NAUFAL MUHARAM NURDIN
SEKOLAH PASCASARJANA INSTITUT PERTANIAN BOGOR
BOGOR 2014
bahwa fitosterol dapat menghambat sintesa VLDL. Uji klinis yang dilakukan Plat & Mensink(2009) yang menggunakan plant stanol pada subjek SM mendapatkan hasil yang mendukung mekanisme tersebut. Plat menemukan bahwa plant stanol ester dapat menurunkan konsentrasi VLDL dan TG pada subjek SM dan menduga bahwa penurunan TG ini berasal dari penurunan produksi partikel VLDL-1 yang tinggi TG (TG rich VLDL-1 particles) di hati (Plat & Mensink 2009).
SIMPULAN DAN SARAN
SimpulanIntervensi pemberian fitosterol yang ditambahkan pada minyak sawit dan digunakan sebagai minyak goreng telah dilakukan selama 8 minggu dengan melibatkan 30 orang subjek yang terbagi menjadi kelompok perlakuan dan kontrol. Tidak didapatkan drop out maupun keluhan/efek samping pada penelitian ini. Rata- rata total konsumsi minyak goreng selama intervensi yaitu 46 ± 23 g/hari sedangkan rata-rata konsumsi minyak yang diperkaya fitosterol pada kelompok perlakuan adalah 38 ± 19 g/hari.
Kesimpulan pada penelitian ini adalah dengan konsumsi minyak sawit yang diperkaya fitosterol sekitar 38 g/hari, dapat mencapai asupan fitosterol sebesar 2 g/hari dan memenuhi asupan fitosterol yang dipersyarakan (>1.3 g/hari). Terdapat perbaikan kadar kolestorol total dan TG namun tidak terdapat perbedaan yang signifikan pada kadar kolesterol LDL.
Saran
Pada penelitian selanjutnya disarankan mengukur efikasi intervensi ini pada subjek dengan jumlah konsumsi minyak goreng normal dan mengukur kadar VLDL untuk melengkapi mekanisme kerja fitosterol
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RINGKASAN
NAUFAL MUHARAM NURDIN. Pengaruh Intervensi Penambahan Fitosterol pada Minyak Sawit Terhadap Profil Lipid Subyek dengan Sindroma Metabolik. Dibimbing oleh RIMBAWAN dan DRAJAT MARTIANTO
Sindroma metabolik (SM) merupakan suatu kondisi yang penting untuk dikaji karena akan meningkatkan resiko penyakit kronis terutama penyakit jantung koroner (PJK) dan diabetes mellitus tipe 2 (DMT2). Sindroma metabolik adalah pengelompokan kriteria terkait abnormalitas metabolik terdiri dari obesitas abdominal, hipertensi, dislipidemia atrogenik dan intoleransi glukosa (Alberti et al. 2009). Fitosterol merupakan sterol utama yang ditemukan pada minyak nabati sehingga disebut juga plant sterol. Fitosterol dapat mengurangi absorpsi kolesterol di saluran pencernaan dan potensial untuk digunakan dalam pencegahan dan terapi hyperlipidemia (Bender 2006). Fitosterol dalam bentuk ester dapat larut pada minyak dan mempunyai stabilitas yang cukup baik terhadap panas sehingga dapat dapat dicampurkan pada minyak sawit dan digunakan sebagai minyak goreng (Hallikainen 2001, Soupas et al. 2005, Dewi et al. 2013).
Tujuan penelitian ini adalah untuk mengevaluasi pengaruh intervensi penambahan fitosterol pada minyak sawit yang digunakan sebagai minyak goreng terhadap profil lipid yang terdiri dari kolesterol total, kolesterol HDL, kolesterol LDL dan trigliserida pada subjek sindroma metabolik. Penelitian ini merupakan uji klinis acak tersamar ganda. Sebanyak 30 subjek dewasa umur 40-60 tahun yang memenuhi kriteria sindroma metabolik terlibat pada penelitian ini. Subjek dibagi menjadi 2 kelompok yaitu kelompok kontrol dan perlakuan. Kelompok perlakuan diberikan minyak sawit yang diperkaya 6.5% (w/w) fitosterol dan digunakan sebagai minyak goreng sesuai kebiasaan sehari-hari. Pada kelompok kontrol diberikan minyak sawit tanpa fitosterol. Perlakuan ini diberikan selama 8 minggu. Konsumsi pangan dinilai melalui metode 24 jam-recall setiap 2 minggu. Pengukuran antropometri dan profil lipid darah dilakukan pada awal dan akhir intervensi.
Setelah 8 minggu intervensi, estimasi rata-rata total konsumsi minyak sawit yaitu 46 ± 23 g/hari dan rata-rata estimasi asupan fitosterol pada kelompok perlakuan yaitu sebesar dan 2.0 ± 1 g/hari. Tidak terdapat perbedaan nyata asupan pada kedua kelompok tersebut. Rata-rata konsumsi kalori dari lemak pada kedua kelompok mencapai 40% dari total konsumsi kalori pada kelompok tersebut. Asupan fitosterol telah diatas jumlah yang disyaratkan (>1.3 g/hari).
Hasil pada penelitian ini menunjukkan tidak terdapat perbedaan nyata kadar kolesterol-LDL (p>0.05) antara awal dan akhir intervensi, sedangkan kadar kolesterol-total dan trigliserida menurun secara signifikan (p<0.05). Walaupun estimasi asupan fitosterol telah mencapai 2 g/hari namun pada akhir intervensi tidak didapatkan penurunan kadar LDL yang signifikan. Hal ini kemungkinan disebabkan karena pada subjek SM, absorpsi kolesterol di intestinal rendah dan sintesis kolesterol endogen tinggi sehingga hal ini diduga menghambat efektivitas fitosterol. Kadar kolesterol-total dan trigliserida yang menurun secara signifikan diduga terkait dengan VLDL. Fitosterol dapat menghambat sintesis endogen VLDL di hati. Pada kelompok kontrol terdapat kecenderungan peningkatan kadar
kolesterol total dan walaupun secara statistik tidak berbeda nyata. Hal ini dapat disebabkan karena konsumsi minyak sawit yang tinggi
Kesimpulan pada penelitian ini adalah dengan konsumsi minyak sawit yang diperkaya fitosterol sekitar 40 g/hari, dapat mencapai asupan fitosterol sebesar 2 g/hari dan memenuhi asupan fitosterol yang dipersyarakan (1.3 g/hari). Terdapat perbaikan kadar kolestorol total dan TG namun tidak terdapat perbedaan yang signifikan pada kadar kolesterol LDL.
SUMMARY
NAUFAL MUHARAM NURDIN. The Effect of Phytosterol-enriched Palm Oil Intervention on Lipid Profile among Metabolic Syndrome Subject. Supervised by RIMBAWAN and DRAJAT MARTIANTO
Metabolic syndrome (MetS) is a grouping criteria of metabolic abnormality linked to obesity and insulin resistance which increases the risk of chronic diseases such as diabetes mellitus and coronary heart disease. Phytosterols (plant sterols) is the major sterols found in vegetable oils. Phytosterols may reduce the absorption of cholesterol in the digestive tract and can be used for prevention and therapy for hyperlipidemia. Phytosterol esters are soluble in palm oil and has a good stability to heat and there for can be used as cooking oil.
The objective of this study was to evaluate the effect of palm oil enriched with phytosterol among metabolic syndrome (MetS) subject. This study was a clinical trial with randomized double blind controlled design. Thirty subject with MetS are devided into 2 groups. Intervention group were given palm oil enriched with 6.5% phytosterol and used as cooking oil for habitual use for 8 week. The control group were given palm oil without phytosterol. Nutriens intake was assesed by 24 hours recalls every 2 weeks. Blood lipid profile and nutritional status as measured by anthropometry were analyzed at pre and post intevention. After 8 week intervention, estimated palm cooking oil and phytosterol consumption on intervention group were 46 ± 23 g/day and 2 ± 1 g/day respectively.
No significant changes were observed for LDL cholesterol. This is possible because of low intestinal cholesterol absorption and increased endogenous cholesterol synthesis on the subject with MetS and it is associated with a reduced efficacy of phytosterol ester as hypolipemic agents. There were significant reduction of serum total cholesterol and triglyceride (TG) level compared to the control group (p<0.05). Mechanism of decrease in total cholesterol and TG on the research allegedly associated with VLDL cholesterol.
It was concluded that the intervention of palm cooking oil fortified with phytosterols on the subject of MetS with high oil consumption obtained phytosterol intake as expected. There are improvements in lipid profiles in term of total-cholesterol and TG but not on LDL-cholesterol.