FOOD CONSUMPTION AND INTAKE

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E. EARLIER STUDIES ON PLANT STEROLS INTAKE

Dietary intake of plant sterols has been sparsely studied, probably depending on the lack of analysed food items in general nutritional databases Klingberg 2012. In the European community, the daily plant sterols intake was usually in the range of 200 Morton et al. 1995 - 350 mgday Schothorst Jekel 1999. Other research reported by Klingberg 2012 revealed that the plant sterols intake in Britain was 300 mgday in men and 293 mgday in women while in Sweden was 252 mgday in men and 212 mgday in women. Another study conducted in China showed the plant sterols intake level of 322.1 mgday Han et al. 2007. Estimated energy-adjusted plant sterol intake ranges from 30 to 35 mgMJ, with women having higher intakes than men Valsta et al. 2004. Studies of vegetarian and vegan diets showed that compared to a mixed diet, the plant sterol content of these diets is usually higher Piironen et al. 2000. Study in plant sterols dietary intake is one of observational study which mainly carried out by either cross-sectional or cohort design. Most of plant sterols dietary intake studies were done by cross-sectional design, which involves observation of all of a population at one specific point in time Andersson et al. 2004, Valsta et al. 2004, Wang et al. 2012. Estimating dietary plant sterols intake was done similarly with other intake, by using food consumption data of respondents, to which plant sterols values will be assigned using database of plant sterols level in food. The individual or national food consumption data could be obtained from the databases available Hirai et al. 1986, Morton et al. 1995, Valsta et al. 2004, Han et al. 2007 or by performing food consumption survey using Food Frequency Questionaire Andersson et al. 2004, Jiménez-Escrig et al. 2006, Sanclemente et al. 2009, Wang et al. 2012. Besides food frequency questionnaire, other individual survey method such as duplicate 24-hour Recall method could also be performed Schothorst Jekel 1999. The summary of design, method, and results of several previous studies on plant sterols intake is shown in Table 4.

F. FOOD CONSUMPTION AND INTAKE

The Indonesian Act No. 7 of 1996 explains the food as anything originated from biological sources and water, whether prepared or raw, which is intended as food or drink for human consumption, including food additives, food raw materials, and other addition used in the manufacturing, processing, and or preparation of food or drink. Food is one of the human basic needs as a source of energy and nutrients Bender 2002. The essential nutrients are carbohydrates, fat, protein, vitamins, and minerals Almatsier 2003. Water, although not a nutrient is also essential for the body. On the other hand, there are also non-nutritional substances that can also be beneficial for the body. For examples are fiber, antioxidants, and food sterols. Energy and nutrient needs depend on factors such as age, gender, weight, weight, physical activity, socioeconomic, and geographic conditions Harper et al. 1986; DeBruyne, Pinna, Whitney 2008. Since energy and nutrient intake are largely determined by the type of food consumed, the type of food that should be consumed will also depend on these factors. Worthington and Roberts 2000 divided the factor influencing food consumption into two groups; internal and external factors. Internal factors are factors such as the needs of the individual physiology and habits. Meanwhile, external factors are beyond individual factors, such as food availability and socioeconomic conditions that affect the food accessibility to someone. 11 Table 4. Summary of design, method, and results of several previous studies on plant sterols intake No Objective Design and Method Results Publication Design Dietary survey Data of PS value in foods 1 Studying PS intakes in relation to colorectal cancer risk Cohort Dietary consumption collected from Food Frequency Questionnaire FFQ - Compiled from external source - Derived from calculation of recipe - Laboratory Analysis - PS intakes for men and women respectively were 310 and 303 mgd. - A high dietary intake of plant sterols was not associated with a lower risk of colon and rectal cancers Normen et al. 2001 2 Providing an up-to-date data of PS intake in Finland Cross sectional Data obtained from national databases, which collected by 48 hours dietary recall and 3 days food record - Compiled from external source - Derived from calculation of recipe - Laboratory Analysis PS intake in men was slightly higher than women, i.e. 305 and 237 mgd, respectively. Valsta et al. 2004 3 Estimating PS intake and relationship with serum cholesterol concentration in EPIC Norfolk population Cross- sectional Dietary consumption collected from Food Frequency Questionnaire FFQ - Compiled from external source - Derived from calculation of recipe - PS intakes for men and women respectively were 310 and 303 mgd. - Significant negative trend between total blood and LDL cholesterol and PS intake Andersson et al. 2004 4 Evaluating PS intake and relationship with serum cholesterol concentration in northern Sweden Cross- sectional Dietary consumption collected from Food Frequency Questionnaire FFQ - Compiled from external source - Derived from calculation of recipe - Laboratory Analysis - Men had a mean plant sterol intake of 252 mgd, which was significantly higher than women, 212 mgd P 0.001. - Higher plant sterol density was associated with lower serum total cholesterol in both men and women and with lower LDL cholesterol in women Klingberg et al. 2008. 5 Evaluating the associations between natural dietary intake of PS and carotid intima –media thickness IMT and serum lipids in Chinese adult. Cross- sectional Dietary consumption collected from Food Frequency Questionnaire FFQ - Obtained from database available - Men had higher PS intake 330 mgd than women 311 mgd p= 0.007. - Multivariate analysis showed a dose-dependent inverse association of total PS intake with serum TC, LDLc, non-HDLc in highest quartile of intake 447 mgd. Wang et al. 2012 12

G. FOOD CONSUMPTION SURVEY