The prevalence of non-communicable diseases such as heart disease and stroke, as well as obesity and dyslipidemia, are known to be high among the Minangkabau population (the majority ethnic group in West Sumatra, Indonesia). The Minangkabau population has long been known for having traditional food options that is dominated by the use of coconut milk, slow cooked cooking and spices. One of their best-known foods is Rendang (slow-cooked beef stew), which for four consecutive years now has become one of the world's 50 most delicious food according to CNN. Meanwhile, the prevalence of obesity in West Sumatran according to the results of the Indonesian National Health Survey in 2018 reach 20%, while the prevalence of central obesity (fat accumulation in the abdomen and waist) reaches 32%, and their prevalence of dyslipidemia ranges from 24 to 35%. It has been long suspected, the cause of this high rate of non-communicable disease (NCD) is relate to their consumption of their own local food.
Rendang, the delicious slow-cooked beef stew from West Sumatera
Inspired by those facts, Gusnedi, a lecturer at the Department of Nutrition Health Polytechnic of Padang, West Sumatra, Indonesia, conducted a study to see whether the dietary practices of Minangkabau people, especially women at child-bearing age, influenced the high prevalence of dyslipidemia and obesity among them. Gusnedi determined to reduce the problem of dyslipidemia among Minangkabau women by creating and promoting the use of balanced nutrition guidelines, without overlooking the culinary cultural roots of the community. His research is focused on a group of women of childbearing age because of their nutritional and health status will also affect the health status of their children and other family members. Using the modified WHO Optifood modules*, he identified the Minangkabau women’s nutrient gaps, and then compiled a weekly food menu recommendation for them. The food guideline includes local favorite foods of the Minangkabau people, with specific portion and consumption frequency recommendation. Gusnedi also recruited Minangkabau women with dyslipidemia and divided them into two groups. In one group he educated them how to have a better eating based on the local food-based balanced nutrition guidelines, while in the other group he let the women received regular nutritional counseling based on usual practice.
It turned out that after 12 weeks, women who received local food-based balanced nutrition guidelines, managed to improve their dietary and intake practices, experienced weight loss, and reduction in their BMI and waist circumference. Unfortunately, the lipid profiles in the two groups after 12 weejs were not significantly different. Gusnedi suspected this was due to the high consumption of foods fried in bulk palm oil. The use of cooking oil that is not processed properly may increase the levels of saturated fatty acids which are risk factors for non-communicable diseases. In addition, he also observed that the women tended to reduce the traditional types of curry (gulai), that usually contained spices as the source of antioxidants.
Gusnedi's findings were supported by the study from his colleague, Patricia Budhartanti Liman, a researcher from Faculty of Medicine, Trisakti University, Jakarta, Indonesia. Liman examined the Carborxymethyl Lysine (CML) contained in foods of Minangkabau and West Java (Sundanesse) population. CML is one of the elements in food that may influence weight gain and increase the onset of central obesity. Liman identified that in the Minangkabau community, there were several types of food containing high CML including Rendang, fried bilis (small fish) and kalio. The consumption of foods containing CML among Minangkabau population is actually lower compared to the Sundanesse population.
DR. dr. Patricia Budhartanti Liman with her family and her promotion team
Gusnedi and Liman's research brings important findings that we cannot simply blame certain type of food as a cause of non-communicable diseases. We should also look at the portion and frequency of the food we consumed, and the processing process of the food. Dietary and food interventions to prevent obesity and non-communicable diseases need to focus, not only on limiting consumption of certain type of food, but also the food production and distribution chain.
The results of Gusnedi and Liman's research were part of their doctoral thesis at the Faculty of Medicine, University of Indonesia at 9th January 2020. They have received publication grant from SEAMEO RECFON for some part of this work and their related publications in international journals can be read in the journal Asia Pacific Journal of Clinical Nutrition (http://apjcn.nhri.org.tw/server/APJCN/28/2/310.pdf) and Nutrients (https: // www .mdpi.com / 2072-6643 / 11/12/3057).