fatty Ground flax seeds 1 TBS=1.6 g/serving
acids e.g. eicosapentanoic acid (EPA) and Flaxseed oil 1 TBS=7.3 g/serving
dexahexanoic acid (DHA). If religion permits it is
English walnuts 1 TBS (7 halves) = 2.6 g/serving
important to consume fatty fish. Good sources of
marine omega -3 fatty acids: Soybean oil 1 TBS =0.94 g/serving
Salmon, farmed or wild Chia seeds (sabza) 1 tsp =1.7 gm/serving
Mackerel Chia seeds are a good source of plant omega 3
Herring ALA. One ounce of chia seeds "sabza” provide 5
gm of ALA. Chia seeds are also a good source of
sardines
antioxidants, fiber and calcium. This petite whole
Methyl mercury concerns from eating fish grain has a mild flavor and can be eaten whole or
ground, raw or cooked. Chia seeds can be soaked in
Limit eating large fish due to greater mercury water and added to salads, dhal or chapatti flour.
content such as: Try them sprinkled on yogurt, salad and soup
– Swordfish or tossed with rice. Traditionally chia seeds are used
in Indian desserts that are high in saturated fat and
– King mackerel
calories e.g. kulfi faluda. To increase intake of ALA,
– Albacore tuna flax seed powder can also be used in preparing
– Shark curries like sambar or dhal (lentil soup), vegetables,
– Tile fish chappatis and salad dressing.
Population Recommendation
Persons who do not have Eat a variety of fish (preferably oily) at least twice a week, include oils and
heart disease foods rich in ALA
Persons who have heart Consume 1 gm of EPA+DHA per day, preferably from fatty fish.
disease Supplements could be used in consultation with a physician
16
Preventing Heart Disease in Asian Indians: Diet & Lifestyle Recommendations
3. Trans-
Trans-fats One serving includes ½ cup cooked lentils (dhal
or dals or daals) or ½ cup cooked dry beans
Trans-fats are also considered “bad” fats because (rajma, channa, soy beans), or 2-3 oz each of
they can raise “bad” LDL cholesterol and should be protein foods e.g. lean meat, fish or poultry
eaten in small amounts. Trans-fats are primarily (chicken & turkey) or 4 oz tofu or one egg plus
man-made from vegetable oils as a result of food two egg whites combined.
processing which changes vegetable oils into semi- Choose a variety of protein foods if your
solid fats e.g. partially hydrogenated fats. Trans-fats religion allows. Good food sources of protein
are also produced when oil is re-used. Trans-fats are include beans, lentils, seafood, poultry, lean
also found naturally in meat, cheese, butter and meat and egg whites. Fatty fish e.g. salmon is an
dairy products. Sources of trans- fat are: excellent source of omega 3 fatty acids (good
Baked goods: pastries, cakes, donuts, cookies fat).
Fried foods: French fries, fried chicken, onion Eat fish twice at least per week if religion
permits. Increase the amount and variety of
rings, Indian savory snacks cooked in re-used
fish and seafood consumed by choosing
oil e.g. chevda, bhel
seafood in place of some meat and poultry if
Stick margarine, shortening, dalda (vanaspati) your religion permits. Fish with lowest mercury
17
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
are preferred. These fish are smaller in size e.g. Strategy # 3: Vegetables & Fruits 8 Servings
salmon, pollock, catfish, cod, clams, flounder, (4.5 Cups) Daily
sole, canned light tuna, shrimp, crabs and
scallops. Increase vegetable and fruit intake. Eat a variety
of vegetables, especially dark-green and red and
One egg three times per week is quite orange vegetables and beans and peas.
acceptable in an otherwise low saturated fat/low
cholesterol diet. Substitute frequently with egg Consume a higher intake of vegetables than
whites e.g. egg white omelets. Egg whites have fruits. Fruits are higher in carbohydrate as well
no fat or cholesterol while they are an excellent as calories than vegetables. For e.g. one serving
of a vegetable equals ½ cup cooked or 1 cup
source of protein.
raw=25 calories and one serving of a fruit = one
Tofu is a good source of protein especially for small to medium fruit or ½ cup fresh fruit=60
vegetarians. To reduce saturated fat, consume calories.
tofu in place of paneer in “palak paneer” or Select green vegetables in place of starchy ones
“matar paneer”. as starchy vegetables are higher in calories and
Lentils (daals) or legumes (rajma, channa, black- carbohydrate. Consume leafy green vegetables
eyed beans) prepared with only a small amount (spinach, cabbage, kale, mustard greens) &
of oil are an excellent source of protein and cruciferous vegetables (cauliflower, brussel
soluble fiber. sprouts, broccoli) either raw or prepare them in
a small amount of oil
Soybeans (edamame) are an excellent source of
protein & fiber. Legumes (dried beans and Strategy # 4: Whole Grains: 6 Servings Daily
lentils) including “daal” are naturally low in fat,
high in protein and carbohydrate, plant sterols Consume at least half of all grains as whole
and fiber. grains. Increase whole-grain intake by replacing
refined grains with whole grains. Reduce the
Vegetarian burger patties can be convenient and amount of rice/chappatis when potatoes or
nutritious alternative to the meat patties. Check other starchy vegetables are also included in the
the total fat, saturated fat and cholesterol same meal.
content on the label.
Select 100% whole wheat chapatti flour. Add
Strategy # 2 Dairy Products 2 to 3 Servings Daily oatmeal (high in soluble fiber) &/or soy flour
(high in protein) to chapatti flour. To control
One serving includes 1 cup = 8oz non-fat milk calories, avoid putting ghee/oil when making
or 1% milk or low fat buttermilk or non-fat chappatis.
yogurt. Substitute other whole grains for rice & pulao
Increase intake of fat-free or low-fat milk and e.g. quinoa (high in protein), barley and oats
milk products, such as milk, yogurt, cheese, or (high in soluble fiber), brown rice (high in
fortified soy beverages. fiber).
Select evaporated skim milk or non-fat powder Choose foods with soluble fiber to help lower
milk or non-fat yogurt when making fruit LDL cholesterol (bad cholesterol) e.g. whole
smoothies, fruit shakes and desserts. Use 1% oats, barley, dried beans, fruits and vegetables
milk or evaporated skim milk (along with sugar such as okra, brussel sprouts.
substitutes) when preparing Indian desserts e.g. Limit the consumption of foods that contain
kheer, payassam, paneer or chenna. refined grains cooked with solid fats (butter,
18
Preventing Heart Disease in Asian Indians: Diet & Lifestyle Recommendations
ghee, shortening) and added sugar e.g. cookies, the calories and also half the fat of regular
cakes, pies and Indian sweets such as laddoos, spreads.
mathris, shakarparas. Plant sterols and stanol-esters are found
Strategy # 5: Fats & Oils 4-6 tsp Daily primarily in fortified foods e.g. Bennecol spread
and Promise Activ spread. Only 2 or 3
1 serving = 1 tsp oil or 6 almonds, or 2 walnuts tablespoons of these spreads containing plant
or 2 TBS avocado stanol esters provide 2 grams of plant stanols
and may lower LDL cholesterol by 7-15 %.
Prepare foods using lower fat cooking methods
Beverage supplements containing plant sterols
such as grilling, broiling and baking instead of
such as Cholest-off and Minute Maid Heart
frying and sautéing. To reduce caloric intake,
Wise orange juice may also help lower LDL
cook with a minimum amount of oil.
cholesterol. Plant sterols in food or
Avoid ghee, butter, whole milk & cream in food supplements should be consumed with meals
preparation & processed foods to reduce because they help to lower the absorption of
saturated fat intake. Avoid coconut or coconut dietary cholesterol. The largest LDL cholesterol
cream or use lesser amounts than called for in lowering response is noted when the dose is
the recipe. Although coconut and coconut spread over two or 3 meals per day. Higher
cream are high in saturated fat, coconut water doses above 2 g/day offer little additional
(nariyal- paani) is not high in saturated fat. Limit benefit. Since plant sterol/stanol fortified
use of whole milk in Indian tea “chai” because spreads and supplements also provide calories,
it adds saturated fat in the diet. other sources of fats should be reduced to
Limit consumption of sweets e.g. pastries, kulfi, maintain caloric intake to avoid weight gain.
rasmalai, kheer, barfi, halwa pedas, pies, cakes Avoid excessive intake of nuts and avocados as
and cookies. These are generally prepared with they are high in calories and may lead to weight
saturated fat e.g. butter, ghee and whole milk gain. However, inclusion of few unsalted nuts
and may raise LDL cholesterol, triglyceride and e.g. walnuts, almonds, peanuts, pistachios in a
body weight. heart healthy diet may decrease LDL
Avoid foods high in trans-fats. Like saturated cholesterol when weight is not gained. When
fat, trans- fats raise LDL cholesterol levels & weight is not gained, consumption of 5 oz of
may lower “good” HDL cholesterol. Re-use of unsalted nuts per week is associated with a
cooking oils increases the trans-fat content of reduced risk of heart disease.
the oil. Trans-fats are found in Indian In Indian restaurants select appetizers and
savory/snack foods e.g. mathri, shakar paras entrees cooked in a tandoor. Good choices for
chewda, bhel, sev etc. These are made with appetizers are tandoori fish, tandoori
saturated fat and trans-fat e.g. ghee, shortening vegetables, vegetable salads, fruit salads (fruit-
(vanaspati) and re-used cooking oils. chaat) & roasted papadam with mint chutney.
Select a heart healthy spread (free of saturated Avoid entrees prepared with added cream or
and trans- fat) instead of butter or ghee, Read butter or fried foods.
the label to make sure there is no "partially
Strategy # 6 Decrease your Salt Intake to 1500 mg
hydrogenated" oil in the ingredients list. Then
Sodium Daily to Lower Blood Pressure
look for as little saturated fat as possible. Look
for spreads with less than a total of 2 grams The American Heart Association and the
from saturated and trans-fat per serving. Also recent US dietary guidelines recommend less
look for “light” or “lite” spreads as they are half than 1500 mg of sodium per day. This sodium
19
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
goal is lower than in previous guidelines account. Follow up visits with your RD are also
because new data support this limit. recommended to reach your heart health goals. This
Reduce salt intake by cooking with as little salt is referred to as medical nutrition therapy (MNT) by
as possible. a registered dietitian (RD).
Compare sodium in foods by reading labels e.g. Geeta Sikand, MA, RD, CDE, CLS is a consultant
soup, bread & frozen meals. Choose foods with dietitian in private practice
practice in Irvine, California and
lower numbers. an Associate Clinical Professor of Medicine:
Substitute salt with herbs & spices e.g. cilantro, Cardiology at the University of California Irvine.
mint, cumin, black pepper, lemon. Contact information
information (949) 726-
726-1840 or
gsikand@gmail.com
Avoid highly salted foods e.g. salted nuts,
pickles, chutneys and salted savory/snack foods References
e.g. chevda, bhel etc.
1. South Asia at Health Crossroads with High
Prepare savory snack foods e.g. chewda, bhel Rates of Heart Disease, Diabetes, Obesity and
etc at home with minimum salt and oil. To Other Non communicable Diseases―New
reduce salt in the recipe, enhance flavor by World Bank Report. Press Release No:
using more spices e.g. amchur, cumin, asafetida. 2011/325/SAR Washington, February 9, 2011.
Alcohol Guidelines www.worldbank.org/sarncdreport
2. An epidemic of risk factors for cardiovascular
If you drink and if your physician approves because disease The Lancet, Volume 377, Issue 9765,
you have no medical reasons not to drink alcohol, Page 527, February 12, 2011.
you should limit to one drink or less per day for
women and two drinks or less per day for men. In 3. Effectiveness-Based Guidelines for the
general, one drink is 1 jigger or 1.5 oz hard liquor Prevention of Cardiovascular Disease in
(80 proof spirits) e.g. whiskey, bourbon, vodka etc Women--2011 Update: A Guideline from the
or 5 oz dry red or white wine or 12 oz beer. American Heart Association. Executive Writing
Committee, Mosca L, Benjamin EJ et al
What is the role of vitamin supplements and Circulation. 2011;123:00-00. February 16,
antioxidants in preventing heart disease? 2011.
Vitamin C supplements in combination with vitamin 4. The Importance of Population-Wide Sodium
E and/or beta carotene have not shown any benefit Reduction as a Means to Prevent
in the prevention of heart disease. Some studies Cardiovascular Disease and Stroke: A Call to
have shown they could be harmful. Vitamin D is Action from the American Heart Association”.
also under study. It is expected that ongoing Appel et al http://circ.ahajournals.org
research will shed further light on the role of vitamin Published on line Circulation Jan 13, 2011
D supplementation in the prevention of heart 5. 2010 Dietary Guidelines for Americans
disease. released January 31, 2011
www.dietaryguidelines.gov.
Do you need a Registered Dietitian (RD)?
(RD)?
6. The Practical Guide: Identification, Evaluation
A registered dietitian has expertise in nutrition. and Treatment of Overweight and Obesity in
With the help of a RD, a heart healthy meal plan Adults: Bethesda, Md: National Institute of
will be developed while taking your personal food Health National Heart Lung & Blood Institute;
preferences and medical history and lab reports into 2000. NIH Publication No 00-4084.
20
Preventing Heart Disease in Asian Indians: Diet & Lifestyle Recommendations
21
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
24. Grundy SM. Small LDL, atherogenic 27. Barnett and Garg, Preventing cardiovascular
dyslipidemia, and the metabolic syndrome. complications in diabetes and Szapary and
Circulation. 1997; 95:1-4. Conway, Functional foods in the prevention of
25. Reaven G. Insulin resistance and cardiovascular disease In: Carson, Burke, Hark.
compensatory hyperlinsulinemia: role in Cardiovascular Nutrition: Disease Management
hypertension, dyslipidemia and coronary heart and Prevention. Chicago, IL: American
disease. Am Heart J. 1991;121:1283-1288 Dietetic Association, 2004
26. Sikand G, Kashyap ML, Yang I. Medical 28. What you need to know about mercury in fish
Nutrition Therapy lowers serum cholesterol and shellfish. FDA/CFSAN Consumer
and saves medication costs in men with
Advisory EPA-823-R-04-005. March 2004.
hypercholesterolemia. J Am Diet Assoc.
1998;98: 889-894. http://www.cfsan.fda.gov/~dms/admehg3.html.
22
Chapter 4
Renal Diet for Asian Indians
Chhaya Patel, MA, RD, CSR
23
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
24
Renal Diet for Asian Indians
25
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
26
Renal Diet for Asian Indians
27
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
28
Renal Diet for Asian Indians
Helpful Hints to Lower Phosphorus Legumes, nuts and seeds will need to be limited for
patients with chronic kidney disease, if potassium
Use non-dairy milk substitutes, such as Mocha and phosphorus levels become an issue.
Mix®, Coffee Rich®, Coffee-Mate, Rice Consumption of a vegetarian diet may require an
Dream® or Dairy Delicious® in place of milk increase in the number of phosphate binders for
on cereals and in recipes. patients in end stage renal disease (ESRD) or on
Try cream cheese on crackers or sandwiches dialysis.
instead of cheese or peanut butter. Potassium
When using cheese in cooking, choose the
sharpest flavor and use less than the amount Potassium (K
K) is a mineral that is necessary to keep
listed in the recipe. your muscles functioning properly. The heart is
Enjoy sorbet, fruit ices, Italian ices, popsicles or your biggest muscle. That is why your heart is
sherbet instead of ice cream for a cool and tasty affected when potassium levels are too high or too
treat. low.
Drink non-cola sodas. All cola drinks (diet and Healthy kidneys regulate the amount of potassium
regular) contain phosphoric acid. Try some of the body needs. In kidney failure, the amount of
the flavored seltzer waters or make your own. potassium in the body can get too high and cause
Check labels on canned or bottled beverages to dangerous problems.
make sure they do not contain phoshates.
Eat popcorn (unsalted) instead of nuts for a High Potassium in the blood may cause:
snack. Nausea
Choose hard candy as it has less phosphorus Difficulty breathing
than chocolate. ↑K
Irregular heartbeat
Try mixed vegetables instead of lima beans or
Cardiac arrest/heart attack
corn with meals.
Tingling In the extremities
If biscuits, pancakes, and waffles are a favorite,
make them from scratch as mixes and Loss of consciousness
commercial products are high in phosphorus. Slow or weak pulse
29
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Low Potassium in the blood may cause: Pears, canned, 1 small or ½ lge
Pineapple, fresh or canned
Muscle weakness Plums (2)
↓K Nausea, vomiting, diarrhea Prunes (2)
Irregular heartbeat Raspberries
Dizziness
Normal Potassium Level is 3.5 to 5.5. Rhubarb
Your dialysis treatment helps control your Strawberries (5 medium)
blood potassium level. Make every scheduled Tangerine (1)
treatment and stay the full length of the Watermelon (1 cup)
treatment.
If your Potassium is lower than this you sho
should Juices
talk to your Dietitian about getting more Apple
potassium in your diet. cranberry
If your Potassium is higher than this you should grape
limit the amount of potassium that you eat. pineapple
Most of the Potassium in your diet comes from peach nectar
Fruits and Vegetables. Use the following tables pear
to determine which fruits and vegetables are the nectar
best choices. apricot nectar
Foods to Enjoy (Serving Size is ½ cup unless Grapefruit juice: Discuss medication reactions with
otherwise stated) your dietitian or doctor.
Fruits Vegetables
Apple, applesauce Asparagus
Apricots (1) Bamboo shoots, canned
Blackberries Bean sprouts
Blueberries Beets, canned
Boysenberries Broccoli
Cherries Brussels sprouts
Coconut Cabbage
Cranberries Carrot
Cranberry sauce Cauliflower
Figs (2) Celery
Fruit cocktail Collards
Grapefruit (½) Corn*
Grapes Cucumber
Kumquats Eggplant
Lemon Endive
Lime Green beans, wax beans
Mandarin oranges, canned Kale
Peaches, cnd, fresh 1 small or ½ lge Leeks
30
Renal Diet for Asian Indians
Lettuce Juices
Mushrooms
Mustard greens Orange juice
Okra Prune juice
Onion Avoid any juices with added calcium
Parsley
Peas, green* Miscellaneous Foods
Peppers, green or red, mild or hot
Radishes Bran cereal
Summer squash Chocolate
Salt substitute
Spaghetti squash
Lite salt
Snow peas
Nuts and seeds
Toria Soy milk
Turnips & turnip greens
Watercress Vegetables
Waterchestnuts, cnd
Zucchini Artichokes
Avocado
Potatoes-
Potatoes-only if soaked 2 to 4 hrs to reduce Bamboo shoots, fresh
potassium (Ask your dietitian about “Dialyzing” Beans, dried, ckd (kidney, lentils, lima, navy,
potatoes) pinto, soy)
Beets, fresh and beet greens
(*allowed but high in phosphorus) Cactus
Chard
Food that May Cause High Potassium (Please limit Chinese cabbage
or avoid!) Fenugreek leaves
Kohlrabi
Fruits Papadi
Bananas Peas (dried)
Pickles
Cantaloupe
Potatoes, unless “dialyzed”
Casaba melon
Pumpkin
Dates Rutabagas
Dried fruits Sauerkraut**
Honeydew melon Spinach (cooked)
Kiwi Succotash
Mango Sweet potatoes
Nectarine Tomato
Oranges Tomato paste, puree or sauce
Papaya Tuver
Persimmons Waterchestnuts, fresh
Starfruit (carambola)
(poisonous for dialysis pts, not based on K+
Juices
content). Do Not Eat! Carrot juice
Tomato juice**
31
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
32
Renal Diet for Asian Indians
Sodium restriction for vegetarians with kidney onion powder, oregano, paprika, parsley, pepper,
disease peppermint, poppy seeds, poultry seasoning,
rosemary, saffron, sage, Tabasco® brand hot sauce
Sodium content of some vegetarian foods can be only (other have added sodium), tarragon, thyme,
high. The foods with high sodium content are vanilla extract, vinegar, Wright’s Liquid Smoke®,
usually processed, commercially-produced plant Mrs. Dash®.
proteins. To reduce sodium intake, the use of high
sodium foods such as meat analogs, salted nuts, High sodium seasonings to avoid
miso, frozen entrees, marinated tofu products,
savory snacks and meals in a cup should be limited. Accent®, BBQ sauce, seasoned salt such as Lawry’s®,
In comparison to meat, meat analogs have much celery salt, garlic salt, onion salt, Old Bay®, pickles,
higher sodium content and need to be limited. soy sauce, steak sauce, Worchestershire sauce.
Other low sodium seasonings to use Your fluid intake must be balanced with the amount
of fluid you excrete in your urine. If you drink or
Almond extract, allspice, anise, basil, bay leaf, eat more fluid than you excrete daily you will retain
carraway seed, cardamom, celery seed, chili powder, fluid and gain “fluid weight”.
chives, cilantro, cinnamon, clove, cumin, curry, dill,
dry mustard, garlic, garlic powder, ginger, When measuring your fluids, use an 8 oz. cup or
horseradish, lemon juice, mace, maple extract, measuring cup.
33
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
34
Renal Diet for Asian Indians
Vegetarians can substitute beans, lentils or tofu Take your vitamin after hemodialysis on dialysis
for meats days and anytime on other days.
Portions served in restaurants may be very
A balanced vegetarian diet that includes a variety of
large; watch your serving size and take excess
plant foods is able to meet the needs for vitamins
home
and minerals, as well. The position of the American
Grilled items are good choices Dietetic Association on vegetarian diets states,
Mixed dishes such as casseroles are generally “appropriately planned vegetarian diets are
high in phosphorus and sodium healthful, nutritionally adequate and provide health
benefits in the prevention and treatment of certain
Vegetables diseases.”
Fresh, steamed, or fried; unsalted Iron, calcium, zinc, vitamin D and B12 should not
be a concern for vegetarians on dialysis. The renal
Breads/Starches
vitamin that hemodialysis patients are usually
Nan, Chapati, Paratha, Puris, White or Italian prescribed should contain vitamin B12 and zinc.
breads and rolls (without garlic salt)
Nutritional Supplements
Idli, Dosa and rice products
Pasta, macaroni, noodles and rice A variety of nutritional supplements are available to
provide nutrition when you are unable to eat enough
Dessert or do not feel like eating. If you are having
Allowed fruits, sorbet, angel food cake, plain problems eating, your dietitian can provide
cookies, gelatin information on supplements and recommend the
best one for you.
Desserts with out milk products, Pies or
cobblers made with apple, blueberry, cherry or Chhaya Patel, MA, RD, CSR is DaVita Renal /
lemon Divisional Dietitian in the San Francisco Bay Area.
Beverages She is a Certified Specialist in Renal Nutrition,
Nutrition, the
Area 1 Representative for Renal Practice Group of
Tea (made from tea bag), coffee, iced tea(made ADA,
ADA, and she was Associate Chair and Region V
from tea bag), lemonade, water (within allowed representative for the Council on Renal Nutrition /
amount of fluids) NKF. Contact information 925- 925-937-
937-0203 or
chhaya88@hotmail.com.
Dialysis Vitamins
Reference
Hemodialysis removes water soluble vitamins. To
stay your healthiest, you should replace these 1. Chhaya Patel and Mary Denny, Cultural Foods
vitamins by taking a renal vitamin supplement. and Renal Diets: Multilingual Guide for Kidney
Your doctor will prescribe a vitamin for you. Please Disease Patients and Clinical Guide for
take only vitamin and mineral supplements that have Dietitians, CRN Northern CA. 1997.
been approved by your doctor, nurse or dietitian.
35
Chapter 5
The dietary habits of people in the Eastern coastal In terms of day-to-day cooking, Eastern Indians
states of Odisha (language spoken is Odia) and don't use many spices. The flavors are usually subtle,
West Bengal (language spoken is Bengali) include foods are delicately spiced unlike the fiery curries
the consumption of both vegetarian and non- typically associated with Indian cuisine. The main
vegetarian food. It is rare to find strict vegetarians in seasoning is ‘Panch phutana’ (in Odia) or ‘Panch
this region since Brahmins of Odisha (previously Phoran’ (in Bengali), which is a mixture of mustard
called Orissa) and Bengal eat fish and meat (mostly seeds, coriander seeds, methi seeds, black coriander
chicken and mutton). Cooked with very little or, at seeds etc. This mix is widely used for tempering
times without oil, these two eastern states offer a vegetables and dhal/lentils, while garam masala,
curry power, and turmeric are commonly used for
variety of low-calorie delicacies. There are many
non-vegetarian curries. The other major ingredient
similarities yet vast cultural and linguistic diversity
is garlic and mustard seeds finely ground together,
exists, which along with the geographic heterogeneity
called as Besara in Odia and Sorsho Bata in
makes the Odia and Bengali cuisine unique. Both Bengali. Odias and Bengalis are rice eaters and
regions have their distinctive food habits and along with rice, a typical Odia or Bengali meal has to
cooking styles: Bhaja, Bhapa, Bhuna, Chachchari, have a combination of a stir fried or deep-fried
Chhenchara, Dalma, Dalna, Dum, Ghanto, Jhol, vegetable; lentils; a mixed vegetable curry typically
Pora, and Tarakari. To the casual palate, the cooked with garlic and mustard paste or saag made
Eastern Indian food means rice and fish. Both from various green vegetables such as spinach or
states share the love for fish and rice due to the long fenugreek and seasoned with paanch puoran; and of
coastline shared by them on the Bay of Bengal. Fish course, the ubiqitous Maccher Jhol or fish curry.
and other sea food such as crab and shrimp are in
plenty in this region and so are the recipes. Rice is Odia and Bengali cuisine recognizes and gives a
the staple food in Eastern India. The other place for the five basic tastes of astringent, bitter,
characteristic features of coastal cuisines include the sweet, sour and hot. While the Odia meal does not
have a specific course of serving the food items, an
use of coconut in many recipes. Unlike other
authentic Bengali meal does. It begins with bitters,
coastal kitchens, however, coconut oil is not
either in the form of shukto (a kind of stew with
commonly used. Instead, the preferred cooking vegetables, drumsticks or bitter gourd) and moves
medium is mustard oil or refined vegetable oil on in stages through the dhals with fries and fritters,
(mostly groundnut). Traditionally food was cooked a vegetable dish like a ghonto or chhokka, to the
on cowpat (made of dried cowdung), wood or non-vegetarian items of fish or meat. Before ending
charcoal fires but recent years have seen an on a sweet note, there is the occasional treat of
emergence of gas, electric, and microwave ovens. astringent or sweet chutney.
36
Eastern Indian Diet: Odia & Bengali Cuisine
In general, Odia and Bengali meals include one or seasoned with light spices (Panch phoran or
more of the following. Panch Phutana). Often vegetables are cooked
Rice, white and parboiled (most commonly with fish, mutton, and chicken, especially in the
used). Rice is the staple food in Odisha and curry form.
Bengal and is incorporated in many ways. For Fruits are consumed fresh, mostly as after
example puffed rice is used frequently for dinner desserts. These include watermelon,
breakfast and snacks. Pakhala, a popular Odia mango, lichees, apples, oranges, guavas,
dish consumed during the summer months, is papayas, and a variety of plantains, and
made of cooked rice, water, and yoghurt. bananas.
Rotis are consumed mostly at dinnertime or Tea is the most popular drink and is usually
during breakfast. served with milk and sugar. Use of coffee is
rare in the average households. Other popular
Dhals and legumes of various kinds. Most
drinks include coconut milk (from the young
common dhals are toor, urad (especially to
coconut, mostly a popular street-side drink),
make cakes and snacks), gram and mung (most
Lassi, a delicious iced curd drink, and Nimbu
frequently used). Dhal is sometimes cooked
paani (lemon squash).
with vegetables called “dalma.”
Ghee is served on top of cooked rice to
Fish is an integral part of the diet. In fact it is enhance flavor.
considered auspicious, and no Odia and
Bengali function can do without fish. The fish is Water is served with meals. For most
prepared in innumerable ways – steamed or traditional meals, people sit down on the floor
on a mat and eat with their fingers.
braised, stewed with greens or other vegetables
and with sauces that are mustard based. Fish Coconut – is abundantly available and mostly
curry cooked with mustard and garlic paste is used in the cooking (curries, dalma, sweets,
very popular. There is a preference for Hilsa chutneys) etc.
fish followed by Bass, Mullet, Rohu and Katla Sweets
(all are fresh water fishes). The delicious Dahi
Macch is prepared with fried fish dipped in People of Odisha and West Bengal are sweet lovers,
gravy made of curd. and have always been known for their particular
Mutton, chicken, and eggs, along with seafood weakness for sweets. It is rare to see meals
are also used. The coastline offers an abundant completed without sweets. The choice of sweets for
variety of shrimps, lobsters, and crabs that are Odia and Bengali meals are unlimited. From the
relished in a variety of cooking styles and often ubiquitous mishti doi and rossogolla, to the rarer
spiced up. pithey and pulli, the choice is boundless. Certain
sweets are made on special events. Use of chhana
Consumption of lamb and pork are not very
(reduced milk) for making sweets is honed to
common in Eastern India. perfection. Rasgolla and innumerable varieties of
Vegetables are consumed in different forms: sandesh are available today. Besides these the
stir-fried, sautéed, bhartha (pureed or minced tradition of homemade pitha, and sweets made of
vegetables), or curried with a paste of garlic, rice powder, sweet potato, kheer, coconut and gur is
ginger, and onion. Fresh vegetables are often still common.
37
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Meal Pattern for the Traditional Odia/Bengali Client with Type 2 Diabete
38
Eastern Indian Diet: Odia & Bengali Cuisine
39
Chapter 6
South Indian Cuisine
Nirmala Ramasubramanian, MS, RD, CDE
South Indian cuisine refers to foods from 4 states, brown sugar-based cooked rice and lentils
namely Tamil Nadu, Karnataka, Andhra Pradhesh (sweet pongal, appam,adirasam, jilebi), and
and Kerala; also included is Pondichery, which is a other sweetmeats, using clarified butter, nuts
union territory. Variations in food practices along and spices like cardamom (Kesari, Halwa etc).
with language, culture, heritage and customs are very Ghee or clarified butter is served with rice as a
apparent among the 4 states. There are innumerable flavor enhancer. Sesame, peanut and vegetable
area-- based specialty foods. For example, oils are generally used in cooking
Pondichery cuisine is a blend of different cultures, Salt served separately on the plate for optional
including Tamil Nadu, Kerala and Andhra Pradesh use
while it also reflects the French influence. However,
Pickles and pappads (crispy wafers) are often
one may be able to find some common features.
used as side dishes
In general, South Indian meals include one or more Water served with meals
of the following in varied forms: Hot beverages such as "milky" coffee or tea with
Rice, white or parboiled. Since rice is the staple sugar
food of South India it is incorporated in various The most commonly used spices are coriander,
ways. asafetida, cumin seeds, fenugreek, ginger,
Dhals or legumes of various kinds. Most pepper (red, green, and black), turmeric,
common dhals are toor, urad, Bengal-gram and saffron, cardamom and various combinations of
mung. The 2 staples, namely rice and different these used as curry powders and dessert
dhals are used in a variety of ways- pounded, enhancers.
ground, fermented, boiled, sautéed and so on.
Shredded coconut, coconut oil, coconut milk, fried
e.g. Idli, Dosa etc.
plantain chips and fish are more common in Kerala
Most commonly used animal protein foods are and Pondicherry, whereas spicier foods are popular
fish, chicken, lamb, mutton and eggs for non- in Andhra, including pickles and chutneys. Cereal-
vegetarians lentil preparations using oil or clarified butter are
Vegetables, both green and starchy, are more common in Karnataka and Tamil Nadu.
generally stir-fried or roasted to crispness (curry
or porial) and/or served wet including dhals and Acculturation of Indians in America includes the
coconut (koottu) selection of American or other ethnic foods as main
meals or snacks especially by younger generation.
Fruits are usually consumed fresh or as juices
e.g. Sandwiches, pizza, pasta etc. Additionally foods
Desserts are generally made from reduced milk from other regions of India are commonly used by
and white sugar (payasam or kheer), jaggery or South Indians, e.g. puris, samosas, chapathis, etc.
40
South Indian Cuisine
Meal Pattern for the Traditional South Indian Client with Diabetes Type 2
Meal Typical Modified
Total Calories : 3585 Total Calories : 1905
CHO : 525 gm (59%) CHO : 269 gm (55%)
Protein : 128 gm (14%) Protein : 88 gm (18%)
Fat : 107 gm (27%) Fat : 58 gm (27%)
Breakfast 1 cup coffee with whole milk 1 cup of coffee with ½ cup fat free or 1%
7:30 A.M. 3 Idlis or milk
1 plate of Upuma 2 Slices of whole wheat or multi grain
toast
2 tbsp. of coconut chutney
2 tsp. of Margarine
OR
2 small Idlis OR
1 cup of cracked wheat upuma
with 2 Tbsp. of tomato /veg or dhal
chutney
Snack None 1 Fresh fruit (a small apple)
10:30 A.M. 8 oz. diluted buttermilk (½ cup lowfat
yogurt and ½ cup water)
3 cups of White rice 1 ½ cups of Brown rice OR
Lunch 1 cup Sambhar 2 small rotis with ½ cup of brown rice
12:30 P.M. 1 cup Rasam 1 cup Sambhar or dhal
1 cup green plantain curry 1 Cup Rasam
1 cup mixed veg. koottu 1 cup green beans curry
1 cup curds/whole milk yogurt Shredded Carrot Salad with lemon juice
1 or 2 fried papadums or potato chips ½ cup fat free yogurt
2 tsp ghee, 1 small roasted pappad/appalam
Pickles 2 tsp oil in cooking
Afternoon 2 murukkus/chaklis (pretzel like fried) ½ cup dry cereal mix (made with puffed
coffee Coffee with whole milk rice, puffed wheat and ~6 peanuts or ~4
4 P.M. cashews)
1 Cup coffee with fat free milk
41
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Dinner 3 cups of cooked white rice 1 cup cooked brown rice or cracked
7:30 P.M. 3 oz. of fish, chicken, or lamb (Non wheat
vegetarians) 3 oz fish or white meat chicken (Non
1 cup sambhar or dhal based vegetables vegetarians) OR
1 cup fried vegetables such as Potato or 1 cup whole gram dhal or chick peas
Bhendi sundal
1 cup whole milk yogurt 1 cup spinach curry (dry or wet)
Pickles/pappads etc 1 cup Raita with grated cucumber (½
cup low fat yogurt and ½ cup cucumber)
2 tsp oil in cooking
Snack 1 fresh fruit 1 Kiwi or small orange
9:30 P.M. 1 cup ice cream 4 walnuts or 12 peanuts
42
South Indian Cuisine
Tips for changes more than 3 eggs per week. Egg whites are
okay.
1. Use brown rice instead of white rice. The
11. Vegetarians may increase and improve the
increase in fiber content will improve glycemic
quantity and quality of protein by incorporating
control. There is a general misconception that
diabetics must avoid all rice, which is not soy curd (tofu), soy
soy flour, skim milk powder,
necessary. Avoiding excess portions is the key. nut butters and if allowed, egg whites.
whites
2. Instead of using rice as the main staple grain, 12. Pickles, chutneys, pappadums, etc. are very high
include a variety of grains such as cracked in sodium. People with hypertension must take
wheat, oats, barley, quinoa, ragi and other note that table salt, baking powder, and baking
millets.
millets soda are sources of sodium and therefore must
3. Avoid washing rice several times before cooking be used carefully.
or cooking in excess water and draining. 13. Desserts must be restricted to allowed quantities
4. Keep in mind that the recommended portions of fresh fruits.
fruits Artificially sweetened low fat
are for cooked products wherever applicable. desserts or desserts using allowed foods with
e.g.1 Serving of dhal= 2 Tbsp of uncooked dhal minimal amount of real sugar may be used with
1 Serving of rice = 3 Tbsp. of uncooked rice. prudence.
This is important because the finished product 14. Drink plenty of water throughout the day,day at
may vary greatly in quantity and consistency! least 6 to 8 cups a day.
day
5. Try to cook with minimum amount of oil. oil 15. Learn to read the nutrition labels on food
Preferred oils are olive, canola or peanut oils as packages.
they are high in monounsaturated oils.
Weekend and Party Planning
6. While using potato, green plantain or other
starchy vegetables, remember to count them as South Indians are very similar to other immigrants
carbohydrates and cut down on rice eaten at the in trying to entertain and relax on the weekends.
same meal. Smarter thing would be to select Food becomes an important part of the social
green vegetables more often than starchy gatherings. Quite often, festivals and holidays are
ones. celebrated on the weekends with friends. Pot-luck
7. Use green vegetables more freely and learn to dinners are very popular. Men may indulge in
cook them in small amounts of oil. Salads are alcoholic beverages while women generally limit
good with every meal.meal Simple lemon and themselves to sodas and juices.
vinegar dressings may be freely used.
8. Switch over to fat free,
free, skim or 1% milk instead Party meals consist of several varieties of rice, vadas,
of whole milk. This will reduce the saturated fat and bondas as well as fried and creamy vegetables
and calorie content of the diet. prepared with liberal quantities of oil and coconut,
9. Avoid fried snack foods as much as possible;
possible nuts and dry fruits. Fried home made rice/lentil
learn to cook with recipes requiring dry snacks, roasted nuts, potato chips, rice and lentil
roasting, baking etc. Remember people with wafers, and chutneys make the feasts mouth
diabetes are more susceptible to high watering and of course calorie-laden! Special
cholesterol in their blood, as well as heart desserts of various kinds appropriate to the
disease. festival/celebration are also brought in, in addition to
10. Use lean cuts of animal proteins (meats/poultry) cakes and doughnuts to satisfy the palate of the
and use appropriate portion sizes.
sizes Avoid using younger generation.
43
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
44
Chapter 7
Maharashtrian Cuisine
Keya Deshpande Karwankar, MS
Maharashtrian cuisine boasts of being wholesome, The vegetables are more or less steamed and
nutritious and intricate. You would find one lightly seasoned so as to retain their nutritional
ingredient like dal could be made in three or four value. Deep frying and roasting is not a common
elaborately different ways. The cuisine encompasses practice. And few of the common dishes are
a variety of food preparations, from the coconut bharit (lightly cooked or raw vegetables in
based coastal cuisine to an interior distinctive cuisine yogurt), paale bhaji (leafy vegetables), paatal bhaji
known as Varadi cuisine. Although, all the them (spinach or fenugreek with lentil and peanuts),
share a lot of commonalities: zunka (made with gram flour and vegetable).
Salad or koshimbir is a very important part of
Grain Group
every meal. It is made out of a variety of raw
Examples of one serving size would be: 1 chapati, ½ vegetables like cucumber, tomatoes, onions,
cup of cooked rice, ½ cup of pohe. spinach. And this is garnished with coriander and
As in most of the other states of India, rice is peanut powder, and is lightly seasoned with
the staple food grain in Maharashtra too. A phodni (hot oil with spices).
maharashtrian meal cannot be complete Fruits Group
without chapati or bhakri (jawar or bajra roti)
with toop (clarified butter-ghee). Example of a serving size would be a tennis ball size
Breakfast comprises of preparation like pohe of apple, a medium banana, ½ cup of aam ras.
(seasoned beaten rice). Fruits are consumed both whole and pureed.
Desserts or sweets like sheera (sweet semolina), Aam ras (mango puree) and shikran (banana in
kheer, shankarpaali (made out of refined flour milk) are commonly consumed. And in
and sugar) are common. And special occasions summer pana (raw mango juice) is relished.
call for puris (deep fried) or one of the most (Pureed ,sweetened fruits carry concentrated
liked maharashtrian dish called puranpoli calories and adjustments have to be made
(chapati with a lentil and jaggery filling). accordingly to avoid a high sugar load at any
one meal).
Vegetable Group
Milk/Yogurt Group
Example of a serving size would be ½ cup of cooked
vegetables and 1 cup of raw vegetables, like spinach. Example of a serving size would be 1 cup of
There is an enormous variety of vegetables in the milk, ½ cup of yogurt, 1 cup of butter milk.
regular diet made in both gravy and dry style. Milk is used in the preparation of tea and many
Curries like bharlivangi, bharlibhendi are made of the sweet preparations like kheer.
on special occasions.
45
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Yogurt is a very vital ingredient in preparing enjoy a variety of fish like bombil (bombay
koshimbir, bhajis (vegetables), chutney (spicy duck), which is batter fried, bangda (mackerel)
accompaniment made out of a variety of foods) is curried with red chilles, ginger and tirphal (a
and it is also used to make a famous spice). Paaplet (pomphret) is usually barbecued
maharashtrian dessert, shrikhand (Curd whey or shallow fried.
with sugar). Lamb and chicken is mainly consumed in the
Taak (buttermilk) and yogurt is also eaten with interior part of maharashtra.
rice. Buttermilk is also used to make taaka chi Foods in this group are excellent sources of
kadi (buttermilk with gram flour). proteins, B vitamins, iron and zinc. Lentils/ dals
are also a good source of fiber.
Meat, Poultry, Fish, Dry beans/Lentils, Eggs and
Nuts Group preparations during upaas (fast)
Food preparations
An example would be ½ a cup of dal, ½ cup of Fasting time actually turns out like a feast, as
chicken or mutton curry. maharashtrians prepare numerous dishes garnished
Dal (Toor dal) or umpti (sweet and sour toor with peanuts. Sabudana chi khichadi, sabudana
dal) are a must with rice for a maharashtrian. A wada (a deep fried snack) bagaar (a type of rice),
variety of lentils like masoor, chana, toor, mung batata cha khees (grated potato-seasoned) are the
are used in the preparation of varan (dal). hot favorites during fasting.
Mooga chi dal (mung dal) , mooga chi usal ,
Jaggery, tamarind and kala masala (is a special
vatana chi usal (dried peas) are also the
blend of spices) is added in most of the vegetables
delicacies. Sprouted mung dal is used widely
and lentils which makes the foods piquant .
and is prepared in many different ways.
Peanuts are used in a lot of preparations like Although maharashtrians usually tend to stick to the
chutney, chikki (peanut and jaggery), and it is traditional cooking style, maharashtrians in America
used as garnish for many of the koshimbiri and have incorporated a tad of western cooking, making
bhaji. it a nice blend of both.
The people in the coastal parts of maharashtra
One Day Menu Plan for a Traditional Maharashtrian Client with Type II
II Diabetes
46
Maharashtrian Cuisine
47
Chapter 8
Gujarati Cuisine
Rita Batheja, MS, RD, CDN
Gujarati Cuisine is primarily vegetarian with Jain and (sweetened milk with saffron and nuts), Papad,
Buddhist influences. Gujarat can be divided into 4 Chutney and Pickle.
regions and due to the different climatic conditions;
there are slight variations in eating habits and Kathiawad
Kathiawad
preparation of food. The four regions are South and Kathiawadis love Dhebras (made from wheat flour,
North Gujarat, Kathiavad and Kutch. Gujaratis have yogurt, spinach, green chilies, sugar and salt) that
a sweet tooth and therefore add jiggery and/or sugar they eat with Chhunda (sweet, sour and hot mango
to every dish from vegetables to chutneys including pickle). They also use Methia Masala (dry powder
dal and pickles. Jains do not eat onion and garlic. made from fenugreek seeds, chili powder and salt)
Rotli is prepared soft like a petal, Phulkas to a to sprinkle on vegetables. They also use red chili
crunchy bone dry texture called Khakhras. powder to make spicy cuisine and eat lot of peanuts
Khakhras are used for breakfast or as a snack or and til (sesame seeds) – Peanut Chiki (made with
while travelling. gud) tastes delicious.
South Gujarat Kutch
In Surat,
Surat vegetable dishes like Undhiyu and Paunkh Kutchi cuisine is very simple. They mainly use rice
are very popular. Suratis add green chilies to add life and pulses. Main dish is Khichdi (mixture of rice
to the food. They love sweets like Nankhatais and and mung dal) and Kadhi (curry made of yogurt) or
Gharis which they buy from local bakeries and Bajra no rotlo (made from Millet) with homemade
shops. No expensive ingredients are used or pure ghee (butter) and gud (jaggery), guvarnu shak
elaborate preparations are made yet food in its (vegetable) and Chhash (buttermilk). Kutchhis also
simplicity tastes exotically different. eat Dudhi Muthia (made from Snake Squash and
flour) and some common dishes like Dhokla (a salty
North Gujarat steamed cake), Doodhpak or Shrikhand (sweet
made of Whoe Milk Yogurt, Cardamom, Slivered
Food is non-spicy and oil is used sparingly. It is
Pistachio/ Almonds, Saffron and Charodi) with hot
popular for its traditional Gujarati Thali, which has
fluffy puris.
its origins in this city. It consists of Farsan (appetizer)
like Khaman Dhokla and Khandvi (chickpea flour), In short, Gujarati Cuisine’s concentration is on fried
one variety of Dal or Kadhi (prepared from yogurt), snacks and the use of plenty of ghee, oil, sugar and
hot fluffy Puri or Rotli, couple of vegetables, jaggery. Many Gujaratis do not eat green vegetables
sprouted beans, Raita (yogurt), Doodhpak frequently and hardly eat fruits.
48
Gujarati Cuisine
49
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Weekend and Party Plannig offer variety of sliced vegetables with Humus
(Mediterranean dish) as an example. Humus is
Gujaratis love weekend gatherings and partying, made from ground chick peas, sesame paste (Til-
which starts from Friday evening till Sunday evening. high in calcium), green chillies, ginger and lemon
Mostly men drink few pegs of scotch with snacks (easy recipe – can keep in the refrigerator).
such as kachoris, samosas, vegetable cutlets, cashew
rolls and varieties of Bhajias. Problems in this area Consider serving Handva, Dhokla and Idli instead
that call for your attention before you go to that of fried items. Example 1” square Dhokla = 1 Rotli,
party or the restaurant: Remember PORTION ½ cup Pauva = 1 Rotli, got the idea! That is called
CONTROL and move more eat less that makes carbohydrate counting. Dairy, vegetables, fruit and
perfect sense. Plan your day’s meal ahead of time so food from the grains group all contain carbohydrate.
that importance is given to healthful preparations, Consumers with Diabetes need to learn about
the kind and amount of fat used and the importance serving sizes.
of avoiding carbohydrate or fat loading, Modified Party Meal
Party meal consists of ½ cup lettuce and tomato salad
Fried Papad, Puries, Shrikhand (rich sweet made 1 teaspoon fat free salad dressing (Walden farm
from whole milk yogurt, sugar, Cardamom, Slivered brand tastes good)
Pistachio/Almond, Saffron and Charodi ) Valor nu 1 3” Puri
1
50
Gujarati Cuisine
51
Chapter 9
North Indian Cuisine
Madhu Gadia, MS, RD, CDE
North Indian cuisine typically represents foods of North Indian food is a combination of simple to
Punjab, Haryana, Delhi, Jammu and Kashmir, very elegant vegetarian and non-vegetarian fare. A
Himachal Pradesh, Uttar Pradesh, Uttarakhand, simple vegetarian meal may consist of moong dal,
Rajasthan, Bihar, Jharkhand, Chhattisgarh, and subji and phulka (thin whole wheat roti). The food
Madhya Pradesh. Basically, all the states north and is seasoned with asafoetida, cumin, turmeric,
west of Maharashtra are often clumped together in coriander powder and garam masala. The garam
this generalization. Each state has its own specialties masala is often referred to as a north Indian spice
but it is the similarities that classify the food of this blend. Onion and garlic may or may not be used.
region. North Indian food is often called “Punjabi Then there are the non-vegetarian favorites like
food”. North Indian food is the most popular food chicken and lamb dishes heavily seasoned with
in restaurants and therefore it is synonymous with spices, onion, ginger and garlic. Foods like stuffed
Indian food throughout the world. paratha, saag and makki-ki-roti (corn roti), chole and
bhature, kofta, rogan josh, tandoori chicken,
Wheat is the staple food of this region. “Basmati” biryanies and pulao are very popular in this cuisine.
rice is grown in the northern plains and is often the Variety of desserts such as barfi, laddu, and gulab
rice of choice for pulaos and biryanis. Variety of dals jamun are extremely popular in this region.
or beans such as garbanzo, kidney, urad as well as
moong and toor dal are used. Milk, butter and ghee North Indian food is often described as “rich”. The
are used extensively. Chicken and mutton are the food is often fried, and a fair amount of ghee, butter
most popular meats eaten in this region. Most of the and nuts may be is used. The food is seasoned
cooking is done on the stovetop using the roasting heavily with onion, ginger, garlic and spices like
and frying method. cardamom, cinnamon and cloves that give the food
a “rich” color and flavor.
Punjabis and refugees from West Punjab (which is
now in Pakistan), came and settled in Punjab and Nutritionally speaking, north Indian meals with
Delhi. They were very enterprising people and had plenty of whole grains, green leafy vegetables, and
a style and food of their own. They popularized beans are high in complex carbohydrates, fiber,
tandoori food (that gets its name from the tandoor vitamins and minerals. The overall fat and saturated
clay oven in which the food is cooked) in this region. fat content of traditional meals may be high due to
Punjabis opened restaurants at every corner and extensive use of milk, butter, ghee and oil. The meal
thus tandoori food was born. They developed a can be easily modified in overall fat content by using
‘formula’ that worked and Punjabi food became small amount of unsaturated oil to season the food.
very popular. Today most Indian restaurants around In order to reduce saturated fat, substitute low fat or
the world serve tandoori dishes and typically Punjabi fat free milk wherever possible and use butter and
food. ghee sparingly.
52
North Indian Cuisine
53
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Breakfast 1 cup çhai (Tea) / whole milk 1 cup çhai / skim milk
3 teaspoons sugar no calorie sweetener
1 potato paratha 2 whole wheat toast
1 tsp Pickle 1 teaspoon butter
1 cup skim milk
Lunch 2 roti with 1 teaspoon ghee 2 roti-no ghee
1 cup rajmah (or chicken curry) 1 cup low fat rajmah (or low fat
½ cup spinach and potato subji chicken curry)
½ cup onion and cucumber salad ½ cup spinach subji
1 roasted papad ½ cup onion and cucumber salad
1 roasted papad
Tea Time 1 cup chai / whole milk 1 cup chai / skim milk
3 teaspoons sugar no calorie sweetener
¼ cup namkeen (fried snack) 1 oz (30grams) mixed nuts
1 laddu (sweet) 1 Banana
Dinner 2 parathas 2 roti-no ghee
1 cup chole (1 cup Kheema) ½ cup chole (or ½ cup low fat
1 cup potato and pea subji kheema)
½ cup dahi (whole milk yogurt) 1 cup cauliflower subji
½ cup dahi (fat free)
Snack 1 cup Kheer 1 orange
1 cup skim milk
Weekends and Parties associated with special occasion foods of puri, chole,
pakore, and not to mention kheer and halwa
There is often a distinct difference in our eating (generally high-fat foods). Portion control is a good
between weekdays and weekends. Weekdays we are tool to use here. If you are the host, plan your
bound by time and schedules and it is easier to parties to balance meals and incorporate some lower
control the types and amounts of foods we eat. fat foods like vegetable trays as appetizers and use
People will often say they do so well Monday to less fat in your dishes. If you are the guest at a party
Friday implying that they make good choices in their and everything you see is high in fat and calories
meal selection. But come weekends (starting Friday watch your portion sizes, enjoy the company and
night) we lose all restraints in our food selection. thank the hosts for a wonderful evening. You will be
Indians love to party, as it is our way of socializing much happier on Monday morning!
and connecting with our culture. Socializing is
54
North Indian Cuisine
Serving Suggestions
Typical Party Menu (Watch portions and total carbohydrate intake to
avoid elevated blood sugar after the meal, and enjoy
the party and company.)
Samose or pakore with chutney 1 Samosa
Puri 1 Puri
Chole ½ cup Chole
Chicken curry (non-vegetarian) ½ cup Chicken curry (non-vegetarian)
Potato Pea subji ½ cup Cauliflower subji, avoid the potatoes
Cauliflower with potato subji 1 kofta
Kofte 1 cup onion, cucumber, radish salad
Onion, cucumber, radish salad ¼ cup Raita
Boondi Raita Chai
Matar Pulao (Skip pulao and dessert)
Chai
Gulab Jamun
Madhu Gadia, MS, RD, CDE (Registered Dietitian References
and a Certified Diabetes Educator) is an author of
New Indian Home Cooking (Penguin Group 2000) 1. Exchange Lists for Meal Planning, American
and The Indian Vegan Kitchen (Penguin Group Dietetic Association, 1995,
2009). She is a Wellness Director for Compass 2. The Indian Vegan Kitchen: More Than 150
Group and teaches the art of Indian cooking Quick and Healthy Homestyle Recipes; Madhu
around the country. Contact information Gadia, M.S., R.D., 2009.
www.cuisineofindia.com.
www.cuisineofindia.com.
3. New Indian Home Cooking: More than 100
delicious, nutritional and easy low fat recipes!;
Madhu Gadia, M.S, R.D., 2000.
55
Chapter 10
Nepali Cuisine
Suraj Mathema, MS, RD, CDE
Many people of Nepalese origin following Nepali Green vegetables are stir-fried, while most other
dietary practices live in India. Nepali cuisine, in vegetables are seasoned with light spices and
part, has been influenced by cooking practices in prepared in curry form.
North India and Tibet. But, there are many typical Fruits are usually consumed fresh or as juices.
indegenous dishes such as gundruk, lapsi achar, qua Lapsi is typically eaten as achar.
gasa (Newari dish), sukti etc. Also, the sub-ethnic Commonly consumed sweets are: Kheer,
groups have their own variations of dishes. Gulaab Jaamun, Halwa, Mahi (by product of
In general, Nepali meals include one or more of the milk after the butter had been churned out,
following in varied forms: often sweetened before consumption),
Rasogolla, Rasmalai, Laddoos etc.
Rice is most popular in grains, then wheat.
Maize is not as popular as rice and wheat. Even Hot tea is most popular drink for all seasons. It
less popular are millet, barley and buckwheat is served with milk and sugar.
Dals or legumes of various kinds. Most Ghee or clarified butter is often served with rice
common dals are toor, urad, gram and mung. as flavor enhancer. Mustard oil is mostly used
The two staples, namely rice and different dals for cooking.
are used in a variety of ways such as pounded, Water served with meals
ground, boiled, sautéed and so on. The most commonly used spices are coriander,
Most commonly used animal protein foods are, cumin, ginger, turmeric. And others used in
chicken, goat, water buffalo and eggs for non- typical dishes are timur (szechwan pepper –
vegetarians used in aloo achar, qwa gasa etc.), jimbu ( used
in urad dal)
Heart Healthy Meal Pattern for the Traditional Nepali Client
Time Typical Modified
Calories : 2800 Calories : 1900
Carbohydrate : 336 grams (48%) Carbohydrate : 261 grams (55%)
Protein : 140 grams (20%) Protein : 119 grams (25%)
Fat : 99.5 grams (32%) Fat : 42 grams (20%)
Breakfast 1 cup tea with whole milk and sugar 1 cup tea with skim milk (or 1% fat
(7:00 AM) 2 slice bread milk) and with no sugar (preferable).
1 egg 2 slices of whole-wheat bread/ toast.
2 tsp margarine
56
Nepali Cuisine
57
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
58
Nepali Cuisine
59
Chapter 11
Low Fat Cooking & How to Modify a Recipe
Nimesh Bhargava, MS, RD, CNSD, MBA
Diet related diseases like heart disease, obesity, Fats like ghee, butter, oil or even margarine can
cancer and diabetes greatly affect the quality of life. be cut by half to two thirds the amount in the
The need to manage these diseases with proper diet recipes. Try cutting the amount by small
and a growing health-consciousness has brought amounts first then gradually increasing to half to
awareness in people to explore new ways of cooking two thirds the amount. To replace the loss of
and eating. There are many sources to draw from taste when ghee or oil is reduced, consider
including low-fat cookbooks and the latest sources
adding alternatives such as vegetable broth,
are the numerous websites that offer low-fat recipes.
vegetables, fruit juices, herbs, spices, skim milk
It is important to remember that while fats, ‘ghee’ or or skim milk powder.
oils bring richness and taste to the food, they also Change the cooking recipe: Instead of frying,
contain twice the amount of calories as compared to bake, boil, broil or steam the food item. This
carbohydrate or protein. Besides being a
will significantly reduce the amount of fat you
concentrated source of calories they are readily
converted and stored as body fat. The type of fats consume.
and oils as well as amounts used will determine if a Use nonstick cooking pots and pans. Coating
recipe is heart-healthy or not. Most of your favorite baking pans with vegetable cooking spray rather
recipes can be easily changed to lower the fat, salt, than using ghee or oil.
and sugar content and increase fiber. This section of
the book is devoted to tips on making your favorite Sauté foods in water, wine, or fruit juice rather
recipes healthier. than oil or ghee.
Removing or cutting down oils from curry, dal,
Making your favorite recipes
recipes healthier
sambar or rasam. If the recipe was cooked with
With a little practice, you can turn any favorite too much oil, cool it after cooking. Then skim
recipe into a healthy dish. the excess fat with a tea spoon to remove e the
oil from the surface.
Always ask yourself – “Can I reduce the amount of
salt and ghee / oil?” Use a plastic degreaser constructed like a pitcher
with a spout that allows the liquid to be poured from
Always use a measuring cup or a measuring spoon.
the bottom instead of the top.
Never pour from a container or guess the amount of
salt and oil. You may know the amount of oil or salt Trimming fat from poultry, beef or pork:
to be added in the recipe. With time the serving size Remove the skin of the chicken or turkey. Trim
increases if you do not measure the ingredients. visible fat from beef or pork before cooking.
60
LowFat Cooking & How to Modify a Recipe
Reduce the amount of salt by adding spices and Regular Gelatin Sugar-free gelatin mix or fruit
herbs. Below is the list of spices that goes well juice mixed with unflavored
with Meat, Vegetables and Fruits: gelatin
Vegetables: Add lemon, ginger, 1 Whole egg ¼ cup egg substitute
vinegar, dry mango
powder, anardana, black 2 egg whites or 1 egg white 1
pepper, corriander dry or teaspoon vegetable oil
green leaves, sesame seeds, 1 Ounce 3 tablespoons cocoa powder
fennel seeds, basil, baking and 1 tablespoon vegetable oil
oregano, onion, garlic, chocolate
turmeric, tamarind and
1 can Homemade white sauce (1 cup
tarragon
condensed skim milk +2 tablespoons flour
Fruits: Cinnamon, cloves, cream soup +2 tablespoons margarine)
cardamom, vanilla, or mint
Cream of 1 cup of white sauce+¼ cup
Fish, Poultry, Meat: Bay leaf, chives, dry celery soup celery
mustard, lemon, garlic,
onion sage, or basil Cream of 1 cup white sauce+1 cup
mushroom mushroom
Increase fiber by cooking brown rice instead of soup
white rice, use whole wheat bread instead of
Cream of 11/2 cups of white sauce +I
white bread, do not sieve the flour before
chicken soup chicken bouillon cube
making the flat bread or “rotti” and leave skins
on fruits or vegetables Fat in baked Use no more than 1-2
recipes tablespoons of oil per cup of
The following table shows how you can substitute flour: increase liquid slightly to
ingredients to make your recipe healthier; add extra moisture
Food Item Substitute with Syrup packed Juice packed canned fruit
canned fruit
Cream Evaporated Skim Milk
2 tablespoons 1 tablespoon cornstarch or
Whole Milk Skim Milk or 1% Milk
flour arrow shoot
1 cup ghee ¾ cup vegetable oil (as thickener)
1
½ cup ghee /3 cup vegetable oil Sugar in baked Reduce the amount by ½ the
Regular cheese Low fat cheese or skim milk recipes original amount: use no more
cheese than ½ cup added sweetener
(sugar, honey, molasses, etc)
Cream cheese Light cream cheese per cup of flour. Add vanilla
Butter Margarine extract, cinnamom, and nutmeg
to increase sweetness. Use half
Mayonnaise Light mayonnaise or reduce the amount of sugar and
calorie mayonnaise replace the other half with
Salad dressing Reduced calorie, light or fat apple sauce or well ripen
free salad dressing mashed bananas
61
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
62
LowFat Cooking & How to Modify a Recipe
minutes. Garnish with coriander and serve hot with Oil for deep frying
rice. 2 slices bread
Sambar (Modified recipe) Salt & pepper
½ c red lentils Cut tomatoes and onion into small pieces and add
water in a pan. Boil and cook for about 20 – 25
1tsp mustard seeds
minutes. Puree the ingredients in a blender and then
½ tsp asafetida pass it through a sieve. Cut the bread slice in ½ inch
½ tsp fenugreek seeds squares. Heat the oil and fry the bread squares until
½ tsp cumin seeds golden brown. Serve the soup in a bowl, sprinkled it
1 dried red chili halved with croutons, salt and pepper to taste.
2-3 curry leaves Tomato soup (modified recipe)
2 green chili
500 gyms ripe tomatoes
1 cup mixed vegetables cut small pieces (onion,
potato, radish, Aborigine, zucchini, green bell 1 small onion
pepper) 4 cups of water
2tbsp tamarind juice 1 tablespoon olive oil
11/2 cup water 2 slices bread
1tbsp sambar powder Pepper
1 tbsp chopped fresh coriander Oregano & basil leaves
Cook the lentils in boilin Cook the lentils in boiling Cut tomatoes and onion into small pieces and add
water for about 1hour until tender then drain and water in a pan. Boil and cook for about 20 – 25
set aside. Roast mustard seeds, asafetida, fenugreek, minutes. Puree the ingredients in a blender and then
and cumin seeds, red and green chili and curry pass it through a sieve. Brush olive oil on the bread
leaves until the mustard seeds become brown in the slice. Cut the bread slice in ½ inch squares. Sprinkle
heavy frying pan. Add the green chili and vegetables oregano and basil leaves on the bread. Place bread
and add ½ cup of water and cook for 5 minutes. squares in 350°F oven for 10-12 minutes until
Add the tamarind juice, water, sambar powder, golden brown. Serve the soup in a bowl, sprinkled it
turmeric and salt, cover and simmer over a low heat with croutons, and pepper to taste.
until the vegetables are tender. Stir in the cooked
lentils and simmer for 5 minutes. If sambar needs to Vegetables and Vegetarians Dishes
be thickened, blend the rice flour with the water, stir Palak Khadi Serving 4 (original recipe)
recipe)
it into the pan and simmer for a further few minutes.
Garnish with coriander and serve hot with rice. 2 cups plain yogurt
Soups Serving 4 ¼ cup gram flour
½ tsp ground red chili
Tomato soup with bread croutons (Original recipe) ½ tsp ground turmeric
500 gyms ripe tomatoes Salt
1 small onion 2 cups water
4 cups of water ½ cup fresh palak boiled
63
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
64
LowFat Cooking & How to Modify a Recipe
10 minutes. Reserve 1 tablespoon of this mixture 2 table spoon green mango powder
and stir the remainder into dal and beans. Add ½ tsp red chili powder
garam masala. Garnish with the reserved onions and
2 tsp coriander powder
tomato mixture. Serve hot with rice or chappatis.
Black salt to taste
Spiced Chick Peas Serving 4 Coriander fresh chopped
(Original recipe) 1 onion chopped
250 gm chick peas Soak the chick peas overnight in the water with
650cc / 2 ½ cups water baking soda. Boil the chick peas in pressure cooker
for 30 minutes until tender in low fire. Heat oil in
½ tsp baking soda another pan and fry ginger and chilies add all
4 table spoon ghee ingredients simmer for 2-3 minutes. Add the chick
inch grated ginger peas and stir well. Cover and simmer gently for 10
2 green chilies chopped minutes. Sprinkle with coriander and onion. Serve
hot with rice or chappatis.
1 tsp garam masala
2 table spoon green mango powder Rice Dishes Serving (4)
½ tsp red chili powder
Vegetable Pulao (original recipe)
2 tsp coriander powder
Black salt to taste 225 gm/ 1 cup basmati rice washed and soaked
Coriander fresh chopped in cold water for 30 minutes
1 onion chopped ¼ cup ghee
1tsp cumin seeds
Soak the chick peas overnight in the water with
4 cloves
baking soda. Boil the chick peas in pressure cooker
for 30 minutes until tender in low fire. Heat ghee in 1 inch cinnamon stick
another pan and fry ginger and chilies add all 4 cardamom pods
ingredients simmer for 2-3 minutes. Add the chick 2 bay leaves
peas and stir well. Cover and simmer gently for 10
1 red onion finely sliced
minutes. Sprinkle with coriander and onion. Serve
hot with rice or chappatis. 100 gm cauliflower, cut into 1 cm/1/2 inch slices
100 gm peas
Spiced Chick Peas Serving 4
2 medium carrots, cut 2.5 cm/ 1 inch slices
(Modified recipe) 25 gm/ 1/3 cup raisin
250 gm chick peas 1 medium potato, cut into 1 cm / ½ inch pieces
650cc / 2 ½ cups water 1 tsp garam masala ground
½ tsp baking soda ½ tea spoon ground red chili
1
2 table spoon canola oil or vegetable oil /2 tsp turmeric powder
inch grated ginger Salt to taste
2 green chilies chopped 500 cc / 2 cups water
1 tsp garam masala Coriander leaves.
65
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Drain rice and leave it to drain in colander. Heat the 2-3 minutes, add all vegetables, garam masala, chili,
ghee in a non stick pressure cooker over medium turmeric powder, salt and raisin. Then pour water.
heat. Add the cumin seeds followed by cloves, Bring to boil for 1 minute then reduce the heat to
cinnamon stick, cardamom and bay leaves. Let the low, cover and cook for 15 minutes or until tender.
spices sizzle for 15-20 seconds, then add the onion If there is any water left, dry off on a high heat.
and fry until golden. Add the rice stir fry for 2-3 Garnish with washed coriander leaves. Serve with
minutes; add all vegetables, garam masala, chili, low fat plain yogurt.
turmeric powder, salt and raisin. Then pour water.
Bring to boil for 1 minute then reduce the heat to Bread
low, cover and cook for 15 minutes or until tender.
Chappatis or Phulkas Serving 10 (original recipe)
If there is any water left, dry off on a high heat.
Garnish with washed coriander leaves. Serve with 14 oz whole wheat flour plus more for dusting
low fat plain yogurt. ½ tsp slat
1
Vegetable Pulao (modified recipe) /4 cup / 4 table spoon ghee
8 1/2 fluid oz lukewarm water
225 gm/ 1 cup basmati rice washed and soaked
in cold water for 30 minutes In a large bowl mix flour, salt and ghee then
1 table spoon canola or sunflower oil gradually add water and mix until dough is formed.
1tsp cumin seeds Transfer the dough to a clean surface and knead it
4 cloves for 5-6 minutes. Cover the dough with a damp
cotton cloth, leave to rest for 30 minutes. Divide the
1 inch cinnamon stick
dough in half and cut each portion into 10 equal
4 cardamom pods sized balls. Dust a cake of dough lightly with flour
2 bay leaves and roll out into a 6 inch disk. Keep remaining
1 red onion finely sliced cakes covered with a damp cloth.
100 gm cauliflower, cut into 1 cm/1/2 inch slices
Preheat a heavy cast-iron griddle pan over medium
100 gm peas high heat. Place a chapatti on it and cook until
2 medium carrots, cut 2.5 cm/ 1 inch slices surface begins to dry. Turn it over and cook until
25 gm/ 1/3 cup raisin the underside has brown patches. Turn it over again
1 medium potato, cut into 1 cm / ½ inch pieces and press the chapatti with fish slice. The chapatti
1 tsp garam masala ground will puff up now. Cook until brown patches appear
on the other side.
½ tea spoon ground red chili
1
/2 tsp turmeric powder Wrap the chappatis in a sheet of aluminum foil
Salt to taste lined with paper towels to keep hot until you finish
500 cc / 2 cups water cooking all the dough. Serve with any curry or
vegetable dish.
Coriander leaves.
Chappatis or Phulkas Serving 10 (modified recipe)
Wash rice and leave it to drain in colander. Heat the
oil in a non stick pressure cooker over medium 14 oz whole wheat flour plus more for dusting
heat. Add the cumin seeds followed by cloves, ½ tsp slat
cinnamon stick, cardamom and bay leaves. Let the
spices sputter for 15-20 seconds, then add the onion 2 tsp canola oil
and fry until golden. Add the rice & gently stir fry for 8 1/2 fluid oz lukewarm water
66
LowFat Cooking & How to Modify a Recipe
In a large bowl mix flour, salt and oil then gradually Knead well, cover with a damp cotton cloth and
add water and mix until dough is formed. Transfer leave to rest for 15 minutes. Divide the dough into 6
the dough to a clean surface and knead it for 5-6 equal portions and roll out each one into a thick
minutes. Cover the dough with a damp cotton cloth, round. Spread a little ghee. Spoon the filling into the
leave to rest for 30 minutes. Divide the dough in center of each one and fold over. Roll into balls.
half and cut each portion into 10 equal sized balls. Dust a cake of dough lightly with flour and roll out
Dust a cake of dough lightly with flour and roll out into a 5 inch disk. Preheat a cast iron griddle over
into a 6 inch disk. Keep remaining cakes covered medium high heat. Place a paratha on it. Brush a
with a damp cloth. little ghee and turn it again brush a little ghee and fry
on both sides until lightly browned. Serve with plain
Preheat a heavy cast-iron griddle pan over medium low fat yogurt.
high heat. Place a chapatti on it and cook until
surface begins to dry. Turn it over and cook until Cauliflower Paratha Serving 6(modified recipe)
the underside has brown patches. Turn it over again
and press the chapatti with fish slice. The chapatti 350 gm grated cauliflower
will puff up now. Cook until brown patches appear 450 gm / 4 cups whole wheat flour
on the other side. 2 medium potatoes, boiled, peeled and mashed
Wrap the chappatis in a sheet of aluminum foil 2 chopped green chilies
lined with paper towels to keep hot until you finish 1 cm/ ½ inch ginger roots, grated
cooking all the dough. Serve with any curry or 1 tablespoon chopped fresh coriander
vegetable dish. 1 tsp garam masala
Cauliflower Maratha Serving 6 (original recipe) ½ tsp red chili
Salt to taste
350 gm grated cauliflower
1 tsp green mango powder (amchoor)
450 gm / 4 cups whole wheat flour
300 cc/ ½ pt. /1 ¼ cup water
2 medium potatoes, boiled, peeled and mashed
4 table spoon canola oil or vegetable oil
2 chopped green chilies
1 cm/ ½ inch ginger roots, grated Mix salt in cauliflower for 10 minutes. Squeeze out
1 tablespoon chopped fresh coriander the water. Mix cauliflower with potatoes, chilies,
ginger, coriander, garam masala, red chili, mango
1 tsp garam masala
powder. Mix the flour, 1table spoon oil, salt and
½ tsp red chili water to make the dough. Knead well, cover with a
Salt to taste damp cotton cloth and leave to rest for 15 minutes.
1 tsp green mango powder (amchoor) Divide the dough into 6 equal portions and roll out
300 cc/ ½ pt. /1 ¼ cup water each one into a thick round. Spoon the filling into
the center of each one and fold over. Roll into balls.
½ cup ghee
Dust a cake of dough lightly with flour and roll out
Mix salt in cauliflower and let it stand for 10 into a 5 inch disk. Preheat a cast iron griddle over
minutes. Squeeze out the water. Mix cauliflower medium high heat. Place a paratha on it. Brush a
with potatoes, chilies, ginger, coriander, garam little oil and turn it again brush a little oil and fry on
masala, red chili, mango powder. Mix the flour, 4 both sides until lightly browned. Serve with plain low
table spoon ghee, salt and water to make the dough. fat yogurt.
67
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
68
LowFat Cooking & How to Modify a Recipe
Soak the dal in water for 6 hours. Grind coarsely South Indian Coconut Chutney (Modified recipe)
then mix all the ingredients. Heat a heavy based pan
and smear with ghee. Pour a ladleful of batter into 50 gm grated coconut
the pan and spread to a 15 cm / 6 inch in circle. 1 cup plain fat free yogurt
Pour a spoonful of ghee around the edges and cook 2 tsp canola oil or vegetable oil
for about 2 minutes. Until each side is golden color.
½ tsp black mustard seeds
Serve hot with chutney.
2 dried pieces of red chilies
Moong Dal Dosa Serving 10 (Modified recipe) 1 sq inch ginger
250 gm moong dal A bunch of coriander leaves
4 green chilies chopped 1 tsp peanuts chopped
Fresh coriander chopped 4-5 curry leaves
½ medium size radish, scraped and grated Salt to taste
Salt to taste Mix coconut, yogurt, ginger, coriander and salt in a
½ tsp red chili powder blender. Heat oil and fry the mustard seeds until
1
/6 tsp asafetida seeds start cackling. Add chopped peanuts, red
chilies, curry leaves, and stir in the coconut puree.
4 table spoon canola oil or vegetable oil
Leave to cool.
Soak the dal in water for 6 hours. Grind coarsely
Raitas
then mix all the ingredients. Heat a heavy based pan
and smear with oil. Pour a ladle of batter into the Cucumber Raita Serving 4 (original recipe)
pan and spread to a 15 cm / 6 inch in circle. Pour a
spoon of oil around the edges and cook for about 2 1 ½ cup plain yogurt
minutes. Until each side is golden. Serve hot with 1 medium size cucumber
chutney. ½ tsp black salt
South Indian Coconut Chutney (Original recipe) ½ tsp sugar
1 tsp ground roasted cumin (dry roast the
50 gm grated coconut cumin seeds for few seconds until golden color
1 cup plain yogurt then grind.)
2 tsp ghee
In a mixing bowl beat the yogurt with a wire whisk
½ tsp black mustard seeds
until smooth. Peel the cucumber and grate it.
2 dried pieces of red chilies Squeeze out the excess water, mix yogurt, cucumber,
1 inch of ginger salt and sugar. Sprinkle ground roasted cumin over
A bunch of coriander the raita and serve.
4-5 curry leaves Cucumber Raita Serving 4 (modified recipe)
Salt to taste
1 ½ cup fat free yogurt
Mix coconut, Yogurt, coriander, ginger and salt in a 1 medium size cucumber
blender. Heat ghee and fry the mustard seeds until
½ tsp black salt
seeds start cackling. Add red chilies, curry leaves,
and stir in the coconut puree. Leave to cool. ½ tsp sugar
69
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
1 tsp ground roasted cumin (dry roast the Nimesh Bhargava MS, MS, RD, CNSD, MBA is a
cumin seeds for few seconds until golden color certified dietitian / nutritionist. He is Professor of
then grind.) Nutrition at Mount Saint Mary College, Newburgh,
NY and Clinical Nutrition Manager at Somers Somers
In a mixing bowl beat the yogurt with a wire whisk Manor Nursing Home and Rehab Center, Somers,
until smooth. Peel the cucumber and grate it. NY. Contact information nimesh777@yahoo.com
nimesh777@yahoo.com
Squeeze out the excess water, mix yogurt, cucumber,
salt and sugar. Sprinkle ground roasted cumin over
the raita and serve.
70
Chapter 12
Nutritious snacks by delaying hunger and stabilizing Savory and salted items that are deep fat fried,
blood sugars are an essential part of healthful meals. for example: Samosa, Pakoras, Bhujias, and
A recent trend is the availability of a wide variety of Murruku (deep-fried, crunchy spirals).
pre-packaged ready to eat snack items and the Savory and salted items that contain a
proliferation of Indian snack food restaurants in combination of deep-fried and raw ingredients,
most metro areas in the US raising concerns about for example: Bhel puri, Dahi wada, Pani puri
health outcomes. Savory and sweet snack foods have and Chaats.
always been an indispensable part of the Indian
cuisine. We are only too familiar with the Samosas, Sweet snacks prepared and preserved in a sugar
Kachoris, Vadas Chevda, Sev and a myriad of medium, for example: Rasagolla, Pumpkin
petha.
saltines (namkeens) not to mention the sweet “
mithais” whipped out of the kitchen in a quick Sweet snacks deep fat fried and preserved in
minute to be served and shared with a cup of tea or sugar syrup, for example: Jilebi, Gulab Jamun.
coffee with family, friends and even upon the arrival Non-vegetarian snacks baked, fried or grilled,
of unexpected guests. for example: Chicken or mutton tikka, Egg
pakoras, Fish fry, Shish kababs.
Lack of traditional social support systems,
adequate time for food preparation, the need to Nutritional Values
multi task and recently the ready availability of
prepared and ready to eat snacks has left Asian Vegetarian cereal or legume based snack foods are
Indian families with a variety of choices to choose high in carbohydrates. The fat and calorie content is
from though not be necessarily healthful. Most high due to many of the items being either fried or
vegetarian snack items are either made with cereals containing oils, ghee or butter. While the salt
like rice, rice flour, semolina (sooji), refined wheat content of the savory snacks may be high the sweet
flour (maida) or whole wheat flour (atta) and legume snacks tend to have even higher amounts of simple
flours like chick pea flour (besan), moong flour sugars. When served in combination a savory item
either in combination or alone. Some snack items with a sweet snack, - the mini meal may have the
may contain nuts, vegetables, spices, salt, oil, ghee calories, fats and carbohydrates to be safely
and or sugar. considered a meal replacement.
Based on the method of preparation snacks may be: Non-vegetarian snack items though considerably
lower in carbohydrates and higher in protein are
Savory and salted snacks that is not deep-fried, nevertheless calorie rich due to the saturated fats
for example: Uppuma, Pav Bhaji, and Dhokla they may contain.
71
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
72
Choosing Healthy Snacks
coriander chutneys along with tomato salsa may 7. Read all product labels to learn the ingredients
be store bought. Include fresh carrots, they contain.
cucumbers tomatoes and your favorite 8. For a personalized snack/ food plan contact a
vegetables to be eaten raw in your snack list. Registered Dietitian “RD”.
Include unsalted nuts, seeds and whole fruits.
9. A snack is not a meal! – keep snack portions
Do not shop on an empty stomach.
small.
4. If you plan on making snacks avoid deep fat
frying or adding excessive amounts of oil, butter How Nutritious is your Favorite Snack?
or ghee. Use low fat replacements when
feasible. The table below will help you think about possible
healthy snack items in different food groups.
5. When making sweet snacks consider replacing
Remember portions will still have to be controlled
part of the sugar with sugar substitutes like
and so should the use of oils, fats, sugar and salt.
Equal or Splenda.
6. Use salt and baking soda with caution in all
your cookery.
Not so healthy
Healthy
Healthy Snack (Enjoy all the time)
(Enjoy all the time – but within your day’s food plan)
plan)
Plain Puffed rice (mamra, moori, pori.) Bhel puri
Puffed cereals
Whole wheat phulka or chappati Fried maida or whole-wheat puri
Roasted corn on the cob Corn pakora
Boiled potato chaat or tikkia Potato vada or fritters, samosa
Baked vegetable chips
Popcorn Potato chips
Green gram or chickpea sundal or ghugni or Gram flour batter fried bajjia, vegetable fritters.
channa masala. Dal vada
Fresh sprouted moong beans.
Dhokla
Fruit Chaat Sweet fruit preserves chutneys.
Fresh whole fruit Fruit pies and cake.
Chocolate covered fruit.
Grilled tandoori fish, chicken or lamb, kababs or Fish fry, Chicken nuggets, Meatballs, cutlets
tikka and meat croquettes.
Plain lassi Sweet lassi or mango lassi
Roasted unsalted nuts, peanuts Salted nuts peanuts mixed with fried chevda
73
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Samosa Prepare filling and use as stuffing in whole-wheat By not using the pastry shell
/Kachori/eggrolls chappati, roll serve cut as cocktail wraps. and not frying you will cut on
Cherry tomatoes. the calories and fat.
Steamed cabbage leaves.
Bell pepper halves
Alternately form the filling into small patties
lightly flour and roast on griddle
Sooji Uppuma Prepare uppuma with cracked whole wheat Adds fiber.
Fish fry and meat Grill / bake or broil. By not frying, the fat and
patties Do not bread or batter calories are lower. By not
breading or batter dipping you
reduce the starch and calories.
Pappad Roast in microwave or grill over open flame. Do By not frying you cut calories.
not fry. Select less often if on a low salt diet.
Sweet desserts Replace with whole fresh fruit and vegetables Cuts carbohydrates and
Fruit juice /drinks, calories. Adds fiber.
dried fruits,
chocolate coated
raisins or
strawberries.
Portion sizes Small and petite Reduce calories, fats/ carbs
Chips / Dips Replace with fresh vegetables like cucumber, bell Reduce calories, fats and
peppers, carrots, tomatoes, and broccoli. carbohydrates.
Alternately use baked vegetable chips. By including vegetables you
Serve with coriander chutney, mint chutney or reduce calorie intake and
tomato salsa increase fiber.
74
Choosing Healthy Snacks
75
Chapter 13
Desserts of India
Sharmila Chatterjee, MSc, MS, RD, CDE
Desserts are often used to convey gratitude, The first ingredient is usually sugar, a fast absorbing
affection, respect, joy and reward. India with its rich carbohydrate that is absorbed in the blood stream
heritage and diversified culture also varies a great very quickly and raises blood sugar. It is a
deal in sweet preparations. Sweets are either concentrated source of calories (1 tsp or 5 gms = 20
prepared at home or eaten out not limited to any calories) and therefore is referred to as a Calorie
one occasion. Most common are parties, Sweetener as compared to a non-caloric sweetener
lunch/dinner invitations, birthdays, festivals, such as ‘Sweet and Low’ or ‘Equal’ or ‘Splenda’ ®.
anniversaries and, in general, eating out. There are Portion control is one big key to successfully
numerous homemade and traditional sweets or manage diabetes.
desserts prepared which vary from region to region The second ingredient most commonly used in the
and place to place. They are usually passed on from preparation of sweets and desserts is milk. Most
generations to generations. The most common homemade desserts use either milk or milk
preparations that are region specific but not limited products in the form of plain and sweetened yogurt,
to are as follows: condensed milk fudge (khoa), fresh chenna and
paneer cheeses, ghee and clotted cream. However,
North India/Nepal
most of these products when prepared from whole,
Kheer, Gulaab Jammun, Kulfi, Halwa (Suji or evaporated, condensed milk or half n half or full
Gaajar or dhudhi), Mahi cream can raise blood cholesterol or contribute to
heart disease. Most of the desserts or sweets are
South India prepared by either whole milk or half-and-half for
rich and creamy taste.
Payasam, Sweet Pongal, Laddu
Modifications/Tips
East India
1. Use Non-Calorie Sweetener in the preparation
Rosogolla, Misti doi, Pithe, Sandesh, Rasmalai of sweets and desserts. Reduce the portion
sizes. If you cannot make the entire dish with
West India non-calorie sweetener, then use only ¼ of the
amount of sugar suggested in the recipe and
Besan Laddoos, Shrikhand substitute the rest with non-calorie sweetener
Irrespective of the region one belongs to, the main 2. Try using canola or olive oil for frying. Shallow
ingredients that are used in these preparations are frying is better than deep frying and using a non-
grains, sugar, milk and fats or oils. These ingredients stick pan usually consumes less oil. Cooking
are a source of carbohydrate and calories and must spray equally does well and is recommended
be eaten cautiously. for shallow frying.
76
Desserts of India
77
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
78
Chapter 14
Managing your Menu in an Indian Restaurant
Karmeen Kulkarni, MS, RD, BC-ADM, CDE
Eating out at restaurants or bringing takeout food is choice, the fried ones are the ones to avoid.
common in the lifestyle of the average immigrant or Chappatis and naans are fine as long as they are not
person of East Indian origin. At least 3-4 meals are swimming in ghee or oil. Puris and parathas are also
eaten away from home each week. Or there is an laden with fat and not a great choice. Size always
increase in buying convenience or packaged foods matters , so try and select the smaller ones.
from Indian food stores or supermarkets to save
preparation and cooking time. Eating out is one of Entrees
the social and enjoyable recreations for many
individuals. Entrees to keep total fat , saturated fat and calories
on the low end , if you are non-vegetarian, try and
Following are a list of tips to assist in making select fish , chicken , or shrimp. Tandoori and tikka
healthful food choices when eating out: can be low in fat, malai and korma dishes are
creamy and high in fat, and can be incorporated in
Lets start with appetizers the not-so frequent list .Try and reduce the fried
versions of the non – vegetarian items. If you are
A healthful appetizer in Indian cuisine is rare, most
vegetarian meatless entrees are a recommended
are deep fried, for example : samosas, pakoras,
choice, however again check out the oil and or the
puris. Papad can be either fried or baked, so of
ghee in the entrée.
course the baked version is the preferred healthful
piece. Recommendations are to share the appetizer Rice
or take a half of two different types.
Rice most restaurants serve plain pullao, a healthful
Soups version .And if one wants something more, biryani is
Typical Indian soups are a lentil variety or a always on the menu, there are many varieties of
mulligatawny type soup. Both of these type of soups biryani, the chicken , shrimp and vegetable versions
are healthy, low in fat and calories and high in would be recommended over the lamb and beef ,
carbohydrates. Other types of healthful soup mainly for the fat content. Portion size is a key with
choices, are a clear mulligatawny, a light rasam , regards to rice items, as one-third cup of cooked rice
sambar, or a yogurt base Gujarati kadi. Creamy is a starch or carbohydrate serving, so attention to
soups with coconut, which is high in saturated fat the amount of rice as part of the meal is always
should be an infrequent choice. helpful.
There are healthful options and of course the not so Menu items made with garbanzos, lentils, potatoes,
healthful ones. Papads if they are baked area great green peas are starch or carbohydrate servings, and
79
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
80
Chapter 15
Carbohydrate Counting for Indian Foods
Karmeen Kulkarni, MS, RD, BC-ADM, CDE
Carbohydrate counting is a meal planning tool that Foods that do not contain carbohydrate in them are:
helps plan and eat balanced meals and control Meats (poultry, fish, seafood, eggs, red meat)
blood glucose levels, along with the medications and
Fats (butter, oil, margarine, nuts have some
physical activity. When a person uses carbohydrate
carbs)
counting, the focus is on the carbohydrate in the
food. This is due to the fact that carbohydrate raises The carbohydrate content of these foods can be
your blood glucose much more rapidly than the found in the chapter on Food Exchanges
other two macronutrients that provide calories;
protein and fat (excluding alcohol, which is not a Carbohydrate Counting and Blood Glucose
Glucose
macronutrient). Control?
Calculating the amount of carbohydrate in each Blood glucose levels are directly related to the
meal or snack that a person eats each day can help amount of carbohydrate one eats. If the amount of
carbohydrate is tracked at meals and snacks, and the
in keeping the blood glucose at an optimal level,
blood glucose levels are taken before and two hours
adjust the diabetes medication or insulin as needed. after the meal; a trend or pattern will emerge.
Most often carbohydrate foods are associated with Keeping an eye on the carbohydrate intake daily and
starches. For example: pasta, bread, potatoes, corn eating the same amount each day, will assist in
maintaining the blood glucose levels within the target
all contains carbohydrate. But these are not the only
range.
foods that contain carbohydrate. Following is a more
complete list of the food groups whose calories are Starting Carbohydrate Counting
mainly from carbohydrate:
Starches: rice, pasta, bread, cereal, crackers The focus on basic carbohydrate counting is to eat
about the same amount of carbohydrates at the
Starchy vegetables: potatoes, corn, green peas, same time each day to get an estimate on how much
beans and lentils carbohydrate effects the blood glucose levels before
Fruit and fruit juices and two hours after a meal. Counting carbohydrate
Non Starchy vegetables: spinach, tomatoes, can be done either way. Count the total grams of
carbohydrate in a meal or snack; or a carbohydrate
cauliflower
serving is equal to 15 grams of carbohydrate (based
Dairy Foods: yogurt, milk, and other dairy on the exchange food list). The size of the serving
foods will vary based on the type of food you plan to eat,
Sweets / Desserts: cakes, cookies, candy for example ½ cup of cooked aviyal or a three inch
round idly or a six inch chapatti or phulka or ½ cup
Beverages high in sugar
of sambar. All of these foods contain 15 grams of
carbohydrate per serving. This means that if you eat
81
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
more than one more serving of the food item, then 2. Start small: Know the insulin to carb ratio and
you will need to count the carbohydrate in your what one unit of insulin does to your blood
serving size you have eaten. The exchange lists in glucose without eating.
this book contain a listing of the 15 gram portions of
commonly eaten Indian foods. 3. Begin at Home: It’s always easier to eat at home
than eat out because you know the ingredients.
How much Carbohydrate should a person eat? 4. Test your blood glucose (BG) frequently: Test
your BG before and after you eat, to see what
Each person has their own threshold for
impact each food has on your BG.
carbohydrate; the correct amount for them. A few of
the areas to consider when trying to estimate the 5. Learn to read the nutrition facts label: It is
amount of carbohydrate amount for the day is a easier to dose insulin when the carbohydrates
person’s weight and height, the usual food intake, are listed on the package, except for fruits, and
daily work and leisure schedule, the favorite foods, vegetables.
amount of daily physical activity, target blood 6. Keep it simple: Keep it simple. Stick to certain
glucose goals, diabetes medications or insulin (type foods like salad dressing you like.
of insulin and the timing of insulin action) 7. Be consistent: The trick is to be consistent with
habits and the volume of food you eat.
For a female, a basic rule of thumb for estimating
the carbohydrate servings is approximately 45-60 8. Find Technology that works for you and use it:
grams of carbohydrate, or three to four You may use the Lose it iphone app to look up
carbohydrate servings per meal. For males, it is four food’s carbohydrate counts. It will help with
to five carbohydrate servings per meal or 60-75 recipes and nutrition information for one
serving.
grams of carbohydrate per meal. Plan to keep the
carbohydrate amount the same at meals and snacks, 9. Figure out what you can’t eat: Most people with
until the person feels comfortable to move forward diabetes can eat anything in moderation, but
with variations. A Registered Dietitian with expertise carbohydrate counters sometimes find foods
in Indian foods and carbohydrate counting would be that just aren’t worth the glucose spikes.
a resource to consult re individualizing the 10. Study your body: A little bit of record keeping
carbohydrate prescription. goes a long way toward helping you figure things
out about food and insulin dose.
Tips for Successful Carbohydrate Counting
11. Plan it out: Do your grocery shopping and meal
Carbohydrate counting takes a bit of practice, but it’s planning the night before so you know what you
a great way to learn about eating well with diabetes. are having.
It is one option with regarding to meal planning for 12. When you are at a restaurant. Learn how to
diabetes. Here are tips that will help to get you improvise: Don’t take insulin until you see the
started. These are some ideas from which you can menu.
select what works for you: 13. Do your homework: Always check the menu
before you go to a restaurant. It’s okay to ask
1. Educate Yourself: Attend classes on diabetes
for substitutions.
offered at clinics and hospitals related to
diabetes management. Read everything your 14. Stay current: Use different lists of foods as it
doctor, endocrinologist or Certified Diabetes helps to keep current on what the food industry
educator has provided to you. has to say about certain cultural foods,
uncommon foods and popular foods.
82
Carbohydrate Counting for Indian Foods
15. Get comfortable with guesswork: If the meal is individual. Eat and test is the rule of thumb.
mainly pasta, estimate the quantity of noodles 26. Don’t worry about being an expert: You will
and the dose of insulin. never feel like you have it 100 percent but you
16. Get up to speed on the internet: You can look get used to it. Plan for a refresher diabetes
up anything on the internet. You can’t weigh classes.
everything when you go out to eat. 27. Be aware of the following warning signs:
17. When eating out at a restaurant, order basic Hypoglycemia usually sets in with some signals
foods. like shakiness, dizziness, hunger, mood
18. If it is an unknown restaurant, try to order lower changes, increased sweating, head ache, and
carb items. Never take anything for granted. pale skin color. Keep carbohydrates on hand or
pack of glucose tabs.
19. Pay attention to portion size: Learn what
average portion sizes look like and avoid large 28. Treat immediately: Treat your low blood
meals when eating out. glucose with 15 grams of carbohydrate, wait 15
minutes, then check your blood glucose again.
20. Share your meal. The danger of eating out is Test and treat before driving, as needed.
you get huge portions. Split the food up on the
plate into portion sizes before you start eating. Karmeen Kulkarni, MS, RD, BC- BC-ADM, CDE; is
21. Weigh your food with a scale Director, Scientific
Scientific Affairs, Abbott Diabetes Care.
She has served as the President, Health Care &
22. Be smart about mindless munching: When you Education,
Education, American Diabetes Association. She has
are eating things like chips, count out one pioneered the carbohydrate counting approach for
portion instead of eating your way through the people with diabetes. Contact information
bag or bowl. kdev.kul.22@gmail.com.
23. Don’t expect your book, app or list to have all
the answers: Try to stay away from things that Tips for Carbohydrate counting was done by
you know are going to spike your blood Chhaya Patel, MA, RD, CSR, CSR, DaVita Renal/
Renal/
glucose. Stay with foods you know. Divisional Dietitian.
Dietitian. She is the Area 1
Representative for Renal Practice Group
24. Learn the rules then ignore ones that don’t of the American Dietetic Association.
ssociation.
work: Learn what different foods do for you. Contact information 925-
925-937-
937-0203 or
25. Know thyself: Carbohydrate counting is chhaya88@hotmail.com.
83
Chapter 16
Healthy Weight: Make it Your Lifestyle!
Healthy Choices in Nutrition and Physical Activity are Most
Effective in Fighting Obesity
Maintaining a Healthy Weight is a Balancing Act High total cholesterol or high levels of
triglycerides (dyslipidemia)
Calories In = Calories Out
Stroke
Liver and gallbladder disease
Sleep apnea and respiratory problems
Osteoarthritis
Reproductive health complications
Obesity also has physical, psychological, and social
consequences for adults and children. Children and
Obesity is a growing epidemic worldwide and the adolescents are now developing obesity-related
second leading cause of preventable death in diseases, such as type 2 diabetes, that in the past
developing countries were seen only in adults. One study of 5- to 17-year-
olds found that 70% of obese children had at least
Overweight and obesity are major risk factors for a one risk factor for cardiovascular disease and 39%
number of chronic diseases, including diabetes, had at least two risk factors.
heart diseases and cancer. Coronary heart disease is
twice as common in obese people as in normal- Overweight and obesity can be defined as disease
weight people, and obesity substantially exacerbates states in which excess body fat has accumulated to
all cardiac risk factors including diabetes. Obesity is an extent that may have a negative impact on the
associated with decreased longevity and quality of health status of an individual. Obese individuals can
life. differ not only according to the degree of excessive
fat, which they store, but also in the regional
The Health Consequences of Obesity distribution of the fat in the body. Excess abdominal
fat is as great a risk factor for disease as is excess
Coronary heart disease
total body fat. Overweight is currently defined as
Type 2 diabetes body mass index (BMI) of 23 to 24.9 and obesity as
Cancers, such as endometrial, breast, and colon a BMI of ≥25 according to the World Health
High blood pressure (hypertension) Organization Western Pacific Region.
84
Healthy Weight: Make it Your Lifestyle! Healthy Choices in Nutrition and Physical Activity are Most Effective ...
BMI=weight
BMI=weight (pounds)
(pounds) X 703/height inches) 2
703/height ((inches
inches)
2
the long run. Controlling your weight with foods
http://www.nhlbisupport.com/bmi/bmicalc.htm dense in nutrients rather than just “empty” calories
contributes to good health now and as you get older.
Asian Indians with a BMI value in the normal range
have higher associated risks. Consult your doctor for In the past few years,s, a modest weight loss, defined
your healthy BMI. as a weight loss of 5% to 10% of baseline weight, has
received increasing attention as a new treatment
Waist Circumference strategy for overweight and obese patients. Even a
modest weight loss seems to have a positive effect on
Besides using weight and BMI to identify health
obesity- related
d health problems.
risk, a large waist circumference is another sign of
increased risk for many health problems
oblems including: The key to achieving and maintaining a healthy
Heart Disease weight is about a lifestyle that includes enjoyable and
Type 2 Diabetes healthful foods, regular physical activity, and
balancing the number of calories you consume with
High Blood Pressure
the number of calories your body uses.use You need to
Where your fat is located makes a difference. If you enjoy your food- just eat less.
less
are carrying fat around the middle, mainly around
Weight Loss Guidelines
your waist (apple-shaped),
shaped), you are more likely to
develop health problems than if you carry fat mainly Control Calorie Intake
in your hips and thighs (pear-shaped).
shaped).
self monitor regularly to help recognize and
A high-risk waist circumference is: correct any fluctuations quickly
A man with waist measurement over 35 inches – Weigh yourself twice a week
A woman with waist measurement over 31 – Trackk your food intake to calculate calorie
inches intake http://www.fitday.com/
(free online diet journal)
Track your waist circumference as you work toward
your weight loss goals. eat breakfast regularly to help spread your
calorie intake throughout the day. Also curbs
To measure your waist circumference, place a tape overeating and excessive snacking
measure around your bare abdomen just above your
exercise regularly
hip bone. Be sure that the tape is snug (but does not
compress your skin) and that it is parallel to the – Spend 60 minutes daily on physical activity
floor. Relax, exhale, and measure your waist (walking, household chores, dancing etc).
Start small – walk 10 minutes/day to start,
then increase by 3-5
5 minutes each week.
Expanding Portion Sizes
Control portion sizes to control dress size by:
by
Healthy choices in nutrition and physical activity are At home
most effective in fighting obesity.
Eat
at off of a smaller plate so that the portion
Fad diets that promisingng fast results limit your appears to be more than it actually is
nutrient needs, can be unhealthy, and tend to fail in
Don’t make big batches that will allow you to
85
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
86
Healthy Weight: Make it Your Lifestyle! Healthy Choices in Nutrition and Physical Activity are Most Effective ...
Go for a bike ride This can be done with decreased food intake or
Trade in a power mower for a push mower replaced with a lower calorie alternative that is
enjoyable
Park the car 10 minutes from the shopping
center Have a fresh fruit in place of a large samosa as a
Start a neighborhood walking club snack (100g samosa has 400 calories, 100 grams
murukku have 530 Calories) and increased physical
Play ‘catch’ or fly a kite with your children activity. Step up with 10,000steps to burn 300
Dance to your favorite up-beat music for 10 Calories or spend ½ hour mopping your floors plus
minutes a day ½ hour doing housework to burn 230 Calories.
How to lose one pound a week Dr. Wahida Karmally is Associate Research
Scientist, Director of Nutrition in the Irving Institute
One pound of body fat =3500 Calories for Clinical and Translational Research and
Subtracting 500 Calories a day from your daily Lecturer in Dentistry at Columbia University.
University.
caloric intake will result in the loss of 1 pound a Contact information wk2@columbia.edu.
week.
87
Chapter 17
Exchange Lists for Indians with Diabetes
Chhaya Patel, MA, RD, CSR
88
Exchange Lists for Indians with Diabetes
89
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
90
Exchange Lists for Indians with Diabetes
91
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
92
Exchange Lists for Indians with Diabetes
93
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
1
Uppuma, with 1 tsp oil /3 cup 1 carbohydrate, 1 fat
Uttapam, vege 1 small 2 carbohydrate, 1 fat
Vanilla wafers 5 1 carbohydrate, 1 fat
Vegetable cutlet 1 med 1 carbohydrate, 1/2 fat
1
Yogurt, frozen, low-fat, fat free /3 cup 1 carbohydrate, 0-1 fat
Yogurt, frozen, fat free, no sugar ½ cup 1 carbohydrate
Yogurt, low-fat, with fruit 1 cup 3 carbohydrates, 0-1 fat
Free Foods
Coriander chutney 1 tsp 100 mg sodium (Nirav)
Salsa 2 Tbsp 450 mg sodium (Taco bell)
Marinated chillies 1
Follow American Dietetic Association Inc and The of the American Dietetic Association
ssociation.. She was the
American Diabetes Association’s Exchange lists for Associate Chair and Region V representative for
Meal Planning for the following lists: CRN. Contact information 925- 925-937-
937-0203 or
Free foods list chhaya88@hotmail.com.
Drinks References
Condiments
Seasonings 1. Exchange Lists for Meal Planning. American
Diabetes Association, Inc. and The American
Combination foods list
Dietetic Association. 2008.
Fast foods list
Sodium content of some of the foods on this 2. Diabetes Meal Planning for Indian and
exchange lists Pakistani clients. The American Dietetic
Association.
Avoid canned, cured, ready to eat and
processed foods for sodium/salt restricted diets. 3. Patel, C and Denny, M. Cultural Foods and
Renal Diets- A Multilingual Guide for Renal
Chhaya Patel, MA, RD, CSR,CSR, is the DaVita Renal/
Renal/ Patients, Section II, Council on Renal Nutrition
Divisional Dietitian in the San Francisco Bay Area. of Northern California, NKF. Second Edition,
She is a Certified Specialist in Renal Nutrition and 1997.
the Area 1 Representative
Representative for Renal Practice Group
94
Chapter 18
Selecting Foods from Different Food Groups
in the Indian Cuisine
Padmini Balagopal, Rita Batheja, Wahida Karmally, Karmeen Kulkarni, Ranjita Misra,
Sudha Raj, and Nirmala Ramasubramanian
(Fat-Free And Low-Fat Cheese, Milk, Yogurt And Egg yolks, creamed dhals, fried and or highly fatty
Equivalent Foods) and salted meats.
Use Less Often Preserves, dried fruits or fruits with added sugar, salt
or fats
Whole milk and whole milk products, full-fat
yogurts, whole milk paneer, cheeses, sweetened The Vegetable Group
flavored milk, ice creams, whole milk smoothies or Use
milk equivalents from other sources that are high in
fat and/or sugar etc. Brinjal (eggplant), cabbage, capsicum, carrots,
cauliflower, cucumber, drumstick, gourds like
The Meats, Legumes, and Equivalents Group karela, mushrooms, radish, spinach, tomatoes in
salads or with a little oil to sautee the seasonings
(Dry Beans, Eggs, Fish, Lean Meat, Nuts, Skinless
Poultry And Seeds) Use Less Often
Use Pickled or vegetables fried in oil such as bhajias,
fried papads etc.
Egg whites, fish, legumes and dhals (remember they
also have carbohydrates), lean meat, poultry (without The Starch and Grains Group
skin), low-fat tofu,seitan,unsalted nuts and seeds.
(Whole, Fortified and Fiber-Rich Grain Foods)
95
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
96
Chapter 19
Do Indian Spices & Condiments have a Role
to Play in Preventive Health and
Therapeutics?
Padmini Balagopal, Wahida Karmally, Karmeen Kulkarni,
Ranjita Misra and Sudha Raj
Indian spices and condiments have been around for significance (to make sure it would be used).
aeons and influence the nature, taste, flavor and Scientific research is exploring the possible benefits,
characteristics of Indian dishes. Many of them are and/or the presence of bio-active substances, present
part of Ayurveda (the science of life and health) and in these accompaniments. In order to define their
it has always been a moot question as to whether roles, it is necessary to itemize them and examine
they were added to enhance taste and flavor or to the evidence-based research available. Given below,
promote health because many of these spices and is a list of some of the various spices and
condiments have been ascribed health-promoting or condiments that are added in one form or other to
therapeutic roles. In fact, it is postulated that some Indian dishes.
of them like turmeric were given religious
Common Evidence-
Evidence-based
Spice/ ‘Putative’ or
dosage in
No Ref Botanical name Note worthy data ascribed benefits/
Condiment a dish for
benefits side-
side-effects*
4 people
1 - Asafoetida Ferula foetida Acrid, bitter taste, Used as a Approx No side-effects are known
(used to flavor strong, pungent digestive aid to 1 tsp when used in food
dishes) alliaceous odor relieve preparation.
due to its sulphur flatulence
‘Hing’
compounds
2 [1, 2] Basil (used in Ocimum Seeds or leaves Anti-infective A few Effectiveness for claims to
pesto, soups), basilicum used. Has a clove uses ascribed leaves or 2 treat flatulence and
also include (4 diff. types) scent tsps of stimulate appetite has not
‘holy’ basil paste been documented.
‘tulsi’
97
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Common Evidence-
Evidence-based
Spice/ ‘Putative’ or
dosage in
No Ref Botanical name Note worthy data ascribed benefits/
Condiment a dish for
benefits side-
side-effects*
4 people
3 [3-7] Black Cumin Nigella sativa- Thymoquinone; As a digestive 1 tsp Potential to induce
‘Kalajheera’ essential oil- nigellicine, aid apoptotic activity in
thymoquinone; nigellidine, human breast cancer cell
alkaloids and saponins lines and reactivates
saponins Nigella sativa- epigenetically silenced
essential oil- genes; regulate blood
thymoquinone;alk glucose level, inhibit
aloids and cholesterol absorption
saponins and produce dyslipidemic
effects.
4 - Black Pepper Piper Nigrum Used to season Powdered black ½ tsp No available evidence on
‘kali mirch’ pepper and benefits or side effects in
turmeric is used human studies.
‘milagu’
for cough and
upper respi-
ratory infections
5 [8, 9] Caraway seeds Carum carvi Carvone Used to season 1 and ½ Case studies and small
“Sajeera’ dishes tsp trials on bronchial dilatory
dried fruit effects. Chemotherapeutic
and oil properties;
Antimutagenic activity.
6 [10-13] Cardamom Elettaria Along with other As a digestive 1-2 pods Anti-oxidant and may
‘Elaichi’ cardamomum ingredients it aid, relieve have anti-spasmodic
contains flatulence, properties.
‘Elakkai’
phytochemical – stomach cramps No known harmful effects
limonene and 1, 8- with amounts used in
cineole. food preparation.
7 [14, 15] Chillies Capsicum Many varieties Believed to 1 tsp - 1 Capsaicin is used in
( active annum with varying improve taste ½tsp topical pain medications.
compound Degrees of ‘sting’ and health Large doses over a period
Capsaicin) measured in of time can cause chronic
Cayenne ‘scoville heat units’ gastritis, kidney damage
Pepper - SCH and liver damages.
‘Lal mirchi’
8 [16, 17] Cloves Syzygium Can be eaten raw Used to 1 or 2 No side effects are known
Lavang aromaticum or used in dishes improve flavor; when used in food
clove oil used preparation.
Kirambu,
for toothache
Lavangam
Lavangalu
98
Do Indian Spices & Condiments have a Role to Play in Preventive Health and Therapeutics?
Common Evidence-
Evidence-based
Spice/ ‘Putative’ or
dosage in
No Ref Botanical name Note worthy data ascribed benefits/
Condiment a dish for
benefits side-
side-effects*
4 people
9 [18-20] Cinnamon Sold as Inner layer of the Used to ¼ - ½ inch Limited evidence for
‘Dalchini’ cinnamon bark improve flavor diabetes management.
‘Patthai’ Cinnamomum May benefit halitosis
verum, when cinnamon gum is
Karuva
Cinnamomum chewed. No side effects
zeylanicum are known when used in
indigenous to cooking.
Sri Lanka and
southwest India
10 [21, 22] Coriander Coriandrum or Seeds are usually Used for flavor 1 tsp or to Reported to have
leaves (fresh) sativum L ground and leaves taste bactericidal properties,
and Coriander Coriander and stems used as anti-oxidant and hepato-
seeds ‘Dhania’ sativum such protective properties.
‘Kothmeer’
‘kothamalli’
11 [23] Cumin seeds Cuminum Eaten raw or Used as a 1 tsp It has chelating power,
‘jheera’ cyminum added to dishes digestive aid lipid peroxidation
inhibitor with highest
chelating powers.
12 [24-26] Curry leaves Murraya Breaking the Used for flavor 1 tsp Anti-diabetic effect on
‘kadi patha’ koenigii leaves increases and fragnance streptozotocin-induced
the flavor diabetic rats.
13 [27] Fennel Pimpinella Eaten raw or used Used as a 1 tsp Fennel seed is a potential
seeds/Aniseed anisum in cooking mouth freshner source of natural
‘Saunf’ and digestive anti-oxidants
aid; belived to
be a
galactagogue in
breast feeding
14 [28] Fenugreek Trigonella Usually mixed into Help in 1 tsp Fenugreek seeds have
seeds foenum dishes or sprouted digestion and demonstrated a beneficial
‘methi’ graecum etc diarrhea; hypoglycemic effect in
belived to be a diabetic subjects
galactagogue in
breast feeding
99
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Common Evidence-
Evidence-based
Spice/ ‘Putative’ or
dosage in
No Ref Botanical name Note worthy data ascribed benefits/
Condiment a dish for
benefits side-
side-effects*
4 people
15 [29-33] Garlic Allium sativum Used after sautéing Used in 1-4 cloves Beneficial effects of CVD
‘lasan’ in oil to flavor different forms health, prevention of
dishes (powder, dental caries, and
toothpaste, reductions in blood
mouthwash, pressure
raw, crushed)
Believed to have
medicinal value
and a
galactagogue in
breast feeding
16 [34-36] Ginger (fresh) Zinziber Crushed and Used to 1 inch Increased intestinal
‘adrak’ officinale added to dishes contribute to piece motility.
health and help
with digestion
17 [37, 38] Kandanthippili Piper longum Crushed and Aid in digestion 1 tsp Anti-amoebic activity and
‘pipali’ added to dishes anti-inflammatory.
18 [39-41] Nutmeg/ Mystica Whole nuts are Believed to have 1-2 Nutmeg is poisonous and
mace fragrans preferable to psychological pinches should be used in very
ground nutmeg, as effects in varying small quantities in food
‘jaiphal’
flavor deteriorates forms and preparation. Nutmeg
‘jaipatri’ quickly amounts poisoning occurs in large
doses and can cause
death.
19 [42, 43] Onion Allium cepa Organo sulphur Antioxidant 1 small Meta-analysis of 11
‘Pyaz’ compounds. The properties, Randomized Control
outer layers flavor and Trials indicated
contain quercetin- galactagogue hypotensive effects,
a flavonoid with (increase breast increased antioxidant
sulfides. milk status, and increased
production) bioavailability of nitric
oxide. Inconsistencies in
human research.
20 [44] Mango Mangifera Can be eaten raw Antioxidant. To 1-2 fruits No known side effects
‘aam’ Indica or ripe. Used add ‘zest’ to when used in food
widely in chutneys, dishes preparation but mango
‘Manga’
pickles, panna and allergen may cause
other dishes contact dermatitis of the
lips or tongue. Reduces
dental caries. Antioxidant
(Vitamins A, C and E),
dietary fiber and
minerals).
100
Do Indian Spices & Condiments have a Role to Play in Preventive Health and Therapeutics?
Common Evidence-
Evidence-based
Spice/ ‘Putative’ or
dosage in
No Ref Botanical name Note worthy data ascribed benefits/
Condiment a dish for
benefits side-
side-effects*
4 people
22 [45] Mango ginger Curcuma Chopped and Used as a 1 Tbsp Anti-microbial, anti-
‘Am haldi’ amada used as an digestive and oxidant and platelet
accompaniment. anti-bloating aid. aggregation inhibitory
Used to give the activity.
dish a ‘zesty’ flavor
23 - Mango powder Mangifera Used to season Flavoring; to 1 tsp No available human
‘amchoor’ Indica dishes add zest studies.
24 - Mustard seeds Brassica Nigra Can be used whole Used to flavor 1 tsp No known side effects
‘sarson’ or ground, dishes but when used in food
available in white, believed to preparation. May cause
‘kadugu’
black and brown produce ‘heat’ allergy.
forms. Mustard oil when consumed
is used in cooking. in excess.
25 [46, 47] Neem leaves Azadirachta Nimbin, nimbidin, As a toxic killer Oil, Small clinical trials on
indica ninbidol etc. due to its leaves, antioxidant properties;
bitterness; neem flowers increase in CD4+ levels in
sticks as a tooth and seeds HIV patients.
brush; dry
roasted need
flower used in
diarrhea ,
26 [48] Oregano Oreganum Used to season Believed to be 1 tsp Antioxidant effects,
Ajwan Omum vulgari dishes and add a health beneficial in preventing
distinctive flavor promoting atherogenesis and certain
‘ajwan’
Oleanolic acid, types of cancer.
Trachysperum
um ammi ursolic acid,
flavonoids, tannins
27 [49] Poppy seeds Papaner Used to season May cause ½ tsp A few reported cases of
‘postdana’ somniferum and flavor dishes positive results allergies to poppy seeds.
of opiates
Kasa-kasa
screening
28 [50, 51] Saffron Crocus sativus Used in desserts as Used to flavor A few Limited evidence as an
‘keshar’ a flavoring agent milk, milk stamens antidepressant and relieve
dishes and premenstrual syndrome
desserts. Used
in pregnancy to
promote fetal
health and
complexion!
101
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Common Evidence-
Evidence-based
Spice/ ‘Putative’ or
dosage in
No Ref Botanical name Note worthy data ascribed benefits/
Condiment a dish for
benefits side-
side-effects*
4 people
29 [52, 53] Turmeric Curcuma Used to season Regarded as Average Clinical trials using large
‘haldi’ domestica most non-sweet anti- intake is doses show no toxicity of
Curcuma longa vegetable and inflammatory, 2-2.5g/day curcumin, small clinical
legume dishes in antiseptic, and trials showed anti-cancer
the Asian cuisine health effects; low bioavailability
Curcumin promoting does not permit clarity of
effects; purifier beneficial effects.
*Studies done may be at doses very different from common usage.
* There have been no recommended dosages established for the spices and condiments above and the
responsible amount to use is not yet known. Consult your Medical Provider before use.
Ref = References
- indicates that there are no available evidence
Contact information (Padmini
(Padmini Balagopal PhD,
PhD, RD,
RD, 5. Ali, B.H. and G. Blunden, Pharmacological
CDE,
CDE, IBCLC)
IBCLC) velchet2@gmail.com.
velchet2@gmail.com. and toxicological properties of Nigella sativa.
Phytother Res, 2003. 17(4):
17 p. 299-305.
References
6. Burits, M. and F. Bucar, Antioxidant activity of
1. Rattanachaikunsopon, P. and P. Nigella sativa essential oil. Phytother Res, 2000.
Phumkhachorn, Antimicrobial activity of basil 14(5):
14 p. 323-8.
(Ocimum basilicum) oil against Salmonella 7. Isik, H., et al., Potential adjuvant effects of
enteritidis in vitro and in food. Biosci Nigella sativa seeds to improve specific
Biotechnol Biochem. 74(6):
74 p. 1200-4. immunotherapy in allergic rhinitis patients.
2. Opalchenova, G. and D. Obreshkova, Med Princ Pract. 19(3):
19 p. 206-11.
Comparative studies on the activity of basil--an 8. Laribi, B., et al., Fatty acid and essential oil
essential oil from Ocimum basilicum L.--against composition of three Tunisian caraway (Carum
multidrug resistant clinical isolates of the genera carvi L.) seed ecotypes. J Sci Food Agric. 90(3):
90
Staphylococcus, Enterococcus and p. 391-6.
Pseudomonas by using different test methods. J
Microbiol Methods, 2003. 54(1):
54 p. 105-10. 9. Khan, R., et al., Novel compound from
Trachyspermum ammi (Ajowan caraway) seeds
3. Salem, E.M., et al., Comparative study of with antibiofilm and antiadherence activities
Nigella Sativa and triple therapy in eradication against Streptococcus mutans: a potential
of Helicobacter Pylori in patients with non-ulcer chemotherapeutic agent against dental caries. J
dyspepsia. Saudi J Gastroenterol. 16(3):
16 p. 207- Appl Microbiol. 109(6):
109 p. 2151-9.
14.
10. Acharya, A., et al., Chemopreventive properties
4. Akhondian, J., A. Parsa, and H. Rakhshande, of indole-3-carbinol, diindolylmethane and
The effect of Nigella sativa L. (black cumin other constituents of cardamom against
seed) on intractable pediatric seizures. Med Sci carcinogenesis. Recent Pat Food Nutr Agric.
Monit, 2007. 13(12):
13 p. CR555-9. 2(2): p. 166-77.
102
Do Indian Spices & Condiments have a Role to Play in Preventive Health and Therapeutics?
11. Verma, S.K., V. Jain, and S.S. Katewa, Blood salivary anaerobes associated with halitosis. J
pressure lowering, fibrinolysis enhancing and Clin Dent. 22(1):
22 p. 23-6.
antioxidant activities of cardamom (Elettaria 21. Kubo, I., et al., Antibacterial activity of
cardamomum). Indian J Biochem Biophys, coriander volatile compounds against
2009. 46(6):
46 p. 503-6. Salmonella choleraesuis. J Agric Food Chem,
12. Jamal, A., et al., Gastroprotective effect of 2004. 52(11):
52 p. 3329-32.
cardamom, Elettaria cardamomum Maton. 22. Chithra, V. and S. Leelamma, Hypolipidemic
fruits in rats. J Ethnopharmacol, 2006. 103(2):
103 effect of coriander seeds (Coriandrum sativum):
p. 149-53. mechanism of action. Plant Foods Hum Nutr,
13. Suneetha, W.J. and T.P. Krishnakantha, 1997. 51(2):
51 p. 167-72.
Cardamom extract as inhibitor of human 23. Hajhashemi, V., A. Ghannadi, and H.
platelet aggregation. Phytother Res, 2005. 19(5):
19 Jafarabadi, Black cumin seed essential oil, as a
p. 437-40. potent analgesic and antiinflammatory drug.
14. Ritter, J.M., Human models of hyperalgesia and Phytother Res, 2004. 18(3):
18 p. 195-9.
pain (chilli pepper with your acid indigestion, 24. Iyer, U.M. and U.V. Mani, Studies on the effect
Sir?). Br J Clin Pharmacol. 70(2):
70 p. 161-3. of curry leaves supplementation (Murraya
15. Ericson, A., et al., The effects of capsaicin on Koenigi) on lipid profile, glycated proteins and
gastrin secretion in isolated human antral amino acids in non-insulin-dependent diabetic
glands: before and after ingestion of red chilli. patients. Plant Foods Hum Nutr, 1990. 40(4):
40
Dig Dis Sci, 2009. 54(3):
54 p. 491-8. p. 275-82.
16. Raghavenra, H., et al., Eugenol--the active 25. Ningappa, M.B. and L. Srinivas, Purification
principle from cloves inhibits 5-lipoxygenase and characterization of approximately 35 kDa
activity and leukotriene-C4 in human PMNL antioxidant protein from curry leaves (Murraya
cells. Prostaglandins Leukot Essent Fatty Acids, koenigii L.). Toxicol In Vitro, 2008. 22(3):
22 p.
2006. 74(1):
74 p. 23-7. 699-709.
17. Srivastava, K.C. and N. Malhotra, Acetyl 26. Math, M.V. and P. Balasubramaniam, The
eugenol, a component of oil of cloves hypoglycaemic effect of curry leaves (Murraya
(Syzygium aromaticum L.) inhibits aggregation Koenigii spreng). Indian J Physiol Pharmacol,
and alters arachidonic acid metabolism in 2005. 49(2):
49 p. 241-2.
human blood platelets. Prostaglandins Leukot 27. Alexandrovich, I., et al., The effect of fennel
Essent Fatty Acids, 1991. 42(1):
42 p. 73-81. (Foeniculum Vulgare) seed oil emulsion in
18. Blevins, S.M., et al., Effect of cinnamon on infantile colic: a randomized, placebo-
glucose and lipid levels in non insulin- controlled study. Altern Ther Health Med,
dependent type 2 diabetes. Diabetes Care, 2003. 9(4): p. 58-61.
2007. 30(9):
30 p. 2236-7. 28. Pathak, P., S. Srivastava, and S. Grover,
19. Tang, M., D.E. Larson-Meyer, and M. Development of food products based on
Liebman, Effect of cinnamon and turmeric on millets, legumes and fenugreek seeds and their
urinary oxalate excretion, plasma lipids, and suitability in the diabetic diet. Int J Food Sci
plasma glucose in healthy subjects. Am J Clin Nutr, 2000. 51(5):
51 p. 409-14.
Nutr, 2008. 87(5):
87 p. 1262-7.
29. Sobenin, I.A., et al., The effects of time-
20. Zhu, M., et al., Short-term germ-killing effect of released garlic powder tablets on
sugar-sweetened cinnamon chewing gum on multifunctional cardiovascular risk in patients
103
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
with coronary artery disease. Lipids Health Dis. safrole in rat and human urine using gas
9: p. 119. chromatography/mass spectrometry. Ther Drug
30. Namazi, H., The role of garlic in the prevention Monit, 2006. 28(4):
28 p. 568-75.
of ischemia-reperfusion injury: a new 40. Demetriades, A.K., et al., Low cost, high risk:
mechanism. Mol Nutr Food Res, 2008. 52
52(6): accidental nutmeg intoxication. Emerg Med J,
p. 739; author reply 740. 2005. 22(3):
22 p. 223-5.
31. Fani, M.M., J. Kohanteb, and M. Dayaghi, 41. Pastrana Delgado, J., et al., [Nutmeg poisoning].
Inhibitory activity of garlic (Allium sativum) Med Clin (Barc), 2008. 131(16):
131 p. 639.
extract on multidrug-resistant Streptococcus 42. Galeone, C., et al., Onion and garlic use and
mutans. J Indian Soc Pedod Prev Dent, 2007. human cancer. Am J Clin Nutr, 2006. 84(5):
84 p.
25(4):
25 p. 164-8. 1027-32.
32. Borek, C., Garlic reduces dementia and heart- 43. Vazquez-Prieto, M.A. and R.M. Miatello,
disease risk. J Nutr, 2006. 136(3
136 Suppl): p. Organosulfur compounds and cardiovascular
810S-812S. disease. Mol Aspects Med. 31(6):
31 p. 540-5.
33. Lau, B.H., Suppression of LDL oxidation by 44. Rocha Ribeiro, S.M., et al., Antioxidant in
garlic compounds is a possible mechanism of mango (Mangifera indica L.) pulp. Plant Foods
cardiovascular health benefit. J Nutr, 2006. Hum Nutr, 2007. 62(1):
62 p. 13-7.
136(3
136 Suppl): p. 765S-768S.
45. Policegoudra, R.S., et al., Antimicrobial,
34. Chiang, H.M., et al., Ginger significantly antioxidant, cytotoxicity and platelet aggregation
decreased the oral bioavailability of inhibitory activity of a novel molecule isolated
cyclosporine in rats. Am J Chin Med, 2006. and characterized from mango ginger (Curcuma
34(5):
34 p. 845-55. amada Roxb.) rhizome. J Biosci. 35(2):
35 p. 231-
35. Manju, V. and N. Nalini, Effect of ginger on 40.
bacterial enzymes in 1,2-dimethylhydrazine 46. Veeraraghavan, J., et al., Neem leaf extract
induced experimental colon carcinogenesis. Eur induces radiosensitization in human
J Cancer Prev, 2006. 15(5):
15 p. 377-83. neuroblastoma xenograft through modulation
36. Ghayur, M.N. and A.H. Gilani, of apoptotic pathway. Anticancer Res. 31(1):
31 p.
Pharmacological basis for the medicinal use of 161-70.
ginger in gastrointestinal disorders. Dig Dis Sci, 47. Mbah, A.U., et al., Fractionated neem leaf
2005. 50(10):
50 p. 1889-97. extract is safe and increases CD4+ cell levels in
37. Ghoshal, S., B.N. Prasad, and V. Lakshmi, HIV/AIDS patients. Am J Ther, 2007. 14(4):
14 p.
Antiamoebic activity of Piper longum fruits 369-74.
against Entamoeba histolytica in vitro and in 48. Li, Z., et al., Antioxidant-rich spice added to
vivo. J Ethnopharmacol, 1996. 50(3):
50 p. 167-70. hamburger meat during cooking results in
38. Kumar, A., et al., Antiinflammatory Activity of reduced meat, plasma, and urine
Piper longum Fruit Oil. Indian J Pharm Sci, malondialdehyde concentrations. Am J Clin
Nutr. 91(5):
91 p. 1180-4.
2009. 71(4):
71 p. 454-6.
49. Keskin, O. and B.E. Sekerel, Poppy seed
39. Beyer, J., D. Ehlers, and H.H. Maurer, Abuse
allergy: a case report and review of the
of nutmeg (Myristica fragrans Houtt.): studies
literature. Allergy Asthma Proc, 2006. 27(4):
27 p.
on the metabolism and the toxicologic detection
396-8.
of its ingredients elemicin, myristicin, and
104
Do Indian Spices & Condiments have a Role to Play in Preventive Health and Therapeutics?
50. Akhondzadeh, S., et al., Comparison of Crocus 52. Zhang, F., et al., Curcumin inhibits
sativus L. and imipramine in the treatment of cyclooxygenase-2 transcription in bile acid- and
mild to moderate depression: a pilot double- phorbol ester-treated human gastrointestinal
blind randomized trial [ISRCTN45683816]. epithelial cells. Carcinogenesis, 1999. 20(3):
20 p.
BMC Complement Altern Med, 2004. 4: p. 12. 445-51.
51. Agha-Hosseini, M., et al., Crocus sativus L. 53. Sharma, R.A., et al., Pharmacodynamic and
(saffron) in the treatment of premenstrual pharmacokinetic study of oral Curcuma extract
syndrome: a double-blind, randomised and in patients with colorectal cancer. Clin Cancer
placebo-controlled trial. BJOG, 2008. 115(4):
115 p. Res, 2001. 7(7): p. 1894-900.
515-9.
105
Chapter 20
Summary
Padmini Balagopal, PhD, RD, CDE, IBCLC
This book has been written to help you take a The Asian Indian cuisine has many interesting ways
proactive role with your health and help prevent to prepare vegetables, (mainly stir-frying with
and/or manage chronic disease. It is also written to different spices and condiments), legumes and
empower you with information with which you can lentils-also known as dhals (or dals) in a variety of
adapt the Asian-Indian cuisine into a health- gravies like sambaar or rajma, and even ways to
promoting lifestyle that will help prevent the onset of include low-fat milk and yogurt into the everyday
risk factors for many diseases brought about by poor meal (khaddi, paneer or aviyal). When food is
eating. Other lifestyle habits that include exercise consumed in excess, when whole milk is used
and stress-relaxation techniques work synergistically instead of 1% fat or fat-free milk to make the paneer
not only to help you take charge of your health but or when just an excessive amount of foods are eaten
also to optimize it. within a day, foods can become ‘less than favorable’.
It is not the single ‘soda’, the ‘chivda’ or the ‘small
This book is also meant to be a loud call to the men dessert’ that become a problem but the quantity,
and women who have the condition of diabetes, frequency and quality of these dishes can affect the
hypertension or other lifestyle conditions to help whole day’s meal by making it high in calories,
prevent it in their children with appropriate lifestyle simple sugars, starches or oils and fats. The Asian-
modifications. The introduction outlines the current Indian meal can be a balanced meal, high in a
health risks faced by the Asian Indian population variety of grains, vegetables and lentils and less on
with a description of some of the chronic diseases meat or meat alternatives. In these proportions, it
common to this group. The next section tells us how can provide around 20-25 grams of valuable soluble
fetal nutrition, eating and lifestyle habits of children and insoluble fiber, vitamins and minerals along with
and adults have put us at risk for chronic diseases the benefits of spices and condiments (see section
throughout the world epidemiologically. If we guide on Indian Spices and Condiments).
the eating habits of our children from a very young
age, healthful eating can become second nature to The different regional cuisines in this booklet talk
them as they grow up and can help them in the about their characteristics and about how the usual
future when they face healthy and unhealthy food diet of this region can be modified to become
choices!!! Many Asian Indians also face chronic healthier. The Asian-Indian cuisine has been
heart disease and kidney disease and there are two presented in six sections – the Eastern-Indian (Odia
sections that guide you through the Asian-Indian and Bengali) cuisine, the South Indian cuisine, the
cuisine on how to eat to prevent and/or manage Maharashtrian cuisine, the Gujarati cuisine, the
these conditions, both for the vegetarian and the North Indian cuisine and the Nepali cuisine. In the
non-vegetarian.
chapter on Snacks, you will see the variety of snacks
with cautionary alerts on how to keep snack portions
106
Summary
small raising awareness on the possibilities of Excessive weight has become a widespread issue that
healthier substitutes for the fried snacks in the makes the individual vulnerable to chronic disease
Asian-Indian cuisine. Indian desserts and sweets and general ill-health. There is a section in the book
have had many unique characteristics from the use that guides you to interpret your weight, total body
of ‘reduced’ milk to the use of a variety of bases fat and abdominal adiposity that are crucial
from fruits and grains to even the use of vegetables. checkpoints. It also gives detailed guides to help you
The chapter on Indian desserts sheds light on how to lose excess weight with lifestyle modifications of
to modify the many Indian desserts into becoming exercise. These are vital points in self-management
less calorie-intense. education that help you not only to achieve a healthy
body weight but also help you to maintain it.
The Asian-Indian cuisine, both in restaurants and in
the home may have taken an unwise turn towards In recent years, there has been a lot of speculation
more fried, high refined foods lower in fiber and about the role of Indian spices and condiments and
higher in salt. How to turn the Asian-Indian cuisine a section in this book reviews the current research
into becoming a high complex-carbohydrate, low-fat and literature on the role of the various spices and
but high fiber cuisine is outlined in the section on condiments to see if they play an active role in
‘How to modify a recipe’. Some of the current preventive health, therapeutics, or even palliative
recipes are shown with health-promoting care.
modifications. The next section is an appropriate
What are some of the unhealthy trends among our
follow-up as you will be guided through restaurant-
children today? Drinking a lot of soda every day,
eating and the many pitfalls one faces with ideas on
eating a lot of high fat, high-refined carbohydrates
how to select wisely using the ‘healthier’ more
and not maintaining good eating habits are factors
cardio-protective alternatives. You can request that
that make the everyday diet of the younger
dhals be prepared without malai, that palak paneer
generation weak in valuable fiber and nutrients. If
be prepared with low-fat paneer, that the oils like
we do not prevent our children from developing
olive or canola be used, instead of hydrogenated fats
poor eating habits (such as indiscriminate snacking,
including ‘Vanaspati’ or ‘Dalda’, that desserts be
eating ‘fast foods’ frequently and leading sedentary
prepared to be less ‘atherogenic’ or ‘diabetogenic’.
lifestyles from a very young age), the risk factors of
You will find that in each cuisine, all the foods are becoming overweight follows easily and we may lose
divided into different groups – Carbohydrates, the weapon we have to prevent the onset of this
Proteins and Fats, Dairy, Vegetables and Fruits. The disease as the next generation grows up. Bringing up
section of Food Exchanges shows the amount of a our children on the Asian-Indian cuisine or
food that makes up one serving and how they can be managing our diabetes on this cuisine is not difficult
exchanged for one another within a food group. A once we know its strong points as well as the pitfalls
guideline on selecting foods from each food group that accompany it when it is not used properly. You
has also been provided. will find that many chapters in this book caution the
reader about weekend parties (common to this
The Asian Indian cuisine is usually high in ethnic group) that can contribute to excessive eating.
carbohydrates and when carbohydrates become
The following sections include some concise tips to
important in treatment regimens, the chapter on
become aware of signs of hyperglycemia and
carbohydrate counting will help to guide the
hypoglycemia and tips on exercise and blood
individual with specific tips to keep a count with
glucose management.
foods in this cuisine.
107
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Tips on Blood Glucose Management Some of the Signs & Symptoms of Hypoglycemia
When the portions are also large, then the body is Cold sweats, dizziness, feeling faint
stressed to try and keep the blood glucose within Headache
optimal ranges. Conversely, when food eaten is
insufficient, then a person can suffer from Pounding of heart, trembling, nervousness
hypoglycemia. See below for tips on signs and Blurred vision
symptoms of these two conditions. Here are some
Hunger
of the signs & symptoms of Hyperglycemia (when
blood glucose levels are higher than the range at Inability to awaken
which the body functions optimally) and Personality changes
Hypoglycemia (when blood glucose levels drop
below this range). Remember that any of these What can you do?
symptoms does not necessarily mean that you have
the condition. The best way to know is to test your Take Glucose tablets or orange juice (Your
blood glucose and consult your doctor. doctor may have specific instructions for you)
Educate yourself about the 15-15 rule
Some of the Signs & Symptoms of Hyperglycemia
Check blood glucose levels
Increased thirst and urination
Do not give insulin
Weakness, pain in stomach, aching all over
Do not give anything by mouth if unconscious
Heavy labored breathing
Give glucagons according to package
Loss of appetite, nausea and vomiting instructions
Fatigue
What are the causes?
Large amounts of sugar in blood
Ketones in urine Too much insulin
Not enough food
What can you do?
Unusual amount of exercise
Call the Doctor immediately Delayed meals
Take fluids without sugar if able to swallow
Alcohol effects without food
Test blood glucose frequently
How can you avoid Hyperglycemia or
Test urine for ketones Hypoglycemia?
What are the causes? Consult your Doctor and work with your dietitian/
Not enough insulin diabetes educator. Your dietitian can recommend a
diet suited to your lifestyle and preferences. She/he
Too much food can also show you the amounts of calories,
Infection, fever, illness carbohydrates, fats & proteins you are consuming
presently, if you give him/her the information of the
Emotional stress
exact amounts consumed. So keeping a food record
is a useful tool
108
Summary
Eating Tips on Blood Glucose Management 4. Make sure you include 6-8 cups of water every
day. Try to avoid soda or juices as a beverage
(Ask your doctor what the optimal range of blood substitute for water especially for young
glucose for you should be and try to keep your children as this can become a habit that is tough
blood glucose within this range) to break!
There is no diet known as a ‘diabetes diet’ and no 5. Eat 3-4 cups of vegetables (without much oil)
special foods are necessary. The Introduction and fruits with whole grain cereals, brown
explains how the body regulates glucose levels in the basmati, whole wheat flour, oats to increase
fiber intake
blood from the foods we eat. Foods available in the
supermarket can be used and can be eaten but with 6. Avoid excess salt while garnishing foods.
the information and awareness, you can combine 7. Foods like ginger, onion, garlic, cumin seeds,
health-promoting foods in a moderate amounts so fenugreek seeds, fennel seeds, dhals, curry
that the insulin produced by your body (along with leaves, coriander leaves etc have been
any other medication that is prescribed by your recommended in Ayurveda and can continue to
Medical Provider) will help your body use the foods be included
you eat and keep the blood glucose (or ‘blood sugar’ 8. Include a workout program that includes Yoga
as it is commonly called) within the doctor- (after you check this out with your Medical
prescribed range. Provider) everyday or at least 3-4 times a week.
Here are some tools that can help you achieve this There are references at the end of almost every
goal: chapter that can give you additional information.
1. Keep a record of foods and the approximate We have also tried to include some translations at
amounts till you get a good working knowledge the end. A useful reference to keep is the number to
with the help of your Medical Provider and the American Dietetic Association (800-877-1600)
or the e-mail address (www.eatright.org). This
Dietitian.
organization can direct you to resources and
2. Use heart-healthy fats and oils – qualified professionals to help you empower
monounsaturated oils like olive oil, canola oil yourself with helpful information on eating and on
are recommended. If you use ghee, keep it to a how to manage your diabetes and blood glucose
minimum and for occasional use but also count levels.
it in your total daily fat allowance.
More Information on Body Mass Risk Assessment
3. Include plenty of fresh or cooked vegetables and Physical Activity see chapter 16 of this book
(stir-fried with 1-2 tsps of oil to season for 3-4 entitled “Achieving a healthy body weight and
cups of vegetables is recommended). Eating exercise interventions to the prevention and
patterns of some regions talk about the small management of Type 2 diabetes” by Dr. Wahida
quantity of vegetables eaten. This is where the Karmally.
eating patterns can be improved. While stir-
frying vegetables, use the spices, garlic, onion, Key Recommendations (From the Expert Panel on
coriander and other spices of your choice to the Identification, Evaluation, and Treatment of
improve taste instead of large amounts fats and Overweight and Obesity in Adults)
oils. Try to avoid ‘feasting’ and ‘fasting’. If you Weight loss is advised to lower elevated blood
fast, make sure that you have a good balanced pressure in overweight and obese persons with high
meal before and after a ‘fast’. blood pressure. Weight loss is also suggested to
109
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
lower elevated levels of total cholesterol, LDL- loss that may also result in decreases in abdominal
cholesterol, and triglycerides, and to raise low levels fat and increases in cardio respiratory fitness.
of HDL-cholesterol in overweight and obese Behavior therapy is a useful adjunct when
persons with dyslipidemia. Weight loss is effective incorporated into treatment for weight loss and
to lower elevated blood glucose levels in overweight weight maintenance. Weight loss and weight
and obese persons with type 2 diabetes. Use the maintenance therapy should employ the
BMI to assess overweight and obesity. Body weight combination of LCD's, increased physical activity,
alone can be used to follow weight loss, and to and behavior therapy. After successful weight loss,
determine the effectiveness of therapy. The BMI to the likelihood of weight loss maintenance is
classify excess weight and obesity and to estimate enhanced by a program consisting of dietary
relative risk of disease compared to normal weight. therapy, physical activity, and behavior therapy
The waist circumference should be used to assess which should be continued indefinitely. Drug
abdominal fat content. The initial goal of weight therapy can also be used. However, drug safety and
loss therapy should be to reduce body weight by efficacy beyond 1 year of total treatment have not
about 10 percent from baseline. With success (and been established. A weight maintenance program
if warranted), further weight loss can be attempted. should be a priority after the initial 6 months of
Weight loss should be about 1 to 2 pounds per weight loss therapy.
week for a period of 6 months, with the subsequent
strategy based on the amount of weight lost. Low Assessing Your Risk
calorie diets (LCD) for weight loss in overweight and
According to the NHLBI guidelines, assessment of
obese persons. Reducing fat as part of an LCD is a
overweight involves using three key measures:
practical way to reduce calories. Reducing dietary
fat alone without reducing calories is not sufficient Body Mass Index
Index (BMI)
for weight loss. However, reducing dietary fat, along Waist Circumference, and
with reducing dietary carbohydrates, can help
reduce calories. A diet that is individually planned Risk factors for diseases and conditions
to help create a deficit of 500 to 1,000 kcal/day associated with obesity.
should be an integral part of any program aimed at The BMI is a measure of your weight relative to
achieving a weight loss of 1 to 2 pounds per week. your height and waist circumference measures
Physical activity should be part of a comprehensive abdominal fat. Combining these with information
weight loss therapy and weight control program about your additional risk factors yields your risk for
because it: (1) modestly contributes to weight loss in
developing obesity-associated diseases.
overweight and obese adults, (2) may decrease
abdominal fat, (3) increases cardio respiratory BMI is a reliable indicator of total body fat, which is
fitness, and (4) may help with maintenance of weight related to the risk of disease and death. The score is
loss. Physical activity should be an integral part of valid for both men and women but it does have
weight loss therapy and weight maintenance. some limits. The limits are:
Initially, moderate levels of physical activity for 30 to
45 minutes, 3 to 5 days a week, should be It may overestimate body fat in athletes and
encouraged. All adults should set a long-term goal to others who have a muscular build.
accumulate at least 30 minutes or more of It may underestimate body fat in older persons
moderate-intensity physical activity on most, and and others who have lost muscle mass.
preferably all, days of the week. The combination
of a reduced calorie diet and increased physical Use the BMI calculator shown in Chapter 16 to
activity is recommended since it produces weight estimate your total body fat.
110
Summary
Determine your waist circumference by placing a prevention of weight regain. In addition, exercise
measuring tape snugly around your waist. It is a has a benefit of reducing risks of cardiovascular
good indicator of your abdominal fat which is disease and diabetes, beyond that produced by
another predictor of your risk for developing risk weight reduction alone. Starts exercising slowly and
factors for heart disease and other diseases. This gradually increase the intensity. Trying too hard at
risk increases with a waist measurement of over 35 first can lead to injury.
inches or 90 cm in men and over 31 inches or 80
cm in women. Examples of moderate amounts of physical activity
Besides being overweight or obese, there are Common Chores Sporting Activities
additional risk factors to consider are as follows: Washing and waxing a Playing volleyball for 45-
high blood pressure (hypertension), high LDL- car for 45-60 minutes 60 minutes
cholesterol ("bad" cholesterol), low HDL-cholesterol
("good" cholesterol), high triglycerides, high blood Washing windows or Playing touch football
glucose (sugar), and family history of premature floors for 45-60 minutes for 45 minutes
heart disease, physical inactivity, and cigarette Gardening for 30-45 Walking 13/4 miles in
smoking minutes 35 minute (20min/mile)
For people who are considered obese and have two Wheeling self in Basketball (shooting
or more risk factors, the guidelines recommend wheelchair 30-40 baskets) 30 minutes
weight loss. Even a small weight loss (just 10 percent minutes
of your current weight) will help to lower your risk Pushing a stroller 1½ Bicycling 5 miles in 30
of developing diseases associated with obesity. miles in 30 minutes minutes
Patients, who are overweight, do not have a high
waist measurement, and have less than 2 risk factors Raking leaves for 30 Dancing fast (social) for
may need to prevent further weight gain rather than minutes 30 minutes
lose weight. Walking 2 miles in 30 Water aerobics for 30
minutes (15min/mile) minutes
Talk to your doctor to see if you are at an increased
risk and if you should lose weight. Your doctor will Shoveling snow for 15 Swimming Laps for 20
evaluate your BMI, waist measurement, and others minutes minutes
risk factors for heart disease. People who are Stair walking for 15 Basketball (playing
overweight or obese have a greater chance of minutes game) for 15-20 minutes
developing high blood pressure, high blood
cholesterol or other lipid disorders, type 2 diabetes, Bicycling 4 miles in 15
heart disease, stroke, and certain cancers, and even a minutes
small weight loss (just 10 percent of your current Jumping rope for 15
weight) will help to lower your risk of developing minutes
those diseases. Running 1½ miles in 15
Guide to Physical Activity min. (10min/mile)
An increase in physical activity is an important part Your exercise can be done all at one time, or
of your weight management program. Most weight intermittently over the day. Initial activities may be
loss occurs because of decreased caloric intake. walking or swimming at a slow pace. You can start
Sustained physical activity is most helpful in the out by walking 30 minutes for three days a week and
111
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
112
Summary
contributing to an increase the newborn’s immunity, chapter that can give you additional information. A
brain growth and help with overall physiological and useful reference to keep is the number to the
psychological health. For more information, contact American Dietetic Association (800-877-1600) or
ilca.org. the e-mail address (www.eatright.org). This
organization can direct you to resources and
Appendix 2 is Diabetes Numbers at a Glance qualified professionals.
provided by the National Diabetes Education
Program (NDEP). Appendix 3 is a Diabetes Readers of this book must be aware that the
Mellitus Reference Pocket Card for use either by protocols used in this book regarding blood
physicians or as a self-education tool by patients pressure, blood lipids and blood glucose levels are
under the supervision of a Medical Provider. current as of 2011 and every individual must consult
his/her Physician before implementing the
Appendix 4 provides information on the require4s information about target levels from this book.
screening, immunization and counseling preventive
services recommended for normal-risk adults and Padmini Balagopal, PhD, RD,
RD, CDE,
CDE, IBCLC is a
Appendix 5 is a Glossary of terms used in this book Nutrition Consultant and a current board member
to help the reader. Appendix 6 is a 4-sided handout of the International Board of Certified Lactation
in English and several Indian languages that can be Examiners (IBLCE). She is active in the fields of
given to the patient as part of a patient self-education diabetes prevention, management, lactation practice,
program for blood glucose and health management. and training in United States and India. Contact
There are references at the end of almost every information velchet2@gmail.com.
velchet2@gmail.com.
113
Body Mass Index Table
Normal Overweight Obese Extreme Obesity
BMI 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54
Height
Body Weight (pounds)
(inches)
58 91 96 100 105 110 115 119 124 129 134 138 143 148 153 158 162 167 172 177 181 186 191 196 201 205 210 215 220 224 229 234 239 244 248 253 258
59 94 99 104 109 114 119 124 128 133 138 143 148 153 158 163 168 173 178 183 188 193 198 203 208 212 217 222 227 232 237 242 247 252 257 262 267
60 97 102 107 112 118 123 128 133 138 143 148 153 158 163 168 174 179 184 189 194 199 204 209 215 220 225 230 235 240 245 250 255 261 266 271 276
61 100 106 111 116 122 127 132 137 143 148 153 158 164 169 174 180 185 190 195 201 206 211 217 222 227 232 238 243 248 254 259 264 269 275 280 285
62 104 109 115 120 126 131 136 142 147 153 158 164 169 175 180 186 191 196 202 207 213 218 224 229 235 240 246 251 256 262 267 273 278 284 289 295
63 107 113 118 124 130 135 141 146 152 158 163 169 175 180 186 191 197 203 208 214 220 225 231 237 242 248 254 259 265 270 278 282 287 293 299 304
64 110 116 122 128 134 140 145 151 157 163 169 174 180 186 192 197 204 209 215 221 227 232 238 244 250 256 262 267 273 279 285 291 296 302 308 314
65 114 120 126 132 138 144 150 156 162 168 174 180 186 192 198 204 210 216 222 228 234 240 246 252 258 264 270 276 282 288 294 300 306 312 318 324
114
66 118 124 130 136 142 148 155 161 167 173 179 186 192 198 204 210 216 223 229 235 241 247 253 260 266 272 278 284 291 297 303 309 315 322 328 334
67 121 127 134 140 146 153 159 166 172 178 185 191 198 204 211 217 223 230 236 242 249 255 261 268 274 280 287 293 299 306 312 319 325 331 338 344
68 125 131 138 144 151 158 164 171 177 184 190 197 203 210 216 223 230 236 243 249 256 262 269 276 282 289 295 302 308 315 322 328 335 341 348 354
69 128 135 142 149 155 162 169 176 182 189 196 203 209 216 223 230 236 243 250 257 263 270 277 284 291 297 304 311 318 324 331 338 345 351 358 365
70 132 139 146 153 160 167 174 181 188 195 202 209 216 222 229 236 243 250 257 264 271 278 285 292 299 306 313 320 327 334 341 348 355 362 369 376
71 136 143 150 157 165 172 179 186 193 200 208 215 222 229 236 243 250 257 265 272 279 286 293 301 308 315 322 329 338 343 351 358 365 372 379 386
72 140 147 154 162 169 177 184 191 199 206 213 221 228 235 242 250 258 265 272 279 287 294 302 309 316 324 331 338 346 353 361 368 375 383 390 397
73 144 151 159 166 174 182 189 197 204 212 219 227 235 242 250 257 265 272 280 288 295 302 310 318 325 333 340 348 355 363 371 378 386 393 401 408
74 148 155 163 171 179 186 194 202 210 218 225 233 241 249 256 264 272 280 287 295 303 311 319 326 334 342 350 358 365 373 381 389 396 404 412 420
75 152 160 168 176 184 192 200 208 216 224 232 240 248 256 264 272 279 287 295 303 311 319 327 335 343 351 359 367 375 383 391 399 407 415 423 431
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
76 156 164 172 180 189 197 205 213 221 230 238 246 254 263 271 279 287 295 304 312 320 328 336 344 353 361 369 377 385 394 402 410 418 426 435 443
Source: Adapted from Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report.
Meal Plan Number of Menu Ideas for the Menu Ideas for the
Meal/Time
Food Choices Group Vegetarian Indian Non--Vegetarian Indian
Non
Breakfast 1-2 Protein as desired 1 cup paneer jalfrezi with 1 1 egg omelet 1 cup non
8am Vegetables cup bell peppers, onions, starchy vegetables
1 Starch 1 roti or chapati 1 roti or chapati
as desired Fat
Snack 1 Protein 1oz soy nuts 1 oz string cheese
11am 1 Starch ½ cup moong beans sprout ¾ oz whole wheat crackers
as desired Vegetables
as desired Fat
Lunch 1 pm 3-4 Protein as desired 1 cup of tofu curry 1 cup 1 cup chicken curry 1 cup
Vegetables 2 Starch spinach sabji 2 rotis or okra sabji 2 rotis or chapati
1 Milk chapati 1 cup non fat milk
as desired Fat ¾ cup non fat yogurt/curd
Snack 1 Protein 1oz mixed nuts 20 small peanuts
4 pm 1 Starch 1 ½ cup puffed rice 1 cup poha (rice flakes)
1 Fruit 1 small mango 1 small pear
As desired Fat
Dinner 3-4 Protein 1 cup ground soy curry 1 cup mutton curry
7 pm as desired Vegetables 1 cup cabbage sabji 1 cup cauliflower sabji
3 Starch 2 rotis or chapati + ½ cup 3 rotis or chapati
as desired Fat dhal
Snack 1 Milk 1 cup non fat milk 1 cup plain lassi (no sugar
10 pm 1 Fruit or 1 small apple or added)
Starch 6 saltine crackers 1 ¼ cup strawberries or
1 Protein 1Tbsp peanut/almond butter ¾ oz pretzels
¼ cup cottage cheese
115
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Please consider potato, peas, and corn as starch but Food Pyramid for Gestational Diabetes" by Sharmila
not sabji (dry prepared vegetables without Chatterjee and Geetha Desai and the California
gravy/curry) Diabetes and Pregnancy Program, October 2006.
Funding for the development of this material was
Adapted with permission from the California provided by the federal Title V block grant from the
Department of Public Health, California Diabetes California Maternal, Child and Adolescent Health
and Pregnancy Program website: "Asian Indian Division.
116
Appendix 2
Diabetes
Numbers At-
At-a-Glance
National Diabetes Education Program (NDEP)
117
Appendix 3
Diabetes
Diabetes Mellitus Pocket Reference Card
Ritesh Gupta, Anoop Misra, Shashank Joshi, Banshi Saboo, TG Patel
118
Diabetes Mellitus Pocket Reference Card
119
Appendix 4
Clincal Preventive Services for Normal-
Normal-Risk
Adults
Recommended by the U.S. Preventive Services Task Force
Pap smearb Within 3 years of onset of sexual activity or Every 1-3 years
21-65
Abdominal aortic aneurysm Men 65-75 who have ever smoked Once
(ultrasound)
120
Clincal Preventive Services for Normal-Risk Adults
Adult immunization
121
Appendix 5
Glossary
Theja Mahalingaiah, MA, RD & Nirmala Abraham, MS, RD
122
Glossary
that may be exchanged or traded in planning meals. GDM is managed with meal planning, physical
A single exchange contains approximately equal activity, and, in some cases, medication.
amounts of carbohydrate, protein, fat, and calories.
Gram-
Gram- a unit of weight in the metric system. An
Fasting blood glucose test-
test- A method for finding out ounce equals 28 grams. In some meal plans for
how much glucose (sugar) is in the blood. The test people with diabetes, the suggested amounts of food
can show if the person has diabetes. A blood are given in grams.
sample is taken in lab or doctor’s office. The test is
usually done in the morning before the person has Lipid-
Lipid- A term for fat. The body stores fat as energy
eaten. for future use just like a car that has a reserve fuel
tank. When the body needs energy, it can break
Fat-
Fat- One of the three major energy sources in food. down the lipids into fatty acids and burn them like
A concentrated source of calories- about 9 calories glucose (sugar).
per gram. Fat is found in foods from the Fat and
Meat lists. Some kinds of milk also have fat; some Meal Plan-
Plan- A guide showing the number of food
foods from the Starch list also contain fat. exchanges to use in each meal and snack to control
distribution of carbohydrates, proteins, fats, and
*Saturated fat-
fat- Type of fat that tends to raise blood calories throughout the day.
cholesterol levels. It comes primarily from animals
and is usually hard at room temperature. Examples Mineral-
Mineral- Substance essential in small amounts to
of saturated fats are butter, lard, meat fat, solid build and repair body tissue and/or control
shortening, palm oil, and coconut oil. functions of the body. Calcium, iron, magnesium,
phosphorus, potassium, sodium, and zinc are
*Polyunsaturated fat-
fat- Type of fat this is liquid at minerals.
room temperature and is found in vegetable oils.
Safflower, sunflower, corn, and soybean oils contain Non calorie sweetener-
sweetener- A man made sweetener that
the highest amounts of polyunsaturated fats. people use in place of sugar because it has no
Polyunsaturated fats, such as corn oil, can help calories.
lower high blood cholesterol levels when they are
part of a healthful diet. Ex- Saccharin
123
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Sodium-
Sodium- A mineral needed by the body to maintain Vitamins-
Vitamins- Substances found in food, needed in
life, found mainly as a component of salt. Many small amounts to assist in body processes and
individuals need to cut down the amount of sodium functions. These include vitamins A, D, E, the B-
(and salt) they eat to help control high blood complex, C, and K.
pressure.
PREPARED INDIAN DISHES
DISHES
Starch-
Starch- One of the two major types of carbohydrate.
Foods consisting mainly of starch come from the APPETIZERS
Starch list.
Bhujia - fried lentil snacks.
Sugars-
Sugars- One of the two major types of carbohydrate. Bhel puri - puffed rice mixed with fried snacks
Foods consisting mainly of naturally present sugars and spicy sauce (popular street snack)
are those from the Milk, Vegetables, and Fruit lists. Chiura /Chevda /Chira /Awul - Flattened Rice
Added sugars include common table sugar and the for Long shelf life / sauteed or fried. Chaat –
sugar alcohols (sorbitol, mannitol, etc). mixed sweet & savory snack.
Promise Activa (formerly known as Take control)–
– Dahi Vada – Deep fried bean fritters in a yogurt
A type of plant based margarine that helps lower sauce.
blood cholesterol level. Dhokla –a steamed bread made with fermented
chik pea batter.
Tofu – A protein substitute made with soy beans.
Lassi – a yogurt based drink.
Many vegetarian protein alternatives such as
Vegetarian burger patties are made with tofu. Kachori – Deep fried savory pastry stuffed with
lentils.
Trans fatty acid (also called Trans fat)– comes from Mulligatawny – soup made with lentils and spices.
adding hydrogen to vegetable oil through a process Murruku – fried spiral snack.
called hydrogenation. Partially hydrogenated oil is
another name for Trans fat. Trans fats are more Namkeens / Nimki/ Karam - Salty snacks ( spicy
solid than oil is, making them less likely to spoil. at times)–distinct from sweet snacks
Using Trans fats in the manufacturing of foods helps Nimbu paani – a drink similar to lemonade.
foods stay fresh longer. Commercially processed Pakoras – Batter fried vegetables.
goods such as crackers, cookies and cakes, Indian Papad – Baked or fried item that looks like a
savory snacks and many fried foods, may contain Large potao chip made with legumes and or rice
Trans fats. Shortenings (e.g. Vanaspathi commonly flour with spices.
used in India) and some margarine can be high in
Tran’s fat. Unlike other fats, Trans-fatty acids raise Papad – Baked or fried item that looks like a
"bad" (LDL) cholesterol and lowers “good" (HDL) large potato chip made with legumes and or rice
cholesterol. A high LDL cholesterol level in flour with spices.
combination with a low HDL cholesterol level Pani puri – mini puri filled with spicy potato &
increases the risk of heart disease, the leading killer tamarind water ( popular street snack)
of men and women. Pav Bhaji - spicy potato served on bread with
sauce.
Triglycerides-
Triglycerides- Fats normally present in the blood
that are made from food. Gaining too much weight Puris – Deep fried flat bread made with wheat
or consuming too much fat. Alcohol, or flour.
carbohydrates may increase the blood triglycerides. Rasam- Thin soup made with tomatoes, lentils,
tamarind (optional) and spices.
124
Glossary
Samosa – Deep fried pastry stuffed with potatoes Rogan josh – lamb, goat or chicken dish in spicy
& other vegetables or meat. sauce.
Sev – Thin fried lentil noodles. Tandoori Chicken – Marinated chicken baked in
Vada/ Vadai/Bora – Deep fried savory bean clay oven.
fritters. Tandoori Fish – Marinated fish baked in clay
oven.
BREADS
Tikka – boneless marinated meat cooked in
Bathura – fried dough made with all purpose spicy sauce.
sauce.
flour.
Qua gasa – a dish made with dal patty, fried
Chapathi / Phulka / Roti / Rooti – Flat bread boiled egg and timur.
made with wheat flour.
VEGETABLE DISHES
Idli – Stemed dough made of rice and urad dhal
(white lentil). Dalma – Dhals cooked with vegetables.
Nan – Baked (traditionally in clay oven called Dhal – Are cooked legumes. Most common
Tandoor) bread. dhals are toor, mung etc.,
Paratha – a kind of bread made with all purpose Koottu – diced vegetables cooked with dhal and
flour. coconut and added spices.
Roti – a kind of flat bread made with wheat flour. Palak paneer – A dish made with spinach, cheese
and spices.
Thepla – a flat bread made with wheat flour,
gram flour and spices. Saag –made with mixedgreens such as spinach,
mixed greens etc.,
Uppuma – Cooked cream of wheat with onion,
spices and oil. Shukto – a vegetable stew.
Chicken curry – Chicken in spicy sauce. Adirasam – deep fried1sweet dish made with rice
flour.
Chole – A dish made with chikpeas, onions,
tomatoes and spices. Appam – rice/wheat based preparation.
Kabab – ground lamb baked, grilled or fried. Barfies –Look like bar cookies made with ghee,
milk, nuts etc.
Malai Kofta –Cheese and vegetable balls in
special sauce. Gulab Jamoon – A sweet dish soaked in rose
flavored sugar syrup.
Maccher Jhol – Fish curry.
Halwa – a sweet made with milk, sugar, ghee etc.
Palak paneer – A dish made with spinach, cheese
and spices. Jilebi – Fried dish made with chikpea flour and
dipped in sugar syrup.
Pullao – Rice dish made with spices & or with
vegetables; meat.
125
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Kheers – a dessert made by reducing milk and Lemon and Mango pickles are common among
with other ingredients such as vermicelli, rice, many varieties of pickles.
almonds etc., Raita/Pacchadi – A meal accompaniment made
Kulfi –a milk based frozen dessert similar to ice with yogurt; grated cucumber, green chilies,
cream. onions etc.
Laddu – Ball shaped sweet made with chikpea
flour, sugar etc., Measurements and Converstions
Mahi: buttermilk which can be sweetened with
1 ounce =30 grams (actual weight 28.35g)
sugar.
1 fluid ounce =30 millilitres
Misti Doi: sweetened yogurt (actual amount 28.35ml)
Mithai/Misti – Desserts, Sweets. 1 cup = ½ pint = 240 ml = 8 fl ounces
Petha - vegetables preserved in a crystalline sugar 2 cups = 1 pint = 480 ml = 16 fl ounces
medium. 2 pints = 1 quart = 960 ml = 32 fl ounces
Payasam – sweet dish made with milk, sugar, rice 4 quarts = 1 gallon
or dhal. 1 teaspoon fluid = 5 ml or 1/6 oz
Peda – A sweet made with milk, ghee and sugar. 1 tablespoon fluid = 15 ml or ½ oz
Rosagolla - cheese based, syrupy sweet dish. 1 cup (8 oz) = 16 tablespoons
Rasmalai – sweet made with flattened paneer ball 1 kilogram = 2.2045 pounds (2.2 lb)
soaked in cream sauce flavored with cardamom. 1 liter = 1.0567 quarts
Sweet Pongal - sweet tasting cooked rice. 1 pound = 453.6 grams
Payasam – sweet dish made with milk, sugar, rice
or dhal. To change pounds to kilograms, multiply by 0.45
Peda – A sweet made with milk, ghee and sugar.
Guide to Ingredients
Pite- Rice flour pancakes immersed in sweetened
syrup. All-purpose flour – Maida
Rasogolla- Indian cheese balls in sugar syrup Aniseed – Ajowain or Carum
Sandesh: Indian cheese made with sugar. Asafoetida – Hing
Sweet Pongal - Sweet tasting cooked rice. Aubergine – Baingan (egg plant)
Basmati rice – a kind of aromatic rice
MISSELANEOUS Bay leaf – Tej patta
May be sweet , tart or piquant Beets – Chukandar
Besan flour – chikpea flour
Chai – Tea made with milk.
Bottle gourd - Lauki
Chutneys - Are pureed condiments made with
Broad beans – Papdi
coconut, mango, cilantro, mint, Tamarind and
spices. Bitter gourd - Karela
Pickles- are condiments which may be sweet, tart Cauliflower - gobi
or piquant that accompany Indian cuisine. Cluster beans - Papdi
126
Glossary
127
Appendix 6
Diabetes Information in English
and Regional languages
Padmini Balagopal, PhD, RD, CDE, IBCLC
128
Diabetes Information in English and Regional languages
Foods from a variety of sources can be combined to make up a balanced meal. Your personal meal plan
should be designed to suit your lifestyle and would include servings of each food group at every meal. Each
food group and examples of one serving in each food group are as follows: (Please note that values are
approximate).
Shrimp (Prawns) : 1 oz
Low‐fat Tofu : 3 oz
Chicken, turkey (skinless dark meat) : 1 oz
Seitan : 1 oz
Lean lamb, pork, beef : 1 oz
Regular cottage cheese : ¼ cup
Cheeses with 3 gm fat or less : 1 oz
129
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
The use of unsaturated oils like olive oil instead of saturated fats like butter, coconut products and ghee
is recommended. Avoid frequent use of fried foods.
Minimal use of oils, salt and sugar is recommended.
130
Diabetes Information in English and Regional languages
Mid-morning
Lunch
Mid-Afternoon
Dinner
Night Snack
Total
*CHO = Carbohydrate; gms = Grams; oz = ounce; tsp = teaspoon; Tbsp = Tablespoon;
28‐30gms = 1 oz; 8 oz = 1 cup; 3 tsp = 1 Tbsp; 2 Tbsp = 1 oz; ckd = cooked.
131
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
ceQ DeHeves Deenej Üeje [e³eeyeerìerme keÀes efve³eb$eCe ceW kewÀmes jKegB?
SefMe³eeF& Deewj Yeejleer³e HeekeÀMewueer kesÀ Devegmeej met®eveeSB Deewj ceeie&oMe&ve
(DeHeves [e@keÌìj Deewj jpeermì[& [e³esefìMeer³eve keÀer efveiejeveer kesÀ lenled Deceue keÀjW~)
[e³eeyeerìerme Mejerj keÀer Jen DeJemLee nw peye Mejerj He³ee&Hle cee$ee ceW Fvemegefueve veneR yevee mekeÀlee nw DeLeJee Fvemegefueve keÀe GHe³eesie þerkeÀ mes veneR keÀj mekeÀlee nw~ Fvemegefueve kesÀ
Üeje ner Mejerj DeHeves Deenej mes efceueer Meke&Àje ³ee iuegkeÀes]pe mes Gpee& ues mekeÀlee nw~ Fvemegefueve Deewj jkeÌle ceW jns iuegkeÀes]pe keÀer cee$ee keÀe Demeblegueve G®®e jkeÌle iuegkeÀesp] e (neF&Hej
iueeF&efmeefce³ee) DeLeJee efvecve jkeÌle iuegkeÀesp] e (neF&HeesiueeF&efmeefce³ee) kesÀ ªHe ceW meeceves Deeles nQ~
jkeÌle iuegkeÀes]pe keÀer cee$ee SkeÀ efveef½ele cee$ee kesÀ DeemeHeeme jKeveer DeeJeM³ekeÀ nw~ DevegmebOeeve mes osKee ie³ee nw efkeÀ Fmemes DeeBKe, efkeÀ[veer, jkeÌleJeeefnefve³eeB Deewj Mejerj kesÀ Dev³e
DebieeW keÀes kegÀÒeYeeJeeW mes ye®ee³ee pee mekeÀlee nw~
DeHeves [e@keÌìj kesÀ ceeie&oMe&ve kesÀ lenled [e³eeyeerìerme Deewj jkeÌle-iuegkeÀesp] e keÀer cee$ee ef®eefkeÀlmekeÀer³e Deenej ef®eefkeÀlmee, J³eeqkeÌleiele Deenej-³eespevee (He=ÿ 4 osKeW), J³ee³eece Deewj
DeeJeM³ekeÀlee nes Gleveer oJeeF&³eeW mes meblegueve ceW jKeW pee mekeÀles nQ~
Mejerj kesÀ jkeÌle iuegkeÀes]pe keÀes ÒeYeeefJele keÀjves Jeeues kegÀí keÀejkeÀ nQ - DeeHekeÀe Deenej, kesÀuejer, MeejerefjkeÀ ef¬eÀ³eeSB Deewj Mejerj keÀe Je]peve~ keÀeyeexneF&[^sìdme-³egkeÌle Deenej mes
jkeÌle-iuegkeÀesp] e keÀer cee$ee yeæ{leer nw~ ®ejyeer Deewj Òeesìerve ³egkeÌle Yeespeve Yeer DeefOekeÀ cee$ee ceW uesves mes Je]peve yeæ{lee nw~
DeeHeves owefvekeÀ Yeespeve Deewj jkeÌle-iuegkeÀesp] e keÀer cee$ee keÀe y³eewje jefKe³es, efpememes HeefjJele&ve De®íer lejn mes mecePes pee mekesÀ~
DeHeves [e@keÌìj mes HejeceMe& keÀjkesÀ DeHeveer efove®e³ee& ceW J³ee³eece keÀes cenlJeHetCe& mLeeve oW~
lew³eej KeeÐe HeoeLe& Hej ueies uesyeue leLee GmekeÀer meceûeer mes Heefjef®ele neW~ FmekesÀ efueS DeHeves [e³esefìMeer³eve keÀer mene³elee ueW~
[e³eeyeerìerme keÀes efve³ebef$ele efkeÀ³ee pee mekeÀlee nw! efve³ebef$ele keÀjW! DeeHekesÀ yeme keÀer yeele nw!
132
Diabetes Information in English and Regional languages
ceQ DeHeves Deenej Üeje [e³eeyeerìerme keÀes efve³eb$eCe ceW kewÀmes jKegB?
SefMe³eeF& Deewj Yeejleer³e HeekeÀMewueer kesÀ Devegmeej met®eveeSB Deewj ceeie&oMe&ve
(DeHeves [e@keÌìj Deewj jpeermì[& [e³esefìMeer³eve keÀer efveiejeveer kesÀ lenled Deceue keÀjW~)
meblegefuele Deenej kesÀ efueS efJeefJeOe ñeesleeW mes Deenej keÀe meceeJesMe efkeÀ³ee pee mekeÀlee nw~ DeeHekeÀer peerJeveMewueer kesÀ DevegªHe DeeHekesÀ J³eeqkeÌleiele Deenej keÀer ³eespevee yevee³eer pee mekeÀleer nw~
DeeHekeÀer Deenej-³eespevee ceW nj Je]keÌle kesÀ efueS Deenej-Jeie& keÀer cee$ee metef®ele keÀer peeSieer~ efJeefJeOe Deenej-Jeie& Deewj Òel³eskeÀ Deenej-Jeie& keÀer cee$ee kesÀ GoenjCe efvecveefueefKele nQ~ (ke=ÀHe³ee
O³eeve oW efkeÀ Deenej keÀer cee$ee Deboe]pe mes ueer ieF& nQ)
133
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
cekeÌKeve, Ieer pewmeer mes®³egjsìs[ ®ejyeer kesÀ yeoues pewletve kesÀ lesue pewmeer Deveme®³etjsìs[ ®ejyeer keÀe GHe³eesie keÀjves keÀe Òe³eeme keÀjW~ leuee ngDee Yeespeve yeej-yeej ve ueW~
lesue, vecekeÀ leLee ®eerveer keÀe GHe³eesie keÀce mes keÀce keÀjW~
134
Diabetes Information in English and Regional languages
ceQ DeHeves Deenej Üeje [e³eeyeerìerme keÀes efve³eb$eCe ceW kewÀmes jKegB?
SefMe³eeF& Deewj Yeejleer³e HeekeÀMewueer kesÀ Devegmeej met®eveeSB Deewj ceeie&oMe&ve
(DeHeves [e@keÌìj Deewj jpeermì[& [e³esefìMeer³eve keÀer efveiejeveer kesÀ lenled Deceue keÀjW~)
³eesie / J³ee³eece ë mece³e ë
owefvekeÀ keÀe³e&¬eÀce ë mece³eë
Yeespeve Hejesmeer ieF& cee$ee keÀeyeexneF&[^sìdme (ûeece) Òeesìerve (ûeece) ®ejyeer (ûeece) kesÀuejer
megyen
veemlee
oesHenj
veemlee
Meece
veemlee
kegÀue
28-30ûeece = SkeÀ DeeQme, 8 DeeQme = 1 keÀHe, 3 ®ecce®e = 1 yeæ[e ®ecce®e, 2 yeæ[s ®ecce®e = 1 DeeQme
Author: Reviewed by:
Padmini Balagopal,
Balagopal PhD, RD, CDE Wahida Karmally,
Karmally DrPH, CDE, CLA, FNLA
Karmeen Kulkarni,
Kulkarni MS, RD, CDE
Hindi translation by: Reviewed by:
Vanita Manchanda,
Manchanda MS, RD Varsha,
Varsha PhD, RD, CNIS
Roshan Khaki,
Khaki RD LD CDE
Uday Meghani,
Meghani MA (Economics and JMC)
135
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
i
nt я
?
e
- n u
e u
[ k e
яs# i
e $ # %
]
& য i
( %, % % , i | i
g d u+% o
p я | ei g d i| k য i
o g t % য, g a
0
% %ig
g t % %ig
|
2# я 34 k ei g a
t я
,2,k p% e a a 6 %|
k a
a
i e k g
u
t
0
,o&
7 t , d e d
nt য. (20
0#
)
য i ,m9#
,%:; 2 , e oя i
k g t
nt | য %id; 0 ;
k g t =
d | 2
# , (k 0# oя =
d i e 3
o u
2 |
#
pя য g t o; |
#
pя (k
яj )|
7
o u
2 a
2
яs# i
яj pя |
n d
o %
a я /
6 0 8 g я p
p
& k
o u
2|
7
я o |
JCi য
k য JC o 2
o u
2 I
k 0
i |
n য% p C
য
nt
|
я
!!
i
nt য!
136
Diabetes Information in English and Regional languages
i
nt я
?
e
- n u
e u
[ k e
яs# i
e $ # %
]
: я
:
/
: oя :
BMI : :
137
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
3. я
( (k d0#
я# )
[ 1
# , 5 g #, 2 g p, 25 ei
4]
я
я,
0 - 1/2 - 1/2
:7
- 1/2 u, 2:
2 k i
- 1/2
3
- 1/2 ;; - 1/2
h
i - 1/2 , 9, 2u2u - 1/2
я :;,
n - 1/2 - 1
4. C (
)
[ 1
# , 15 g # , 60 o য]
- 1/2 ,
- 1 4;
- 1/2 ;
я# - 1
- 1/2 - 1/2
n C - 1/2 4;
5.
7
7
[1
# ,12 g #, 8 g p, 1- 8 g C;, 100-160
]
7/
# %/ C;
7 - 1 i/k (7 ;) - 1
- 1 un
6. 2
#
[ 1
# , 5 g C;, 45
]
n - 1 2 22 - 2 ; 22
я я - 1 ; 22 я#
- 1 2 22
138
Diabetes Information in English and Regional languages
i
nt я
?
e
- n u
e u
k e
яs# i
e
2 a
яi e яl
e u7
য3/
য3 : :
a я # : :
/
# (gms) p (gms) C; (gms)
я
7
7
t
&t
;
# = %id;, gms = g, oz = un, tsp = 2 22, tbsp = 22, 28-30
gms = 1 un, 8 un = 1 , 3 2 22 = 1 22, 2 22 = 1 un, ckd = n
139
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
eÉ«ÉÉ¥ÉÒ÷Ò»É ¶ÉùÒù{ÉÒ +à λoÉÊlÉ Uà V«ÉÉùà ¶ÉùÒù ~ÉÚùlÉÉÅ ¡É©ÉÉiÉ©ÉÉÅ <{É»ÉÖʱÉ{É ¥É{ÉÉ´ÉÒ ¶ÉHlÉÖÅ {ÉoÉÒ +oÉ´ÉÉ <{É»ÉÖʱÉ{É{ÉÉà A~É«ÉÉàNÉ
¥ÉùÉ¥Éù ùÒlÉà HùÒ ¶ÉHlÉÖÅ {ÉoÉÒ. <{É»ÉÖʱÉ{É wÉùÉ W ¶ÉùÒù +É~ÉiÉÉÅ +ɾÉù©ÉÉÅoÉÒ UÚ÷Ò ~Éeà±ÉÒ ¶ÉHÇùÉ +oÉ´ÉÉ N±ÉÖHÉà»É©ÉÉÅoÉÒ AWÉÇ ±É>
¶ÉHà Uà. <{É»ÉÖʱÉ{É +{Éà ùGlÉ©ÉÉÅ ù¾à±É N±ÉÖHÉà»É{ÉÉÅ ¡É©ÉÉiÉ©ÉÉÅ +»ÉÅlÉÖ±É{É ASSÉ ùGlÉ-N±ÉÖHÉà»É (¾É>~ÉùN±ÉÉ<Ê»ÉÊ©É«ÉÉ) +oÉ´ÉÉ Ê{É©{É
ùGlÉ-N±ÉÖHÉà»É (¾É>~ÉÉàN±ÉÉ<Ê»ÉÊ©É«ÉÉ)©ÉÉÅ ~ÉÊùiÉ©Éà Uà.
ùGlÉ-N±ÉÖHÉà»É{ÉÖÅ ¡É©ÉÉiÉ +àH Ê{ÉÊýÉlÉ ¡É©ÉÉiÉ{ÉÒ +É»É~ÉÉ»É ùÉLÉ´ÉÖÅ W°ùÒ Uà. »ÉŶÉÉàyÉ{É wÉùÉ XiÉ´ÉÉ ©É²«ÉÖÅ Uà Hà +É{ÉÉ wÉùÉ +ÉÅLÉ,
ÊHe{ÉÒ, ùGlÉ´ÉÉʾ{ÉÒ+Éà +{Éà ¶ÉùÒù{ÉÉ +{«É +ÅNÉÉà{Éà ©ÉÉcÒ +»ÉùÉàoÉÒ ¥ÉSÉÉ´ÉÒ ¶ÉHÉ«É Uà.
lÉ©ÉÉùÉ eÉèG÷ù{ÉÉ ©ÉÉNÉÇq¶ÉÇ{É ¾àc³, eÉ«ÉÉ¥ÉÒ÷Ò»É +{Éà ùGlÉ-N±ÉÖHÉà»É{ÉÖÅ ¡É©ÉÉiÉ lÉ¥ÉÒ¥ÉÒ +ɾÉù ÊSÉÊHl»ÉÉ, ´«ÉÎGlÉNÉlÉ +ɾÉù-
«ÉÉàW{ÉÉ (WÖ+Éà ~ÉÉ{ÉÖÅ 4) H»ÉùlÉ +{Éà W°ù ~ÉÚùlÉÒ q´ÉÉ wÉùÉ »ÉÅlÉÖ±É{É©ÉÉÅ ùÉLÉÒ ¶ÉHÉ«É Uà.
¶ÉùÒù{ÉÉ ùGlÉ-N±ÉÖHÉà»É ¡É©ÉÉiÉ{Éà ¡É§ÉÉÊ´ÉlÉ HùlÉÉÅ +©ÉÖH PÉ÷HÉà Uà - lÉ©ÉÉùÉà +ɾÉù, HÖ±É Hà±ÉùÒ, ¶ÉÉùÒÊùH ÊJ«ÉÉ+Éà +{Éà ¶ÉùÒù{ÉÖÅ
´ÉW{É. HÉ¥ÉÉâ¾É<eÄà÷Ã»É yÉùÉ´ÉlÉÉ +ɾÉùoÉÒ ùGlÉ-N±ÉÖHÉà»É{ÉÖÅ ¡É©ÉÉiÉ ´ÉyÉà Uà. SÉù¥ÉÒ +{Éà ¡ÉÉà÷Ò{É´ÉɳÉà LÉÉàùÉH ~ÉiÉ ´ÉyÉÉùà ¡É©ÉÉiÉ©ÉÉÅ
±Éà´ÉÉ«É lÉÉà +à{ÉÉoÉÒ ~ÉiÉ ´ÉW{É ´ÉyÉà Uà.
lÉ©ÉÉùÉ ùÉàW{ÉÉÅ §ÉÉàW{É +{Éà ùGlÉ-N±ÉÖHÉà»É{ÉÉÅ ¡É©ÉÉiÉ{ÉÒ {ÉÉáyÉ ùÉLÉÉà WàoÉÒ £àù£Éù »ÉÉùÒ ùÒlÉà »É©ÉY ¶ÉHÉ«É.
eÉèG÷ù{ÉÒ »É±Éɾ ±É>{Éà lÉ©ÉÉùÒ Êq{ÉSÉ«ÉÉÇ©ÉÉÅ H»ÉùlÉ{Éà ©É¾l´É{ÉÖÅ »oÉÉ{É +É~ÉÉà.
lÉä«ÉÉù LÉÉv-~ÉqÉoÉÉâ ~Éù ±ÉÉNÉà±ÉÉ ±Éà¥É±É +{Éà +à{ÉÒ »ÉÉ©ÉOÉÒoÉÒ ~ÉÊùÊSÉlÉ oÉÉ´É. +É ©ÉÉ÷à +É~É{ÉÉ eÉ«Éà÷Ò¶ÉÒ«É{É{ÉÒ ©Éqq ±ÉÉà.
eÉ«ÉÉ¥ÉÒ÷Ò»É HÉ¥ÉÖ©ÉÉÅ ùÉLÉÒ ¶ÉHÉ«É Uà! HÉ¥ÉÖ©ÉÉÅ ùÉLÉÉà! lÉ©Éà ùÉLÉÒ ¶ÉHÉà UÉà!
140
Diabetes Information in English and Regional languages
»É©ÉlÉÉà±É +ɾÉù ©ÉÉ÷à Ê´ÉÊ´ÉyÉ ¼ÉÉàlÉÉàoÉÒ +ɾÉù{ÉÉà »É©ÉÉ´Éà¶É HùÒ ¶ÉHÉ«É. lÉ©ÉÉùÒ Y´É{É-¶Éä±ÉÒ{Éà +{ÉÖ°~É lÉ©ÉÉùÉ ´«ÉÎGlÉNÉlÉ +ɾÉù{ÉÒ
«ÉÉàW{ÉÉ PÉeÒ ¶ÉHÉ«É. lÉ©ÉÉùÒ +ɾÉù-«ÉÉàW{ÉÉ©ÉÉÅ qùàH ÷ÅH{ÉÉ qùàH LÉÉàùÉH-´ÉNÉÇ{ÉÖÅ ¡É©ÉÉiÉ »ÉÚSÉ´É´ÉÉ©ÉÉÅ +É´Éà Uà. Ê´ÉÊ´ÉyÉ LÉÉàùÉH-´ÉNÉÇ +{Éà
qùàH LÉÉàùÉH-´ÉNÉÇ{ÉÉ ¡É©ÉÉiÉ{ÉÉ AqɾùiÉÉà {ÉÒSÉà ©ÉÖW¥É Uà. (LÉÉàùÉH{ÉÖÅ ¡É©ÉÉiÉ +ÅqÉWà ±ÉLÉà±É Uà Wà{ÉÒ {ÉÉáyÉ ±Éà´ÉÉ Ê´É{ÉÅlÉÒ.)
141
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
©ÉÉLÉiÉ, HÉà~É°Å +{Éà PÉÒ Wà´ÉÒ»ÉàS«ÉÖùà÷àe SÉù¥ÉÒ{ÉÒ ¥Éq±Éà +Éè±ÉÒ´É lÉà±É Wà´ÉÒ +{É»ÉàS«ÉÖùà÷àe SÉù¥ÉÒ ´ÉÉ~Éù´ÉÒ ´ÉyÉÉùà ʾlÉɴɾ Uà.
142
Diabetes Information in English and Regional languages
HÉ¥ÉÉâ¾É>eÄà÷»É
LÉÉàùÉH ~ÉÒù»Éà±ÉÉà §ÉÉNÉ ¡ÉÉà÷Ò{É (OÉÉ©É) SÉù¥ÉÒ (OÉÉ©É) Hà±ÉùÒ
(OÉÉ©É)
»É´ÉÉùà
{ÉÉ»lÉÉà
¥É~ÉÉàùà
{ÉÉ»lÉÉà
»ÉÉÅWà
{ÉÉ»lÉÉà
HÖ±É
28-30 OÉÉ©É = +àH +Éå»É, 8 +Éå»É = 1 H~É, 3 SÉ©ÉSÉÒ = 1SÉ©ÉSÉÉà, 2SÉ©ÉSÉÉ = 1 +Éå»É
143
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
¤ªÀÄä zÉúÀªÀÅ ¤ªÀÄUÉ ¨ÉÃPÀµÀÄÖ E£ÀÄì°£ï vÀAiÀiÁj¸À®Ä C±ÀPÀÛªÁzÁUÀ CxÀªÁ vÀAiÀiÁgÁzÀ E£ÀÄì°£ï£À£ÀÄß G¥ÀAiÉÆÃV¸À®Ä CzÀPÉÌ ¸ÁzsÀåªÁUÀzÁUÀ
ªÀÄzsÀĪÉÄúÀ SÁ¬Ä¯É §gÀÄvÀÛzÉ. E£ÀÄì°£ï ¤ªÀÄä DºÁgÀzÀ°ègÀĪÀ ¸ÀPÀÌgɬÄAzÀ GvÀàwÛAiÀiÁzÀ UÀÆèPÉÆøïC£ÀÄß ±ÀQÛAiÀiÁV ¥ÀjªÀwð¸ÀÄvÀÛzÉ.
gÀPÀÛzÀ°ègÀĪÀ UÀÆèPÉÆÃ¸ï ªÀÄvÀÄÛ E£ÀÄì°£ï £ÀqÀÄªÉ C¸ÀªÀÄvÉ §AzÁUÀ UÀÆèPÉÆÃ¸ï ¥ÀæªÀiÁt ºÉZÁÑzÀgÉ ºÉÊ¥ÀgïUÉèöʹëÄAiÀÄ JAvÀ®Æ ªÀÄvÀÄÛ ¥ÀæªÀiÁt
PÀrªÉÄAiÀiÁzÀgÉ ºÉÊ¥ÉÆÃUÉèöʹëÄAiÀiÁ JAvÀ®Æ PÀgÉAiÀÄÄvÁÛgÉ.
gÀPÀÛzÀ UÀÆèPÉÆù£À ¥ÀæªÀiÁtªÀ£ÀÄß ¤zsÁðjvÀ ±ÉæÃtÂAiÀÄ°è EqÀĪÀÅzÀÄ CvÁåªÀ±ÀåPÀ. EzÀÄ ¤ªÀÄä PÀtÄÚ, ªÀÄÆvÀæPÉÆñÀ (Qrß), gÀPÀÛ£Á¼À ªÀÄwÛvÀgÀ
CAUÁAUÀUÀ¼À°è ¸ÀªÀĸÉåUÀ¼ÀÄ ¨ÁgÀzÀAvÉ PÁ¥ÁqÀ®Ä ¸ÀÄ®¨sÀªÉAzÀÄ ªÉÊzÀåQÃAiÀÄ ¸ÀA±ÉÆÃzsÀ£É vÉÆÃj¹PÉÆnÖzÉ.
¤ªÀÄä ªÉÊzÀågÀ ªÀiÁUÀðzÀ±Àð£ÀzÀ°è ¤ªÀÄUÁVAiÉÄà ªÉÄrPÀ¯ï £ÀÆån涣ï xiÉs gÀ¦ (Medical Nutrition Therapy) vÀAiÀiÁj¹zÀ M§â ªÀåQÛAiÀÄ Hl
G¥ÀZÁgÀUÀ¼À ¥ÀnÖ (£Á®Ì£ÉAiÀÄ ¥ÀÄl £ÉÆÃr), ªÁåAiÀiÁªÀÄ ªÀÄvÀÄÛ OµÀ¢üUÀ½AzÀ qÀAiÀiÁ©nÃ¸ï ªÀÄvÀÄÛ gÀPÀÛzÀ UÀÆèPÉÆù£À ªÀÄlÖªÀ£ÀÄß ¤AiÀÄAwæ¸À®Ä
¸ÁzsÀå«zÉ.
¤ªÀÄä DºÁgÀ, CzÀgÀ°ègÀĪÀ PÁå¯ÉÆÃjUÀ¼ÀÄ, zÉÊ»PÀ ±ÀæªÀÄ ªÀÄvÀÄÛ zÉúÀzÀ vÀÆPÀ EªÀÅUÀ¼ÀÄ ¤ªÀÄä gÀPÀÛzÀ UÀÆèPÉÆÃ¸ï ªÀÄlÖzÀ ªÉÄÃ¯É ¥ÀjuÁªÀÄ
©ÃgÀÄvÀÛzÉ. ±ÀPÀðgÀ ¦µÀÖ vÀÄA©gÀĪÀ DºÁgÀUÀ¼ÀÄ ¸À»vÀ UÀÆèPÉÆÃ¸ï ªÀÄlÖzÀ ªÉÄÃ¯É ¥ÀjuÁªÀÄ ©ÃgÀÄvÀÛzÉ. PÉÆ©â£À ªÀÄvÀÄÛ ¥ÉÆæÃnãï EgÀĪÀ
¥ÀzÁxÀðUÀ¼À£ÀÄß ºÉaÑUÉ ¸Éë¹zÀgÉ zÉúÀzÀ vÀÆPÀzÀ ªÉÄÃ¯É ¥ÀjuÁªÀÄ ©ÃgÀĪÀÅzÀÄ.
¤ªÀÄä DºÁgÀ ªÀÄvÀÄÛ gÀPÀÛzÀ UÀÆèPÉÆÃ¸ï ¥ÀæªÀiÁtzÀ°è DUÀĪÀ Kj½vÀUÀ¼À£ÀÄß UÀªÀĤ¸À®Ä, CzÀgÀ «ªÀgÀUÀ¼À£ÀÄß ¤ªÀÄä DºÁgÀzÀ ¢£ÀZÀjAiÀÄ ¥ÀĸÀÛPÀzÀ°è
§gÉ¢qÀĪÀÅzÀÄ CªÀ±Àå.
zÉÊ»PÀ ªÁåAiÀiÁªÀĪÀ£ÀÄß (¤ªÀÄä ªÉÊzÀågÀ ¸À®ºÉAiÀÄ ªÉÄÃgÉUÉ) ¤ªÀÄä fêÀ£ÀzÀ°è C¼ÀªÀr¹PÉƽî.
¤ªÀÄä wArw¤¸ÀÄUÀ¼À eÉÆvÉ EgÀĪÀ UÀÄgÀÄvÀÄ aÃn (¯Éç¯ï)UÀ¼À, ªÀÄvÀÛzÀgÀ°ègÀĪÀ DºÁgÀzÀ WÀlPÀUÀ¼À ¥ÀjZÀAiÀÄ ªÀiÁrPÉƽî. ¤ªÀÄä ¥ÀjZÀAiÀÄzÀ
DºÁgÀ vÀdÕgÀ°è (qÀAiÀÄnöAiÀÄ£ï) F «µÀAiÀÄzÀ §UÉÎ ¸À®ºÉ ¥ÀqɬÄj.
ªÀÄzsÀĪÉÄúÀ SÁ¬Ä¯ÉAiÀÄ£ÀÄß-
Ä£ÀÄß- ºÀzÀzÀ°èqÀ§ºÀÄzÀÄ ! PÁAiÀÄðUÀvÀgÁV ! ¤«ÄäAzÀ EzÀÄ ¸ÁzsÀå !!
144
Diabetes Information in English and Regional languages
PÁå¯ÉÆÃjøï / ¢£À
ºÀ®ªÀÅ ªÀÄÆ®UÀ½AzÀ DºÁgÀªÀ£ÀÄß ¨Égɹ ¸ÀªÀÄ vÀÆPÀzÀ DºÁgÀ vÀAiÀiÁj¸À§ºÀÄzÀÄ. ¤ªÀÄä ¸ÀéAvÀzÀ Hl, wArUÀ¼À AiÉÆÃd£É ¤ªÀÄä fêÀ£À PÀæªÀÄPÉÌ
C£ÀÄUÀÄtªÁV ªÀiÁqÀ¨ÉÃPÀÄ. ¤ªÀÄä ¥Àæw HlzÀ°è PɼÀUÉ PÉÆnÖgÀĪÀ DºÁgÀ UÀÄA¥ÀÄ ¸ÉÃjgÀ¨ÉÃPÀÄ. D ««zsÀ UÀÄA¥ÀÄUÀ¼À ºÉ¸ÀgÀÄUÀ¼ÀÄ ªÀÄvÀÄÛ
ªÀÄvÀÄÛ MAzÀÄ
HlPÉÌ ¸ÁPÁUÀĪÀµÀÄÖ DºÁgÀ ¥ÀæªÀiÁtzÀ GzÁºÀgÀuÉUÀ¼ÀÄ PɼÀVªÉ. (¸ÀÆZÀ£É : CAzÁf£À C¼ÀvÉUÀ¼ÀÄ)
145
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
ªÉÆmÉÖ : 1 O£ïì
PÀjzÀ «ÄãÀÄ : 1 O£ïì
PÀÄj (j¨ï gÉÆøïÖ, UËæAqï) : 1 O£ïì
mÉA¥É : 1/4 C¼ÀvÉAiÀÄ §lÖ®Ä :
jPÉÆÃl aøï : 1/4 C¼ÀvÉAiÀÄ §lÖ®Ä
mÉÆÃ¥sÀÄ : 3.5 O£ïì
vÀÄA§ PÉÆ©â£ÀzÀÄ :
(MAzÀÄ ¥Á®Ä : 7 UÁæA ¥ÉÆæÃnãï (Protein) 8 + UÁæA PÉƧÄâ (Fat)
ªÀÄvÀÄÛ 100 + PÁå¯ÉÆÃjUÀ¼ÀÄ (Calories)
aøï (¸ÁzsÁgÀt) : 1 O£ïì PÉÆý/lQð ºÁmï qÁUï : 1 (10/lb)
£É®PÀqÀ¯ÉPÁ¬Ä ¨ÉuÉÚ : 1 O£ïì (+ 1 PÉƧÄâ JPïìZÉÃAeï) ¸Á¸ÉÃeï : 1 O£ïì ¥À¤Ãgï : 1 O£ïì
3. vÀgÀPÁjUÀ¼ÀÄ( PÉÆ©â®èzÀÄÝ)
(MAzÀÄ ¥Á®Ä : 2 UÁæA ¥ÉÆæÃnãï (Protein) 5 UÁæA PÁ¨ÉÆÃðºÉÊqÉæÃmï) (CHO) ªÀÄvÀÄÛ 25 PÁå¯ÉÆÃjUÀ¼ÀÄ (Calories)
ºÀ¹gÀÄ vÀgÀPÁj, ªÉÄAvÀåzÀ ¸ÉÆ¥ÀÄà : 1/2 C¼ÀvÉAiÀÄ §lÖ®Ä £ÀÄUÉÎÃPÁ¬Ä, ¨ÉAqÉÃPÁ¬Ä : 1/2 C¼ÀvÉAiÀÄ §lÖ®Ä :
ºÀÄgÀĽPÁ¬Ä : 1/2 C¼ÀvÉAiÀÄ §lÖ®Ä PÁå¥ï¹PÀA : 1/2 C¼ÀvÉAiÀÄ §lÖ®Ä
ÉÆøÀÄUÀqÉØ, PÁ°¥sÀèªÀgï : 1/2 C¼ÀvÉAiÀÄ §lÖ®Ä vÀgÀPÁj ¸À¯Áqï : 1 C¼ÀvÉAiÀÄ §lÖ®Ä.
PÀÄA§¼ÀPÁ¬Ä/¸ÉÆÃgÉPÁ¬Ä : 1/2 C¼ÀvÉAiÀÄ §lÖ®Ä ©½ ªÀÄÆ®AV, ¹ÃªÉħzÀ£ÉÃPÁ¬Ä : 1/2 C¼ÀvÉAiÀÄ §lÖ®Ä
§zÀ£ÉÃPÁ¬Ä : 1/2 C¼ÀvÉAiÀÄ §lÖ®Ä mÉƪÀiÁåmÉÆ : 1/2 C¼ÀvÉAiÀÄ §lÖ®Ä
¸ÁzsÀåªÁzÀµÀÄÖ C£ï¸ÁåZÀÄgÉÃmÉqï PÉÆ©â£À JuÉÚ (D°ªï JuÉÚ vÀgÀºÀzÀÄÝ) §¼À¹ : ¸ÁåZÀÄgÉÃmÉqï PÉÆ©â£À (vÀÄ¥Àà, ¨ÉuÉÚAiÀÄAvÀºÀªÀÅ) §¼ÀPÉ PÀrªÉÄ
ªÀiÁr. PÀjzÀ wArAiÀÄ£ÀÄß DUÁUÀ w£ÀÄߪÀÅzÀ£ÀÄß vÀ¦à¹.
JuÉÚ, G¥ÀÄà, ªÀÄvÀÄÛ ¸ÀPÀÌgÉAiÀÄ£ÀÄß DzÀµÀÄÖ PÀrªÉÄ §¼À¹.
Adapted from choose your Foods : Exchange Lists for Diabetes by American Dietetic Association and
American Diabetes Association (2008: Page 4)
146
Diabetes Information in English and Regional languages
ªÀÄzsÉå ¨É¼ÀV£À
¥sÀ¯ÁºÁgÀ
ªÀÄzsÁåºÀßzÀ Hl
¸ÀAeÉAiÀÄ G¥ÀºÁgÀ
gÁwæAiÀÄ Hl
gÁwæAiÀÄ G¥ÀºÁgÀ
J¯Áè ¸ÉÃj
D¼ÀvÉUÀ¼ÀÄ : 8 O£ïì = C¼ÀvÉAiÀÄ §lÖ®Ä ; 3 nà ZÀªÀÄZÉ = 1 mÉç¯ï ZÀªÀÄZÀ ; 2 mÉç¯ï ZÀªÀÄZÀ = 1 O£ïì ; vÀÆPÀ : 28-30 UÁæA = 1 O£ïì
147
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
േമഹം നിയ
ിാന് ഏെതല്ലാം ആഹാരമാണ് ഉമം?
ഉമം
ഏഷന്-ഇന് പാചകവിധിയില് അവലംബിേ$ നി%േദശ(ള്
(ഒ, േഡാക
. റ0 െടയ0 ം രജിസ്റ്േറ%ഡ് ഡയ4ീഷന്െറയ0 ം സഹായോെട 6മീകരിേ$ത്)
ശരീരില് ആവശിന് ഇ8സ0 ലിന് ഉ9:ാദി:ിാതിരിേയാ ഉ9:ാദി:ി;< ഇ8സ0 ലിന് ശരിയാവണ = ം
ഉപേയാഗിതിരിേയാ െച?0< അവസ@യാണ് േമഹം എ< േരാഗം. ആഹാരിെല പCസാരെയ ശരീരില്
ഊ%Eമായി മാ40<തിന് ഇ8സ0 ലിന് ആവശമാണ്. ഇ8സ0 ലിന് േവ$വിധം വ%ിാതി,<ാല് രFിെല
പCസാരയ0 െട അളവ് ഉയ,ം (ൈഹ:%ഗ്ൈലസീമിയ) ഇ8സ0 ലിന്െറ അളവ് Hടിയാല് രFിെല പCസാരയ0 െട അളവ്
Iറയ0 ം. (ൈഹപ്േപാഗ്ൈലസീമിയ).
രFിെല പCസാരയ0 െട അളവ് നി%ദിഷ . അJപാതില് നിയ
ിേ$ത് ആേരാഗം നിലനി%ാന് ആവശമാണ്.
കണ K കള0െടയ0 ം Lകള0െടയ0 ം രFIഴല0 കള0െടയ0 ം ആേരാഗം ഇതിെന ആNയിOിരി;ം എ<് പഠന(ള് െതളിയിOിQ0$്.
നി(ള0െട േഡാക . റ0 െട ഉപേദശോെടാ:ം ശാസ R ീയമായ ആഹാര6മീകരണവ0 ം വായാമവ0 ം, മ,Tകള0ം േമഹം
നിയ
ി;<തിന് ആവശമാണ്. നാലാമെ േപജില് ആഹാരം എ(ിെന 6മീകരിണെമ<തിെന:4ി തിവാദി;T.
നി(ള് എ് ആഹാരം കഴി;T, അത് എU കേലാറി ഊ%Eം ശരീരിന് പക,T, നി(ള0െട വായാമ6മം, Vം,
ഇവെയല്ലാം ശരീരിെല പCസാരയ0 െട അളവിെന ബാധി;< ഘടക(ളാണ്. ആഹാരിെല അ<Eിന്െറ അളവ്
Hടിയാല് േമഹ േരാഗിയ0 െട രFിെല പCസാരയ0 െട അളവ് Hട0ം. അXേപാെല അധികമായി െകാഴ0:0ം ോQീJം
HQിയാല് നി(ള0െട ഭാരം അമിതമാIം.
ഓേരാ ദിവസവ0 ം നി(ള് കഴി;< ആഹാരവ0 ം അത് രFിെല പCസാരയ0 െട അളവില് ഉ$ാ;< വതിയാന(ള0ം ഒ,
ചാ%Qില് േരഖപ്െപട0ി സ\]ി;ക. അതില\െട നി(ള0െട ആഹാര രീതിയ0 ം അXമ\ലം രFിെല പCസാരയ0 ം എ(െന
ബ^പ്െപQിരി;T എ<് നി(_് തെ< മനസ̀ിലാാം.
ദിവസവ0 ം നി(ള് പിaടേര$ വായാമ6മം േഡാക . റ0 െട മ0 8Hര് സbതം വാ(ിയ േശഷം ചിQപ്െപട0cക.
ആഹാര പായ d 40കള0െട േപാഷക Iറി:് വായിO0, അതില് സ\ചി:ിOിരി;< ഘടകവസ e െള മനസ̀ിലാ;ക. ഒ, ഡയ4ീഷന്
ഈ കാരില് നി(െള സഹായിാന് സാധി;ം.
148
Diabetes Information in English and Regional languages
എെ േമഹേരാഗം
േമഹേരാഗം നിയ
ിാന് എ് ആഹാരമാണ് കഴിേ$ത്?
ഇന് പാചകവിധിയില് അവലംബിേ$ നി%േദശ(ള്
(േഡാക
. റ0 െടയ0 ം രജിസ്റ്േറ%ഡ് ഡയ4ീഷെയ0 ം സഹായോെട 6മീകരിേ$ത്)
വതസ
(ളായ ആഹാരപദാ%ഥ(ള് ഉ_പ്െപട0cേgാഴാണ് ഒ, സമീത ആഹാരം ചിQപ്െപട0ാന്
സാധി;<ത്. നി(ള് 6മീകരി;< ആഹാരം നി(ള0െട ജീവിത രീതി് അJേയാജമായിരിണം.
ദിവേസനയ0 j ആഹാരില് ഓേരാ ഇനവ0 ം എUമാUം ഉ_പ്െപട0ണെമ<് നി%േദശി;<താണ് ഈ
ആഹാര6മീകരണ പhതി. താെഴ അരെമാ, പhതി ത?ാറാാന് സഹായി;< സാേwതിക
വിവര(ള് കാണിOിരി;T. (വിളg0 < അളവ് ഏകേദശമായ ഒ, കണാണ്)
149
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
4. പഴവ%ഗ
(ള്
(ഇവയില് ഒരിനം വിളgിയാല് 15 uാം അ<Eം, 60 കേലാറി)
പഴം: ½ ½ ക:് ആ:ിള്, ഓറC്: 1 (െചറ0 ത്)
മ0 ഴ0 േപയര്: ½ ½ െമലണ്: 1 ക:്
മാ(: ½ ½ ക:് േപരയ
d : ½ ക:് , െചറിയ ടി<ിെല പഴ വ%ഗ(ള്: ½
6. െകാഴ0:0ം എണ
= കള0ം
(ഒരിനം കഴി;േgാള് 5 uാം െകാഴ0:്, 45 കേലാറി)
പാചക എണ = : 1 ടീസ ണ്, തി,മിയ േത(: 2 േടബി_സ ണ്
മാ%ജരിന്: 1 ടീസ ണ് നQ്സ് / സീഡ്̀: 1 േടബി_സ
ണ്
Adapted from Choose your Foods: Exchange Lists for Diabetes by American Dietetic Association
and American Diabetes Association (2008: Page 4).
150
Diabetes Information in English and Regional languages
എെ േമഹേരാഗം
േമഹേരാഗം നിയ
ിാന് എ് ആഹാരമാണ് കഴിേ$ത്?
ഏഷന്/ഇന് പാചകവിധിയില് അവലംബിേ$ നി%േദശ(ള്
േദശ(ള്
(ഒ, േഡാക ് റ%ഡ് ഡയ4ീഷ8െറയ0
. റ0 െടയ0 ം രജിസ്റേ െറയ0 ം സഹായോെട 6മീകരിേ$ത്)
േഡാക
. റ0 െടയ0 ം ഡയ4ീഷെയ0 ം സഹായോെട വFിഗതമായി
ആഹാര6മം ചിQപ്െപട0ാJj പQികയ0 െട ഏകേദശ °പം.
േയാഗാഭാസം/
േയാഗാഭാസം/വായാമം സമയം:
സമയം
മ4് അധ±ാനം സമയം:
സമയം:
പ്മണി്
ഉOഊണ്
നാല് മണി്
അാഴം
ലഘ0 ഭ]ണം
െമാം
151
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
मधुमेह हा असा रोग आहे /यात तुमचे शर0र पुरेसे इ2सुिलन तयार क शकत नाह0 कंवा तयार केले)या इ2सुिलन चा
यो6य तो वापर क शकत नाह0. इ2सुिलनचा उपयोग आपण अ2नात घेतले)या साखरे चा उजा<त =पांतर कर
यासाठ होतो.
आपण अ2नातून घेतलेली साखर आ>ण शर0रात िनमा<ण केलेले इ2सुिलन *ाचा जर मेळ बसला नाह0 तर कधी र@ात)या
साखरे चे ूमाण जाःत तर0 होते नाह0 तर कमी तर0 होते.
र@ातील साखरे चे ूमाण यो6य तेCहढे च असणे हे अEयंत गरजेचे आहे . संशोधनाने असे िसF झाले आहे कG हे ूमाण
यो6य ठे व)यावर तुHहाला डोIयाचे, कडनीचे, र@ वाह2यांचे Jवकार व इतर Cयाधी टाळता येतात.
मधुमेह व र@ातले साखरे चे ूमाण आप)या डॉ%टर"या स)याने व यो6यEया औषोधोपचाया<ने साधता येतात. *ाच बरोबर
यो6य तो आहार, Cयायाम व औषधे *ा कडे ह0 लM ावे.
तुमचा आहार, Eयातून िनमा<ण होणार0 उजा<, तुम"या शर0राची हालचाल व वजन *ां"या ूमाणावरती तुम"या र@ात)या
साखरे चे ूमाण अवलंबून असते. ूमाणापेMा जाःत JपNमय पदाथाचे सेवन के)यांस र@ातील साखरे चे ूमाण वाढते.
तेलकट तुपकट पदाथ< आ>ण ूिथने आहारात जाःत अस)याने वजन वाढू शकते.
ूमाणबF आहार ठे व
यासाठ आप)या आहारातील पदाथाचा त@ा ठे वणे व र@ात)या साखरे "या चढ उतारांची नOद ठे वणे
अEयंत ज=र0 आहे .
तुम"या दनचयPत Cयायामासाठ ठराJवक वेळ ठे वणे अEयंत आवँयक आहे (*ासाठ वैकGय स)ला Sयावा).
Jवशेषतः बाहे न घेतले)या तयार पदाथामधील साहEयांची छापील माहतीची नOद Sयावी. *ासाठ तुमची आहारत( तुमची
मदत क शकेल.
सहा ते आठ 6लास पेय दवसात घेतले गेले पाहजेत. श%यतो साधे पाणी Jपणे उ[म. Caffeine असलेले पेय Jवशेषता
चहा, कॉफG व coke सारखी पेय श%यतो टाळवी
मादक पेयां"या सेवनेब\ल डॉ%टरांना Jवचारावे.
152
Diabetes Information in English and Regional languages
नावं : दनांक :
कॅलोर0 : वजन :
BMI :
आहाराची मांडणी अँया तढहे नेनी Cहावी कG /यात ूिथने, >ःन6ध पदाथ< व JपNमय पदाथ< यो6य ूमाणात येतील. अँया तढहे ने
एकJऽत केले)या आहाराची काह0 उदा: दली आहे त –
१. धा2य/
धा2य/ डाळ0/
डाळ0/ कडधा2य/
कडधा2य/ JपNमय भा/या (तेल / तुप न घालता)
घालता) :
(१ वाटा (वाढणी) १५ मॅम JपNमय पदाथ<, ३ मॅम ूिथने आ>ण ८० कॅलोर0 पुरवतात)
ॄेड / पाव : १ ःलाइस कोरड0 पोळ0 : १ - ६"
भात : १/३ कप (िशजलेला) गहू, म%का, बटाटा : १/२ कप (िशजलेला)
पोपकॉन< : ३ कप हरव केळे / मटार : १/२ कप
अJवअल : १/२ कप पोहे : १/२ कप
सांबर : १/२ कप डाळ0 / कडधा2य : १/२ कप
िशजवलेले नूडल/ सांजा - १/२ कप इडली : १
नान : १/४ (८" x २")
तांtळाचे पीठ - २ tbsp गCहाचे पीठ : २ १/२ tbsp
153
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
४. फळे
(१ वाटा (वाढणी ) १५ मॅम JपNमय पदाथ< व ६० कॅलोर0 पुरवतो)
केळ : १/२ छोटे सफरचंद, संऽ : १ (छोटे )
पेअर मोठे : १/२ कािलंगड़, टरबूज : १ कप
आंबा : १/२ कप पे : १/२ कप
कॅन केलेली फळे : १/२ कप
५. दध
ू व दध
ु ाचे पदाथ<
(१ वाटा (वाढणी ) १२ मॅम JपNमय पदाथ< , ८ मॅम ूिथने , ०-८ मॅम >ःन6ध पदाथ< व १०० - १६० कॅलोर0 पुरवतो)
दध
ू : १ कप
दह0, ताक़ : १ कप
पनीर : १ औंस
ऑिलCह ऑइल सारया तेलाचा वापर तुपा पेMा कंवा नारळ वापन केले)या पदाथापेMा जाःत चांगला. तेलकट पदाथाचे कािमत कमी
सेवन करावे.
एकूणच तेल, तुप, साखर व मीठ *ांचा कािमत कमी वापर करावा.
154
Diabetes Information in English and Regional languages
दप
ु ारचे जेवण
राऽीचे जेवण
राऽीचे ःनॅक
एकूण (Total)
JपNमय पदाथ< = Carbohydrate; ूिथने = Proteins; >ःन6ध पदाथ< = Fat; उजा</ कॅलोर0 = Calories
३० मॅम = १ औसं , ८ औस
ं = १ कप; ३ ट0 ःपून = १ टे बल ःपून; २ टे बल ःपून = १ औसं
155
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
156
Diabetes Information in English and Regional languages
FLÿ Ó;ëÿÁÿç†ÿ Qæ’ÿ¿ ¯ÿçµÿçŸ ¨÷LÿæÀÿÀÿ DÓ#Àëÿ þçÁëÿ$#¯ÿæ Qæ’ÿ¿Àÿ Ó¼çÉ÷~{Àÿ ¨÷Öë†ÿ LÿÀÿæ¾æB¨æÀÿç¯ÿ> Aæ¨~ZÿÀÿ ¯ÿ¿NÿçS†ÿ Qæ’ÿ¿ {¾æfœÿæ Aæ¨~ZÿÀÿ fê¯ÿœÿ ¾æ†ÿ÷æÀÿ {ÉðÁÿêLëÿ {œÿB ¨÷Öë†ÿ {Üÿ¯ÿæ
{Üÿ¯ÿæ
D`ÿç†úÿ> Aæ¨~Zÿ Qæ’ÿ¿ {¾æfœÿæ ¨÷{†ÿ¿Lÿ $Àÿ Qæ’ÿ¿ ¨æBô Qæ’ÿ¿ {É÷~ê LÿA~ ’ÿÀÿLÿæÀÿ, †ÿæÜÿæ D¨{Àÿ þ†ÿæþ†ÿ {’ÿ¯ÿ> œÿçþ§{Àÿ ¯ÿçµÿçÿçŸ Qæ’ÿ¿ {É÷~ê F¯ÿó †ÿæ'Àÿ D’ÿæÜÿÀÿ~ ’ÿçAæSàÿæ, ¾æÜÿæ
¨÷{†ÿ¿Lÿ Qæ’ÿ¿{É÷~ê ¨æBô D•çÎ>
157
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
6. `ÿ¯ÿ} H {†ÿàÿ
(FLÿ $Àÿ Qæ’ÿ¿ 5S÷æþ `ÿ¯ÿ} H 45 Lÿ¿æ{àÿæÀÿê {¾æSæF)
QæB¯ÿæ {†ÿàÿ FLÿ `ÿæþ`ÿú
{LÿæÀÿæœ xÿçAæ 2 `ÿæþ`ÿú
¯ÿæ’ÿæþ Lÿçºæ þqç 1 {s¯ëÿàÿ `ÿæþ`ÿú
WçA 1 {s¯ëÿàÿ `ÿæþ`ÿú
158
Diabetes Information in English and Regional languages
FLÿ ¯ÿ¿Nÿç{Lÿð¢ÿ÷çLÿ Qæ’ÿ¿ {¾æfœÿæÀÿ Aæ¨~Zÿ `ÿçLÿçÓ#Lÿ †ÿ$æ Qæ’ÿ¿ ¯ÿç{ÉÌjZÿ þ†ÿæœëÿ¾æßê FLÿ œÿþëœÿæ
{µÿæfœÿ/Qæ’ÿ¿Àÿ {É÷~ê {Lÿ{†ÿ $Àÿ ¨Àÿç{¯ÿÌ~ {É´†ÿÓæÀÿ (S÷æþ{Àÿ) ¨õÎçÓæÀÿ (S÷æþ{Àÿ) `ÿ¯ÿ} (S÷æþ{Àÿ) Lÿ¿æ{àÿæÀÿê
ÓLÿæÁÿ fÁÿQçAæ
¨í¯ÿöæÜÿ§ Qæ’ÿ¿
þšæÜÿ§ {µÿæfœÿ
A¨ÀÿæÜÿ§ Qæ’ÿ¿
Àÿæ†ÿç÷ {µÿæfœÿ
Àÿæ†ÿç÷ fÁÿQçAæ
Óþë’ÿæß
159
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
ਰੋਗ ਹੋਣ ਦੀ ਹਾਲਤ ਿਵਚ ਤੁ ਹਾਡਾ ਸਰੀਰ ਕਾਫੀ ਮਾਤਰਾ ਿਵਚ ਇੰਸੁਿਲਨ ਪੈਦਾ ਨਹ ਕਰਦਾ ਜਾਂ ਇੰਸੁਿਲਨ ਸਰੀਰ ਿਵਚ ਸਹੀ ਤਰਾਂ ਵਰਤੀ ਨਹ ਜਾਂਦੀ |
ਇੰਸੁਿਲਨ ਤੁ ਹਾਡੇ ਸਰੀਰ ਨੂ ੰ ਸ਼ਕਰ ਤ ਸ਼ਕਤੀ ਲੈ ਣ ਦੇ ਕਾਬਲ ਬਣਾਉਦੀ ਹੈ -ਤੁ ਹਾਡੇ ਖਾਣੇ ਿਵਚ ਖੰਡ ਨੂ ੰ ਭੰਨ ਿਦਤਾ ਜਾਂਦਾ ਹੈ |
ਇੰਸੁਿਲਨ ਅਤੇ ਖੂਨ ਿਵਚ ਸ਼ਕਰ ਦੀਆਂ ਮਾਤਰਾਵਾਂ ਿਵਚ ਸਹੀ ਤਵਾਜਨ ਨਾਂ ਹੋਣ ਕਰਕੇ ਖੂਨ ਿਵਚ ਸ਼ਕਰ ਦੀ ਮਾਤਰਾ ਹਇਪ- ਲੀਿਸਿਮਆ ਵਧ ਜਾਂਦੀ ਹੈ -ਜਾਂ ਤੁ ਹਾਡੇ
ਖੂਨ ਿਵਚ ਸ਼ਕਰ ਦੀ ਮਾਤਰਾ ਘਟ ਿਹਪੋ ਲੈ ਿਸਿਮਆਂ ਜਾਂਦੀ ਹੈ |
ਖੂਨ ਿਵਚ ਸ਼ਕਰ ਦੀ ਮਾਤਰਾ ਨੂ ੰ ਮੰਨ ਹੋਈ ਮਾ ਤਾ ਤੱਕ ਬਣਾਈ ਰਖਣਾ ਮਹਤਵਪੂਰਨ ਹੈ ਅਤੇ ਖੋਜ ਕਰਨ ਤੇ ਪਤਾ ਲਗਾ ਹੈ ਿਕ ਇਹ ਤੁ ਹਾਡੀਆਂ ਅਖਾਂ,ਗੁਰਿਦਆਂ ,ਖੂਨ
ਦੀਆਂ ਨਾਲੀਆਂ ਅਤੇ ਹੋਰ ਅੰਗਾਂ ਿਵਚ ਨੁ ਕਸ ਪੈਣ ਤ ਰੋਕਦੀ ਹੈ |
ਤੁ ਹਾਡੇ ਡਾ ਟਰ ਦੀ ਿਨਗਰਾਨੀ ਹੇਠ ਮੇਡੀਕਲ ਿਨਿਟਸਨ ਥਾਪੀ ,ਅਤੇ ਿਵਅਕਤੀਗਤ ਭੋਜਨ ਯੋਜਨਾਂ ਨਾਂ ੪ ਦੇਖੋ ,ਕਸਰਤ ਅਤੇ ਜਰੂਰਤ ਮੁਤਾਬਕ ਦਵਾਈਆਂ ਨਾਲ
ਤੁ ਹਾਡਾ ਰੋਗ ਅਤੇ ਖੂਨ ਿਵਚ ਸ਼ਕਰ ਦੀ ਮਾਤਰਾ ਿਨਯੰਤਰਨ ਿਵਚ ਰਖੀ ਜਾ ਸਕਦੀ ਹੈ |
ਤੁ ਹਾਡਾ ਖਾਣਾ ,ਸਾਰੀਆਂ ਲੋ ਰੀਆਂ ,ਕੰਮ ਅਤੇ ਸਰੀਰਕ ਭਾਰ ਤੁ ਹਾਡੇ ਖੂਨ ਮਾਤਰਾਵਾਂ ਤੇ ਅਸਰ ਪਾ ਦੇ ਹਨ | ਖਾਣੇ ਿਜਨਾਂ ਿਵਚ ਕ ਬੋਿਹਦਰੇਟ ਹੁੰਦਾ ਹੈ ਉਹ ਖੂਨ ਿਵਚ
ਸ਼ਕਰ ਦੀ ਮਾਤਰਾ ਵਧਾ ਸਕਦੇ ਹਨ |ਜੇ ਿਜਆਦਾ ਖਾਧਾ ਜਾਵੇ ਤਾਂ ਨਾਹੱਟ ਅਤੇ ਪੋਤੀ ਜ ਸਰੀਰਕ ਭਾਰ ਤੇ ਅਸਰ ਪਾ ਦੇ ਹਨ |
ਖੂਨ ਿਵਚ ਸ਼ਕਰ ਦੇ ਵਧਣ ਘੱਟਣ ਨੂ ੰ ਸਹੀ ਤਰਾਂ ਸਮਝਣ ਲਈ ,ਖੂਨ ਿਵਚ ਸ਼ਕਰ ਦੀ ਮਾਤਰਾ ਦਾ ਅਤੇ ਖਾਣ ਦੀ ਮਾਤਰਾ ਦੀ ਹਰ ਰੋਜ ਿਮਣਤੀ ਕਰਕੇ ਚਾਰਟ ਿਤਆਰ
ਕਰਕੇ ਿਧਆਨ ਰਖੋ |
ਰੋਜਮਰਾ ਦੀ ਸੇਹਤ ਨੂ ੰ ਠੀਕ ਰਖਣ ਦੀ ਯੋਜਨਾ ਿਵਚਆਪਣੇ ਡਾ ਟਰ ਨਾਲ ਬਾਤ ਕਰਕੇ ,ਕਸਰਤ ਨੂ ੰ ਵੀ ਸ਼ਾਮਲ ਕਰੋ
ਖਾਣ ਵਾਲੀਆਂ ਚੀਜਾਂ ਉਤੇ ਿਕਦਾਂ ਦਾ ਲੇ ਬਲ ਹੈ ਅਤੇ ਉਸ ਿਵਚ ਿਕਦਾਂ ਦੀ ਤੱਤ ਹਨ ,ਨਾਲ ਪੂਰੀ ਵਾਕਫੀ ਰਖੋ |ਤੁ ਹਾਡਾ ਖੁਰਾ ਮਾਿਹਰਰਿਜ ਟ ਡ ) ਇਸ ਿਵਚ ਤੁ ਹਾਡੀ
ਮੱਦਤ ਕਰ ਸਕਦਾ ਹੈ |
160
Diabetes Information in English and Regional languages
ਤੁ ਲਨਾਤਿਮਕ ਖੁਰਾਕ ਬਣਾਉਣ ਲਈ ਵਖ ਵਖ ਸੋਿਮਆਂ ਤ ਖੁਰਾਕ ਲੈ ਕੇ ਇਕਤਰ ਕਰ ਲਵੋ |ਤੁ ਹਾਡਾ ਿਵਅਕਤੀਗਤ ਖੁਰਾਕ ਯੋਜਨਾ ਚਾਰਟ ਤੁ ਹਾਨੂ ੰ ਦਸੇਗਾ ਿਕ
ਤੁ ਸ ਿਕਸ ਤਰਾਂ ਦੀ ਖੁਰਾਕ ਖਾਣੀ ਹੈ|ਹਰ ਖੁਰਾਕ ਇਕਤਤਾ ਿਵਚ ਿਕਸ ਿਕਸਮ ਦੀ ਖੁਰਾਕ ਲੈ ਣ ਦੀਆਂ ਉਦਾਹਰਨਾ ਅਤੇ ਵਖਰੀਆਂ ਇ ਤਤਾਵਾਂ ਹੇਠ ਿਲਖੇ ਅਨੁ ਸਾਰ ਹਨ :
੧. ਦਾਣੇ /ਬੀ ਜ/ਮੈਦੇ( ਟਾ ਚੀ)ਸਬਜੀਆਂ (ਿਜਨਾਂ ਿਵਚ ਿਚਕਨਾਹਟ ਜਾਂ ਤੇਲ ਨਾਂ ਪਾਏ ਹੋਣ)
[ਤਕਰੀਬਨ ੧੫ ਗਾਮ ਸੀ ਐਚ ਓ ,੩ ਗਾਮ ਪੋਟੀਨ ਅਤੇ ੮੦ ਲੋ ਰੀਆਂ ਦੀ ੧ ਖੁਰਾਕ ]
ਬੇਡ: ੧ ਲਾਏਸ ਸੁਕੀ ਰੋਟੀ: ੧-੬” ਚੌ ੀ
ਚਾਵਲ :੧/੩ ਕਪ (ਪਕ ਹੋਏ) ਕਣਕ ,ਮੱਕੀ ,ਜ,ਆਲੂ :੧/੨ ਕਪ(ਪਕਾਏ ਹੋਏ )
ਪੋ ਕੋਰਨ:੩ ਕਪ ਹਰੇ ਕੇਲੇ kele/ਮਟਰ : ੧/੨ ਕਪ
ਏਿਵਆਲ : ੧/੨ ਕਪ ਪੋਹਾ/ ੧/੨ ਕਪ
ਸਾਂਬਰ: ੧/੨ ਕਪ (੭ ਗਾਮ ਪੋਟੀਨ) ਦਾਲਾਂ/ਬੀ ਜ/ਪਗੀ ਦਾਲ:੧/੨ ਕਪ (੧੦੦ ਕਲੋ ਰੀਆਂ +੭ ਗਾਮ ਪੋਟੀਨ )
ਪਕਾਏ ਹੋਏ ਨੂ ਡਲਜ /ਸੂਜੀ :੧/੨ ਕਪ ਇਡਲੀ:੧ ਨਾਨ:੧/੪ 8" x xx 2"
ਚਾਵਲ-ਆਟਾ:੨ ਵੱਢਾ ਚਮਚ ਕਣਕ ਦਾ ਆਟਾ : ੨ ੧/੨ ਵੱਢਾ ਚਮਚ
161
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
162
Diabetes Information in English and Regional languages
ਸ਼ਾਹਵੇਲਾ
ਦੁ ਪੇਹਰਵੇਲਾ
ਰਾਤਵੇਲਾ
ਲੌ ਢਾ ਵੇਲਾ
ਰਾਤ ਦੇ ਸਨੈ ਕ
ਜੋੜ
163
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
164
Diabetes Information in English and Regional languages
•¥§Ì a≥ Ì∫`ß] $ªì .ØQa¥ó πæ≥ ¶$ªì ëã∫ßü ¢ªk awao ØR£ª≥ßI .ª… •ì` ¶$ªì ¨aA∫aA ØÔÆQ ªêwaz ªQ Ì∫`ß] $ªì
.∫g§ÆΩ∫%¡ D¶aó Ø≥ßI Ì∫`ß] $ªì ù£< ”Æ≥ .∫g§w< aB] Ø≥ßI ¢ªk πΩªì ¨$ªì
(ùÆúü ´£ ùÆI ªw Ø¡aU) ¢ßÆ’ª≈ ªw ∫$ªì ∫`∫¶ b∫g£∫ ØQ ¸§ì ØõßU ªw ª∏Õ¶ Pª£∫ .1
(cwaúæÌ 80 · •ÆÕ¶aE q∫aó ØÕ ,¶∫ ¤w∫ Øk q∫aó 15 ùÔÕ∫ ≤∞ Ø∏’ Ô≥)
ØÕ¶` ùÔk cÆΩ±k 1 (ØÕ¶` ùA˚) ¸waA
$∫ ßÕªŒE ,ßQÚ ,ØΩªÔü,Ô∏Ì GÌ DßÌ ß§ü `ߣªU
(¨˚ ØÌ Øk)
cÆE DßÌ $∫ ,ßúÆÌ ßΩªk GÌ 3 (±È) ¢`ªÌDªE
GÌ $∫ ª∏Õ¶ ØõßU-¢ßÆõ∫f GÌ $∫ ùwßw∫
•ÆÕ¶aE q∫aó 7 ¨aúæÌ GÌ $∫ a∆£ªk
1 Øõ˚1
165
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
Kè¶ ßQ g§¥R§ü
ßQ g§¥R§ü
ßtY ¢ßU¶
¶$ªì ßQ H∫`
a¥U ØQ H∫`
ùÕßÕ
HalÌ /ñßw Kè¶
¢ßÆõßàlpü «k ¢ßÆ¡ Kè¶
,ô£ªŒŸ 1 q∫aó 30 ,ßVˇU ¶<¶ tbsp,ßVˇU ¶+§£ tsp ,ô£ªŒŸ OZ,q∫aó gms,mŒw`¸æ≥ßA`ªÌ CHO
ö$` -Ckd ,ô£ªŒŸ 1-ªVˇU ∫<¶ 2 , ßVˇU ¶<¶ Ô≥ -ªVˇU ∫+§£ 3 ,GÌ 1- ô£ªŒŸ 8
Ø≥º ùJÔ£ ¢ªü aÅ£ ØQ aŒÌ∫˚ •Æ“Æ≥ Ø≥
Author : Padmini Balagopal, PhD, RD, CDE
Sindhi translation by: Reviewed by:
Murli Sadani Mr Purshotam Sharangdhar
Mrs. Sushila Sharangdhar, BS, RD
167
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
168
Diabetes Information in English and Regional languages
ªðò˜ : «îF :
è«ô£Kèœ/å¼ ï£À‚° : ð£¬îò â¬ì :
àƒèœ BMI : Þ´Š¹„ ²Ÿø÷¾ :
ð™«õÁ õ¬è Ýî£óƒè¬÷„ «ê˜‰î àí¾Š ªð£¼œè¬÷„ «ê˜‰¶ å¼ êK MAî àí¾Š ð†®ò™ îò£K‚èô£‹. àƒèœ
îQŠð†®ò¬ô àƒèœ õ£›‚¬è º¬ø‚° ãŸøð® ܬñ‚è «õ‡´‹. 嚪õ£¼ «õ¬÷ àíM½‹, 嚪õ£¼ àí¾ˆ
ªî£¬èJL¼‰¶‹ êKò£ù Ü÷¾ ðKñ£Ÿøˆ¬î„ «ê˜ˆ¶‚ ªè£œ÷ «õ‡´‹. 嚪õ£¼ àí¾ˆªî£°ŠHL¼‰¶‹ å¼
ðKñ£Ÿø Ü÷M¡ â´ˆ¶‚裆´èœ H¡õ¼ñ£Á (Þ‰î ñFŠd†´ Ü÷¾èœ «î£ó£òñ£ù¬õ).
169
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
170
Diabetes Information in English and Regional languages
àƒèœ ñ¼ˆ¶õ˜ ñŸÁ‹ ðF¾ ªðŸø àíMò™ õ™½ï˜ ̘ˆF ªêŒò «õ‡®ò
îQ ïð˜ àí¾ˆF†ìˆFŸè£ù ñ£FKŠ ð®õ‹.
«ò£è£êù‹/àìŸðJŸC : è£ô«ïó‹ :
裬ô àí¾
ºŸðè™ àí¾
ñFò àí¾
HŸðè™ àí¾
Þó¾ àí¾
Þó¾„ CŸÁ‡®
ªñ£ˆî‹
171
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
J"³°iH›<£ _ȆǶƒÿ\©‹¹ Jªé‹²†Í°+¬<£ā JOkOz# x|O^Î#°, =¶~¡¾^Î~¡ÅHê ㄬHê~¡O KÇH›øx P~ËQê¼xH÷ ‡÷\÷O
KŒeā# x†Ç°=¶eq.
172
Diabetes Information in English and Regional languages
173
Indian Foods: AAPI's Guide to Nutrition, Health and Diabetes
174
Diabetes Information in English and Regional languages
ƒÕ[<ŒxH÷ =òO^ΰ
=°^¥¼‚¬ìß ƒÕ[#O
q°@“ =°^¥¼‚¬ìßO
~Œãu ƒÕ[#O
~Œãu ª÷ßH±
"³ò`ÇëO
* CHO = Hê~ËÄÌ‚áìã_Í\˜; gms = ãQê=ò°; oz = B<£ā; tsp = \© ‹¬¶æ<£; Tbsp = >è|°…˜ ‹¬¶æ<£; 28- 30gms = 1 B<£ā,
8 oz = 1 H›„¬ôæ; 3 tsp = 1 >è|¶…˜ ‹¬¶æ<£; 2 Tbsp = 1 B<£ā; ckd = =O_#q.
175