The effect yellow passion fruit peel juice (Passiflora eduils f.flavicarpa deg) on LDL to HDL cholesterol ratio in type 2 diabetes mellitus patients as predictors of cardiovascular disease

Background: The ratio of LDL to HDL illustrates the profile of LDL and HDL cholesterol in the blood and it is one of the important components as an indicator of risk for cardiovascular disease. High fiber content, especially pectin (water-soluble fiber) on the skin of yellow passion fruit can prevent the absorption of carbohydrates, reduce the absorption of fat and blood cholesterol so that it can control blood lipid levels. Objectives: To assess the effect of fruit peel juice on LDL to HDL cholesterol ratio in patients with diabetes mellitus as predictors of cardiovascular disease in the working area of Teppo Health Center, Pinrang Regency. Methods: This study was a quasi-experimental design with a non-randomized pre-test and post-test with the control group. The method of selecting samples with a purposive sampling method of 40 people divided into 2 groups. The treatment group was given 250 ml of yellow passion fruit peel juice /day and education for 15 days while the control group was given education only. Results: The result showed that LDL to HDL cholesterol ratio in the intervention group decreased about 0.56 while in contrast LDL to HDL cholesterol ratio in the control group increased about 0.25 and statistically, the change was the difference (p> 0.05). Conclussion: Thus there is a significant difference in the mean Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) Vol. 8, No. 2, 2020: 61-67 Available online at: http://ejournal.almaata. ac.id/index.php/IJND DOI : http://dx.doi. org/10.21927/ijnd.2020. 8(2). 61-67 The effect yellow passion fruit peel juice on LDL to HDL cholesterol ratio in type 2 diabetes mellitus patients as predictors . 62 previous myocardial infarction, family history of coronary heart disease, and serum high-sensitivity C-reactive protein, there was an approximately twofold increase in the risk of sudden cardiac death (SCD) compared with serum quintile of LDL to HDL cholesterol ratio > 4.22 compared to a ratio of LDL to HDL cholesterol ≤ 2.30 (7) One way to manage dyslipidemia as a major risk factor for cardiovascular disease is through diet modification. A study conducted in Taiwan shows that diet is significantly related to the incidence of dyslipidemia (8), including fat intake and fiber intake. The intake of saturated fat can increase blood cholesterol levels, especially LDL and reduce HDL levels, which results in the continued process of atherosclerosis in blood vessels (9), so that it can cause coronary heart disease. While fiber intake can reduce the risk of diseases such as diabetes, dyslipidemia, obesity and, cardiovascular disease (10). Study Kutsiyah et al. (2013), showed that subjects who had high LDL cholesterol and high total cholesterol tended to have lower fiber intake compared to normal ones. Meanwhile, subjects who have low triglyceride levels tend to have higher fiber intake compared to subjects who have high triglyceride levels (11). Each region has its peculiarities for the region, including food potential. South Sulawesi is famous for its passion fruit and there are several passion fruit factories that manage passion fruit into passion fruit syrup. Passion fruit contains high fiber, including the skin which represents almost half of the mass of fruit which turned out to have high fiber content. However, in the process of processing, so far the passion fruit skins are only leftover products that are LDL to HDL cholesterol ratio between the intervention group and the control group after administration of yellow passion fruit skin juice in people with diabetes mellitus.