in west java province, indonesia - apacph2015apacph2015.fkm.ui.ac.id/ppt/22 october 2015/18....
TRANSCRIPT
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Dietary trans fat intake and its relation to lipoprotein (a) level in a sample of adultslipoprotein (a) level in a sample of adults
in West Java Province, Indonesia
Sartika RADSartika RAD
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IntroductionIndonesia is now experiencing the epidemiologic
transition that is characterized by double burdens bothtransition that is characterized by double burdens, both eradicating infectious diseases & NCD that become
degenerative diseasesdegenerative diseases.
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IntroductionIntroduction• BasicHealthResearch,2010,prevalenceofNCDincreased from 42% toincreasedfrom42%to60% &halfofthemis
d b CVDcausedbyCVD• One of the causes of NCD related to life style, including dietarystyle, including dietary factors & one of them is fat intake
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Background• Fats contain FA & glycerol• Two (2) forms of FA isomers of cis& trans
• Trans isomer structure more i il t SFAsimilar to SFA
• It found in ruminant animal, DF food & products using HVO
• Aro (1997) the high amounts of• Aro (1997) the high amounts of TFA had more adverse effects on l h d d llipoproteins than did equal amounts of SFA
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BackgroundBackground• Lipoprotein (a) a low density l & h d b h llipoprotein & synthesized by the liver
• It consists of cholest, phospholipid, TG & apo‐lipoprotein
• Lp (a) promote thrombosis, inflammation, foam cell , ,formation & development of atherosclerosis (Marcovina, 1997 & Boffa, 2004)
• In prospective cohort study (Bennet 2008) a positive(Bennet, 2008) a positive association between Lp (a) concentration & risk of CHD
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bObjectives
to determine the mean intake of TFA d it l ti t li t i ( )and its relation to lipoprotein (a)
levellevel
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METHODSMETHODS
• Study design a cross sectionalS bj t d lt d 30 55 li i i• Subjects adults aged 30‐55 years living in urban & rural areas in West Java Province, Indonesia
• From the total selected populations (150From the total selected populations (150 subjects), only 100 subjects met the inclusion criteria & were eligible for this studycriteria & were eligible for this study
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Data collection• Data collected by the researcher and 3
dtrained nutritionists• The subjects interviewed using a standardized e subjects te e ed us g a sta da d edquestionnaire and 24‐hour food recall Bl d l ll t d i th i ft• Blood samples collected in the morning after a fasting for 10‐12 hours to assess Lp (a) & using immuno‐turbidimetri methods
• Blood samples taken by 2 laboratory analystsBlood samples taken by 2 laboratory analysts & analyzed in the ‘Prodia’ Laboratory
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Cont’d
• The nutrient intake calculated using an extendedThe nutrient intake calculated using an extended version of the Nutrient Calculation Software as I d i F d C iti D t bIndonesian Food Composition Database.
• Total TFA intake calculated from fried foods, ruminant products & food product using margarine or HVOor HVO
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Result Table 1. Distribution of respondents based on Lp
(a) level in urban & rural areas (p>0 05)
Lp (a) level Urban Rural Total
(a) level in urban & rural areas (p>0.05)
p ( )
n % n % n %
Normal 21 70.0 50 71.4 71 71.0
Not normal
Th ti f L ( ) ‘ t l’ i b
Not normal9 30.0 20 28.6 29 29.0
The proportion of Lp (a) ‘not normal’ in urban was slightly higher than rural areas caused by
diff i lif t l f t ( h di t i t kdifferences in lifestyle factors (such as : dietary intake, PA, smoking habit) & genetic factors
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Table 2. The mean intake of TFA in urban andTable 2. The mean intake of TFA in urban and rural areas (p>0.05)
Area n Mean + SD (% total Kcal)
Urban 30 0.38+ 0.23
Rural 69 0.36 + 0.12
‐ The mean intake of TFA was 0.37% (NS)ik ( ) h i k f‐ Sartika (2011) the mean intake of TFA among
Indonesian adults 0.48% (the highest contribution from f i d f d )fried foods)
‐ Recommendation from AHA (2006) TFA intake <1%TE
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Table 3. The association between TFA intake & Lp (a)
Lp(a)‘Not
Lp (a)‘Normal’
P valueOR (95% CI)
Trans fatty acid ‘Not
normal’‘Normal’
TotalOR (95% CI)
yintake n % n % n % Hi h 26 54 2 22 45 8 48 48 5 0 00 High 26 54,2 22 45,8 48 48,5 0,00 Low 3 5,9 48 94,1 51 51,5 18,91 (5,167‐69,193)
‐ Subjects who consume 'high' TFA has a risk 18 91 times to
Low 3 5,9 48 94,1 51 51,5 18,91 (5,167 69,193)
Subjects who consume high TFA has a risk 18.91 times to achieve the levels of Lp (a) 'not normal’
‐ The experimental study from Mensink (1992) the highThe experimental study from Mensink (1992) the high diets in TFA may increase serum levels of Lp (a)
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Other studiesOther studies
• Catanzaro JA (1996) Lp (a) levels >20 mg/dlhave risk of CHD &>20 mg/dl have risk of CHD &
stroke • According to Jones, et al
(2007)Lp(a) is a stable marker for assessing the risk of all major formsassessing the risk of all major forms
of vascular disease
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ConclusionConclusion• The mean intake of TFA is 0 37% TE• The mean intake of TFA is 0.37% TE
• TFA intake associated with a level of Lp (a)
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THANK YOU
YOUR ATTENTIONY
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The effect of excess TFA&SFA intake to liver damage, fat metabolism and risk of CVDfat metabolism and risk of CVD