A Healthier YOU! Nutrition is a powerful tool

Our Health and Happiness is by product of Our Genes: Sorry we can not change it

Our: Environment:We can modify it

Our Lifestyle:Yes we can change itDo South Asians Die earlyAre South Asians at higher risk for heart disease?People from South AsiaIndia, Pakistan, Bangladesh, Nepal, Bhutan, Maldives and Sri Lankahave a four times greater risk of heart disease than the general population and have a much greater chance of having a heart attack before age 50.Heart attacks strike South Asian men and women at younger ages and the attacks are more deadly compared to any other ethnic group. Almost one in three in this group will die from heart disease before age 65.In India, cardiovascular disease remains the No. 1 cause of death. One study found that South Asians developed heart disease 10 years earlier than other groups.BAD DIET AND BAD HABBITS:An alarmingly high number of South Asians appear to beinsulin resistant, a pre-diabetic condition in which the body does not process insulin efficiently. Insulin-resistant patients have similar rates of cardiovascular events as those with full-blown diabetes.Body mass index (BMI)in South Asians often falls into a thin-fat syndrome: People may have an acceptable BMI, but they also carry more of their weight in their abdomen and that visceral fat is more likely to lead to a cardiovascular event.More than one-third of South Asian men and 17% of South Asian women have metabolic syndrome. Metabolic syndrome is a cluster of conditions including:High blood pressureHigh blood sugar levelsExcess body fat around the waistAbnormal cholesterol levels that increase the risk of heart disease, stroke and diabetesIf more than one of these conditions occur in combination, the risk is even greater. South Asians are more likely to have high triglycerides and low HDL (the good cholesterol).

Which South Asians are at risk for heart disease?People from India, Pakistan, Bangladesh, Nepal, Bhutan, Maldives and Sri Lanka have a higher risk of developing heart disease at an early age than any other ethnic group. Men appear to have a slightly higher risk than do women.Stanford South Asian Translational Heart Initiative (SSATHI), strongly encourage South Asians between the ages of 20 to 60 to be screened for cardiovascular risk factors, so that these can be identified and treated before heart disease sets in.Diabetes in America25.8 million Americans of all ages have diabetes18.8 million diagnosed 7 million undiagnosed >9.3% of the population

79 million Americans have pre-DM

By 2050: Increase from ~1:10 to 1 in 3 Americans with diabetes

What can we do?Focus On: Pre-DiabetesThe Art and Science of DSM, 20145How do our counties look?

CountyIndicatorNumberButte9.5%15,773Sutter8.8%5,854Yuba8.5%4,233

Diagnosed Diabetes Percentage -- 2011http://www.cdc.gov/diabetes/atlas/countydata/atlas.html6Diabetes Prevention Program3,234 individuals with Pre-Diabetes & overweight5 years (stopped after 3, excellent results)Metformin850 mg BIDPlacebo groupPlacebo pills Diet and Exercise30 minutes physical activity a day5-7% body weight reduction

Source: NIH, Diabetes Prevention Program

7Diabetes Prevention Program3,234 individuals with Pre-DiabetesMetformin22% Developed DM 31% Risk ReductionPlacebo group29% Developed DMDiet and Exercise14% Developed DM58% Risk Reduction < 60 years of age71% Risk Reduction >60 years of ageFor every 2.2 pounds of weight loss: risk of Diabetes reduced by 13 percentDiet and Exercise is an effective treatment for Pre-Diabetes

Source: NIH, Diabetes Prevention Program

8Build a Better Plate

Balance CaloriesEnjoy your food but eat lessExercise MoreAvoid over sized portions

Calories inCalories outEat 2 servings: 250 x 2 = 500 Calories in 2 cupsOne pound= 3,500 calories -500 calories/day = 1 pound per week Food20 oz soda cup regular ice cream1 beef SausageCandy Bar (Regular Sized)1 slice pizza (1/8th of 12)ExerciseWalk for 2.5 milesOne hour: General Cleaning Cycle leisurely paceWater aerobicsBowling (90 minutes)Golf (with clubs)Yoga

Based on person 155lbs

11Cheeseburger

20 Years Ago

Today330 Calories_________________The average person (130 lbs) would need to lift weights for : _______________Adapted from http://www.nhlbi.nih.gov12Portion Sizes of MeatOne 3-ounce serving cup beans/legumes

Turkey Sandwich

20 Years Ago

Today320 Calories________ caloriesThe average person would need to ride a bike for: _________________Adapted from http://www.nhlbi.nih.gov14Portion Sizes of GrainsOne cup pasta or cereal

Eat a rainbow of colorFull of FiberAntioxidantsVitaminsMineralsHELP YOU FEEL FULL!

Nutrition Information: MyFitnessPal.comPhoto Credit: ChooseMyPlate.gov

16Are Americans Getting Enough Fruits and Vegetables?CDC State Indicator Report on Fruits and Vegetables, 201317

18FatLiquid Fat: Choose More OftenSolid Fats-:Choose Less OftenCanola OilOlive OilPeanut OilButterBaconLard

1 teaspoon of fat has 45 calories

19Pizza!20 Years AgoToday

How long would you have to golf (walking & carrying clubs) to burn 350 more calories? ___________500 calories_____ calories 20Re-Think Your Drink

How many teaspoons of sugar are in these drinks?21Portion Sizes of DairyOne cup low-fat milk One cup low-fat yogurt

My Plate in Action

Sources: ChooseMyPlate.gov, NYC My Plate Planner, http://kblog.lunchboxbunch.com/2013/07/savory-miso-broccoli-spiced-lentil.html, https://foodandhealth.com/make-a-healthful-holiday-plate/

23Learn What You Currently Eat and DrinkPeople who are most successful at losing weight and keeping it off track their intake regularly.What you EatHow muchyou eat and drinkPen and paper or online toolsUSDA Supper TrackerMyFitness Pal

Adapted from http://www.choosemyplate.gov24Simple Lifestyle ChangesMove more!Eat healthy foodsPlan aheadUse the ChooseMyPlate as a guideMake a list before shoppingAvoid shopping while hungryLimit sugary drinksEat more fruits and vegetablesReach a healthy weightStop Smoking

http://mylifecheck.heart.org/ Image source: eatright.org

25One Samosa has 308 so this plate =caloriesx4=1232

4 Vegetable Pakoras have 150 Calories, how many you eat?

Kheer One cup has 560 Calories

One Gulab Jamun has 150 Calories

Langer issues: Need discussion Most of the food is friendTransfats are still usedRefriend food is even worse than fried foodDhesi Ghee and driping butterTOO MUCH SUGARHalf and half in tea or whole milk is used.Creamer is used in cooking DalPrasad can be made simple and healthy: need some discussionAverage Size Jalebi has 150 calories

One ounce of almonds have 64

One ounce of Walnuts have 185 Calories

One cup of Moong Dal have 212 Calories

Stress and heart

The relationship between stress, heart disease and sudden death has been recognized since antiquity. The incidence of heart attacks and sudden death have been shown to increase significantly following the acute stress of natural disasters like hurricanes, earthquakes and tsunamis and as a consequence of any severe stressor that evokes fight or flight responses. Coronary heart disease is also much more common in individuals subjected to chronic stress and recent research has focused on how to identify and prevent this growing problem, particularly with respect to job stress.Stress is Major Risk Factor for heart disease1947: was Major stress on Sikh Community.1984: Still remain stress on us in different shapesBeing an Immigrant is a stressful situationAdapting to new home/ economic survival Cultural class between generations

We are victims of stressIntra community conflictsLitigationsNo meaningful mediation or conflict resolutionNo well thought plan to address cultural clashWe also cause lot of stress to each otherHow to reduce StressApply Simple teachings of Gurbani to your lifeAvoid Ninda and ChugliSimplify your life styleUse Materials to better your life not to live for material.Meditate and exercise dailyDo some Charity (Seva), gives sense of contentmentSpend quality time with family and friends, they will remember you for good memories BUT not the expensive gifts.

Our community at cross roadsWe have not collectively healed from the wounds of 1947 and 1984.We have no well thought out strategy to move ahead as a community.No clear vision to deal with issues related to seniors and children.Generation gap issues like marriage out side community and language barrier between generations Your souls lives in your bodyPlease protect you body and health more than your car and home or other material possessions. You can not replace it.