NUTRACEUTICALS AND PUBLIC

HEALTH PROBLEMS
(Lesson 7 & 8)

P. Wiryono P.,SJ
FOCUS OF DISCUSSION
A. VISION OF PUBLIC HEALTH

B. FOOD AND EATING PATTERN

C. PROBLEMS RELATED TO SPECIFIC AGE
GROUPS



A. VISION OF PUBLIC HEALTH
* Some visions of public :

1. The right identification of the causes of desease the right
choice of its drugs

2. People find health care services more easily everytime they get
sick.

3. Better condition of public health due to the improvements in
terms of eating pattern, education, and economic condition.
Indicators used are: the increase of life expentancy, the
decrease of child death rate, the decrease of mother death
rate, and the quality of food consumed. Additional indicator:
the absence of hungry people or eating less than normal.
(Lanjutan . . . )
4. The maintaining of environment free from pollutions (air,
water, land), flood, drought, diseases, electromagnetic
radiation, and other factors decreasing the
environmental quality so that the health of people living
there is secured. This fouth vision is the newest vision
of public health.





.
What kinds of
step should be
taken in relation
to this swine-flu
endemy?
.
VS
Show us which
one is more
healthy?
Environment kept healthy !!
.
(continued . . . )
* The most threatening environmental pollution affecting
public health comes from hazardous chemical ingredients
such additives for food coloring, food preserving, using
as solvent, formaldehid, and metal.

* Pollution coming from microorganism has been considered
has having similar hazardous effects. As example, fever,
diarrhea, etc which sometimes come from flood.
(continued . . . )
The most hazardous
pollution!!

(Lanjutan . . . )
* A comprehensive vision of public health is needed. It should
contains elements of promotion, prevention, curative action,
and rehabilitation. It must cover the whole aspects of human
life: physic, mentality, social economic, culture, and
environment.

* Public vision as formulated in UU-RI No. 23 Th 1992 on
Public Health seems to be comprehensive enough.

* What is still lacking is the establishment of positive
perspective in relation between public health and the local
culture and environment of the people.


(Lanjutan . . . )
* In Indonesia there are various local cultures and
environments which provided a lot of local knowledge valuable
for developing a kind of Indonesian traditional medicine which
can be compared with Chinese traditional medicine.

* Unfortunately the development of Indonesian traditional
medicine is not so emphasized in the UU-RI No.23 Th. 1992
about Public Health. We can find only one statement of the
importance of preserving and supervising the traditional
medicine. Meanwhile China, Sri Lanka, and India have been
developing their traditional medicines to the level of getting
international recognizion by doing serious researches,
introducing innovation, and applying quality improvement.
(Lanjutan . . . )
India and Sri Lanka have been developing an alternative
health care system named Ayurvedic. From China we can
learn about TCM (Traditional Chinese Medicine).

Question :




What has
been
developed in
Indonesia?
Traditional Chinese
Medicines
Indonesian Traditional Medicines?
B. FOOD AND EATING PATTERN
* Basic steps to secure public health begin with
the following strategies:
1. Promotion strategy = to maintain and improve
public health through supplying food and
promoting healthy eating pattern for people.

2. Prevention strategy = to prevent diseases
through keeping people always in good health.
(Continued . . . )
* Both strategies above use food and eating
pattern as their important tools. There are some
needs or challenges need to be aware of in
relation to the two strategies :
1. The need to improve continously the eating
pattern of people.
2. The need to be aware of food consumed.
3. The need of sufficient water supply.
(Continued . . . )
4. Some nutrients are easily to be
neglected.
5. The secret of longevity (= having longer
life)
6. The close correlation between eating
pattern and life style.
7. Obesity and diabetes.
8. Prevention of degeneratif diseases.

(continued . . . . )
* Below we can give some explanation concerning
each need or challenge mentioned above :

1. The need to improve continously the eating
pattern of people :

Here is the principle : eat various kinds of food
containing all nutrients needed by the body in a
balance.

.
What kind
of eating
pattern I
develop?
.
.
Why didnt I
choose this
food?
(continued . . . )
Since the body needs growing and developing, the
variety of food consumed should be improved continously.



Is it the
right way to
improve food
consumed?
(Lanjutan . . . )
2. The need to be aware of food consumed

In 1988 was published Permenkes No. 722/Menkes/Per.IX/88
about the banning of boraks to be used as food additive for
preservation. In 1999 was published Permenkes No. 1168/Menkes
/Per/X/99 about the banning of formalin to be used as food additive
for preservation. These two chemical compounds have been used
widely as food additives for preserving foods such as: bakso, mi
basah, empek-empek, tahu, meat, fresh fishes, salted fishes, etc.

(continued . . . )
The reason was understandable: consuming
boraks in a certain amount will affect on nerve
system disorder which cannot be cured. Formalin
in a certain amount will be toxic that creates
stomach irritation, allergic, cancer, and death.
Be Careful : Boraks & Formalin !!
(continued . . . )
The problem was that Indonesian law enformcement is
very weak. Boraxs and formalin are still being used by
small food producers to get better income. As a result,
the food consumers have to be careful concerning the
presence of the two detrimental chemical compounds.


(Lanjutan . . . )
Food consumers have to be aware about food
contaminations caused by bacteria, metal (Pb and Cu),
additives such as: rhodamin B, methanil yellow, amranth,
sakarin, etc.

3. The need of sufficient water supply.

Problems come when there is lack of drinkable water so
that people consume only a little bit of it.
(continued . . . )

Risks of consuming very little water in
the body :




Disorder in the metabolim of fat in the body.
Disgestive system functions less efficiently
The inrease of the toxicity in the body.
Disorder in the kidney.
Pain in the tissues and joints.
Defects in the blood circulatory of the brain that may initiate
stroke.

Recomendation:
Drink water every day about 8 to 10 glasses containing
8 ons of water. If you are doing intensive physical
exercises, drink more than 10 glasses. A serius atletic
needs 13 to 14 glasses of water every day. Add 1 glass
if your body weight 0,373 kg above the ideal weight.
He needs about 13-14 glasses per day !!
.
Drink water free from bacteria, metal, and
other contaminant materials.
.
(continued . . . )
4. Some nutrients easily to be neglected

Fibre tends to be neglected as an important nutrient. In the
digestive system it functions to bind the gall acids as the
final products of cholesterol execreted together with faeces.
Fibre deficiency effects on the stiffness of the faeces that
creates an extra effort to execret it. Fibre can be found in
fruits and oat bran.







(Lanjutan . . . )
The other neglectable nutrient is choline. Choline plays
important role in almost every system of the body from
the brain, liver to the heart. It aids in the metabolism
of fats, plays a critical role in making acetylcholine,
known as neurotransmitter which is essential for sending
nerve signals in the brain and nervous system. It plays
important role in functions such as movement,
coordination, muscle stimulation and contraction, brain
functions including thought, memory, and intellect.
Sources of choline: brewers yeast, cabbage, cauliflower,
egg yolks, legumes, oatmeal, oranges, organ meats,
potatoes, wheat germ, and whole milk.

(continued . . . )
5. The secret of longevity (= having longer life)

Some places like: Bama in Guangxi Province, China, Okinawa in
Japan,Sunchang in Korea, and Hunza in Pakistan, have populations
with higher age average compared to other places in the world. The
secret of their longevity is related to their eating philosophy : Stop
eating before being satisfied (= Berhentilah makan sebelum
kenyang) or Eat 8/10 of being satisfied (= Makanlah 8/10
kenyang), Make an eating pattern: not to be hungry and never to
be satisfied (= Buatlah pola makan : tidak kelaparan tetapi tak
pernah kenyang).

(continued . . . )
Besides this philosophy, people there cook their meals by
using special oils: rami oil, tea oil, or canola oil. Their
food menu consists of rice, vegetables, fruits, and peas
containing a lot of unsaturated fat, vitamine E, vitamine
B1, flavonoids, isoflavons, saponin, vitamine B, and
vitamine C which protect the body from the free
radicals.




(Lanjutan . . . )
6. The close correlation between eating pattern and life
style.

Life style which tends to consume heavy meals (= makan
enak) increases the risk of high cholesterol,
hypertension, uric acid, plaque, and heart diseases. To
prevent this risks, people have to change their eating
pattern toward an healthy eating pattern, do more
physical exercises, and have enough taking rest.
.
.
Healthy eating pattern should follow these tips :

a. Drink plain water minimum 8 glasses every day.
b. Eat 3 times a day in adequate amount.
c. Digest the food bit by bit and swallow it slowly to help the
stomach process easily.
d. Choose the low fat food and avoid the gorengan food.
e. Eat a lot of fruit and vegetables.
f. Limit the consumption of alcoholic drinks because they
contain high calories and increase the accumulation of fat
in your body.
g. Choose the fresh meat, avoid the canned foods, sauces,
because they contain a lot of calorie and fat.
h. Limit the consumption of fast foods.
i. Take your dinner before 19:00 o clock

.
.
What do
you think
about
them?
C. PROBLEMS RELATED TO SPECIFIC AGE
GROUPS

Group of BALITA and Children

Group of Pregnant & Breast Feeding Women

Group of Adults

Group of Retired Peoples

Group of BALITA and Children







Who has this kid?
(Continued . . . )
* There is a critical period of the human foetus growing
in the mothers womb : in the age of 2 weeks till 12
weeks. Critical period = period with very high
sensitivity to lack of nutrition needed for the
formation of most vital organs : brain, heart, hands,
eyes, legs, teeth, palate, genital, and ears.

* Lack of Omega 3 and 6 during the critical period will
effect on the defection of coordination system and
the memory system of the brain. Lack of vitamin A
will effect on the defection of neuron structure. Lack
of vitamin B12 creates the discrepancy of myelin
growth of the brain.


(Continued . . . )
* Lack of Zn, Fe, and Iodium during the critical period will
create defections in the multiplication of brain cells,
difficulties in the mental interaction, hare-lips, deaf ears,
idiot, and physical handicaps.
Lack of energy protein, vitamin A, Fe, and Iodium will affect
areas in Indonesia which have poor nutrition problems. These
areas usually have other problems related to lack of the
consumption of Omega 3 and 6.
The improvement of nutrition for human foetus has to be
carried out through the improvement of nutrition for the
mother during the pregnancy.

The improvement of nutrition for the mothers has to be
carried out through long processes of the fulfillment of
woman rights, improvement of education, information
providing, good services, and proper living quality.
(Continued . . . )
For a healthy growth an infant needs not only material
nutrition but also spiritual nutrition such as invitation for
personal communication, singing together, learning for
counting and reading, and other spiritual feeding of the
mother, father, and other family members.

* When the kids start to enter the school, their habit of
taking breakfast has to be put in regularity. Breakfast
should not be forgotten. Their study performance will
depend on their regular breakfast. Kids who didnt take
breakfast will get difficulty in concentrating their mind,
slow in response, and poor in understanding, slow in
motion, and becoming sensitive (= mudah tersinggung).


Pregnant and Breast Feeding Woman Group
(Continued . . . )

* Pregnant woman needs more calorie. It must be more
than 300 calorie. Foods eaten should be more nutritious
to help the foetus grow healthily.

* Lack of vitamin A, Fe, and Iodium has been
experienced by women from areas in Indonesia which
have nutrition problems. These areas have also problems
related to lack of Omega 3 and 6 for the pregnant
women.

* Improvement for the above condition has to be carried
out through a long way : the fulfillment of woman
rights, improvement of woman education, information
providing, better services, and proper living quality.
(Continued . . . )
* The roles of a mother to secure the life of a foetus should be
started before the pregnancy. The unhealthy life of the mother
before the pregnancy will be affecting such as : (1) being
retarded, (2) physical and mental handicaps, (3) low weight and pre
maturity, (4) longer pregnancy, and (5) death of the foetus.

* There is a group of pregnant mothers who have high
risks :
1. Mother being pregnant before 16 years old or too
young.
2. Mother being pregnant after 35 years old.
3. Mother being pregnant after 4 years married.
4. Interval from the last kid more than 10 years.
5. Interval between pregnancies less than 2 years.
6. Too many children, more than 4 children.
7. Having too low height and too light weight less than
45 kg
(Continued . . . )
8. Having too heavy weight or too thin body.
9. Having sadness related history of the previous pregnancy.
10. Having family inherited defects.
11. Heavy smoker, dependent on drug, or dependent on alcoholic
drinks.

Group of mothers with high risks should be careful during their
pregnancies. There is a need for mother health monitoring, regular
observation of the fuetus, and regular checking of blood pressure,
urine, possible inflammation, contraction, etc.

(Lanjutan . . . )
.
Let prepare our meal
together !
(Continued . . .)
* Defect of the foetus might come as resulted from
consuming highly alcohol or the mother is a serious
smoker. It might come from misusing of drug such as :
isotetrionin, adrogen hormone, DES, litium,
streptomycin, and tetracyclin.

* Brain defect and hyperactive behavior of the kid might
come from stress and depression experienced by the
mother during pregnancy. The hyperactive kid will have
problem of difficulty in eating, difficulty in sleeping,
easy to be angry, fear, and difficulty in concentration.

* Hypertension experienced by the pregnant woman is a
risk for the foetus later to have hypertension problems
such as : decreasing blood flow to the brain, heart, and
gal and the problem of toxicity.
Adult Group
(Continued . . . )
* Adults pursuing career seriously tend to put into priority
such as : physical fitness, stamina, looked young, and
having attractive body performance. For all of these
they need to have enough knowledge about nutritious
foods, healthy living pattern, and commitment to
discipline himself or herself every day. In practice there
are many challenges that have to be faced such as :
a. Work-loads that create tension, stress, and
depression.
b. The need of having regular physical exercises that is
quite difficult to meet and tends to be irregular.
c. The coming of difficulties in sleeping



It is unfair! How I have to finish
all these home-works?
Various kinds of stress expression
.
Iihh!!
Aduuh !!
Mati aku !!
(Continued . . . )
d. The decreasing of stamina.
e. The starting of obesity problem.
f. The early coming of aging problem.

When the challenges really come, there is no alternative
except taking drug. Before it happens, preventive
efforts should take place in accordance with the
awareness and knowledge of living healthily which exist.
* A book titled Hidup Sehat dengan Akal Sehat, containing
articles about health written in Kompas from 1994 to
1998 gave a lot of tips about living healthily in a cheap
way, easy to manage, and no risk for adult group. This
book can be used as a practical guide.
(Continued . . . )
* The adult group can take supplement products as
a preventive effort to avoid the possible risks
mentioned above. In relation to obesity risk
several products having special benefits can be
recommended : 1) for pressing the eating
appetite : fiber, 2) prohibiting fat accumulation
: citric acid, 3) fat burning : Ma Huang,
Gamma-linolenic acid (GLA), L-carnitine, and 4)
preventing the absorption of calorie in the colon
: Cascara sagrada, licorice, ginger.

(Continued . . . )
* Facing the problem of aging the following
supplements can be chosen : vitamin E to prevent
the Alzheimer, tretionin to avoid the aging of
the skin,calcium to avoid the bone brittleness.
The aging process is believed to start since 30-
40 years old. Indicators : 1) the decreasing
function of psycho-eurology in relation to seeing
& hearing ability, 2) the decreasing function of
mental abilities as related to cognition ability,
intelligence, calculation ability,learning ability,
and memory, 3) the decreasing function of

(Lanjutan . . . )
of sensomotoric : any movement tending to be
slow and less accurate, and 4) the decreasing
function of neuro-physiology such as the
decreasing cardiovascular reflective ability.


(Lanjutan . . .)
* The best way to avoid early aging
process is : doing regular physical
exercises. The exercises should be
designed for improving the fitness not
for competition. There are several
kinds of exercise that can be chosen
: swimming, aerobic, bicycling, yoga,
Tai Chi, Wai Tan Kung, etc.

Retired Person Group
(Continued . . . )
* The most relevant question to raise is :
Is there any chance to be healthy in the
retirement years (lanjut usia)?

* The answer should be : Yes, there is! Its
explanation should be that the quality of
being healthy is different for the retired
persons, adults, adolescents, children, and
balitas.
(Continued . . . )
The quality of being healthy for a retired person takes
place in congruence with the aging process which cannot
be avoided. The aging process is very natural. Some
ways to keep healthy during the retirement are as
follows :
1. Keep the good health.
2. Consume the nutritious foods.
3. Do physical exercises regularly in congruence with the
age.
4. Keep the thinking away from the negative environment
5. Every 3 months have consultation with a medical
doctor.
(Continued . . . )
Retirement age needs a philosophy expressed in
the following prayer: God, give me a strength
to change what can be changed, courage to
accept what cannot be changed, and wisdom to
know the difference. With this full acceptance
philosophy and living in sense of happiness, the
retirement age can be experiences in quietness,
peace, and full health.
How devout they
are praying!
(Continued . . .)
Some tips given by an expert as follows :

Use your time for good activities and
start to develop your hobbies which had
been left!

Dont worry about the liver problem. You
are still able to live with one third of your
liver functioning!

(Continued . . . )
* There are some problems that the retired
persons experience easily:
1. Hearing problem.
2. Easy to forget.
3. Parkinson.
4. Metabolism system problems.
5. Respiration system problems.
6. Easy to be tired.
7. Decaying bones.

How they are still
fresh!
(Continued . . . )
The above problems are related closely to the
aging process. Prevention of such problems
should be started when persons are still young
through healthy life, regular physical exercises,
positive thinking, etc. Starting in the retirement
years is too late.
Question: Can the above problems be cured by
taking drug?
Answer : They are natural. It is better to keep
like that.

Aging process ?
.
(Continued . . . )
Medical care for the above problems should be
accompanied by a medical doctor. There is a possibility
that the problems are not related to the aging process.
Through analysis the problems can be identified.

Keluhannya apa Pak?
(Continued . . . )
* Besides the above problems, the retired persons
can find changes in their bodies related to their
faces, hair color, performances, stamina,
nervous system, hearing system. Factors related
to those changes are as follows :
a. Food quality (fat, protein content, etc).
b. Environment (pollution, toxicity, etc)
c. Burden in mind (creating possible stress)
d. Genetic factors.

.
.