Rural Balinese have metabolic syndrome

Rural Balinese have metabolic syndrome

Wahyoe Boediwardhana, Jakarta Post, Bali

Bali is like a magnet that draws tourists from around the world. Its natural beauty and rich culture are the main attractions that people come to enjoy.

Last year, the island attracted 1.4 million visitors, according to the provincial statistics office. Such a large number of tourists has obviously affected the people's way of life as intensive interaction occurs between visitors and locals, especially as many overseas visitors decide to take up residence on the island.

"The impact has not always been positive. For example, the influence of foreigners' lifestyles and cultures on the people," said Ketut Suastika from the Department of Internal Medicine at the Faculty of Medicine, Udayana University, Denpasar.

Many people lead unhealthy lifestyles, which make them prone to various kinds of disease. Surprisingly, this is experienced not only by city residents but also villagers, as revealed by Suastika during an event titled Meet the Experts, organized by PT Pfizer at Hotel Conrad from Sept.17 to Sept.19.

He said many rural people in Bali suffered from metabolic syndrome, which has five elements: diabetes mellitus, hypertension, obesity, low HDL cholesterol and high triglyceridemia (dislipidemia).

Suastika, who is also an endocrinologist and expert in metabolism and diabetes at Sanglah Hospital, said that in March last year, 20 medical experts from the Department of Internal Medicine, Udayana University/Sanglah Hospital, assisted by researchers from the graduate school of life sciences and the department of metabolism and community health science, faculty of health science, school of medicine, Kobe University, Japan, carried out a study in Sangsit village, Sawan district, Singaraja.

They examined 471 people -- 240 men and 231 women -- aged between 19 and 87 years old. Using random sampling, the researchers found that 19.2 percent of the total population of the village had at least three out of the five elements of metabolic syndrome.

They were diagnosed based on the criteria set by the World Health Organization for Asia-Pacific.

For example, obesity was determined based on the waistline. A man was diagnosed as suffering from obesity if his waistline was 90 centimeters or more, while for a woman, it was 80 centimeters or more.

The prevalence of people suffering from obesity was 26 percent. More women suffered from obesity with the figure standing at 30.9 percent of the women who were examined during the study, while the number of men who suffered from obesity was 21.3 percent.

There were also more women suffering from diabetes. The figures were 7.7 percent for the women and 7.3 percent of the men. The study concluded that on average, 7.5 percent of the villagers suffered from diabetes.

Suastika said that the findings were quite surprising considering that Sangsit is not a well-developed area and the lifestyle of the people is not like that of people in Denpasar.

What's more, at the national level it is estimated that the prevalence of diabetes mellitus among Indonesian people who are 15 years old or older is only between 1.2 percent and 2.3 percent.

The study also found that 50 percent of the people in Sangsit village suffer from hypertension. The prevalence among women was 53.9 percent while among the men it was 46.2 percent.

A total of 43.5 percent of the women and 28.5 percent of the men had low High Density Lipid (HDL) cholesterol in the blood. But more men had high triglyceridemia (TG). According to the study, 27.2 percent of the men and 22.4 of the women had high TG.

Suastika said that the findings provided an insight into the state of health of rural people in Bali, and even in Indonesia as a whole, as most rural areas in the country had similar characteristics.

There has yet to be any research on metabolic syndrome carried out at the national level using the right methods. Such a study would be expensive, time-consuming and require the services of a great many doctors, he said.

The latest report from the International Diabetes Federation (IDF/WHO) shows that the number of diabetes mellitus patients in the world has reached alarming levels, the cost has tripled and one out of every two people suffering from the disease has not been diagnosed.

"Early diagnosis is the only way to control this chronic and expensive disease," said IDF president Wendell Mayes Jr.

The high levels of metabolic syndrome among rural people in Bali is caused primarily by changing lifestyles. People now eat unhealthy food, suffer from high levels of stress, and get less physical exercise.

Suastika suggested that people change their lifestyles and take more exercise.

Medically, there were various medicines for people with metabolic syndrome. But the government also needed to involve itself in resolving the problem by adopting policies that were beneficial to both economic development and public health.

He gave as an example the rapid expansion of the fast-food business, which he said was one of the main reasons for the increasing prevalence of metabolic syndrome.

"In developed countries, people have demanded that governments control junk food. In Indonesia, this has not been addressed. Therefore, the government should pay attention to this," he said.

Another important thing was the development of sports facilities or other facilities that would encourage people to adopt healthier lifestyle, such as the provision of bicycle lanes in urban areas.