Pengaruh Penambahan Chia Seed (Salvia hispanica L.) pada Jus Belimbing (Averrhoa carambola L.) terhadap Tekanan Darah Penderita Hipertensi
Abstract
Hipertensi jika tidak dikendalikan dapat menyebabkan berbagai penyakit komplikasi hingga kematian. Pengendalian hipertensi dapat melalui dua cara, yaitu dengan pengobatan farmakologis melalui obat-obatan antihipertensi dan non farmakologis dengan menerapkan pola makan (diet) sehat, seperti mengonsumsi sayuran, buah-buahan, biji-bijian, produk susu rendah lemak, daging tanpa lemak, mengurangi asupan natrium, meningkatkan asupan kalium, kalsium, magnesium, dan antioksidan. Beberapa penelitian telah membuktikan bahwa konsumsi belimbing manis dan chia seed dapat mengontrol tekanan darah pada penderita hipertensi, akan tetapi kandungan gizi seperti kalsium dan magnesium masih relatif rendah pada belimbing manis. Berdasarkan USDA (2011) chia seed memiliki kandungan kalsium dan magnesium yang tinggi. Sementara itu, penelitian National Health and Nutrition Examination (NHANES) dari tahun 2005 hingga 2010 menunjukkan bahwa konsumsi buah utuh menurun seiring bertambahnya usia, sehingga perlu adanya modifikasi pangan yang memiliki kandungan gizi yang baik dan dapat diterima oleh semua usia (Banfield et al. 2016; Wan et al. 2020).
Tujuan umum penelitian ini adalah menganalisis pengaruh penambahan chia seed pada jus belimbing terhadap tekanan darah penderita hipertensi. Tujuan khusus dari penelitian ini yaitu (1) membuat formula penambahan chia seed pada jus belimbing yang dapat diterima secara organoleptik (uji hedonik dan uji mutu hedonik), (2) menganalisis tingkat penerimaan panelis terhadap penambahan chia seed pada jus belimbing dan menentukan formula terpilih, (3) menganalisis kandungan gizi (kadar air, abu, karbohidrat, lemak, protein, kalium, kalsium, magnesium, natrium) dan kapasitas antioksidan penambahan chia seed pada jus belimbing, (4) menganalisis pengaruh intervensi penambahan chia seed pada jus belimbing terhadap tekanan darah subjek hipertensi.
Penelitian ini merupakan penelitian eksperimental yang dibagi menjadi dua tahapan penelitian. Pada tahap pertama pengembangan produk menggunakan desain Rancangan Acak Lengkap (RAL) yakni penambahan chia seed pada jus belimbing (F1=Jus belimbing, F2=Jus belimbing dengan penambahan chia seed 10 g, F3=Jus belimbing dengan penambahan chia seed 15 g, F4=Jus belimbing dengan penambahan chia seed 20 g) yang kemudian dilakukan uji organoleptik untuk menentukan produk terpilih. Hasil uji organoleptik dianalisis dengan Kruskal-Wallis dan Mann-Whitney. Analisis pengaruh penambahan chia seed terhadap kandungan gizi dan kapasitas antioksidan jus belimbing dilakukan dengan Independent T-Test. Karakteristik subjek diuji dengan Independent T-Test. Perbedaan tekanan darah sebelum dan sesudah intervensi pada masing-masing kelompok diuji dengan Paired T-Test. Perbedaan tekanan darah antar kelompok diuji dengan Independent T-Test. Semua analisis statistik tersebut telah dilakukan dengan menggunakan IBM perangkat lunak statistik SPSS versi 26.
Berdasarkan hasil uji organoleptik yang dianalisis menggunakan Kruskal Wallis menunjukkan bahwa terdapat perbedaan yang signifikan pada semua parameter uji hedonik (warna, rasa, aroma, kekentalan, aftertaste, mouthfeel, dan overall) dan uji mutu hedonik (warna, rasa, aroma, dan kekentalan). Penambahan chia seed memengaruhi rata-rata kesukaan panelis terhadap produk jus belimbing, semakin banyak penambahan chia seed menurunkan rata-rata nilai sensoris produk. Pada penelitian ini produk terpilih adalah formula jus belimbing dengan penambahan chia seed sebanyak 10 g. Penambahan chia seed sebanyak 10 g pada jus belimbing meningkatkan kandungan gizi dan kapasitas antioksidan jus belimbing. Kadar air, abu, karbohidrat, lemak, protein, kalsium, magnesium, dan kapasitas antioksidan berbeda nyata signifikan pada jus belimbing dengan penambahan chia seed 10 g, sedangkan kadar kalium dan natrium tidak berbeda. Hasil penelitian menunjukkan bahwa, dalam 200 ml jus belimbing dengan penambahan chia seed 10 g memiliki kadar air 89,21%, abu 0,32%, karbohidrat 7,14%, lemak 1,75%, protein 1,55%, kalium 206 mg, kalsium 34,84 mg, magnesium 17,80 mg, natrium 2,46 mg, dan kapasitas antioksidan 78,49%.
Tahap kedua merupakan penelitian quasi experiment dengan pre-post test two group. Subjek penelitian dipilih dengan porposive sampling yakni berdasarkan kriteria inklusi dan eksklusi. Penelitian dilaksanakan di wilayah kerja Puskesmas Gelumbang Kabupaten Muara Enim selama 14 hari terhadap 36 subjek yang dibagi menjadi dua kelompok, yaitu kelompok intervensi jus belimbing (n=18) dan kelompok intervensi jus belimbing dengan penambahan chia seed 10 g (n=18). Karakteristik subjek penelitian yang meliputi jenis kelamin, usia, pendidikan, pekerjaan, merokok, dan riwayat keturunan hipertensi pada kedua kelompok tidak berbeda secara signifikan (p>0,05). Kedua kelompok intervensi memiliki status gizi obesitas tingkat I yaitu dengan rata-rata indeks massa tubuh (IMT) sebesar 27,43 kg/m2 dan 26,75 kg/m2. Aktivitas fisik kedua kelompok menunjukkan dalam kategori sedang yaitu dengan rata-rata nilai International Physical Activity Questionnaire (IPAQ) sebesar 1972,33 MET-Met/Minggu dan 1939,55 MET-Met/Minggu. Tingkat stress kedua kelompok menunjukkan dalam kategori ringan dengan rata-rata nilai Depression Anxiety Stress Scales (DASS) sebesar 15,33 dan 16,94. Asupan gizi dan kecukupan gizi pada kedua kelompok tidak berbeda secara signifikan (p>0,05). Kepatuhan konsumsi pada kelompok jus belimbing lebih tinggi dibandingkan kelompok jus belimbing dengan penambahan chia seed 10 g, akan tetapi tidak berbeda secara signifikan (p>0,05). Terjadi penurunan tekanan darah sistolik dan diastolik yang signifikan (p=0,00) pada kedua kelompok subjek setelah intervensi jus belimbing dan jus belimbing dengan penambahan chia seed 10 g. Rata-rata selisih penurunan tekanan darah sistolik dan diastolik setelah intervensi jus belimbing dengan penambahan chia seed 10 g lebih besar dibandingkan intervensi jus belimbing, akan tetapi tidak berbeda secara signifikan (p>0,05). Penelitian selanjutnya disarankan untuk mengolah chia seed menjadi tepung dan memodifikasi menjadi produk seperti puding untuk meningkatkan tingkat kesukaan terhadap produk dan perlu adanya penambahan intervensi untuk melihat perbedaan yang signifikan pada penambahan chia seed terhadap tekanan darah. Penderita hipertensi disarankan untuk menjaga berat badan dengan status gizi normal, meningkatkan asupan sayuran dan buah-buahan, serta meningkatkan aktivitas fisik sebagai upaya pengontrolan tekanan darah. Uncontrolled hypertension can cause various complications, diseases, and even death. Control of hypertension can be managed in two (2) ways: the pharmacological treatment through antihypertensive drugs and the non-pharmacological treatment by implementing a healthy diet such as consuming healthy foods like vegetables, fruits, whole grains, low-fat dairy products, lean /non-fat meat and reduces sodium intake, also increase potassium, calcium, magnesium and antioxidant intake. There is evidence from several studies that the consumption of sweet star fruit and chia seeds is able to control blood pressure in people with hypertension; however, the nutrition contents, such as calcium and magnesium, are still relatively low in sweet star fruit. According to USDA (2011), chia seeds have high calcium and magnesium content. Meanwhile, a study of the National Health and Nutrition Examination (NHANES) from 2005 to 2010 showed that whole fruit consumption decreases with age. Therefore, there is a need to create a food modification with good nutritional content that is able to be for all ages (Banfield et al. 2016; Wan et al. 2020).
The general purpose of this research is to analyze the effect of chia seeds, in addition to sweet star fruit juice, on the blood pressure of people with hypertension (hypertensive sufferers). Meanwhile, the specific objectives of this research are: (1) creating a formula for adding chia seeds to sweet star fruit juice that is acceptable organoleptically (hedonic test and hedonic quality test), (2) analyzing the acceptance level of chia seeds addition to sweet star fruit juice from panelists and determining (decide) the selected formula, (3) analyzing the nutritional contents (water, ash, carbohydrate, fat, protein, potassium, calcium, magnesium, sodium contents) also the antioxidant capacity of chia seeds addition to the sweet star fruit juice, (4) analyzing the effect from intervention of chia seeds addition to sweet star fruit juice on blood pressure of subject study (people with hypertension).
This research is experimental research which is divided into two research stages. In the first stage of product development using a Completely Randomized Design (CRD) design, namely the addition of chia seeds to star fruit juice (F1=Star fruit juice, F2=Star fruit juice with the addition of 10 g chia seeds, F3=Star fruit juice with the addition of 15 g chia seeds, F4= Star fruit juice with the addition of chia seeds 20 g) which was then carried out by organoleptic testing to determine the selected product. Next, the organoleptic test results were analyzed by Kruskal-Wallis and Mann-Whitney tests. Analysis of the effect of chia seeds, in addition to the nutrition content and antioxidant capacity of sweet star fruit, was carried out by the Independent T-Test. Subject characteristics were tested by Independent T-Test, and differences in blood pressure before and after intervention for each group were tested by Paired-T-Test. Then, blood pressure differences between groups were tested using the Independent T-test. All statistical analyses were performed by IBM SPSS statistical software version 26.
The results of organoleptic tests analyzed using Kruskal Wallis test showed significant differences found in all hedonic test parameters (color, taste, aroma, viscosity, aftertaste, mouth feel, and overall) and in the hedonic quality tests (color, taste, aroma, and viscosity). Chia seed addition affects panelists’ average preference (taste preference) for star fruit juice products, in which the more chia seeds added to star fruit juice, the less (decrease) the average sensory value of the product. In this study, the selected product was a sweet star fruit juice formulation with 10 g chia seeds addition. The addition of 10 g of chia seeds to sweet star fruit juice increases the nutritional content and antioxidant capacity of sweet star fruit juice. Water content, ash, carbohydrate, fat, protein, calcium, magnesium and antioxidant capacity were significantly observed in star fruit juice with 10 g chia seeds addition, while the potassium and sodium levels were not different. The results showed that 200 ml of star fruit juice with 10 g chia seeds addition has nutritional contents of water content (89,21%), ash (0,32 %), carbohydrate (7,14 %), fat (1,75 %), protein (1,55 %), potassium (206 mg), calcium (34,84 mg), magnesium (17,80 mg), sodium (2,46 mg), and antioxidant capacity (78,49 %).
The second stage was a quasi-experimental research with a pre-post test of two groups. The research subjects were selected by porposive sampling, namely based on inclusion and exclusion criteria. The research was carried out in the working area of the Gelumbang Health Center, Muara Enim Regency, for 14 days to 36 subjects of study who were divided into two groups of the star fruit juice intervention group (n=18) and star fruit juice with 10 g of chia seeds addition intervention group (n=18). The study subjects' characteristics, including gender, age, education, occupation, smoking, and hereditary history of hypertension in the two groups, were not significantly different (p>0,05). Both intervention groups had level I obesity nutritional status, with an average body mass index (BMI) of 27,43 kg/m2 and 26,75 kg/m2. The physical activity of both groups was shown to be in the moderate category, with an average International Physical Activity Questionnaire (IPAQ) score of 1972,33 MET-Met/Week and 1939,55 MET-Met/Week. The stress levels of both groups showed in the mild category with an average Depression Anxiety Stress Scale (DASS) score of 15,33 and 16,94. The nutritional intake and adequacy of the two groups did not differ significantly (p>0,05). Consumption compliance in the star fruit juice group was higher than the star fruit juice group with the addition of chia seed 10 g, but not significantly different (p>0,05). A significant reduction was found in systolic and diastolic blood pressure (p=0,00) in both subject groups after the intervention of star fruit juice and star fruit juice with 10 g of chia seeds addition. Furthermore, the average difference in the reduction of systolic and diastolic blood pressure after the intervention of star fruit juice with 10 g of chia seeds addition was greater than the intervention of star fruit juice without chia seeds addition. However, it is not significantly different (p>0,05). Further research suggested processing chia seeds into flour and modifying them into products such as pudding to increase the level of liking for the product and the need for additional interventions to see a significant difference in the addition of chia seeds to blood pressure. Hypertension patients are advised to maintain body weight, increase intake of vegetables and fruits, and increase physical activity to control blood pressure.
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- MT - Human Ecology [2239]