EFEK SUPLEMEN PROTEIN BERBASIS-SUSU TERHADAP KESEIMBANGAN MIKROFLORA TUBERKULOSIS PARU DARI PASIEN DALAM PENGOBATAN (EFFECT OF MILK-BASED PROTEIN SUPPLEMENT ON THE MICROFLORA BALANCE OF PULMONARY TUBERCULOSIS FROM TREATED PATIENTS)

Abstract

ABSTRACT

Background: Pulmonary tuberculosis (TB) patients, in addition to frequently suffering from nutritional deficiency, may have impaired gut microflora balance as effect of low daily dietary intake and antibiotics therapy use, respectively. Lactobacillus acidophilus and Bifidobacterium longum is a normal inhabitant of human gut microflora, which able to improve nutrients absorption and modulate immune response. Objective: To test the effect of milk-based protein (MBP) supplement on the microflora balance of TB (maintaining growth and metabolic activity of probiotic bacteria) from treated patients. Methods: Several methods was applied to determine nutrients concentration and probiotic population. (1) types and carbohydrate amount and vitamin A concentration in MBP supplement was determined by HPLC method, zinc concentration used AAS method and amount of protein used micro Kjeldahl method; (2) total energy, fat and vitamin D concentration was calculated based on their concentration in each ingredient; (3) total cells count for growth and metabolic activity test of probiotics bacteria was used plating technique and HPLC method, respectively; (4) acceptance test to MBP supplement was performed using organoleptic test three point Likert scale. Results: In each 100 gram MBP supplement was containing (a) monosaccharide (1,710 mg), disaccharides (43,870 mg) and oligosaccharides (490 mg), vitamin A, zinc, protein, energy, fat dan vitamin D, (b) it supplement capable maintained growth of probiotics bacteria (> 1x 10 log₁₀ cfu/mL) and stimulated lactic acid production five times higher (4,5 M lactic acid/mL) than placebo (0,9 M lactic acid/ml); (c) MBP supplements has been accepted by all subjects. Conclusion: MBP supplement had capacity to maintain growth and improved metabolic activity of two indigenous probiotic bacteria in the human gut.

Keywords: milk-based protein supplement, probiotic, microflora, pulmonary tuberculosis.

ABSTRAK

Latar belakang: Pasien tuberkulosis (TB) Paru, di samping sering mengalami defisiensi zat gizi, diduga mengalami gangguan keseimbangan mikroflora usus akibat rendahnya konsumsi makanan dan penggunaan terapi antibiotika. Lactobacillus acidophilus dan Bifidobacterium longum merupakan penghuni normal mikroflora usus manusia, yang mampu memperbaiki penyerapan zat gizi dan memodulasi respon imun. Tujuan: Menguji efek suplemen protein berbasis-susu (PBS) terhadap keseimbangan mikroflora TB (pemeliharaan pertumbuhan dan aktivitas metabolik bakteri prebiotik) dari pasien dalam pengobatan. Metode: Beberapa metode diterapkan untuk menentukan konsentrasi zat gizi dan populasi probiotik. (1) jenis dan jumlah karbohidrat serta konsentrasi vitamin A dalam suplemen PBS menggunakan metode HPLC, konsentrasi seng menggunakan metode AAS, dan jumlah protein menggunakan metode mikro Kjeldahl; (2) jumlah energi, lemak dan konsentrasi vitamin D dihitung berdasarkan kandungan zat gizi dalam setiap bahan; (3) populasi bakteri probiotik menggunakan teknik plating dan aktivitas metabolik dengan metode HPLC; (4) daya terima suplemen PBS secara organoleptik menggunakan skala Likert. Hasil: Setiap 100 gram suplemen PBS terkandung: (a) karbohidrat monosakarida (1.710 mg), disakarida (43.870 mg) dan oligosakarida (490 mg) serta energi, lemak, protein, vitamin A, vitamin D, dan seng; (b) suplemen PBS mampu memelihara pertumbuhan bakteri probiotik (> 1x 10 log₁₀ cfu/mL) dan menstimulasi produksi asam laktat lima kali lebih tinggi (4,5 M asam laktat/mL) dibandingkan dengan plasebo (0,9 M asam laktat/mL); (c) suplemen PBS disukai oleh seluruh subyek. Kesimpulan: Suplemen PBS memiliki kapasitas mempertahankan pertumbuhan bakteri probiotik dan meningkatkan aktivitas metabolik dua probiotik indigenus saluran pencernaan manusia. [Penel Gizi Makan 2011, 34(2): 147-156]