1957 Judaica JEWISH COOKBOOK Diabetes KOSHER RECIPES Hebrew WIZO Israel DIET

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Seller: judaica-bookstore ✉️ (2,805) 100%, Location: TEL AVIV, IL, Ships to: WORLDWIDE, Item: 285488804054 1957 Judaica JEWISH COOKBOOK Diabetes KOSHER RECIPES Hebrew WIZO Israel DIET. DESCRIPTION :  Up for auction is an UNUSUAL scarce  WIZO Kosher COOK BOOK which was published in ISRAEL in 1957 , Only a few years after the birth of the Israel State , In times of depression , And which in a certain way reflects those exciting years in Israel history . The COOKBOOK is dedicated to DIABETES and offers a detailed useful NUTRITION info and DIABETES ORIENTED DIET as well as NUMEROUS RECEIPTS for DIABETES . This unique COOK BOOK is a  sought after cookbook for Kosher cook books collectors . Original illustrated wrappers . 6.5 x 5" . 70 pp. Illustrated. Numerous Kosher recipes. Hebrew.  Very good condition. Clean  . Tightly bound. ( Pls look at scan for  images  )  Will be sent inside a protective rigid packaging .    PAYMENTS : Payment method accepted : Paypal & All credit cards. SHIPPMENT : SHIPP worldwide via registered airmail is $ 25 . Book will be sent inside a protective packaging. Handling around 5-10 days after payment. 

The Women's International Zionist Organization (WIZO; Hebrew: ויצו, Vitzo‎), is a non-political volunteer organization dedicated to social welfare in all sectors of Israeli society, the advancement of the status of women, and Jewish education in Israel and the Diaspora. WIZO was founded in England in 1920 by Rebecca Sieff, Dr. Vera Weizmann (wife of Israel's first president, Dr. Chaim Weizmann), Edith Eder, Romana Goodman and Henrietta Irwell to provide community services for the residents of Mandate Palestine. WIZO branches opened across Europe but many were closed down in the wake of Nazi occupation and the Holocaust. Branches in Latin America continued to operate during the war. In 1949, after the establishment of the State of Israel, WIZO moved its headquarters to Israel and Sieff became president of the world WIZO organization. In 1966, she was replaced by Rosa Ginossar. Other past presidents include Raya Jaglom and Michal Modai. Among WIZO's early social welfare projects in Mandatory Palestine were the establishment of Tipat Halav well-baby clinics and clothing distribution centers, many still in operation today.[1] WIZO opened the country's first day care center in Tel Aviv in 1926. In 2008, WIZO, together with two other Women's organizations, received the Israel Prize for its lifetime achievements and special contribution to society and the State of Israel.[2][3] Political activity in Israel WIZO formed a party and ran for Knesset in Israel's first elections in 1949, receiving 1.2% of the vote. It won one seat and was represented by Rachel Cohen-Kagan, chairwoman of WIZO at the time. Cohen-Kagan later ran in the fifth Knesset as a member of the Liberal Party (though she was a member of the group that broke away to form the Independent Liberals). Today Today, WIZO runs 170 day care centers in Israel, caring for 14,000 children of working mothers, new immigrants and needy families. The organization also runs summer camps, courses for single-parent families and therapeutic frameworks for children removed from their homes by court order.[4] WIZO is now the largest women's Zionist organization in the world. In 2008, 36 member countries sent delegates to Israel to celebrate the organization's 88th birthday. [5] The current World WIZO president is Helena Glaser.[6] ******** ******** Israeli cuisine (Hebrew: הַמִּטְבָּח הַיִּשְׂרָאֵלִי‎ HaMitbakh HaYisraeli) is a very diverse cuisine consisting of local dishes as well as foods brought to Israel by Jewish immigrants from around the world. Large elements of food by Mizrahi Jews and Arab cuisine such as falafel, shakshouka, couscous, Israeli salad and hummus have become synonymous with Israeli cuisine.One of the local foods considered to be a unique culinary contribution is ptitim, which is often referred to by chefs as "Israeli couscous". Ptitim were invented in the early days of the State of Israel when rice was scarce. Israel's first prime minister, David Ben-Gurion, asked the Osem company to devise a wheat-based substitute.[2] It was appropriately nicknamed "Ben-Gurion's rice". Israel has its own distinct cuisine, the two main currents that can be seen as Israeli Cuisine are the foods originating from the Israeli-Mizrahi culture (Jews originating from the Middle East) and the traditional Jewish foods brought by Jewish immigrants from Europe and the West. Traditional Jewish food is eaten by many, however, like other countries based in western culture, American and European cuisines are largely eaten. Israeli-Mizrahi cuisine (the cuisine of Jews from Asia and North Africa) features grilled meats, puff pastries (sweet and savory), rice dishes, stuffed vegetables, pita breads and salads. There are many similarities to Arab cuisine.Salads - A wide variety of salads, or meze, is often set out on the table before the main course. Hummus adopted from Arab cuisine, tahini (known in Israel as t'hina), matbucha red pepper salad, Moroccan carrot salad, Israeli salad which is a finely diced tomato and cucumber salad and adopted from Arab cuisine, coleslaw and various eggplant salads are common. A liver-flavored eggplant salad invented during the Austerity period is still a popular dish.Spicy dips - Skhug brought to Israel by Yemenite Jews, Harissa brought by Tunisian and North African Jews, and Pilpelchuma brought by Libyan Jews, are different hot sauces made from chili peppers and garlic.Amba - Indian and Iraqi Jews introduced amba, a pickled mango sauce that is spooned over shwarma and felafel.Labneh - adopted from Arab cuisine, A soft white cheese with a slightly sour taste derived from the Arab kitchen.Pita - adopted from Arab cuisine, pita is a soft, round bread that can be halved and stuffed with felafel, salads or various meats. Bits of pita can be torn off and used to scoop up creamy spreads like hummus or eggplant salad. Schnitzel or steak in pita are said to be an Israeli invention. Lafa (an Arabic word, means roll) is a flat pita that is rolled up with a felafel or shwarma filling.Shakshouka - A spicy egg and tomato dish.Fried snacks such as felafel, kibbeh, Moroccan cigars and pastelim (spicy fried pastries) hail from various Middle Eastern countries.Soups - Bean soup and lentil soup are Mizrahi favorites.Pastries - Bourekas brought to Israel by Jews from Turkey and the Balkans are very popular. Malawach and the Jachnun were introduced by the Yemenite Jews.Sandwiches - Sabich is an Iraqi pita sandwich stuffed with eggplant, hard boiled eggs and tahini. Fricassee is a fried roll stuffed with tuna, cooked potatoes and matbucha brought from Tunisia.Grilled meat - Kebab and shashlik are popular, as is the Jerusalem mixed grill.Shwarma Originally from Turkey. Traditionally it was made from lamb.Fish - Fried, grilled and baked fish is often served whole, with the head intact. Hraime (חריימה), fish cooked in hot pepper sauce, is served in many Mizrahi households in honor of Shabbat.Hummus, chips and salad - The most common accompaniments to food served in a pita. The addition of french fries seems to be exclusive to Israel.Mujadara - A popular rice and lentil dish adopted from Arab cuisine, (known in Israel as "mejadra")Desserts - Baklava is a sweet Turkish pastry often served as dessert, along with small cups of Turkish coffee, in Middle Eastern restaurants.Halva - This Turkish sweet, made from techina and sugar, is popular in Israel and used to make original desserts like halva parfait.Black coffee - Sometimes served with hel (cardamom). Many ethnic dishes have been incorporated in Israeli cuisine, brought to Israel by immigrants from those countries. East European dishes include chicken soup, schnitzel and chopped liver, Gefilte fish and Kugel. "Jerusalem Kugel" made with caramelized sugar and spiced with black pepper is a speciality of Ashkenazi Jews in Jerusalem. The first Israeli patisseries were opened by Ashkenazi Jews, who popularized cakes and pastries popular in central Europe, such as sabrina and strudel. Holiday pastries in Israel are the sufganiyah, eaten on Hanukkah, and the hamantashen, eaten on Purim. North African dishes popular in Israel include couscous, mafrum, shakshouka, matbucha, Moroccan cooked carrot salad and chraime (slices of fish cooked in a spicy tomato sauce). Balkan foods incorporated in Israeli cuisine are burekas, yoghurt and taramosalata. Yemenite foods include jachnun, malawach, skhug, saluf and kubane. Iraqi dishes popular in Israel include amba, various types of kubbeh, sambusac, sabich and pickled vegetables (hamutzim, Hebrew: חמוצים‎). Cholent Hamin (also spelled chamin) is a traditional Sabbath dish prepared by Jews all over the world in countless variations. The basic ingredients are meat and beans or rice simmered overnight on a hotplate or placed in a slow oven before lighting the candles on Friday night. Cholent - East European Shabbat stew usually containing chunks of meat, potatoes, barley, and beans. Skhina (or s′hina) - hamin of the Moroccan Jews. Tebit - hamin of chicken and rice of the Iraqi Jews. The laws of the holiday of Passover add further dietary restrictions. Restaurants in Israel have come up with creative alternatives using potato starch and other non-standard ingredients to create pasta, hamburger buns, pizza, and other fast foods in kosher-for-Passover versions. After Passover, the celebration of Mimouna takes place, a tradition brought to Israel from the Jewish communities of North Africa, during which the Mofletta is eaten. Two main Israeli invented snack foods are Bamba and Bissli. Bamba is a soft peanut-flavored snack food and Bisli is crunchy and comes in various flavors, including BBQ, pizza, falafel and onion. Krembo (Hebrew: קרמבו‎) is a chocolate-coated marshmallow treat that is also very popular in Israel. It is sold only in the winter, and is very popular as an alternative to ice-cream.[3] It comes wrapped in colorful aluminum foil, and consists of a round biscuit base covered with a dollop of marshmallow cream coated in chocolate. Milky is a unique dairy pudding and one of the most popular foods in Israel. Shkedei Marak, known as "soup mandel" in English, is another Israeli invention and used very commonly with chicken soup. ******** Kosher foods are those that conform to the rules of Jewish religion. These rules form the main aspect of kashrut, Jewish dietary laws. Reasons for food being non-kosher include the presence of ingredients derived from non-kosher animals or from kosher animals that were not properly slaughtered, a mixture of meat and milk, wine or grape juice (or their derivatives) produced without supervision, the use of produce from Israel that has not been tithed, or even the use of cooking utensils and machinery which had previously been used for non-kosher food.Animal speciesIn Judaism most of the laws of Kashrut pertain to animals. The Torah explicitly states which animals are permitted or forbidden. In regard to birds, the Torah provides no general rule, and instead the Deuteronomic Code and Priestly Code explicitly list the prohibited birds, using names that have uncertain translations; the list seems to mainly consist of birds of prey, fish-eating water-birds, and the bat.By contrast, for water creatures, Leviticus and Deuteronomy both give the general rule that anything residing in the waters (which Leviticus specifies as being the seas and rivers) is ritually clean if it has both fins and scales,[1][2] in contrast to anything residing in the waters with neither fins nor scales,[3][4] which Leviticus calls filthy (Hebrew: sheqets). All flying creeping things were also to be considered ritually unclean, [6][7] according to both Leviticus and Deuteronomy, but unlike Deuteronomy, Leviticus identifies four exceptions; the exceptions are of uncertain translation, but are clearly locusts and similar creatures, and there is a tradition upheld by Jews from Yemen about which animals constitute the kosher locusts.With regard to land beasts (Hebrew:Behemoth), Deuteronomy and Leviticus both state that anything which chews the cud and has a cloven hoof would be ritually clean, but those animals which only chew the cud or only have cloven hooves would be unclean.[8][9] The texts identify four animals in particular as being unclean for this reason - the hare, hyrax, camel, and pig — although the camel both ruminates and has two toes, while the hare and hyrax are coprophages rather than ruminants; the latter issues have been discussed by many, including the recent book on the subject by Rabbi Natan Slifkin[10] Leviticus, but not Deuteronomy, also states that every creeping thing which creeps upon the earth should be considered filthy (Hebrew: sheqets).Animal parts Blood and fat One of the main biblical food laws is the forbidding of eating blood on account of the life [being] in the blood; this ban and reason are listed in the Noahide Laws[, and twice in Leviticus[13][14], as well as by Deuteronomy[15] The Priestly Code also prohibits the eating of fat, if it came from sacrificial land animals (cattle, sheep, and goats), since the fat is the portion of the meat exclusively allocated to Yahweh (by burning it on the altar).[16] The classical rabbis argued that, in a number of cases, the prohibition against consuming blood was impractical, and there should be exceptions; they claimed that consuming the blood which remained on the inside of meat (as opposed to the blood on the surface of it, dripping from it, or housed within the veins), would be permitted, and that the blood of fish and locusts could also be consumed.To comply with this prohibition, a number of preparation techniques became practiced within traditional Judaism. The main technique, known as melihah, involves the meat being soaked in water for about half an hour, which opens pores;[21] after this, the meat is placed on a slanted board or in a wicker basket, and is thickly covered with salt on each side, and left for between twenty minutes and one hour.[22] The salt covering draws blood from the meat by osmosis, and so the salt must be subsequently removed from the meat (usually by trying to shake most of it off, and then washing the meat twice [23]) in order to complete the extraction of the blood.Melihah is not sufficient to extract blood from the liver, lungs, heart, and certain other internal organs, since they naturally contain a high density of blood, and therefore these organs are usually removed before the rest of the meat is salted; roasting on the other hand will usually cause blood to be discharged, and it is therefore the usual treatment given to these organs (if they are to be eaten at all), and it is also an alternative cooking method for the rest of the meat.Thigh meatThe Bible mentions in passing that there was an Israelite tradition of not eating the sinew which shrank upon the hollow of the thigh,[25] but the Talmud interprets this as an explicit prohibition against doing so[26]; the Bible attributes the tradition to the dislocation of the hollow of Jacob's thigh during a wrestle with God, in a biblical narrative set at Penuel.[27] Within Judaism the rule has usually been interpreted as referring to the sciatic nerve, the removal of which is a very time-consuming process demanding a great deal of special training, and is therefore rarely done outside Israel as there is little demand in general populations for kosher meat. The Talmud excludes bird meat from the restriction.[Animal produceIn addition to meat, all other produce of ritually unclean animals, as well as from unhealthy animals, were banned by the Talmudic writers[29]; this included eggs (including fish roe)[30][31][32]) and milk,[33] as well as derived products such as cheese and jelly,[34] but did not include materials merely manufactured or gathered by animals, such as honey (although, in the case of honey from animals other than bees, there was a difference of opinion among the ancient writers.[35][36][37] According to the rabbinical writers, eggs from ritually pure animals would always be prolate ("pointy") at one end and oblate ("rounded") at the other, helping to reduce uncertainty about whether consumption was permitted or not.[38][39][40]Dairy productsThe classical rabbinical writers imply that milk from an animal whose meat is kosher is also kosher. However, as animals are considered non-kosher if they are discovered, after slaughter, to have been diseased, this could make its milk, taken from the animal when it was alive, retro-actively non-kosher. However, by adhering to the principle that the majority case overrules the exception, Jewish tradition continues to regard such milk as kosher, since statistically it is true that most animals producing such milk are kosher; the same principle is not applied to the possibility of consuming meat from an animal which has not been checked for disease. Rabbi Hershel Schachter, a prominent rosh yeshiva at Yeshiva University, has made the bold claim that with modern dairy farm equipment, milk from the minority of non-kosher cows is invariably mixed with that of the majority of kosher cows, thus invalidating the permissibility of consuming milk from a large dairy operation; the Orthodox Union, however, released a statement declaring the milk permissible based on some leniencies.The Shulchan Aruch (Yoreh De’ah 115:1) rules one may consume only "cholov yisroel" (חלב ישראל), or milk produced with a Torah-observant Jewish person present. Lacking proper supervision, one cannot be sure whether the milk came from a kosher animal.[41] Some recent American rabbinical authorities, most notably Rabbi Moshe Feinstein, ruled that the protection provided by cholov yisroel is unnecessary because the regulations imposed on the US milk industry by the USDA are so focused and strict that the milk industry can be trusted to self-regulate (i.e. when they label an item "cow's milk" to not include milk from any other animal). Some Haredi and Modern Orthodox rabbis hold that this leniency cannot be employed and only milk and dairy products with milk-to-bottle supervision may be consumed.The custom arose in Taludic times not to eat dairy after meat, but the length of time needed to elapse differs by community. Dutch Jews wait an hour, probably on the idea that that separation makes clear that the dairy is a separate 'meal'. German Jews wait three hours, and Eastern European Jews typically wait six hours or in some cases into the sixth hour.Breast MilkAlthough human meat is generally assumed to have been among the forbidden foods, the prohibition against produce was not regarded by the rabbinical writers as applying to women's breast milk[42][43][44][45][46]; the only restriction applied to this substance was that it could only be consumed directly from the breasts by children younger than four (or five if the child is ill), and children older than two were only permitted to continue to suckle breasts, if they had not stopped doing so for more than three consecutive days.[47][48][49][50][51] CheeseThe situation of cheese is complicated by the fact that the production of hard cheese usually involves rennet, an enzyme which splits milk into curds and whey. Although rennet can be made from vegetable or microbial sources, most forms are derived from the stomach linings of animals, and therefore could potentially be non-kosher. Only rennet made from the stomachs of kosher-animals, if they have been slaughtered according to the laws of kashrut, is kosher. If a kosher animal is not slaughtered according to the halakha, the rennet is not kosher. Rennet is not considered a meat product and does not violate the prohibition of mixing meat and dairy.Jacob ben Meir, one of the most prominent medieval rabbis, championed the viewpoint that all cheese was kosher, a standpoint which was practised in communities in Narbonne and Italy. Contemporary Orthodox authorities do not follow this ruling, and hold that cheese requires formal kashrut certification to be kosher, some even arguing that this is necessary for cheese made with non-animal rennet. In practice, Orthodox Jews, and some Conservative Jews who observe the kashrut laws, only eat cheese if they are certain that the rennet itself was kosher.GelatinGelatin is also a product with complicated implications for Orthodox Jews. Gelatin is hydrolysed collagen, the main protein in animal connective tissue, and therefore could potentially come from a non-kosher source, such as pig bones. Gelatin has historically been a prominent source of glue, finding uses from musical instruments to embroidery, one of the main historic emulsions used in cosmetics and in photographic film, the main coating given to medical capsule pills, and a form of food including jelly, trifle, and marshmallows; the status of gelatin in kashrut is consequently fairly controversial.Due to the ambiguity over the source of individual items derived from gelatin, many Orthodox rabbis regard it as generally being non-kosher. However, Conservative rabbis[52] and several prominent Orthodox rabbis, including Ovadia Yosef — the former Sephardic Chief Rabbi of Israel — argue that gelatin has undergone such total chemical change and processing that it should not count as meat, and therefore would be kosher[53]; technically, gelatin is just produced by separating the three strands in each collagen fibre's triple helix, an action performed simply by boiling collagen in water.One of the main methods of avoiding non-kosher gelatin is to substitute gelatin-like materials in its place; substances with a similar chemical behaviour include food starch from tapioca, chemically modified pectins, and carrageenan combined with certain vegetable gums — guar gum, locust bean gum, xanthan gum, gum acacia, agar, and others. Although gelatin is used for several purposes by a wide variety of manufacturers, it has started to be replaced with these substitutes in a number of products, due to the use of gelatin also being a significant concern to vegans.Production methodsSlaughterOf the rules appearing, in two groups, in exodus, most do not express dietary laws, but one of the few dietary rules it does list is a ban on eating the meat from animals which have been torn by beasts;[54] a related law appears in Deuteronomy's law code, totally prohibiting the consumption of anything that has died from natural causes, and even giving away or selling such things.[55] The Book of Ezekiel infers[56] that the rules about animals which die of natural causes, or are torn by beasts, were only adhered to by the priests,[57] and were only intended for them;[58] the implication that they did not apply to, and were not upheld by, ordinary Israelites was noticed by the classical rabbis, who declared that the prophet Elijah shall some day explain this problematic passage.[59]Since the Bible prohibits eating meat from animals dying from natural causes, and all animals killed by beasts, traditional Jewish thought has expressed the view that all meat must come from animals which have been slaughtered according to Jewish law. These strict guidelines require that the animal is killed by a single cut across the throat to a precise depth, severing both carotid arteries, both jugular veins, both vagus nerves, the trachea and the esophagus, no higher than the epiglottis and no lower than where cilia begin inside the trachea, causing the animal to bleed to death. Orthodox Jews argue that this ensures the animal dies instantly without unnecessary suffering, but many animal rights activists view the process as cruel, arguing that the animal may not lose consciousness immediately, and activists have called for it to be banned.[60][61]To avoid tearing, and to ensure the cut is thorough, such slaughter is usually performed by a trained individual, with a large razor-sharp knife, which is checked before each killing to ensure that it has no irregularities (such as nicks and dents); if irregularities are discovered, or the cut is too shallow, the meat is deemed not kosher, and is sold to the non-Jewish public. Rabbis usually require the slaughterer, known within Judaism as a shochet, to also be a pious Jew of good character, who observes the Shabbat, and believes that the slaughter victims are sacrificing their lives for the good of the slaughterer and their community. In smaller communities the shochet was often the town rabbi, or a rabbi from a local synagogue, but large slaughterhouses usually employ a full-time shochet if they intend to sell kosher meat.The Talmud, and later Jewish authorities, also prohibit the consumption of meat from animals who were slaughtered despite being in the process of dying from disease; but this is not based on concern for the health of the eater, instead being an extension of the rules banning the meat from animals torn by beasts, and animals who die from natural causes.[62][63][64] To comply with this Talmudic injunction against eating diseased animals, Orthodox Jews usually require that the corpses of freshly slaughtered animals are thoroughly inspected. There are 70 different traditional checks for irregularities and growths; for example, there are checks to ensure that the lungs have absolutely no scars, which might have been caused by an inflammation, and if this check is passed then the meat is termed glatt, literally meaning smooth.Compromises in countries with animal cruelty laws that prohibit such practices involve stunning the animal to lessen the suffering that occurs while the animal bleeds to death. However, the use of electric shocks to daze the animal is often not accepted by some markets as producing meat which is kosher.[60]Dead animalsThe Talmud prohibits the consumption of animals which are still alive.[65] The consumption of eggs which have started to hatch was regarded as falling under the ban on eating parts of live animals; the Yoreh De'ah argues that if there is blood in the yolk then hatching must have begun, and therefore consumption of the egg would be forbidden.[66]Modern Orthodox Jews adhere to these requirements, but although the Ashkenazi Orthodox Jews treat an egg as non-kosher if blood is found anywhere within it[citation needed], the Sephardi Orthodox Jews only consider blood in the yolk to be a problem; the Sephardi treat eggs with blood in the albumen as legitimate food, if the blood is removed before use.Seething a kid in its mother's milkThree times the Torah specifically forbids seething a young goat in its mother's milk (Exodus 23:19, Exodus 34:26, and Deuteronomy 14:21). The Talmud interprets this as a general prohibition against cooking meat and dairy products together, and against eating such a mixture. To help prevent accidental violation of these rules, the modern standard Orthodox practice is to classify food into either being meat, dairy, or neither; the latter category is more usually referred to as parve from the Yiddish word parev (פארעוו) (also spelled "pareve") meaning neutral. As the biblical prohibition specifically refers to (young) goats, the flesh of mammals is logically categorised as meat, while that of fish is considered parve; however, rather than being considered parve, the flesh of birds is regarded by Modern halakha (Jewish law) as meat, though only by Rabbinic decree.Involvement by non-JewsThe classical rabbis prohibited any item of food that had been consecrated to an idol, or had been used in the service of an idol;[67] since the Talmud views all non-Jews as idolaters, and viewed intermarriage with apprehension, it included within this prohibition any food which has been cooked/prepared completely by non-Jews.[68][69] However, bread sold by a non-Jewish baker was not included in the prohibition;[68][69] similarly, a number of Jewish writers believed that food prepared on behalf of Jews, by non-Jewish servants, would not count as idolatry, although this view was opposed by Jacob ben Asher.[70]Consequently, modern Orthodox Jews generally believe that wine, cheese, certain cooked foods, and sometimes even dairy products[71][72][73], should only be prepared by Jews. The prohibition against drinking non-Jewish wine, traditionally called yayin nesekh (literally meaning wine for offering [to a deity]), is not absolute. Cooked wine (Hebrew: yayin mevushal), meaning wine which has been heated, is regarded as drinkable on the basis that heated wine was not historically used as a religious libation; thus kosher wine includes mulled wine, and pasteurised wine, regardless of producer, but Orthodox Judaism only regards other forms of wine as kosher if prepared by a Jew.Some Jews refer to these prohibited foods as akum, an acronym of Obhde Kokhabkim U Mazzaloth, meaning worshippers of stars and planets; akum is thus a reference to activities which these Jews view as idolatry, and in many significant works of post-classical Jewish literature, such as the Shulchan Aruch, it has been applied to Christians in particular. However, among the classical rabbis, there were a number who refused to treat Christians as idolaters, and consequently regarded food which had been manufactured by them as being kosher; this detail has been noted and upheld by a number of religious authorities in Conservative Judaism, such as Rabbi Israel Silverman, and Rabbi Elliot N. Dorff.Conservative Judaism is more lenient; in the 1960s, Rabbi Israel Silverman issued a responsum, officially approved by the Committee on Jewish Law and Standards, in which he argued that wine manufactured by an automated process was not manufactured by gentiles, and therefore would be kosher. A later responsum of Conservative Judaism was issued by Rabbi Elliott Dorff, who argued, based on precedents in 15th-19th century responsa, that many foods, such as wheat and oil products, which had once been forbidden when produced by non-Jews, were eventually declared kosher; on this basis he concluded that wine and grape products produced by non-Jews would be permissible.Harmful foodKnown poisonsFor obvious reasons, the Talmud adds to the biblical regulations a prohibition against consuming poisoned animals.[74] Similarly the Yoreh De'ah prohibits the drinking of water, if the water had been left overnight and uncovered in an area where there might be serpents, on the basis that a serpent might have left its venom in the water.[75]Fish and meat, togetherA concern for the health of the eater is also behind the instigation, by the Talmud and Yoreh Deah, to never eat or cook fish with meat, and instead ensure that the mouth is washed between consuming fish and consuming meat; these texts explain that the prohibition is for the purpose of avoiding tzaraat (or tzaraas) – a disease which the texts suggest would be caused by eating meat and fish together.[76][77] Tzaraat was a bodily affliction that is often translated loosely as leprosy; this translation can prove problematic because, in the scientific realm, leprosy is caused by a parasitic species of bacterium Mycobacterium leprae, and has no other instigation, such as eating fish and meat together. Those who take on stricter observances, such as Modern Orthodox Jews, continue to follow this ban,[78][79] while other denominations, such as Conservative Jews may or may not.[80]The Book of Genesis implies that there were no restrictions on any fruit, cereal, nuts, or other vegetable matter growing upon the earth.[81] However, Leviticus forbids the consumption of fruit from trees which are less than three years old,[82] and the eating of any grain which is too young to have been ready for harvest before the previous Passover[83]; the latter rule is known as Yoshon, roughly meaning old, and the former is known as Orlah, meaning foreskin, due to the biblical instruction that young trees should metaphorically be considered to be uncircumcised.[84] A related biblical rule argues that the first of the first fruits should be brought to sanctuaries[85].Orthodox Jews generally adhere to these rules, but only for the produce of Israel, to which they believe it exclusively applies. Most Orthodox Jews also adhere to Joseph Caro's view that agricultural produce would not be non-kosher if the Levite Tithe has not been exacted from it, nor if it has been harvested during a Sabbatical Year.[86]All fresh fruits and vegetables are kosher in principle. Jewish law requires that they be carefully checked and cleaned to make sure that there are no insects on them, as insects are not kosher (except certain grasshoppers and crickets according to the Jews of Yemen only, see main article). The Orthodox community is particular not to consume produce which may have insect infestation, and check and wash certain forms of produce very carefully. Many Orthodox Jews avoid certain vegetables, such as broccoli, because they may be infested and exceedingly hard to clean. Some kashrut certifying organizations completely recommend against consumption of certain vegetables they deem impossible to clean.According to the U.S. Dept. of Agriculture, commercially it is not possible to remove all insects, and a sizable amount remain. Responding to this issue, some companies now sell thoroughly washed and inspected produce for those who do not wish to do it themselves, even going to the trouble of filtering the wash water to ensure that it carries no microscopic creatures [see discussion of such animals in tap water, above]. These may or may not meet rabbinical standards for being insect-free.Processed itemsProcessed items (e.g. dry cereals, baked goods, canned fruits and vegetables, frozen vegetables, and [dried fruit such as raisins) can also include small quantities of non-kosher ingredients. This is because these items are often cooked and processed in factories using equipment that is also used for non-kosher foods, may involve containers used for processing that have been greased with animal fats. Sometimes additives are introduced, and fruits or vegetables may have been prepared with milk products or with ingredients such as non-kosher meat broths.For these reasons, Orthodox rabbis advise against consuming such products without a hechsher (mark of rabbinical certification of kashrut) being on the product. By contrast, some Conservative rabbis regard a careful reading of the ingredients to be a sufficient precaution. However, certain processed foods are usually regarded (by most Jews) as being an exception: plain tea, salt, 100% cocoa, carbonated water, some frozen fruits, including berries, and coffee, have only very basic processing from their natural state; these fruits are often frozen in their natural form and then bagged, while carbonated water is generally the addition of carbon dioxide to natural water.Passover restrictionsDuring Passover, there are additional food restrictions in Orthodox Judaism; in this branch of Judaism, leavened products are prohibited during the festival. Jews who are concerned about accidentally consuming leavened food, during passover, typically maintain an entirely separate set of crockery and cutlery for Passover; it is also common for those concerned about such things to rigorously clean their homes, to ensure that even the tiniest of remains of leavened products are removed. Some Jews even have a separate kitchen exclusively for use during Passover.Products made from the traditional five species of grain, which might have been inadvertently moistened after harvest, and thus begun to ferment (an aspect of the leavening process), are regarded by Orthodox Jews as prohibited during Passover; the five species are conventionally viewed to be wheat, rye, barley, spelt and oats, although the latter two may actually refer to emmer (sometimes confused with spelt, which did not historically grow in the Middle East) and two-rowed barley.Among the Ashkenazi Jews there is an additional customary practice of avoiding the consumption of kitniyot (literally meaning little things) during Passover; the list of items regarded as kitniyot varies between communities, and can include things such as rice, legumes (including peas, peanuts, and beans), and corn. Due to the prevalence of corn syrup in certain well-known processed foods, such as Coca-Cola, many items common in western countries are regarded as impermissible by Ashkenazic Jews during Passover. [For Passover consumption, some companies produce products similar to their standard versions but with Kosher-for-Passover ingredients. Coca-Cola, for example, produces and distributes kosher for Passover Coke, made with cane sugar instead of corn syrup, in the U.S. during Passover since Rabbi Tobias Geffen certified Coca-Cola as kosher 1935 *** Diabetes mellitus (DM), commonly known as diabetes, is a group of metabolic disorders characterized by high blood sugar levels over a prolonged period.[10] Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger.[2] If left untreated, diabetes can cause many complications.[2] Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death.[3] Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.[2] Diabetes is due to either the pancreas not producing enough insulin, or the cells of the body not responding properly to the insulin produced.[11] There are three main types of diabetes mellitus:[2] Type 1 diabetes results from the pancreas's failure to produce enough insulin due to loss of beta cells.[2] This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes".[2] The cause is unknown.[2] Type 2 diabetes begins with insulin resistance, a condition in which cells fail to respond to insulin properly.[2] As the disease progresses, a lack of insulin may also develop.[12] This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes".[2] The most common cause is a combination of excessive body weight and insufficient exercise.[2] Gestational diabetes is the third main form, and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.[2] Prevention and treatment involve maintaining a healthy diet, regular physical exercise, a normal body weight, and avoiding use of tobacco.[2] Control of blood pressure and maintaining proper foot care are important for people with the disease.[2] Type 1 diabetes must be managed with insulin injections.[2] Type 2 diabetes may be treated with medications with or without insulin.[13] Insulin and some oral medications can cause low blood sugar.[14] Weight loss surgery in those with obesity is sometimes an effective measure in those with type 2 diabetes.[15] Gestational diabetes usually resolves after the birth of the baby.[16] As of 2017, an estimated 425 million people had diabetes worldwide,[9] with type 2 diabetes making up about 90% of the cases.[17][18] This represents 8.8% of the adult population,[9] with equal rates in both women and men.[19] Trend suggests that rates will continue to rise.[9] Diabetes at least doubles a person's risk of early death.[2] In 2017, diabetes resulted in approximately 3.2 to 5.0 million deaths.[9] The global economic cost of diabetes related health expenditure in 2017 was estimated at US$727 billion.[9] In the United States, diabetes cost nearly US$245 billion in 2012.[20] Average medical expenditures among people with diabetes are about 2.3 times higher.[21] Contents 1 Signs and symptoms 1.1 Diabetic emergencies 1.2 Complications 2 Causes 2.1 Type 1 2.2 Type 2 2.3 Gestational diabetes 2.4 Other types 3 Pathophysiology 4 Diagnosis 5 Prevention 6 Management 6.1 Lifestyle 6.2 Medications 6.3 Surgery 6.4 Support 7 Epidemiology 8 History 8.1 Etymology 9 Society and culture 9.1 Naming 10 Other animals 11 Research 11.1 Major clinical trials 12 References 13 External links Signs and symptoms Overview of the most significant symptoms of diabetes The classic symptoms of untreated diabetes are unintended weight loss, polyuria (increased urination), polydipsia (increased thirst), and polyphagia (increased hunger).[22] Symptoms may develop rapidly (weeks or months) in type 1 diabetes, while they usually develop much more slowly and may be subtle or absent in type 2 diabetes. Other symptoms of diabetes mellitus include weight loss and tiredness.[23] Several other signs and symptoms can mark the onset of diabetes although they are not specific to the disease. In addition to the known ones above, they include blurred vision, headache, fatigue, slow healing of cuts, and itchy skin. Prolonged high blood glucose can cause glucose absorption in the lens of the eye, which leads to changes in its shape, resulting in vision changes. Long-term vision loss can also be caused by diabetic retinopathy. A number of skin rashes that can occur in diabetes are collectively known as diabetic dermadromes.[24] Diabetic emergencies People (usually with type 1 diabetes) may also experience episodes of diabetic ketoacidosis (DKA), a metabolic disturbance characterized by nausea, vomiting and abdominal pain, the smell of acetone on the breath, deep breathing known as Kussmaul breathing, and in severe cases a decreased level of consciousness.[25] A rare but equally severe possibility is hyperosmolar hyperglycemic state (HHS), which is more common in type 2 diabetes and is mainly the result of dehydration.[25] Treatment-related low blood sugar (hypoglycemia) is common in people with type 1 and also type 2 diabetes depending on the medication being used. Most cases are mild and are not considered medical emergencies. Effects can range from feelings of unease, sweating, trembling, and increased appetite in mild cases to more serious effects such as confusion, changes in behavior such as aggressiveness, seizures, unconsciousness, and (rarely) permanent brain damage or death in severe cases.[26][27] rapid breathing and sweating, cold, pale skin are characteristic of low blood sugar but not definitive.[28][unreliable medical source?] Mild to moderate cases are self-treated by eating or drinking something high in sugar. Severe cases can lead to unconsciousness and must be treated with intravenous glucose or injections with glucagon.[29][unreliable medical source?] Complications Main article: Complications of diabetes mellitus Retinopathy, nephropathy, and neuropathy are potential complications of diabetes All forms of diabetes increase the risk of long-term complications. These typically develop after many years (10–20) but may be the first symptom in those who have otherwise not received a diagnosis before that time. The major long-term complications relate to damage to blood vessels. Diabetes doubles the risk of cardiovascular disease[30]and about 75% of deaths in people with diabetes are due to coronary artery disease.[31] Other macrovascular diseasesinclude stroke, and peripheral artery disease. The primary complications of diabetes due to damage in small blood vessels include damage to the eyes, kidneys, and nerves.[32] Damage to the eyes, known as diabetic retinopathy, is caused by damage to the blood vessels in the retina of the eye, and can result in gradual vision loss and eventual blindness.[32] Diabetes also increases the risk of having glaucoma, cataracts, and other eye problems. It is recommended that diabetics visit an eye doctor once a year.[33] Damage to the kidneys, known as diabetic nephropathy, can lead to tissue scarring, urine protein loss, and eventually chronic kidney disease, sometimes requiring dialysis or kidney transplantation.[32] Damage to the nerves of the body, known as diabetic neuropathy, is the most common complication of diabetes.[32] The symptoms can include numbness, tingling, pain, and altered pain sensation, which can lead to damage to the skin. Diabetes-related foot problems (such as diabetic foot ulcers) may occur, and can be difficult to treat, occasionally requiring amputation. Additionally, proximal diabetic neuropathycauses painful muscle atrophy and weakness. There is a link between cognitive deficit and diabetes. Compared to those without diabetes, those with the disease have a 1.2 to 1.5-fold greater rate of decline in cognitive function.[34] Being diabetic, especially when on insulin, increases the risk of falls in older people.[35] Causes Comparison of type 1 and 2 diabetes[17] Feature Type 1 diabetes Type 2 diabetes Onset Sudden Gradual Age at onset Mostly in children Mostly in adults Body size Thin or normal[36] Often obese Ketoacidosis Common Rare Autoantibodies Usually present Absent Endogenous insulin Low or absent Normal, decreased or increased Concordance  in identical twins 50% 90% Prevalence ~10% ~90% Diabetes mellitus is classified into four broad categories: type 1, type 2, gestational diabetes, and "other specific types".[11] The "other specific types" are a collection of a few dozen individual causes.[11] Diabetes is a more variable disease than once thought and people may have combinations of forms.[37] The term "diabetes", without qualification, usually refers to diabetes mellitus. Type 1 Main article: Type 1 diabetes Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta cells of the pancreatic islets, leading to insulin deficiency. This type can be further classified as immune-mediated or idiopathic. The majority of type 1 diabetes is of the immune-mediated nature, in which a T cell-mediated autoimmune attack leads to the loss of beta cells and thus insulin.[38] It causes approximately 10% of diabetes mellitus cases in North America and Europe. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages. Although it has been called "juvenile diabetes" due to the frequent onset in children, the majority of individuals living with type 1 diabetes are now adults.[39] "Brittle" diabetes, also known as unstable diabetes or labile diabetes, is a term that was traditionally used to describe the dramatic and recurrent swings in glucoselevels, often occurring for no apparent reason in insulin-dependent diabetes. This term, however, has no biologic basis and should not be used.[40] Still, type 1 diabetes can be accompanied by irregular and unpredictable high blood sugar levels, frequently with ketosis, and sometimes with serious low blood sugar levels. Other complications include an impaired counterregulatory response to low blood sugar, infection, gastroparesis (which leads to erratic absorption of dietary carbohydrates), and endocrinopathies (e.g., Addison's disease).[40] These phenomena are believed to occur no more frequently than in 1% to 2% of persons with type 1 diabetes.[41] Autoimmune attack in type 1 diabetes. Type 1 diabetes is partly inherited, with multiple genes, including certain HLA genotypes, known to influence the risk of diabetes. In genetically susceptible people, the onset of diabetes can be triggered by one or more environmental factors,[42]such as a viral infection or diet. Several viruses have been implicated, but to date there is no stringent evidence to support this hypothesis in humans.[42][43] Among dietary factors, data suggest that gliadin (a protein present in gluten) may play a role in the development of type 1 diabetes, but the mechanism is not fully understood.[44][45] Type 1 diabetes can occur at any age, and a significant proportion is diagnosed during adulthood. Latent autoimmune diabetes of adults (LADA) is the diagnostic term applied when type 1 diabetes develops in adults; it has a slower onset than the same condition in children. Given this difference, some use the unofficial term "type 1.5 diabetes" for this condition. Adults with LADA are frequently initially misdiagnosed as having type 2 diabetes, based on age rather than cause[46] Type 2 Main article: Type 2 diabetes Reduced insulin secretion and absorption leads to high glucose content in the blood. Type 2 diabetes is characterized by insulin resistance, which may be combined with relatively reduced insulin secretion.[11]The defective responsiveness of body tissues to insulin is believed to involve the insulin receptor. However, the specific defects are not known. Diabetes mellitus cases due to a known defect are classified separately. Type 2 diabetes is the most common type of diabetes mellitus.[2] Many people with type 2 diabetes have evidence of "prediabetes" (impaired fasting glucose and/or impaired glucose tolerance) for many years before meeting the criteria for type 2 diabetes.[citation needed]Prediabetes and easy overt type 2 diabetes can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce the liver's glucose production.[citation needed] Type 2 diabetes is primarily due to lifestyle factors and genetics.[47] A number of lifestyle factors are known to be important to the development of type 2 diabetes, including obesity (defined by a body mass index of greater than 30), lack of physical activity, poor diet, stress, and urbanization.[17] Excess body fat is associated with 30% of cases in those of Chinese and Japanese descent, 60–80% of cases in those of European and African descent, and 100% of Pima Indians and Pacific Islanders.[11] Even those who are not obese often have a high waist–hip ratio.[11] Dietary factors also influence the risk of developing type 2 diabetes. Consumption of sugar-sweetened drinks in excess is associated with an increased risk.[48][49]The type of fats in the diet is also important, with saturated fat and trans fats increasing the risk and polyunsaturated and monounsaturated fat decreasing the risk.[47]Eating lots of white rice, and other starches, also may increase the risk of diabetes.[50] A lack of physical activity is believed to cause 7% of cases.[51] Gestational diabetes Main article: Gestational diabetes Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 2–10% of all pregnancies and may improve or disappear after delivery.[52] However, after pregnancy approximately 5–10% of women with GDM are found to have DM, most commonly type 2.[52] GDM is fully treatable, but requires careful medical supervision throughout the pregnancy. Management may include dietary changes, blood glucose monitoring, and in some cases, insulin may be required[53] Though it may be transient, untreated GDM can damage the health of the fetus or mother. Risks to the baby include macrosomia (high birth weight), congenital heartand central nervous system abnormalities, and skeletal muscle malformations. Increased levels of insulin in a fetus's blood may inhibit fetal surfactant production and cause infant respiratory distress syndrome. A high blood bilirubin level may result from red blood cell destruction. In severe cases, perinatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment. Labor induction may be indicated with decreased placental function. A caesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia.[54] Other types Maturity onset diabetes of the young (MODY) is a rare autosomal dominant inherited form of diabetes, due to one of several single-gene mutations causing defects in insulin production.[55] It is significantly less common than the three main types, constituting 1-2% of all cases. The name of this disease refers to early hypotheses as to its nature. Being due to a defective gene, this disease varies in age at presentation and in severity according to the specific gene defect; thus there are at least 13 subtypes of MODY. People with MODY often can control it without using insulin.[56] Some cases of diabetes are caused by the body's tissue receptors not responding to insulin (even when insulin levels are normal, which is what separates it from type 2 diabetes); this form is very uncommon. Genetic mutations (autosomal or mitochondrial) can lead to defects in beta cell function. Abnormal insulin action may also have been genetically determined in some cases. Any disease that causes extensive damage to the pancreas may lead to diabetes (for example, chronic pancreatitis and cystic fibrosis). Diseases associated with excessive secretion of insulin-antagonistic hormones can cause diabetes (which is typically resolved once the hormone excess is removed). Many drugs impair insulin secretion and some toxins damage pancreatic beta cells, whereas others increase insulin resistance (especially glucocorticoids which can provoke "steroid diabetes"). The ICD-10 (1992) diagnostic entity, malnutrition-related diabetes mellitus (MRDM or MMDM, ICD-10 code E12), was deprecated by the World Health Organization (WHO) when the current taxonomy was introduced in 1999.[57] The following is a comprehensive list of other causes of diabetes:[58] Genetic defects of β-cell function Maturity onset diabetes of the young Mitochondrial DNA mutations Genetic defects in insulin processing or insulin action Defects in proinsulin conversion Insulin gene mutations Insulin receptor mutations Exocrine pancreatic defects Chronic pancreatitis Pancreatectomy Pancreatic neoplasia Cystic fibrosis Hemochromatosis Fibrocalculous pancreatopathy Endocrinopathies Growth hormone excess (acromegaly) Cushing syndrome Hyperthyroidism Hypothyroidism Pheochromocytoma Glucagonoma Infections Cytomegalovirus infection Coxsackievirus B Drugs Glucocorticoids Thyroid hormone β-adrenergic agonists Statins[59] Type 3 diabetes is a name used by some researchers for Alzheimer's disease, as there is evidence that insulin resistance in the brain plays a role in the latter. It is not formally recognised as a form of diabetes.[60] Pathophysiology The fluctuation of blood sugar (red) and the sugar-lowering hormone insulin (blue) in humans during the course of a day with three meals. One of the effects of a sugar-rich vs a starch-rich meal is highlighted. Mechanism of insulin release in normal pancreatic beta cells. Insulin production is more or less constant within the beta cells. Its release is triggered by food, chiefly food containing absorbable glucose. Insulin is the principal hormone that regulates the uptake of glucose from the blood into most cells of the body, especially liver, adipose tissue and muscle, except smooth muscle, in which insulin acts via the IGF-1. Therefore, deficiency of insulin or the insensitivity of its receptors play a central role in all forms of diabetes mellitus.[61] The body obtains glucose from three main sources: the intestinal absorption of food; the breakdown of glycogen (glycogenolysis), the storage form of glucose found in the liver; and gluconeogenesis, the generation of glucose from non-carbohydrate substrates in the body.[62] Insulin plays a critical role in balancing glucose levels in the body. Insulin can inhibit the breakdown of glycogen or the process of gluconeogenesis, it can stimulate the transport of glucose into fat and muscle cells, and it can stimulate the storage of glucose in the form of glycogen.[62] Insulin is released into the blood by beta cells (β-cells), found in the islets of Langerhans in the pancreas, in response to rising levels of blood glucose, typically after eating. Insulin is used by about two-thirds of the body's cells to absorb glucose from the blood for use as fuel, for conversion to other needed molecules, or for storage. Lower glucose levels result in decreased insulin release from the beta cells and in the breakdown of glycogen to glucose. This process is mainly controlled by the hormone glucagon, which acts in the opposite manner to insulin.[63] If the amount of insulin available is insufficient, or if cells respond poorly to the effects of insulin (insulin insensitivity or insulin resistance), or if the insulin itself is defective, then glucose is not absorbed properly by the body cells that require it, and is not stored appropriately in the liver and muscles. The net effect is persistently high levels of blood glucose, poor protein synthesis, and other metabolic derangements, such as acidosis.[62] When glucose concentration in the blood remains high over time, the kidneys reach a threshold of reabsorption, and the body excretes glucose in the urine (glycosuria).[64] This increases the osmotic pressureof the urine and inhibits reabsorption of water by the kidney, resulting in increased urine production (polyuria) and increased fluid loss. Lost blood volume is replaced osmotically from water in body cells and other body compartments, causing dehydration and increased thirst (polydipsia).[62] In addition, intracellular glucose deficiency stimulates appetite leading to excessive food intake (polyphagia).[65] Diagnosis See also: Glycated hemoglobin and Glucose tolerance test WHO diabetes diagnostic criteria[66][67]  edit Condition 2-hour glucose Fasting glucose HbA1c Unit mmol/l(mg/dl) mmol/l(mg/dl) mmol/mol DCCT % Normal <7.8 (<140) <6.1 (<110) <42 <6.0 Impaired fasting glycaemia <7.8 (<140) ≥6.1(≥110) & <7.0(<126) 42-46 6.0–6.4 Impaired glucose tolerance ≥7.8 (≥140) <7.0 (<126) 42-46 6.0–6.4 Diabetes mellitus ≥11.1 (≥200) ≥7.0 (≥126) ≥48 ≥6.5 Diabetes mellitus is characterized by recurrent or persistent high blood sugar, and is diagnosed by demonstrating any one of the following:[57] Fasting plasma glucose level ≥ 7.0 mmol/l (126 mg/dl) Plasma glucose ≥ 11.1 mmol/l (200 mg/dl) two hours after a 75 gram oral glucose load as in a glucose tolerance test (OGTT) Symptoms of high blood sugar and casual plasma glucose ≥ 11.1 mmol/l (200 mg/dl) Glycated hemoglobin (HbA1C) ≥ 48 mmol/mol (≥ 6.5 DCCT %).[68] A positive result, in the absence of unequivocal high blood sugar, should be confirmed by a repeat of any of the above methods on a different day. It is preferable to measure a fasting glucose level because of the ease of measurement and the considerable time commitment of formal glucose tolerance testing, which takes two hours to complete and offers no prognostic advantage over the fasting test.[69] According to the current definition, two fasting glucose measurements above 7.0 mmol/l (126 mg/dl) is considered diagnostic for diabetes mellitus. Per the WHO, people with fasting glucose levels from 6.1 to 6.9 mmol/l (110 to 125 mg/dl) are considered to have impaired fasting glucose.[70] people with plasma glucose at or above 7.8 mmol/l (140 mg/dl), but not over 11.1 mmol/l (200 mg/dl), two hours after a 75 gram oral glucose load are considered to have impaired glucose tolerance. Of these two prediabetic states, the latter in particular is a major risk factor for progression to full-blown diabetes mellitus, as well as cardiovascular disease.[71] The American Diabetes Association (ADA) since 2003 uses a slightly different range for impaired fasting glucose of 5.6 to 6.9 mmol/l (100 to 125 mg/dl).[72] Glycated hemoglobin is better than fasting glucose for determining risks of cardiovascular disease and death from any cause.[73] Prevention See also: Prevention of type 2 diabetes There is no known preventive measure for type 1 diabetes.[2] Type 2 diabetes—which accounts for 85–90% of all cases worldwide—can often be prevented or delayed by maintaining a normal body weight, engaging in physical activity, and eating a healthy diet.[2] Higher levels of physical activity (more than 90 minutes per day) reduce the risk of diabetes by 28%.[74] Dietary changes known to be effective in helping to prevent diabetes include maintaining a diet rich in whole grains and fiber, and choosing good fats, such as the polyunsaturated fats found in nuts, vegetable oils, and fish.[75] Limiting sugary beverages and eating less red meat and other sources of saturated fat can also help prevent diabetes.[75] Tobacco smoking is also associated with an increased risk of diabetes and its complications, so smoking cessation can be an important preventive measure as well.[76] The relationship between type 2 diabetes and the main modifiable risk factors (excess weight, unhealthy diet, physical inactivity and tobacco use) is similar in all regions of the world. There is growing evidence that the underlying determinants of diabetes are a reflection of the major forces driving social, economic and cultural change: globalization, urbanization, population aging, and the general health policy environment.[77] Management Main article: Diabetes management Overview of the management of diabetes Diabetes mellitus is a chronic disease, for which there is no known cure except in very specific situations.[78] Management concentrates on keeping blood sugar levels as close to normal, without causing low blood sugar. This can usually be accomplished with a healthy diet, exercise, weight loss, and use of appropriate medications (insulin in the case of type 1 diabetes; oral medications, as well as possibly insulin, in type 2 diabetes). Learning about the disease and actively participating in the treatment is important, since complications are far less common and less severe in people who have well-managed blood sugar levels.[79][80] The goal of treatment is an HbA1C level of 6.5%, but should not be lower than that, and may be set higher.[81] Attention is also paid to other health problems that may accelerate the negative effects of diabetes. These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise.[81] Specialized footwear is widely used to reduce the risk of ulceration, or re-ulceration, in at-risk diabetic feet. Evidence for the efficacy of this remains equivocal, however.[82] Lifestyle See also: Diabetic diet People with diabetes can benefit from education about the disease and treatment, good nutrition to achieve a normal body weight, and exercise, with the goal of keeping both short-term and long-term blood glucose levels within acceptable bounds. In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications are recommended to control blood pressure.[83][84] No single dietary pattern is best for all people with diabetes. For overweight people with type 2 diabetes, any diet that achieves weight loss is effective.[85][86] Medications Glucose control See also: Anti-diabetic medication Medications used to treat diabetes do so by lowering blood sugar levels. There is broad consensus that when people with diabetes maintain tight glucose control (also called "tight glycemic control") – keeping the glucose levels in their blood within normal ranges – that they experience fewer complications like kidney problemsand eye problems.[87][88] There is however debate as to whether this is cost effective for people later in life.[89] There are a number of different classes of anti-diabetic medications. Some are available by mouth, such as metformin, while others are only available by injection such as GLP-1 agonists. Type 1 diabetes can only be treated with insulin, typically with a combination of regular and NPH insulin, or synthetic insulin analogs.[citation needed] Metformin is generally recommended as a first line treatment for type 2 diabetes, as there is good evidence that it decreases mortality.[7] It works by decreasing the liver's production of glucose.[90] Several other groups of drugs, mostly given by mouth, may also decrease blood sugar in type II DM. These include agents that increase insulin release, agents that decrease absorption of sugar from the intestines, agents that make the body more sensitive to insulin, and agents that increase the excretion of glucose in the urine.[90] When insulin is used in type 2 diabetes, a long-acting formulation is usually added initially, while continuing oral medications.[7] Doses of insulin are then increased to effect.[7][91] Blood pressure Since cardiovascular disease is a serious complication associated with diabetes, some have recommended blood pressure levels below 130/80 mmHg.[92] However, evidence supports less than or equal to somewhere between 140/90 mmHg to 160/100 mmHg; the only additional benefit found for blood pressure targets beneath this range was an isolated decrease in stroke risk, and this was accompanied by an increased risk of other serious adverse events.[93][94] A 2016 review found potential harm to treating lower than 140 mmHg.[95] Among medications that lower blood pressure, angiotensin converting enzyme inhibitors (ACEIs) improve outcomes in those with DM while the similar medications angiotensin receptor blockers (ARBs) do not.[96] Aspirin is also recommended for people with cardiovascular problems, however routine use of aspirin has not been found to improve outcomes in uncomplicated diabetes.[97] Surgery Weight loss surgery in those with obesity and type two diabetes is often an effective measure.[15] Many are able to maintain normal blood sugar levels with little or no medications following surgery[98] and long-term mortality is decreased.[99] There is, however, a short-term mortality risk of less than 1% from the surgery.[100] The body mass index cutoffs for when surgery is appropriate are not yet clear.[99] It is recommended that this option be considered in those who are unable to get both their weight and blood sugar under control.[101] A pancreas transplant is occasionally considered for people with type 1 diabetes who have severe complications of their disease, including end stage kidney diseaserequiring kidney transplantation.[102] Support In countries using a general practitioner system, such as the United Kingdom, care may take place mainly outside hospitals, with hospital-based specialist care used only in case of complications, difficult blood sugar control, or research projects. In other circumstances, general practitioners and specialists share care in a team approach. Home telehealth support can be an effective management technique.[103] Epidemiology Main article: Epidemiology of diabetes mellitus Rates of diabetes worldwide in 2014. The worldwide prevalence was 9.2%. Mortality rate of diabetes worldwide in 2012 per million inhabitants   28–91   92–114   115–141   142–163   164–184   185–209   210–247   248–309   310–404   405–1879 In 2017, 425 million people had diabetes worldwide,[9] up from an estimated 382 million people in 2013[18] and from 108 million in 1980.[104] Accounting for the shifting age structure of the global population, the prevalence of diabetes is 8.8% among adults, nearly double the rate of 4.7% in 1980.[9] [104] Type 2 makes up about 90% of the cases.[17][19] Some data indicate rates are roughly equal in women and men,[19] but male excess in diabetes has been found in many populations with higher type 2 incidence, possibly due to sex-related differences in insulin sensitivity, consequences of obesity and regional body fat deposition, and other contributing factors such as high blood pressure, tobacco smoking, and alcohol intake.[105][106] The WHO estimates that diabetes mellitus resulted in 1.5 million deaths in 2012, making it the 8th leading cause of death.[13][104] However another 2.2 million deaths worldwide were attributable to high blood glucose and the increased risks of cardiovascular disease and other associated complications (e.g. kidney failure), which often lead to premature death and are often listed as the underlying cause on death certificates rather than diabetes.[104][107] For example, in 2017, the International Diabetes Federation (IDF) estimated that diabetes resulted in 4.0 million deaths worldwide,[9] using modeling to estimate the total number of deaths that could be directly or indirectly attributed to diabetes.[9] Diabetes mellitus occurs throughout the world but is more common (especially type 2) in more developed countries. The greatest increase in rates has however been seen in low- and middle-income countries,[104]where more than 80% of diabetic deaths occur.[108] The fastest prevalence increase is expected to occur in Asia and Africa, where most people with diabetes will probably live in 2030.[109] The increase in rates in developing countries follows the trend of urbanization and lifestyle changes, including increasingly sedentary lifestyles, less physically demanding work and the global nutrition transition, marked by increased intake of foods that are high energy-dense but nutrient-poor (often high in sugar and saturated fats, sometimes referred to as the "Western-style" diet).[104][109] The global number of diabetes cases might increase by 48% between 2017 and 2045.[9] History Main article: History of diabetes Diabetes was one of the first diseases described,[110] with an Egyptian manuscript from c. 1500 BCE mentioning "too great emptying of the urine."[111] The Ebers papyrus includes a recommendation for a drink to take in such cases.[112] The first described cases are believed to have been type 1 diabetes.[111] Indian physicians around the same time identified the disease and classified it as madhumeha or "honey urine", noting the urine would attract ants.[111][112] The term "diabetes" or "to pass through" was first used in 230 BCE by the Greek Apollonius of Memphis.[111] The disease was considered rare during the time of the Roman empire, with Galen commenting he had only seen two cases during his career.[111] This is possibly due to the diet and lifestyle of the ancients, or because the clinical symptoms were observed during the advanced stage of the disease. Galen named the disease "diarrhea of the urine" (diarrhea urinosa).[113] The earliest surviving work with a detailed reference to diabetes is that of Aretaeus of Cappadocia (2nd or early 3rd century CE). He described the symptoms and the course of the disease, which he attributed to the moisture and coldness, reflecting the beliefs of the "Pneumatic School". He hypothesized a correlation between diabetes and other diseases, and he discussed differential diagnosis from the snakebite, which also provokes excessive thirst. His work remained unknown in the West until 1552, when the first Latin edition was published in Venice.[113] Two types of diabetes were identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400–500 CE with one type being associated with youth and another type with being overweight.[111] The term "mellitus" or "from honey" was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus, which is also associated with frequent urination.[111] Effective treatment was not developed until the early part of the 20th century, when Canadians Frederick Banting and Charles Herbert Best isolated and purified insulin in 1921 and 1922.[111] This was followed by the development of the long-acting insulin NPH in the 1940s.[111] Etymology The word diabetes (/ˌdaɪ.əˈbiːtiːz/ or /ˌdaɪ.əˈbiːtɪs/) comes from Latin diabētēs, which in turn comes from Ancient Greek διαβήτης (diabētēs), which literally means "a passer through; a siphon".[114] Ancient Greek physician Aretaeus of Cappadocia (fl. 1st century CE) used that word, with the intended meaning "excessive discharge of urine", as the name for the disease.[115][116] Ultimately, the word comes from Greek διαβαίνειν (diabainein), meaning "to pass through,"[114] which is composed of δια- (dia-), meaning "through" and βαίνειν (bainein), meaning "to go".[115] The word "diabetes" is first recorded in English, in the form diabete, in a medical text written around 1425. The word mellitus (/məˈlaɪtəs/ or /ˈmɛlɪtəs/) comes from the classical Latin word mellītus, meaning "mellite"[117] (i.e. sweetened with honey;[117] honey-sweet[118]). The Latin word comes from mell-, which comes from mel, meaning "honey";[117][118] sweetness;[118] pleasant thing,[118] and the suffix -ītus,[117] whose meaning is the same as that of the English suffix "-ite".[119] It was Thomas Willis who in 1675 added "mellitus" to the word "diabetes" as a designation for the disease, when he noticed the urine of a diabetic had a sweet taste (glycosuria). This sweet taste had been noticed in urine by the ancient Greeks, Chinese, Egyptians, Indians, and Persians. Society and culture Further information: List of films featuring diabetes The 1989 "St. Vincent Declaration"[120][121] was the result of international efforts to improve the care accorded to those with diabetes. Doing so is important not only in terms of quality of life and life expectancy but also economically – expenses due to diabetes have been shown to be a major drain on health – and productivity-related resources for healthcare systems and governments. Several countries established more and less successful national diabetes programmes to improve treatment of the disease.[122] People with diabetes who have neuropathic symptoms such as numbness or tingling in feet or hands are twice as likely to be unemployed as those without the symptoms.[123] In 2010, diabetes-related emergency room (ER) visit rates in the United States were higher among people from the lowest income communities (526 per 10,000 population) than from the highest income communities (236 per 10,000 population). Approximately 9.4% of diabetes-related ER visits were for the uninsured.[124] Naming The term "type 1 diabetes" has replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and insulin-dependent diabetes mellitus (IDDM). Likewise, the term "type 2 diabetes" has replaced several former terms, including adult-onset diabetes, obesity-related diabetes, and noninsulin-dependent diabetes mellitus (NIDDM). Beyond these two types, there is no agreed-upon standard nomenclature.[citation needed] Diabetes mellitus is also occasionally known as "sugar diabetes" to differentiate it from diabetes insipidus.[125] Other animals Main articles: Diabetes in dogs and Diabetes in cats In animals, diabetes is most commonly encountered in dogs and cats. Middle-aged animals are most commonly affected. Female dogs are twice as likely to be affected as males, while according to some sources, male cats are also more prone than females. In both species, all breeds may be affected, but some small dog breeds are particularly likely to develop diabetes, such as Miniature Poodles.[126] Feline diabetes mellitus is strikingly similar to human type 2 diabetes. The Burmese breed, along with the Russian Blue, Abyssinian, and Norwegian Forest cat breeds, showed an increased risk of DM, while several breeds showed a lower risk. There is an association between overweight and an increased risk of feline diabetes.[127] The symptoms may relate to fluid loss and polyuria, but the course may also be insidious. Diabetic animals are more prone to infections. The long-term complications recognized in humans are much rarer in animals. The principles of treatment (weight loss, oral antidiabetics, subcutaneous insulin) and management of emergencies (e.g. ketoacidosis) are similar to those in humans.[126] Research See also: Diabetes (journal) Inhalable insulin has been developed.[128] The original products were withdrawn due to side effects.[128] Afrezza, under development by the pharmaceuticals company MannKind Corporation, was approved by the United States Food and Drug Administration (FDA) for general sale in June 2014.[129] An advantage to inhaled insulin is that it may be more convenient and easy to use.[130] Transdermal insulin in the form of a cream has been developed and trials are being conducted on people with type 2 diabetes.[131][132] Major clinical trials The Diabetes Control and Complications Trial (DCCT) was a clinical study conducted by the United States National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) that was published in the New England Journal of Medicine in 1993. Test subjects all had diabetes mellitus type 1 and were randomized to a tight glycemic arm and a control arm with the standard of care at the time; people were followed for an average of seven years, and people in the treatment had dramatically lower rates of diabetic complications. It was as a landmark study at the time, and significantly changed the management of all forms of diabetes.[89][133][134] The United Kingdom Prospective Diabetes Study (UKPDS) was a clinical study conducted by Z that was published in The Lancet in 1998. Around 3,800 people with type 2 diabetes were followed for an average of ten years, and were treated with tight glucose control or the standard of care, and again the treatment arm had far better outcomes. This confirmed the importance of tight glucose control, as well as blood pressure control, for people with this condition.[89][135][136] ***  WIZO IS ESTABLISHED IN THE UK. BEGINS CARING FOR THE WOMEN & CHILDREN IN ERETZ YISRAEL The idea of reviving a Jewish national home after 2,000 years of exile seemed almost overwhelming. A group of very strong women, whose husbands were involved in Zionist activity, felt that women should have a distinctive and equal role in the return to Zion. Some of these women were also suffragettes, struggling for the political right of women to vote alongside men in England. These women, led by Rebecca Sieff, Vera Weizmann and Romana Goodman, wives of prominent Zionists and powerful personalities in their own right, founded a “Ladies Committee” within the British Zionist Federation in 1918.  On January 12, 1919, they held the founding conference of a Women’s Federation in Britain in London for the purpose of setting up a Women’s Federation in Britain. This eventually became known as the Federation of Zionist Women, later British WIZO, and today WIZOUK.   The founding father of Zionism, Theodore Herzl, was an Austro-Hungarian Jewish journalist and founder of the World Zionist Movement. The first headquarters of the Zionist movement were in Germany.  With the defeat of Germany in WW1, and the granting of a British Mandate over Palestine by the League of Nations and the Balfour Declaration guaranteeing a Jewish national home in Palestine, the headquarters of the Zionist Movement moved to Britain. The new Zionist leadership was led by Prof. Chaim Weizmann in London. A Visit that Changed History The idea of reviving a Jewish national home after 2,000 years of exile seemed almost overwhelming. A group of very strong women, whose husbands were involved in Zionist activity, felt that women should have a distinctive and equal role in the return to Zion. Some of these women were also suffragettes, struggling for the political right of women to vote alongside men in England. These women, led by Rebecca Sieff, Vera Weizmann and Romana Goodman, wives of prominent Zionists and powerful personalities in their own right, founded a “Ladies Committee” within the British Zionist Federation in 1918.  On January 12, 1919, they held the founding conference of a Women’s Federation in Britain in London for the purpose of setting up a Women’s Federation in Britain. This eventually became known as the Federation of Zionist Women, later British WIZO, and today WIZOUK.   In 1918, three of the founders, Rebecca Sieff, wife of Israel Sieff the Zionist movement’s Political Secretary, Dr. Vera Weizmann, wife of Zionist movement President Chaim Weizmann, and Edith Eder, wife of Zionist leader Dr. Eder, had the opportunity to participate in a Zionist Commission visit to Eretz Israel/Palestine, to see the unfolding reality with their own eyes.  What they discovered shocked them to the core.  Following WWI, the Jewish population in Palestine had dwindled due to expulsion, disease and famine.  The situation of women, both the chalutzot (pioneers) and the city women from the old yishuv (pre-state Jewish community) was unbearable.  They were suffering both physically and spiritually. The Founding of World WIZO The three women decided they had to found an international organization of Zionist women to confront this situation.  Thus the founding conference of World WIZO (the Women’s International Zionist Organization) was held in London on July 11, 1920. Rebecca Sieff gave rein to her ideas, and the outline of activities for the new international organization. She spoke at length on the idea that women should work together in an organized fashion, and in doing so, their abilities and powers would develop. She felt that women should work within an independent framework, but in cooperation with their male comrades - for the rebuilding of the Zionist home. In order to realize the dream of the establishment of a national home, women -- via education and training -- had to develop their own specific abilities, so as to play the most useful role possible.    They appealed to the Yishuv in Eretz-Israel "to take cognizance of the particular approach of women, stemming not from motives of prestige, or privilege, but in answer to genuine needs, and to ensure functioning on a firm basis". The proposed areas of activity: "Education, Home Economics, Legislation, Health and Social Services. All are areas which are completely neglected in Palestine and to which only an organized body can hope to bring about change". Strong emphasis was placed on agriculture (through the influence of Chana Maisel-Schochat) as the first step towards a national revival. There was a demand to establish agricultural schools, which would provide the training for women to become efficient agriculturalists. Training would also be given on the domestic aspect of rural life, "Training is vital for the farmer's wife". However, at very first conference, the discussion on the women led inevitably to discussion about children and:  a) A desire to help women go out to work, by providing alternative care for children.  b) The desire to help women fulfill their function as a mother to the best of their ability, by providing them with       professional guidance in child care and nutrition. The part played by the founders in carving out the aims of the organization cannot be emphasized highly enough. The personal interests and experience of these women defined the areas of activity within the new organization. Each woman took note of needs within her field of expertise. Edit Eder, an educator, placed strong emphasis on the area of education, which did not reflect the needs, and reality of the country. Dr. Vera Weizmann, a Medical Doctor, noted the high rate of infant mortality and the poor state of health amongst the women and children.  Rebecca Sieff wanted to see the women organized, active, and equal to the men. The striving for equality provoked a discussion at the Conference, on the position of Jewish woman in Jewish law. The difficult aspects, and those which bore down hard on the woman were stressed, and hope was expressed that a central Rabbinical Authority would emerge that could deal with these problems. (This subject does not appear in the constitution on of WIZO, possibly because of the diversity of opinions among the participants.  We therefore find that activity in this area was delayed for many years). The platform focused on vital areas of training for women who arrived in Eretz-Israel unprepared for the prevailing needs. These areas included home economics, articulation and the welfare needs of children. The constitution of WIZO has undergone many changes and additions, but the central basic aims have remained constant, their interpretation and implementation have always been characterized by a flexible approach. From the outset, it was decreed, "The type of work being undertaken by WIZO must change in keeping with changing conditions". It is this flexibility which has been a source of strength to WIZO throughout all the years of its activity. As a concrete expression of the constitution, a detailed plan of work was decided upon at the first conference in Carlsbad in 1921. The resolutions that were adopted for practical action in Eretz-Israel were:  a) The establishment of a home for immigrant girls  b) The establishment of an agricultural school for girls   c) Provision of kitchen equipment for the girls school in Haifa.  d) The establishment of a center for the care of babies.   In order to raise funds for implementing the plans, it was decided to set up a Jewelry Fund, with Lady Samuel at its head. This decision was taken due to the difficulty in transferring money from one country to another, and also because they felt it was important for every woman to make a sacrifice for Eretz-Israel. To sum up the discussions which paved the way of the founders when establishing WIZO in 1920 there are two main guidelines: The recognition of the need for an organization; the recognition that such an organization would have the power to achieve what individuals could only aspire to. Awareness of the fact that the essence of the program lies in ‘educating women for productive work in  Eretz-Israel" The Hebrew Women's Organization As these developments were taking place in Europe, the women in Eretz Israel/Palestine also began to organize to further their goals and defend their rights. “Associations of Women” were founded in 1917, a “League of Women for Equal Rights in Eretz Israel” in 1919, and the “Hebrew Women’s Organization” (Histadrut Nashim Ivriot) was founded in 1920. Soon these organizations began to have a working relationship with, and to receive support, from World WIZO.     WIZO’s Activities During Its Early Days Tipat Halav (‘A Drop of Milk’) Baby Welfare Clinics The first baby welfare clinics opened in Jerusalem. Many women gave birth and reared their children in the most abject sanitary conditions, without medical intervention, and in conditions that that endangered the lives of the mother and her baby. Added circumstances such as a shortage of doctors, inadequate hospital facilities, a difficult climate, a water shortage in Jerusalem and lack of suitable nutrition led to a high rate of infant mortality. Individual volunteers tried to help, without much avail. It was Dr. Helena Kagan  who pioneered the way to providing medical aid and guidance. She would visit the neighbourhoods of the Old City of Jerusalem giving help where necessary and sharing advice. But she could not possibly give all the assistance that was needed. Many women did not seek medical help nor go to the hospitals, due to lack of knowledge or superstition. Against this background, Batsheva Kesselman conceived the idea of an organization of women. It was decided that this organization (the HNI) would help ‘Hadassah’ to give medical assistance to pregnant women and babies, it’s main contribution being  the establishment of Baby Welfare Clinics. The HNI would speak to the women, persuade them to be examined by a doctor during their last months of pregnancy. The women were encouraged to give birth in hospitals, or visits were made to those women who chose to give birth at home. There were also follow up visits to the women who chose to give birth in the hospitals. All this was carried out with the full cooperation of ‘Hadassah’, which provided the medical assistance, whilst the women of HNI would give guidance and provide the general care. Tipat Halav (‘A Drop of Milk’) Baby Welfare Clinics          During the daily meetings between the members of the HNI and the women in the neighbourhoods, it soon became clear that it was not enough to deal with the pregnant women and the new mothers, but that guidance should also be given to include the rearing the newly born infants. Since it was impossible to burden ‘Hadassah’ with ongoing daily care, the HNI decided to set up advisory clinics.The first such clinic was opened in a room in the Old City of Jerusalem on the twenty third of June, nineteen twenty one. Dr. Helena Kagan worked there, voluntarily, as a pediatrician. She was helped by Batsheva Kesselman, who held  overall responsibility for the clinic. A second station was opened, shortly afterwards, in a shed in the grounds of Hadassah Hospital, which was then known as the Rothschild Hospital. At the beginning, there was a weak response from the women, who had expected to come to the clinics and receive material assistance. To their dismay, they were only given advice from the doctor, so they stopped coming.   A main problem amongst the new mothers was a lack of milk for breast feeding, which was a result of inadequate nutrition. Dr. Kagan taught them how to help themselves by supplementing their feed with cows milk. However, due to financial constraints, most women could not afford to buy cow’s milk, and it was decided to distribute milk.  The HNI was given a meager budget for the distribution of milk. In the beginning, each district chairman in Jerusalem was responsible for distributing the milk in her area. However this was not effective and it was decided to distribute the milk at the baby welfare clinics. When the milk was distributed in the clinics, the number of women who visited the clinics sharply increased and larger sums of money had to be allocated.  For the first time the HNI faced the main problem of a lack of economic resources and money had to be found from various sources. Thus, for example, Flora Solomon, wife of a senior official in the Mandatory Government, contributed £25 a month for this purpose, on condition that this task would remain as her responsibility. In a special agreement that was drawn up with the HNI gave her responsibility for the distribution of the milk, assisted by members of the HNI.  The activities at the clinic included, besides the actual distribution of milk, ensuring the cleanliness of the cowshed, the pasteurization of the milk, bacteriological and chemical examinations, and the preparation of formulas according to the direction of the doctor, and adding sugar and water for each baby. The whole enterprise was given the name, ‘Tipat Halav’ (‘A Drop of Milk’) and was located at the Baby Welfare Clinics. When they received the milk, the visiting women would also receive advice and the medical services of a doctor. Thus, the combination of the two, led to the increased awareness of medical services amongst women, and it meant that they received correct advice regarding nutrition.  Gradually the name ‘Tipat Halav’ took over in the Baby Welfare Clinics, and over a period of time, the concept included weekly consultations with the doctor and nurse. Social Work From the very beginning, the HNI pioneered social welfare work in Israeli society. Examples include the Baby Welfare Clinics and Tipat Halav clinics, as well as the projects to help the needy such as the Sewing Circles, Committee for the Distribution of Clothing and the Care of Abandoned Children.  Providing help for one’s fellow man was not new to Jewish culture. The innovations made by the HNI lay in their work methods and their concept regarding the quality of social work. According to this concept, the needy should not be given charity, but they should receive what is owed to them as members of the community, i.e. not philanthropy, but constructive aid.  The aim was not to give a lot of aid, but to cause the numbers of those requiring aid to decrease. This change in intent became termed as ‘social work’ rather than ‘tzedaka’ (charity), or ‘nadava’ (alms). Henrietta Szold contended that the correct meaning of ‘Social Work’ is ‘working for the good of the whole community’ including education and health. If all the factors are not taken into account it cannot be classified as ‘social welfare work’. The members of the NHI saw the work as being Zionistic in every aspect.  The ideas that were proposed by the HNI ran into opposition from some groups of the old settlement. The groups felt that various societies that were already giving help and charity were being overlapped, such as The Gemillat Hassadim (Benevolent Society) Linat Zedek (Free Lodging Society), Ezrat Nashim (Help for Women) etc… There were other circles which did not look kindly upon the idea. The word ‘help’ aroused antagonism, as the new pioneers saw it as symbolizing the old ways of distributing charity, which was inconsistent with the image of the modern Jew, who was self sufficient.  For example, the Agricultural Center declared a ban upon clothes that arrived from America for distribution to the needy, feeling that this was in direct opposition to the community of workers in the country. Their opposition led to a change in tactics. With the consent of Hadassah, which organized the collection of clothes abroad, it was decided to sell them at low prices. This was the beginning of the ‘Beged Zol’ (cheap clothing) enterprise. This is just one example of providing constructive help, not just being philanthropic for its own sake! Agricultural Education and Schools The training of women in agriculture was seen, by the founders of WIZO, as part of the Zionist endeavor. In order to build a normal nation, a certain proportion of men and women must till the soil. ‘At the core of our aspirations for Eretz Israel is the creation of a free, Hebrew, functioning settlement, mainly a settlement of agricultural workers, which will plant hardy roots in the soil to serve as a strong basis, economically, physically, spiritually and politically, for the entire nation.’ By working in agriculture, the women would be a resourceful factor.  One of the basic principles of WIZO was, (and is) to encourage women to be independent and productive in every possible area.  Combined, these two motives led to a preference for agriculture, ‘Our dream of dreams is to see a Jewish farmer, his wife by his side, both trained to work in agriculture in Eretz Israel’. Since Jews in general, and Jewish women particularly, had not worked in agriculture in their countries of origin, they had to be provided with training. There was, at the time, one agricultural school for boys, Mikveh Israel (which was founded in 1870) but no girls were accepted there. Agricultural training for women began in the Maon (‘Home’) - later to be known as ‘The School for Home Economics’, with Hanna Maisel Shohat as the principal.  Courses were held on growing vegetables and flowers, cultivating bees, and lessons in home management. Agricultural Farms During the 1920’s, the Moetzet Hapoalot (Women’s Council), the Jewish Agency and the Jewish National Fund (which allocated land) set up six training farms for women, which were known as Working Women’s Farms. They were set up in order to provide training, over a period of two years, in all fields of agriculture. The farms were in Nachlat Yehuda (1922), Shechunat Borochov, Petach Tikva (1923), Talpiot Jerusalem (1924), Hadera (1925), Mula (1926). Funds were needed for housing and for work  apparatus, which the Moetzet Hapoalot were unable to provide.  It was at this point that WIZO went into action, the initiative being a joint one. The farm at Mula was the first to benefit from WIZO’s support. This small farm was established in 1926, with a group of 17 girls, at the initiative of Moetzet Hapoalot and the Department of Agriculture in the Zionist Executive. The farm suffered many problems, lack of water, unsuitable soil, Arab environs.  The Department of Agriculture gave little financial support, and the farm was on the verge of closing down. In 1927, the WIZO Federation in Argentina took the farm under its sponsorship, pledging to supply its needs and to assist in its  development (in exchange, the Federation was released from making payments to the general budget of WIZO. It was the first such arrangement of its type, and did not last long!) Sara Malchin, (a pioneer who was trained at Kinneret) was appointed as Principal. A few decades later, in the 1940’s boys were also accepted. Financial difficulties continued, and in 1952, when the Moetzet Hapoalot relinquished its share of ownership, the agricultural farm became a Gadna Farm, in an agreement with the Ministry of Defense, and boys received pre-army training, together with agricultural training.  This program lasted for four years, when it was decided that the WIZO federation of Argentina, the Ministry of Agriculture, and the Ministry of Education with the help of the Jewish Agency, would convert the farm into an agricultural high school, which would serve the settlements of new immigrants that surrounded the area.  Today, it also serves as a boarding school for children from other areas, or from families who are under the care of the welfare authorities. In 1928, Moetzet Hapoalot asked WIZO to help with the upkeep of other farms, due to ongoing financial problems. A decision was reached in which three other farms that had trained women, Shechunat Borochov, Nachlat Yehuda and Petach Tikva, were transferred to WIZO in 1930. The American organization, Pioneer Women, undertook the financial maintenance of the other farms belonging to Moetzet Hapoalot. Vegetable Gardens and Travelling Madrichot  (Teachers) WIZO’s agricultural training did not begin and end with agricultural schools. Anna Jaffe, Rozia Yevnin and Freda Meyerov set up WIZO’s Training Department in 1927, in order to extend agricultural education beyond the confines of WIZO’s educational institutions.   The first madrichot (teachers) were graduates of the "School for the Study of Housekeeping and Agriculture". (The Maon"). They taught gardening in Tel Aviv. They also taught home economics and kitchen management, in kibbutzim, in addition to vegetable growing. A third realm of activity was to teach ‘Gardening for children,’ to madrichot in schools and nursery schools. Activities Related to Agricultural Training: One of the activities that most suited the needs of the time was the cultivation of vegetable gardens.  This period, 1926-27, was a period of economic crisis.  The economic crisis had begun a short time after the Fourth Aliyah arrived from Poland, and many families were reduced to utter destitution. Freda Meyerov appealed to the WIZO Executive in London, stating that "not only do women have to take the fullest advantage of the little money that they have, but they also have to be taught how to make a few extra pounds’. One way to save money was by growing vegetables in their back yards, because in this way they can invest the little money they have and make it fruitful. During the times in the seasons when vegetables and fruit were plentiful, they could be made into preserves. "Is not one of the aims of WIZO to educate women towards life digging the soil, and for home-making? It seems natural to expand this activity to include women in the towns too. Could not WIZO send experts in gardening, and home management, in order to teach these women?" In terms of concrete assistance, she asked WIZO to send instructions, written and verbal, on the laying of gardens, the rearing of poultry, cultivating bees, etc. "Here, too, it is advisable to organize popular lectures every now and then on these subjects, for small groups of women living in the suburbs". It was agreed to grant a trial period for the plan and the modest sum of £100 was allocated. Meyerov, together with Yevnin, who had studied agriculture in Berlin, themselves went out to persuade housewives of the benefits of vegetable-growing, since most of the women did not have the faintest idea of how to work the soil, or how to grow vegetables. In the Tel Aviv area, the neighborhoods selected for the experiment were areas that were settled by workers. The homes were shacks, surrounded by sand dunes. "WIZO's Training Department, in addition to guidance, provided the women with seed, fertilizer and rich soil, even giving them small, long-term loans in order to cover initial expenses. Despite all this, the madrichot at the beginning were met with evasion and reservation, sometimes even ridicule, on the part of the women. "On these drifting sands, nothing will ever grow", they argued. "Just leave us alone". Slowly and gradually, their distrust was overcome, and a few women were prepared to try out the suggestions. Patches of sand were marked off round the shacks (usually with empty cans) and black fertile soil was brought in and spread over the sand. Two madrichot, who had been trained at the 'Maon', and were under the supervision of the 'Maon' gardener, set out three times a week to visit the 20 gardens, that were participating in the program.   In 1928, the garden produce was exhibited in a show, and it drew the attention and interest of the whole country. Many women immigrants did not know how to use this produce (or 'grass' as it was dubbed by the Polish immigrants). The abundance of produce also raised the problem of what to do with the surplus. It was decided to teach the housewives how to cook the vegetables (see Chapter on Nutrition). The practical aspect of this endeavor was clearly revealed when, in 1929, the Arabs, who were the chief suppliers of fruit and vegetables, boycotted the Jewish shops. These new gardens then became the sole source of vegetables. A graphic description of the work of the madrichot, and the development of this project, can be found in a letter written by one of the madrichot, and sent to the Instruction Department on the tenth anniversary of its opening. " ... The madricha would go from place to place, visiting each garden, according to a plan. Where the work was not progressing sufficiently, she herself, took up the garden tools, prepared the soil, and created some form of garden, helping to plant seedlings or seeds, and outlining to the woman what she had to do before the next visit. Then she would go on to the next garden. There were many obstacles along the path of the madrichot.   A shortage of essential means, apathy, and even recrimination on the part of the women in the event of failure, sometimes defiance, which was accompanied by the reaction "It is not worth it." "Yet, despite all, both the madricha and the women saw the fruit of their labors. The contrast between the waste land, covered with thorny bushes and drifting sands, and the tidy gardens of the homesteads, highlighted the joy in creativity that went hand in hand with the hard work. Especially the joy of the new settler, not long in the country, who had had no idea of how or where to begin. With patience and perseverance, the madricha won her over, and succeeded in teaching her agriculture, which was so alien to her.  The madricha could indeed feel a sense of accomplishment " All in all, it was obvious that the vegetable gardens served a number of purposes: Economically - saving money in the family budget, and/or increasing the budget when the housewife grew more vegetables than her family required, and then sold the surplus.  Fostering a bond between the soil and the women immigrants, and helping the immigrants to adjust to alien conditions. Teaching the women to become manufacturers, and not only consumers. Enrichment of the family food basket, with items that formed the basis of healthy nutrition. Disappointment with the response of adults to vegetable growing led to the idea that one should begin to develop an affinity towards plants and greenery at an early age. "And so we arrived at the idea of teaching in the kindergartens. The children, we hoped, would inspire their parents with their spirit, prodding them on ..." The idea spread quickly, first to Haifa and Jerusalem, and later to a few of the larger urban settlements. In 1929, the Training Department conceived the idea of extending its sphere of activity to nursery schools. Thus, from an early age the children would be linked to the soil, through working it, teaching them to love gardens, "as future pioneers, who would conquer the wilderness". In 1929, it appears that the number of children receiving instruction in Tel Aviv was 1,400, which was 30% of the total number of children in elementary schools. 700 children in kindergartens were involved, as well as 400 in Jerusalem. The madrichot, after being trained, were integrated into the program, helping with the  work, attending once a week.     ebay4675/168

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  • Country of Manufacture: Israel
  • Country/Region of Manufacture: Israel
  • Religion: Judaism

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