The shape of the world a generation from now will be influenced far more by how we communicate the values of our society to others than by military or diplomatic superiority. William Fulbright, 1964

Wednesday, March 19, 2014


Dian Handayani
Beware the silent killer                                        

Supermarkets are designed to seduce.  There’s nothing left to chance in the layouts, with cheaper products on the lower shelves while dearer items are stacked at eye level.
Price drives choice, along with brand name, though discerning shoppers are also starting to select on labelling – the result of growing awareness of nutrition and the need to be careful in kitchen and selective in the market.
Ahead in this movement has been Brawijaya University lecturer Dr Dian Handayani, 40, a pioneer in the struggle to sell the idea that the food we eat today determines our health tomorrow.
“Indonesia ranks high in the world for the incidence of diabetes,” she said on the university’s campus in Malang, East Java. “That’s serious and a major public health problem, but the disease can be controlled.  It doesn’t need to be a death sentence.”
The World Diabetes Foundation estimates about 7.6 million Indonesians have diabetes, but half are unaware because they don’t seek medical advice or get misdiagnosed.  Hence its ‘silent killer’ title.
Diabetes is a complex disorder affecting the body’s ability to process some foods. Genetic predisposition is a factor,.  It’s also closely linked to lifestyles and obesity.
Dr Handayani got to see the awful effects of the debilitating disease when her grandmother was diagnosed with high blood sugar, typically late in life.
Although still studying and raising a family Dr Handayani took the elderly lady into her home. She gave insulin injections and prepared the right foods.  But at a wedding party the grandmother over-indulged on a fruit cocktail, went into a coma and died a few days later.
The shocking experience helped convince the granddaughter that she was on the right track, laid down by her prescient schoolteacher father, Mohammad Amin Karim.
“I was still a teenager in Malang when he suggested I should study nutrition,” she said. “He’d done the research and predicted that rising overseas concern with healthy living and fresh foods would come to Indonesia.
“I wasn’t too keen because the only courses available were two-year diplomas. I thought the subject was more about cooking and I didn’t believe this was real science.
“Then I discovered that studying nutrition meant I could learn to prevent and manage disease.”
The problem was academic credibility. Dian and her colleagues pushed to get nutrition recognized as a legitimate health science worthy to be taught in prestigious institutions. That meant persuading Jakarta bureaucrats, a tough task for a campus that didn’t have the independence and clout of Yogyakarta’s Universitas Gadjah Mada, another contender.
About ten years ago they succeeded and Brawijaya became the first State university to offer a bachelor degree. Now 40 diploma, 26 degree and six post-graduate courses are available around the Republic – though no doctorates.
With the help of an Indonesian government scholarship, Dr Handayani became the first person in East Java with a PhD in nutrition.
She gained the qualification after four years at Wollongong University on Australia’s east coast studying the effects of oats and shiitake (also known as Black Forest) mushrooms on rats.
Could these foods separate fats so they’re excreted rather than stored? If so they’d benefit humanity everywhere, from the malnourished to the obese.
The high-energy, low fat mushrooms originated in East Asia.  They’re widely used in cooking and alternative medicines, particularly for cancer treatment.  However Dr Handayani’s study showed they also have a downside. If consumed in big quantities they can cause liver damage.
Bad news for the 130 rodents Dr Handayani fed, but another piece of valuable information in the diet jigsaw.
Unlike some nutritionists Dr Handayani isn’t a sergeant in the food police, haranguing indulgers, spreading guilt.  She eats rice and even lets her children (parents may want to black out these next three words) eat fast food.
However these indulgences are rare (“once a month, maybe”) because her message is moderation, and that includes rice, the carbohydrate that fuels the nation – but also creates blood sugar problems.
“Diets are changing in Indonesia and becoming more westernized,” she said. “Milk and bread are popular along with foods like pizzas and chips. 
“The problem is that we enjoy big quantities of traditional foods, while Western meals need to be consumed in small serves.  That’s not always well understood.”
Also unclear are the benefits and hazards that go with foods.  In Indonesia not all products are labelled with the ingredients and their nutritional value.
That fizzy drink you crave may contain ten teaspoons of sugar.  The chicken fried in recycled oil could coat your arteries and send you into cardiac arrest.
Researching food faults is not a task for the fearful, for almost everything has a good and dark side – though the latter is usually revealed when taken in excess.
“I’ve been told by health authorities that food labelling in Indonesia will be compulsory within three years,” she said.  “That’s my dream.”
 But it’s only part of the solution, for decoding much information requires a reasonable level of education, patience, discipline and determination. Australia is considering health star ratings. Consumers like the idea but there’s opposition from manufacturers who claim buyers will be further confused.
Dr Handayani is no remote academic, pushing theory but not a shopping trolley. She studied on a tiny stipend in Australia with her family so knows about trundling through overbearing supermarket aisles armed only with a thin wallet.
She’s also skilled at wheeling the kids away from child-high shelves stacked with tooth-rotters. “I persuade them with logic, and they’re good with that,” she said.
For many homemakers, price pips quality.  At the end of a harrowing day it’s the fast fried rather than the slow wash, peel, chop and steam for high-fiber fruits and vegetables. 
Work pressures, easy availability and minimal preparation trumps wholemeal bread, olive oil and fat-free yoghurt.  Exercise? Absolutely essential. But where’s the time?
“Changing people’s habits can be extremely difficult,” she said.  “However if we choose wisely we can reduce the risk, stay fit and even prevent disease.  Isn’t that worthwhile?”

(First published in The Jakarta Post, 19 March 2014)


1 comment:

Ross B. Taylor AM said...

An important story. Sugar is the silent killer. Indonesia is swamped with sugar..even in bread.

Education is also critical to ensure people can choice better quality foods...if they can afford it; and that is another issue.