Sugar Palms and Health

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Sugar Palms and Health

• Preparations for a program to help local people
  and obtain valuable data on the health effects of
  palm sugar

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Background

• Initial surveys were done by Dr. Willie Smits on
  the relation between the life expectancy of local
  people and their utilization of either white
  sugar or palm sugar
• The results of the survey show a dramatic
  difference of some 11 years increase in life
  expectancy when using palm sugar
• The difference in life expectancy was especially
  strongly correlated with significant less
  occurrence in heart and coronary diseases/
  diabetes/ gout and asthma with palm sugar users

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Degree of data reliability

• Data were collected from direct relatives on some
  2000 people that had died a natural death
• From these data only 877 records were used from
  people that during their lifetime had used only
  white sugar or palm sugar
• The ratios between various categories, eg. The
  male/female lifetime expectancy consistency in
  ratio, seem to indicate that the data base is good

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Advantage of Tomohon

• Tomohon is a very good place for this kind of
  study because of the homogenity of the local
  people that all are from the same ethnic group
  with relatively little genetic variation
• Moreover 70 of the population is farmer, lives
  under very healthy conditions, have the same
  culture and eat all virtually the same food items
• The people in Tomohon are very open to this kind
  of research

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What is the plan?

• To provide a free diagnose and some free
  medication to the people of Tomohon who are 50
  years and older while making a database of their
  health condition through anamnese
• To analyze their blood sampes and measure several
  physical characteristics and see how they relate
  to the use of palm sugar
• To formulate follow up research on the health
  benefits of palm sugar when confirmed.

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How?

• The Masarang Foundation has a network that
  comprises more than half the people of Tomohon
  and has strong support for the program
• More than twenty doctors in Tomohon are willing
  to support this research
• There are enough specialists available in Manado
  to support and supervise the formulation and
  execution of this program

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What do we want to check?

• First of all an anamneses interview will be done
  with regard to the peoples health. Doctors will
  be specially trained beforehand
• We will especially look for data on certain
  conditions like heart and coronary diseases,
  diabetes, gout and asthma
• A physical examiniation will look at body sizes
  and obesity and other possible abnormalities
• In addition blood pressure will be measured, and
  blood samples collected to determine glucose
  levels, cholesterol, etc.

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How long will it take to conduct?

• Per patient about 25 minutes are needed (after
  initial training)
• There are more than 20 docters are available
• There are 8.646 orang above 50 years in Tomohon
  willing
• Diperkirakan sekitar 8000 orang akan mendaftarkan
  diri untuk diperiksa kesehatan/menerima
  pengobatan gratis
• The execution of the work would take 16 work days
  (6 a week in Indonesia) so about three weeks

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How much does it cost?

• Per patient the doctors are paid 12.500 Rupiah
  meaning a total of about 100 Million Rupiah
• For each patient several tests are done including
  cholesterol (HDL, LDL, Triglicerida, sugar, etc.)
  costing some 250.000 Rupiah per patient meaning
  (including the provision of generic medicines for
  part of the people) of about 1.6 Billion Rupiah
• To prepare the program and the training of the
  doctors a workshop is needed for some three days
  with specialist doctors costing some 80 Million
  Rupiah
• For the database and analyses some facilities and
  staff are needed, as well as a concluding
  workshop total some 190 Million Rp
• Totally needed is estimated almost (1.97) 2
  Billion Rupiah or some 150.000 Euros for the
  local costs but this depends upon what outside
  expertise will be involved and what additional
  ideas there are

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Heart and Coronary Diseases

• Tingkat serangan jantung, tekanan darah tinggi,
  stroke semuanya lebih rendah di antara pemakai
  gula Aren
• Umumnya penyakit ini adalah welfare disease yang
  berhubungan dengan stress dan obesitas
• Gula Aren memperlancar pencernaan makanan dan di
  percobaan dengan tikus konsumsi gula sendiri
  berkurang jika yang dipakai adalah gula aren yang
  memiliki rasa lebih manis
• Mungkin secara tidak langsung tingkat obesitas
  menyebabkan perbedaan yang sangat nyata ini?
• Atau karena gula Aren mendorong aktivitas?
• Atau karena kandungan Kalium pada gula Aren?

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Diabetes

• Diabetes is extremely common in the Minahasa
  region and is often related to income and
  consumption level
• Aren palm sugar contains a combination of Vitamin
  C, Niacin, Calcium and Magnesium, which is
  beneficial for diabetics
• This might indicate that there is not only a
  correlation between the low degree of diabetes
  with palm sugar users but that there might be a
  causal relationship

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Gout

• Gout is a very common problem in the Minahasa
  region and so far from our database there are no
  palm sugar users that have the condition.
• This is highly interesting, since Uric Acid
  excretion from kidney stones is known to be aided
  by Aren extracts!
• Or is it because Palm Sugar users are less like
  to be obese?
• These are some of the possible mechanisms through
  which palm sugar might influence gout.
• Or could it be that Palm Sugar Users drink less
  alcohol than the rest of the population?
• Hereditary metabolic disorder in which excess
  uric-acid salts, normally excreted in urine, are
  deposited as needle-sharp crystals in joints,
  causing attacks of severe inflammation. The most
  common site is the base of the big toe. One of
  the oldest diseases in medical literature, gout
  is far more common in men. Attacks usually do not
  begin until middle age. They cause heat, redness,
  and extreme tenderness and pain, and often
  subside in a week or two.

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Asma

• Asma biasa ada hubungan dengan polusi udara dan
  stress
• Tapi di Tomohon kurang sekali terdapat dua faktor
  ini
• Karena itu sangat menarik apa yang menyebabkan
  tingkat asma pada orang pengguna gula Aren sangat
  lebih kecil dibandingkan pengguna gula putih
• Rumah sakit Bethesda menjual obat tradisional dan
  gula Aren adalah obat batuk dan dianjurkan
• Berarti ada kemungkinan terdapat zat tertentu di
  dalam gula Aren yang membantu mengurangi asma

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Lain-lain

• Mungkin masih akan muncul efek lain atau korelasi
  lain dari penelitian mendalam mengenai gula Aren
• Nanti orang tua yang umumnya banyak tahu mengenai
  pengobatan tradisional akan juga diwawancarai
  mengenai pengetahuan mereka
• Informasi mengenai penggunaan obat oleh mereka
  sendiri serta pengetahuan diperkirakan akan
  sangat bermanfaat untuk menyusun penelitian
  tambahan
• Informasi yang diperoleh hanya dipublikasikan
  atas dasar persetujuan semua pihak yang terlibat,
  terutama Yayasan Masarang dan Eka Tjipta
  Foundation