Who is at risk for I Can Lower My Risk for Type 2 Diabetes: A Guide for American Indians? ? 

- Reach and maintain a reasonable body weight.  - Make wise food choices most of the time.  - Be physically active every day.  - Take your prescribed medicines.
                
Doing these things can reduce your risk of developing type 2 diabetes. Keeping your blood pressure and cholesterol on target also helps you stay healthy.
                
If you are pregnant, plan to breastfeed your baby. Ask your health care provider for the names of people to call for help learning to breastfeed. Besides being good for your baby, breastfeeding is good for you. Studies done with the help of Pima Indian volunteers have shown that breastfeeding may lower the baby's risk of becoming overweight and getting diabetes.
                
Getting Started.
                
Making changes in your life such as eating less can be hard. You can make the changes easier by taking these steps:
                
- Make a plan to change something that you do.  - Decide exactly what you will do and when you will do it.  - Plan what you need to get ready.  - Think about what might prevent you from reaching your goal.  - Find family and friends who will support and encourage you.  - Decide how you will reward yourselfwith a nonfood itemor activitywhen you do what you have planned.
                
Your health care provider, a registered dietitian, or a counselor can help you make a plan.
                
Reach and Maintain a Reasonable Body Weight.
                
Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin correctly. The extra weight may also cause high blood pressure. The DPP study showed that losing even a few pounds can help lower your risk of developing type 2 diabetes, because weight loss helps your body use insulin more effectively. Every pound you lose lowers your risk of getting diabetes. In the DPP, people who lost 5 to 7 percent of their body weight lowered their risk of developing type 2 diabetes. They had less than half the risk of developing diabetes as people who didn't make lifestyle changes. A 5- to 7-percent weight loss for a 150-pound person, for example, would be about 7 to 10 pounds. If you're overweight, choose sensible ways to lose weight.
                
- Don't use crash diets. Instead, eat smaller servings of the foods you usually have, and limit the amount of fat you eat.  - Increase your physical activity. Aim for at least 30 minutes of exercise most days of the week. Do something you enjoy, like biking or walking with a friend.  - Set a reasonable weight-loss goal, such as losing about a pound a week. Aim for a long-term goal of losing the number of pounds that's right for you.
                
Choosing My Weight Loss Goal.
                
Losing 5 to 7 percent of your total weight can help lower your risk of getting type 2 diabetes. You are more likely to lose weight if:
                
- you're physically active   - you cut down on fat and calories  - Use these steps to choose a goal. Talk with your health care provider and your dietitian about your goal and how to reach it.
                
To find your weight loss goal for losing about 5 to 7 percent of your weight, find the weight closest to yours on the chart below. Follow the row across to see how many pounds you need to lose.
                
Your weight in pounds    5 percent loss in pounds*    7 percent loss in pounds**          150    8    11        175    9    12        200    10    14        225    11    16        250    13    18        275    14    19        300    15    21        325    16    23        350    18    25
                
*To find your exact weight loss goal in pounds for a 5 percent loss, multiply your weight by .05.
                
**To find your exact weight loss goal in pounds for a 7 percent loss, multiply your weight by .07.
                
Write your weight loss goal here:
                
To lower my risk of getting type 2 diabetes, my goal is to lose about ___________ pounds.
                
Write down what you will do to lose weight. I will:
                

                

                

                

                

                

                

                

                

                

                

                

                

                

                

                

                

                

                

                

                

                

                

                

                

                

                
Choose a date to start your plan for losing weight and write it here:
                
Start date: ___________________
                
Look ahead to when you think you can meet your goal. Allow about a week for each pound or half-pound you'd like to lose. Write the date for meeting your goal here:
                
End date: ___________________
                
Make Wise Food Choices Most of The Time
                
What you eat has a big impact on your health. By making wise food choices, you can help control your body weight, blood glucose, blood pressure, and cholesterol.
                
- Keep track of what you eat and drink. People who keep track are more successful in losing weight. You can use the Daily Food and Drink Tracker to write down what you eat and drink.   - Take a look at the serving sizes of the foods you eat. Reduce serving sizes of main courses, meat, desserts, and other foods high in fat. Increase the amount of fruits and vegetables at every meal. Below is a chart for choosing sensible serving sizes using your hand as a measuring guide. Because your hand is proportioned to the rest of your body, it can be used to measure a healthy serving size for your body. Remember, the chart is only a guide. Choose your serving sizes and foods wisely.  - Limit your fat intake to about 25 percent of your total calories. Your health care provider or dietitian can help you figure out how many grams of fat to have every day. You can check food labels for fat content. For example, if your food choices add up to about 2,000 calories a day, try to eat no more than 56 grams of fat. See Ways to Lower The Amount of Fat in Your Meals and Snacks.  - Cut down on calories by eating smaller servings and by cutting back on fat. People in the DPP lifestyle change group lowered their daily calorie total by an average of about 450 calories. Your health care provider or dietitian can work with you to develop a meal plan that helps you lose weight.  - Choose healthy commodity foods (items provided by the government to help people consume a nutritious diet), including those lower in fat.  - When you meet your goal, reward yourself with something special, like a new outfit or a movie.
                
Choose Sensible Serving Sizes
                
Amount of food    Types of food    Size of one serving (the same size as:)          3 ounces    meat, chicken, turkey, or fish    the palm of a hand or a deck of cards         1 cup    cooked vegetables salads casseroles or stews, such as chili with beans milk     an average-sized fist         1/2 cup    fruit or fruit juice starchy vegetables, such as potatoes or corn pinto beans and other dried beans rice or noodles cereal     half of an average-sized fist         1 ounce    snack food    one handful         1 Tablespoon    salad dressing    the tip of a thumb         1 teaspoon    margarine    a fingertip
                

                
Ways to Lower The Amount of Fat in Your Meals and Snacks
                
- Choose lower-fat foods. Example: Instead of sunflower seeds (20 grams of fat),  choose pretzels (1 gram).  Savings: 19 grams.    - Use low-fat versions of foods. Example: Instead of regular margarine (5 grams of fat),  use low-fat margarine (2 grams). Savings: 3 grams.    - Use low-fat seasonings. Example: Instead of putting butter and sour cream on your baked potato  (20 grams of fat), have salsa (0 grams). Savings: 20 grams.    - Cook with less fat. Example: Instead of making fried chicken (31 grams of fat),  roast or grill the chicken (9 grams). Savings: 22 grams.
                
Remember that low-fat or fat-free products still contain calories. Be careful about how much you eat. In fact, some low-fat or fat-free products are high in calories. Check the food label
                
Be Physically Active Every Day
                
- Keep track of what you do for exercise and how long you do it. Use the Daily Physical Activity Tracker to keep track of your physical activity.  - Aim for at least 30 minutes of physical activity a day most days of the week.  - Incorporate physical activity into plans with family and friends. Set a good example for your children. Play softball on weekends. Go on a family hike.  - Be active every day. For example, walk to the store, clean the house, or work in the garden, rather than watch TV.
                
Getting Started on a Walking Routine
                
Walking is a great way to be physically active. Before you get started, talk with your health care provider about whether it's OK for you to walk for exercise. Then get comfortable shoes that provide good support. You can use the Daily Physical Activity Tracker to start your routine gradually. Try to walk at least 5 times a week. Build up little by little to 30 minutes a day of brisk walking.
                
My Walking Program
                
Week number    Warm-up time (minutes) Walk slowly    Fast walk time (minutes) Walk briskly    Cool-down time (minutes) Walk slowly    Total (minutes)          1    5    5    5    15        2    5    8    5    18        3    5    11    5    21        4    5    14    5    24        5    5    17    5    27        6    5    20    5    30        7    5    23    5    33        8    5    26    5    36        9+    5    30    5    40
                
Take Your Prescribed Medicines
                

                

                
Daily Food and Drink Tracker
                
Use the Daily Food and Drink Tracker to keep track of everything you eat and drink. Make a copy of the form for each day. Write down the time, the name of the food or drink, and how much you had. For a free booklet with information on fat grams and calories, call the National Diabetes Education Program at 1888693NDEP (18886936337) and request a copy of the Game Plan Fat and Calorie Counter(PDF, 405.05 KB).
                
Sample
                
Daily Food and Drink TrackerDate: _____________
                
Time    Name    Amount    Fat Grams    Calories          8:00 am    oatmeal    1/2 cup    1    80            fat-free milk    1 cup    0    90
                

                
Daily Physical Activity Tracker
                
Use the Daily Physical Activity Tracker to keep track of your physical activity. Make a copy of the form for each day. Write down what you do and for how long.
                
Sample
                
Daily Physical Activity TrackerDate: _____________
                
Type of Activity    Minutes          Walking    20        Gardening    10
                

                
Daily Food and Drink TrackerDate: _____________
                
Time    Name    Amount    Fat Grams    Calories                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                TOTALS        
                
Daily Physical Activity TrackerDate: _____________           Type of Activity     Minutes                                                                                                                                                                                                                                                                                                                                                                                           TOTAL