The Effects of Anti-Atherogenic Properties of Beverage of the Date Seeds (Phoenix Dactilifera L.) In Pre-Menopause Women: A Study Of Indonesian Women

Abstract

Background: people commonly consume some seeds like steeping as beverage. This is the first study that was to prove the effects of anti-atherogenic properties of beverage of the date seeds in pre-menopause women. Materials and methods: The quasi-experimental design was used in the study. Thirty-two of pre-menopause women with hyperlipidemia history in Gununglurah village, Banyumas, Central Java were recruited. Each participant signed an informed consent to obtain a 5 cc blood sample through the mediana cubital vein. Lipid profiles test was done before and after treatment. Beverage of the Date seeds of Deglet Nour cultivar was consumed for 14 days with the dosage of 2.5 grams each day. The data were analyzed by using the paired t-test with a significance level of p< 0.05. Results: Prior to treatment, pre-menopause women tend to have unhealthy lipid profile. The mean scores of total cholesterol, triglyceride, HDL and LDL levels were 251.53  35.23, 232.50  35.17, 35.69  6.55, 167.11  40.31 mg/dL respectively. After consuming beverage of the date seeds, the total cholesterol, triglycerides, LDL, and atherogenic levels were decreased, while HDL level was significantly increased (p< 0.05). Conclusion: The study demonstrated that the lipid profiles of the pre-menopause women were improved after date seed beverage consumption. The implication of the study was that pre-menopause women could consume the date seed beverage routinely to maintain a good lipid profiles and keep healthy. The professional health care also can give the education regarding with the benefit of the date seed beverage in decreasing the lipid profiles in pre-menopause women.

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Transylvanian
Review
Vol XXVI, No. 29, 2018
Transylvanian Review
Centrul de Studii Transilvane| str. Mihail Kogalniceanu nr. 12-14, et.5, Cluj-Napoca
Email: transylvanianreview@gmail.com
Online Submission System: http://transylvanianreviewjournal.org/

Saryono and Proverawati Transylvanian Review: Vol XXVI, No. 29, June 2018
7649
The Effects of Anti-Atherogenic Properties of Beverage of
the Date Seeds (Phoenix Dactilifera L.) In Pre-Menopause
Women: A Study Of Indonesian Women
Saryono Saryono1 and Atikah Proverawati2
1School of Nursing, Health Sciences of Faculty, University of Jenderal Soedirman, Purwokerto, Indonesia
2School of Nutrition, Health Sciences of Faculty, University of Jenderal Soedirman, Purwokerto, Indonesia
Abstract
Background: people commonly consume some seeds like steeping as beverage. This is the first study that was to
prove the effects of anti-atherogenic properties of beverage of the date seeds in pre-menopause women.
Materials and methods: The quasi-experimental design was used in the study. Thirty-two of pre-menopause women
with hyperlipidemia history in Gununglurah village, Banyumas, Central Java were recruited. Each participant
signed an informed consent to obtain a 5 cc blood sample through the mediana cubital vein. Lipid profiles test was
done before and after treatment. Beverage of the Date seeds of Deglet Nour cultivar was consumed for 14 days with
the dosage of 2.5 grams each day. The data were analyzed by using the paired t-test with a significance level of p<
0.05.
Results: Prior to treatment, pre-menopause women tend to have unhealthy lipid profile. The mean scores of total
cholesterol, triglyceride, HDL and LDL levels were 251.53  35.23, 232.50  35.17, 35.69  6.55, 167.11  40.31
mg/dL respectively. After consuming beverage of the date seeds, the total cholesterol, triglycerides, LDL, and
atherogenic levels were decreased, while HDL level was significantly increased (p< 0.05).
Conclusion: The study demonstrated that the lipid profiles of the pre-menopause women were improved after date
seed beverage consumption. The implication of the study was that pre-menopause women could consume the date
seed beverage routinely to maintain a good lipid profiles and keep healthy. The professional health care also can
give the education regarding with the benefit of the date seed beverage in decreasing the lipid profiles in pre-
menopause women.
Keywords: Date seeds, lipid profile, pre-menopause women, atherosclerosis.
 Corresponding author: School of Nursing, Health Sciences of Faculty, University of Jenderal Soedirman,
Purwokerto, Indonesia.

Saryono and Proverawati Transylvanian Review: Vol XXVI, No. 29, June 2018
7650
Introduction
Atherosclerosis is a necessary topic to be
discussed now that it is the main cause of coronary
artery disease. A previous study showed that the high
cholesterol intake and genetic abnormalities will build
up in arteries which then cause atherosclerosis. The
high cholesterol intake can increase low-density
lipoprotein cholesterol (LDL). One of the
atherosclerosis risk factor is aging. The ratio of LDL
and HDL can be used as indicator for people with high
risk of cardiovascular diseases (Acay
et al
. 2014) due
to LDL can be oxidized which will increase the risk of
atherosclerosis (Rohatgi
et al
. 2014). The way to
decrease lipid profiles in the body was by taking
medications such as statins, triparanol, resins,
torcetrapib, probucol, and niacin (Remaley
et al
.
2014). One of the negative of these medications is
they can be harmful for the human body. Recently,
people use herbal therapy to decrease the lipid
profiles called as anti-atherogenic therapy
(Ahmadvand
et al
. 2017). One of the anti-atherogenic
therapy is date seeds consumption. It consists of
antioxidants such as polyphenols, flavonoid, gallic
acid, epicatechin, vitamin C, and vitamin E (Afiq
et al
.
2013, Chaira
et al
. 2007, Niazi
et al
. 2017, Juhaimi
et
al
. 2012). The activity of date seeds antioxidants are
proven to raise sperm cell membrane strength,
increase antioxidants capacity, and decrease of
malondialdehyde (Saryono
et al
. 2015, Saryono,
Rahmawati,
et al
. 2017) (Orabi & Shawky 2014) (El-
far
et al
. 2016). The anti-atherogenic effect of date
seeds was to be proven in rats. However, there has
been no publication on the date seeds effect in pre-
menopause women (Saryono, Eliyan,
et al
. 2017). The
antioxidants in date seeds extract increase insulin
secretion through pancreatic beta-cell regeneration
(El-Fouhil
et al
. 2013). Pre-menopause women have a
lot of risk of degenerative disease related with the
decrease of estrogen secretion. Dyslipidemia is
commonly occurred in pre-menopause women.
Beverage of the date seeds for improving lipid profile
has not been made earlier, especially for pre-
menopause women. The aim of this study was to
examine the date seeds beverage as anti-atherogenic
to improve the lipid profiles in pre-menopause women.
Material and Methods
Date Seeds Preparation
Deglet Noer date seeds were washed with water
to clean from the fruit meat left over. A cleansed date
seeds were dried under the sun for a day. Then, the
seeds were roasted and blended into powder. The date
seeds powder was sifted using flour sieve. Then, the
powder was packed into 2.5 grams of date seeds for
each pack and distributed to each participant.
Phytochemical Screening
Phytochemical analysis of polyphenols, tannins,
flavonoids, alkaloids and saponins, was carried out by
using standard procedures to identify the constituents
as described by Muchtadi, (1989).
Tannin Test
A volume of 2 ml of above filtrate was taken in a
test tube and few drops of 1 M FeCl3 were added.
Observed result of green color indicates presence of
condensed tannin, whereas the appearance of blue
color indicates hydrolysable tannin.
Saponins Test
The extract was added with 10 mL of hot water
then cooled, shaken vigorously for 10 seconds. The
formation of steady foam for not less 10 minutes as
more than 1 cm long indicates the presence of
saponins compound. The foam will be lost with the
addition of 2N HCl.
Flavonoids Test
A volume of 2 ml of acid extract was taken in a
two separate test tubes, to the first test tube 2 ml of
distilled water and in second tube 2 ml of NaOH were
added. Appearance of yellow color indicates flavonoids
positive.
Alkaloid Test
A few drops of alcohol extract were placed in a
filter paper, and Dragendroff’s reagent was sprayed
over the filter paper. Result appearance of reddish
brown color in filter paper indicates the presence of
alkaloids.
Experimental Design
This is a quasi-experimental study, pre and post-
test, without control group design. Thirty-two pre-
menopause women aged 45-58 years old in
Gununglurah Village, Banyumas, Indonesia were the
subjects of this study. They did not have metabolic
diseases history, statin drug medication, and
complications of pre-menopause syndrome, normal
daily activity and cooperative. The study was
conducted in March 2016 to October 2016 in
Banyumas District, Central Java, Indonesia.
Beverage of date seeds was consumed over 14 days
with the dosage of 2.5 grams each day. Each pack of
the date seeds powder can be brewed with 250 ccs of
boiling water. Date seeds beverage could be drunk
with some sugar and other flavors and served after
meal.
Lipid Profile Test

Saryono and Proverawati Transylvanian Review: Vol XXVI, No. 29, June 2018
7651
Five milliliters of blood sample were taken
through the mediana cubital vein before and after
treatment. The blood was collected in EDTA
vacutainer for several tests of total cholesterol (TC),
LDL, Triglycerides (TG), and HDL. The lipid profiles
parameters are measured using Enzymatic
Colorimetric Assay method, while atherogenic index
(AI) is measured using log 10 (TG/HDLc).
Statistical Analysis
The paired t-test was used to compare the mean
score before and after treatment. The significance
level was approved if p< 0.05. Ethical permission and
informed consent were done prior to the study.
Results
The result of qualitative phytochemical analysis
demonstrated that date seed powder contain saponin,
flavonoid, alkaloid and tannin. Among the test result,
flavonoid and tannin test displayed strong color,
suggesting the highest content of flavonoid and
tannin. However, quantitative test of date seeds
powder contains mainly of flavonoids the amount of
21.68 mg / mL (Table 1). Date seeds contain more
active compound like flavonoid, tannin, saponin and
alkaloid. This compound have an important role as
antioxidant to stop free radical chain reaction. The
average of age and body weight of the participants
were 51 years old and 68 kg (Table 2). The mean of
the study sample has an ideal body mass index but
has high blood pressure. Pre-menopause or elderly
will generally begin to be increasing the rate of free
radical oxidation product. Fat oxidation in the blood
vessels result a stiffness of blood vessels. This will
decrease blood vessel elasticity so that blood pressure
increases. The mean of TC, TG, LDL, and atherogenic
index were increased and HDL level was decreased
before consuming the date seeds beverage.
Nevertheless, after consuming the date seeds
beverage for 14 days, the average of TC, TG, LDL, and
atherogenic index were decreased and HDL level was
increased (Table 3). The paired t- test result showed
that there was a significant difference before and
after treatment (p< 0.005). The beverage of date seeds
can improve lipid profiles through decreasing of TC,
TG, LDL and atherogenic index and increasing of
HDL levels.
Table 1: Qualitative and quantitative test of phytochemical analysis of date seed
No
Phytochemicals
Inference
Qualitative test
1
Flavonoid
+++
2
Tannin
+++
3
Saponin
++
4
Alkaloid
+
Quantitative test
1
Polyphenol level
8.74 mg/mL
2
Flavonoid level
21.68 mg/mL
+: low positivity, ++: moderate positivity, +++: high positivity
Table 2: Respondent profile
Variable
Ranges
Mean
Age (years)
45-58
51
Blood pressure
Systole (mmHg)
100-170
130
Diastole (mmHg)
60-100
90
Weight (kg)
41-72
68
Table 3: Lipid Profile differences between before and after treatment
Variable
pre-test
post-test
p
Mean
SD
Mean
SD
Total Cholesterol (mg/dL)
251.53
35.23
215.38
21.10
0,000*
Triglycerides (mg/dL)
232.50
35.17
204.03
24.51
0,000*
HDL (mg/dL)
35.69
6.55
43.22
5.63
0,000*
LDL (mg/dL)
167.11
40.31
130.11
23.63
0,000*
Atherogenic Index
0.81
0.12
0.67
0.08
0,000*
*Significance level p<0.05
Discussion
The result of this study showed that the
consumption of beverage of the date seeds improve
lipid profiles. The means of total cholesterol,
triglycerides, LDL, and atherogenic index level in pre-
menopause women before the treatment were
increase. After the treatment, all of the parameters in
lipid profiles are improve. This is possibly occurred

Saryono and Proverawati Transylvanian Review: Vol XXVI, No. 29, June 2018
7652
because the flavonoid component in date seeds which
act as antioxidants. The antioxidants act as inhibitors
in potential LDL oxidations and remove cholesterol
from macrophage, they also raise HDL binding and
removing cholesterol from the cells (Neori
et al
. 2013).
The result of a preceding research proves that date
seeds increase antioxidants status which can be seen
in various enzyme (such as SOD, GPX, Catalase) and
Vitamin E (Saryono, Hisni,
et al
. 2017). Date seeds
also contain essential fatty acid such as oleic, linoleic,
lauric, and palmitic acid. Oleic acid is essential in
preventing cardiovascular diseases. Oleic acid diet can
increase HDL level in blood and decrease LDL level
(Gilmore
et al
. 2011). Previous studies reported that
the effects of date seeds extract can decrease total
plasma cholesterol and LDL level significantly (Alsaif
et al
. 2007, Hasan & Mohieldein 2016). However,
preceding studies about beverage of the date seeds
have not been made earlier, while individuals with
high triglycerides level have coronary artery disease
risks. High cholesterol diet in rabbit for 10 weeks has
proven that it could raise the triglycerides level
significantly. The raising of triglycerides can be
decreased until 65% by consuming the date seeds
extract water for 10 weeks. This is because HDL
prevents atherosclerosis by raising reverse lipid
transport through building up cholesterol and another
lipid translocation from peripheral to liver tissue for
the next step of processing (Hasan
et al
. 2010).
Another study showed that the effects of date seed
diet in rats can reduce total cholesterol plasma,
triglycerides, and LDL cholesterol, while also
increasing HDL cholesterol plasma (Saryono
et al
.
2017, Hasan & Mohieldein, 2016). This supports the
fact that consuming date seed can manage cholesterol
absorption and metabolism. The possible components
responsible for those effects are fibers and
phytochemical in date seeds (Platat
et al
. 2014,
Ardekani
et al
. 2010, Yasin
et al
. 2015, Bouhlali
et al
.
2015). This therapeutic effects of date seed are
assumed attribute to its polyphenol and flavonoid
content (Al-Farsi & Lee 2008). Phenols are
antioxidants that can react with intermediate radicals
to produce stable and nonreactive phenolic radicals. A
non-reactive and stable radical product will terminate
undesirable radical oxidation processes. Flavonoids
are natural antioxidants that have the advantage of
safely not contaminated with chemicals and have no
side effects. Fiber component in date seed can
decrease cholesterol absorption and bile acid
reabsorption in lumen intestine, so it decrease insulin
secretion. Fiber fermentation produces short-chain
fatty acid which inhibits liver cholesterol biosynthesis.
Another study shows that consumption of date fruit
has an effects to body’s lipid profile (Rock
et al
. 2009).
A previous study demonstrated the antioxidants in
date seeds can increase paraoxonase enzyme activity
in mice with hypercholesterolemia. It is crucial in
preventing the oxidations of lipoprotein and helping
in the hydrolysis of oxidized cholesterol. PON1 is the
antioxidants enzyme which comes with HDL, the
functions as protection against atherosclerosis by
preventing lipoprotein oxidations and helping in the
hydrolysis of oxidized cholesterol, phospholipids in
atherosclerosis lesion and oxidized LDL. Thus, date
seeds effects correlate with antioxidants such as
phenolic compound (Takaeidi
et al
. 2014). The
implication of this research is everyone who likes
drinking coffee or tea can substitute with date seed
steeping. This drinking is not only safe but its can
improve the profile lipid. Date seed steeping can also
be consumed daily to keep body’s health. However,
there was no control group in this research, so more
research needed to confirm other factors that can
influence.
Conclusion
Beverage of the date seeds is proven to improve
HDL level and decrease LDL, triglycerides, total
cholesterol and atherogenic index in pre-menopause
women in Indonesia. In particular, the active
compound in the date seeds (e.g., flavonoid) is a key
component to improve lipid profiles. Further study is
needed to test the safety in the human body for long
term use.
Acknowledgment
The authors expresses their gratitude towards
Dr. Hernayanti for the technical assist in laboratory
test.
Conflict Of Interest
The authors declare that they have no conflict of
interest.
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