THE EFFECT OF CONSUMPTION TOMATOES TO REDUCE BLOOD CHOLESTEROL LEVELS IN MENOPAUSAL WOMEN

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1 THE EFFECT OF CONSUMPTION TOMATOES TO REDUCE BLOOD CHOLESTEROL LEVELS IN MENOPAUSAL WOMEN Siswi Wulandari, Hurin Fitriatun Nuriyah, Fitra Dwi Afriliana Study Program Bachelor of Midwifery Faculty Of Health Sciences Kadiri University ABSTRACT Introduction: Cholesterol is a waxy, fat-like substance that s found in all cells of the body. High blood cholesterol is a condition in which have too much cholesterol in blood. The condition usually has no signs or symptoms. Then, many people don t know that their cholesterol levels are too high. The purpose of this research was to determine any effect of consuming tomatoes and the reducing of blood cholesterol levels in menopausal women in Sukorame Public Health Center at Kediri city on Methods: The research design is pre experimental with one group pretest postest design. The population are all menopausal woman who have cholesterol level 200 mg/dl and there are 16 respondents selected by using total sampling. This research have been work on March The data were analyzed by Wilcoxon test. Result: the result showed that after consuming tomatoes the level of cholesterol is moreless. The analysis showed α = 0,05, and it was obtained ρ value = 0,006 so ρ value < α it means H0 is denied and H1 is accepted. There is a correlation between consuming tomatoes and reducing of level of cholesterol among the menopausal woman in Sukorame Public Health Center at Kediri City on Discussion Based on the result, after they consuming tomatoes, 9 respondents have reducing level of cholesterol (56,25%). So there is a correlation between consuming tomatoes and the reducing of blood cholesterol levels in menopausal women in Sukorame Public Health Center at Kediri city on Keywords: menopausal woman, tomatoes, level of cholesterol

2 INTRODUCTION Diseases of the heart and blood vessels are the main cause of death in the world. From the results obtained by researchers there are 10 diseases that often occur in elderly pre and one of them is coronary heart disease. The incidence of coronary heart disease in the town of Kediri there are as many as the number of sufferers with 288 males as much as 172 and 116 women. The incidence of heart disease and blood vessels are affected by many factors, one of which was caused by the hiperkolesterolemia, i.e. a condition where cholesterol levels in the blood increases above normal. The initial survey conducted by researchers at the Sukorame clinic there are 51 menopausal woman who suffered coronary heart disease by From the above data show that still high levels of cholesterol on menopausal women at Sukorame Public Health Center. In menopausal women is said to be pre elderly so expect to be able to stay healthy, stay active and independent. Because the recognize the menopause is not as easy as he thought. Nevertheless, identify the menopausal or change of life is the key to handling are effective against the symptoms of menopause and attempts to avoid complications that could potentially happen. Because we get a lot of complaints of illness suffered, among others: rheumatism, hypertension, and high cholesterol. Causes of cholesterol levels in the blood can be affected by several factors, namely one is the intake of nutrients from the food that is a source of fat. Increased consumption of fat by as much as 100 mg/day can increase total cholesterol levels by as much as 2-3mg/dl. This situation can be affected by several factors, one of which HMG CoA reductase activity that can decrease cholesterol synthesis. To lower the cholesterol synthesis is to consume fiber and vitamin a high cholesterol level in the blood decreases. Cholesterol is the beginning of a range of illness, such as heart disease, stroke and vision disorders (Apriyanti, 2010). A solution that can be done to treat high cholesterol levels can be done by way of treatment to lower their blood cholesterol levels in menopausal women i.e. pharmacological (drug class: statins, niacin, resin, ezetimebe, and omega-3 fatty acids) and non pharmacological treatment (choose foods contain healthy fats, limiting cholesterol levels, choose foods that contain fiber, consuming fish, avoid alcohol, avoidance of smoking, and do sports) (a hit, 2013).The selection of nutritious food in menopausal women is needed to maintain health and prevent disease or complications from the disease that has already suffered. Nutrients are believed to support the health and prevent heart disease including carotenoids, polyphenols (flavonoids and non-flavonoids), omega 3 fatty acids, and allinin (garlic). One of the kartenoid contained in the food is likopen. Source of foodstuffs containing likopen is tomatoes. Tomatoes have a component bioaktif and nutrients like potassium, folic acid, vitamins A, C, and e. in addition, Tomatoes contain a mix of carotenoids -carotene, phytoene (PE),γ include lycopene carotenoid (LYC), neurosprene, phytofluene (PF), β-carotene, and lutein. Tomato ripe at this stage is characterized by the color change to red because it contains carotenoids, which also contains nutrients and other bioaktif such as tocopherols, folic acid, phenolics, glycoalkaloids, flacanoids. Tomato fruit is easily obtainable ingredients are also easy to come by and easily processed due to software, making it easy to consume it. Most people know the tomatoes just as additional ingredients and cuisine of the drink as processed into syrup. Whereas in tomato there is a role in likopen prevent the onset of cardiovascular disease. Likopen found on tomato fruit plays a role in regulating the metabolism of cholesterol by inhibiting the enzyme HMG-CoA work reductase (enzyme that plays a role in the synthesis of cholesterol in hepar) and increase the degradation of LDL cholesterol (Iswari, 2009). Because of many benefit of tomatoes, the researcher interested to study The Effect Of Consumption Tomatoes to Reduce Blood Cholesterol Levels in Menopausal Women in Sukorame Public Health Center at Kediri city in METHOD This research is a pre-experimental study with One Group Pre Test Post Test Design. This research is giving a pre-test before treatment, after being treated, then given a post-test. This methods are to determine whether there are differences between the results before being treated with after being treated. The population is all menopausal woman are in the Sukorame health centers that have who

3 have cholesterol level 200 mg/dl. The sample is a part of menopausal woman and there are 16 respondents selected. The sampling technique uses total sampling technique. The independent variables is the consuming of tomatoes and the dependent variable is reduce of cholesterol level of menopausal woman. This research was conducted in Sukorame Public Health Center at Kediri city, whereas this study was conducted in March Ethical clearance process: giving informed consent, Interview with menopausal woman who being a sample. Data collection procedure: 1) Giving pre test, 2) Giving tomato s syrup, 3) Post test. Procedurs : 1) Materials : Tomatoes, ½ tablespoon sugar, knife, Pan, plastic glass, gas cooker, spoon, food scales. 2) How to make: a) Take 150 gr of tomatoes in food scales, b) clean wash tomatoes, c) slice tomato and put in pan, d) put sugar and 240 ml water, e) cook tomatoes and filter it, f) remove and serve to respondents once a day until 14 days. To determine the effect of tomatoes to reduce level of cholesterol are using Wilcoxon test with an error level of 5%. Interpretation of the results of analysis, if the value of the test statistic > table value or values obtained level ρ <α with α = 0.05 significance level. RESULT Tabel 1. Frequency Distribution Characteristics of Respondents Based on Age, education and job in Sukorame Public Health Center at Kediri City In 2016 Age Frequency Presentation < 45 years old 1 6,25% years old 15 93,75% 60 years old 0 0% Tabel 2. Frequency Distribution Characteristics of Respondents Based on Educational Background in Sukorame Public Health Center at Kediri City In 2016 Educational Background Frequency Presentation Elementary school 7 43,75 High school 8 50 College 1 6,25 Tabel 3 Frequency Distribution Characteristics of Respondents Based on Job in the Sukorame Public Health Center at Kediri City In 2016 Job Frequency Presentation Government Employees 1 6,25 Non Government Employees 5 31,25 Farmer 0 0 Entrepreneur 2 12,5 Housewife 8 50 Total

4 Tabel 4 Frequency Distribution Characteristics of Respondents B efore consuming tomatoes in the Sukorame Public Health Center at Kediri City In 2016 Reduce level of cholesterol Frequency Presentation Good 0 0 Moderate 11 68,75 High 5 31,25 Tabel 5 Frequency Distribution Characteristics of Respondents After consuming tomatoes in the Sukorame Public Health Center at Kediri City In 2016 Reduce level of cholesterol Frequency Presentation Good 9 56,25 Moderate 7 43,75 High 0 0 Tabel 6 Statistic result from effect of before and after consuming tomatoes in Sukorame Public Health Center at Kediri City In 2016 Reduce level of cholesterol Before consuming tomatoes After consuming tomatoes Explanation % N % N % Good ,25 Up 56,25 Moderate 11 68, ,75 Down 43,75 High 5 31, Down 31, Ρ=0.006 α= 0.05 Based on table 6 obtained statistical results influence consuming tomato against the decrease of blood cholesterol levels in menopausal women before and after treatment is done, namely the granting of tomatoes. Increase in blood cholesterol levels as much as (56,25%) from (0%) on the category very well, and on a sufficient decline of categories (68.75) becomes (43,75%), on high blood cholesterol levels (31,25%) decreased to (0%). DISCUSSION Under normal conditions the levels of total cholesterol your body needs i.e. < 200 mg/dl, and when 200 mg/dl will cause a build-up of cholesterol in the blood vessel walls, which will slowly harden the blood vessel walls so as inhibit the blood flow and can cause arteriosclerosis in arteries and cardiovascular disease (Karim et al, 2001). Based on the research results obtained that the tomato syrup before most respondents experienced enough cholesterol levels, so that needs to be done to the women menopause treatment to lower cholesterol levels. Causes of cholesterol levels in the blood at menopausal women can be affected by several factors, namely one is the intake of nutrients from the

5 food that is a source of fat. Increased consumption of fat by as much as 100 mg/day can increase total cholesterol levels by as much as 2-3mg/dl. Based on table 5 shows that, after the grant of the syrup tomato against the decrease of blood cholesterol levels in menopausal women most (56,25%) of the respondents experienced a decline in blood cholesterol levels than simply being good i.e. 8 people.based on the results obtained that most menopausal women experience decreased against cholesterol levels with the awarding of the tomatoes so that the giving of a tomato is considered effective to lower cholesterol levels, in addition to easy tomato syrup obtained and made very effective against cholesterol levels decrease when done correctly in accordance with the measure.on menopausal women before and after treatment is done to decrease blood cholesterol levels. Increase in blood cholesterol levels as much as (56,25%) from (0%) on the category very well, and on a sufficient decline of categories (68.75) becomes (43,75%), on high blood cholesterol levels (31,25%) decreased to (0%). While the results of statistical tests using wilcoxon test obtained p value of because ρ-value 0.05 then H0 < rejected, and H1 is accepted, meaning that there is influence the awarding of the tomatoes against the decrease of blood cholesterol levels in menopausal women before and after treatment is done in the area of public health Sukorame Kediri Based on the results of the research that has been done that non pharmacological treatment by administering syrup tomato 150 g plus half a spoon of sugar by as much as 2 times a day for 14 days can be used to decrease blood cholesterol levels. The tomato is one of the fruits that are rich in vitamin C, simply applied reached mg per gram of tomato part 180 edible. Needs vitamin C 60 mg per day for men, to fill with enough to consume 300 grams of tomatoes. The mineral content of phosphorus is prominent enough with mg per 180 gram tomato. Eating tomatoes regularly, one third vitamin C requirements (33 percent) has been reached. So also is the case with most needs in vitamin A and vitamin k. one obstetrician in the tomato is likopen. Likopen is a bright red carotenoid pigment found in tomatoes and other red fruits is one of a very powerful antioxidant. In addition as an anti aging, skin lycopene also has benefits to prevent cardiovascular disease. Likopen on tomato fruit can lower cholesterol levels. Likopen is absorbed by passive diffusion in membranes of mucous cells in the brush border of intestinal smooth assisted by salt bile. Likopen out through the lymph system mesentrik in the form of kilomikron which then enters the natural blood to enter the network as the adrenal glands, kidney, adipose tissue, spleen lungs and reproductive organs. Likopen lowers cholesterol levels by pressing the synthesis of cholesterol by approximately 40% by inhibiting the enzyme HMG-Coa on research with human subjects (Sulistyowati, 2006). CONCLUSION AND RECOMMENDATION Based on study, tomatoes can reduces level of cholesterol in menopausal woman. So, there is a effect of consumption tomatoes to decrease level of cholesterol of menopausal woman in Sukorame Public Health Center at Kediri city in Recommendation for menopausal woman who are experiencing problems in high cholesterol level, can consume foods that can help decrease level of cholesterol without taking any medication. REFERENCES Adam, J. M. F., (2007), Dislipidemia, Chapter 437, Buku Ajar Ilmu Penyakit Dalam, Edisi IV, Jilid III, 1929, Fakultas Kedokteran Universitas Indonesia, Jakarta. Almatsier, S. (2001). Prinsip Dasar Ilmu Gizi. Jakarta: PT.Gramedia Pustaka Utama Devlin, T. M., (2006), Textbook of Biochemistry: with Clinical Correlations, Sixth Edition, , John Wiley and Sons, inc. Pp, New York. Dumadi, S. R., (2002), Risiko Kolesterol Darah dan Diet Lemak, Jurnal Farmasi Pancasila, 1 (1), Fan, C., Wo, X., Dou, X., Xu, L., Qian, Y., Luo, Y. and Yan, J., (2006), Regulation of LDL Receptor Expression by the Effect of Curcumin on Sterol Regulatory Elemen Pathway, Pharmacological Reports, 56 (1), Galton, D. and Krone, W., (1991), Hiperlipidemia in Practice, Gower Medical Publising, London.

6 Hartini, M. And Astirin, O. P., (2009), Kadar Kolesterol Darah Tikus Putih (Rattus norvegicus) Hiperkolesterolemik Setelah Perlakuan VCO, Bioteknologi, 6 (2), Lim, C. S., Jin, D. Q., Mok, H., Oh, S. J., Lee, J. U., Hwang, J. K., Ha, I. and Han, J. S., (2005), Antioxidant and antiinflamatory activities of xanthorrhizol in hippocampal neurons and primary cultured microglia, J Neurosci Res, 82 (6), Mahley, R.W. and Bersot, T.P., (2007), Goodman & Gilman Dasar Farmakologi Terapi, diterjemahkan oleh Tim alih Bahasa Sekolah Farmasi ITB, Edisi kesepuluh, volume I, , EGC, Jakarta. Mauli, I., (2005), Pengaruh Perasan Segar Buncis (Phaseolus vulgaris L) Terhadap Kadar Kolesterol Total Tikus Putih Jantan Galur Wistar yang diberi Diet Kolesterol Tinggi, Skripsi, Fakultas Farmasi Jakarta. Suyatna, F.D., (2008), Farmakologi dan Terapi, edisi kelima, , Departemen Farmakologi dan Terapeutik Fakultas Kedokteran UI, Jakarta. Wientarsih, I. (2000). Influence of curcumin on lipid metabolism in rabbits. Disertasi. Georg-August University, Gottingen-Germany. Wiryowidagdo, S. and Sitanggang, M., (2002), Tanaman Obat untuk Penyakit Jantung, Darah Tinggi, dan Kolesterol, Cetakan 1, 23, Agromedia Pustaka, Jakarta. Wolkoff, A. W. and Cohen, D. E., (2003), Hepatocyte Transport of Bile Acids, Am J Physiol Gastrointest Liver Physiol, 284 (1), G175.

Food and Nutrition. In this chapter, you will Learn About. The six major nutrients your body needs. The Food Guide Pyramid.

Food and Nutrition. In this chapter, you will Learn About. The six major nutrients your body needs. The Food Guide Pyramid. Food and Nutrition In this chapter, you will Learn About The six major nutrients your body needs. The Food Guide Pyramid. Healthful meals and nutritious snacks. The digestive and excretory systems. How