Luciana B. Sutanto : Closing the gap from small town to International

Dr. dr. Luciana B. Sutanto, MS, SpGK, or you can call her ‘Lucy’, was born in Yogyakarta on October 6th. Spent most of her childhood in Magelang, a small town in central Java, where everything within a reach, the green scenery of this town will make you don’t want to leave this place.

It’s a country-like town where neighbors greet you like you’re one of their own family. The feeling is nothing compare to the crowd- bad-traffic Jakarta, the city where She spent years taking her PhD and course in Intensive Care Consultant Program. ”It started accidentally as I was trying to help my friend to take this program (the Intensive Care Consultant Program), but when I learned more about this program I found it was very interesting which motivated me to join”.

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Her parents, Mr. and Mrs. Agung Sutanto, raised 3 children with disciplinary in education. The late Dr. Agung Sutanto, is a well known Obgyn and the founder of RSIA Gladiool Magelang. “My father taught us (Lucy and her two sibling, Evy and Doddy) various skills and sports. He never complained about our school grades, no matter how bad we got. But, mother always reminded us to study well and behave”. Lucy smiled.

Her father did an amazing role, all of his children became doctors, Doddy is famous as an Obgyn sub-specialized in fertilization, Evy is a general practitioner doctor, master in biomedical science and there is Lucy, who specialized in clinical nutrition.

When I asked her why she did not follow her father’s step to become an OBGYN? “after I finished my MD, I worked for a community health center in Temanggung, central Java. One of it's health program was Posyandu (a monthly clinic for children and pregnant women), by then I realized that nutrition care in the community was still neglected. One day at a clinic, a patient asked me about the nutrition of her child, it opened my mind that my knowledge in nutrition was still lacking. What concerned me most, many cases of weights of babies under 5 were increased but still below WHO's recommendation. After observation, I knew that their food consumption was not varied and unnourished, we need to integrate nutritionist with the primary care provider/pediatrician. This gap in care motivated me to study nutrition”.

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She lives in 2 cities now, most of her daily routine was spent in Magelang, as director of RSIA Gladiool Magelang, a position she engage after years served as lecture in Department of Nutrition Faculty of Medicine University of Indonesia, “Gladiool Mother’s & Child’s Hospital is a family business. After my father retired I am deeply engage as a Director to run the operations of the hospital and medical (nutrition) practice”. Beside her busy schedule in hospital, Lucy also was appointed to be the president of Indonesian Nutrition Association (INA). Base in Jakarta, the association focus on education, postgraduate training, practice, research and publication in Nutrition. Recently INA just launched their first scientific journal entitled World Nutrition Journal. “Indonesian Nutrition Association (INA) is the continuation of Nutri Indonesia Foundation (NIF). After the founder of NIF passed away, the members formalized the legal entity to INA. I was appointed as the president due to my specialization in nutrition and my experience within INA”. INA also held a National Symposium named Nutri Symposium, the symposium attended by more than 200 enthusiast participant from Health Care Providers (HCP) nationwide. The speakers (whom also good colleagues of Lucy) from Indonesia and abroad also join together to support this event, the event has been a success for years.

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“I have been attending international nutrition meetings every year since I was a Master Degree student (as this article was written, Lucy already flew to Iran to attend the International conference in Mashhad, then continued to Netherlands for participating in ESPEN congress). By attending international meetings it helps me in peer network and learn latest trends & nutrition practice globally, it is important to have support from experts internationally for knowledge sharing and to support each other in developing nutrition activities”. And we can see the good relationship impact in this year Nutri Symposium, whereas speakers from US, Iran, Australia, Spain, Malaysia and Philippines all together share their expertise and knowledge on this 2 days symposium.

Mashhad: A city full of stories

Mashhad is Iran’s holiest and second-largest city. Its raison d’être and main sight is the beautiful, massive and ever-growing Haram (shrine complex) commemorating the AD 818 martyrdom of Shiite Islam’s eighth Imam, Imam Reza. The pain of Imam Reza’s death is still felt very personally well over a millennium later and more than 20 million pilgrims converge here each year to pay their respects. Witnessing their tears is a moving experience, even if you’re not Muslim yourself.

Dr.dr. Saptawati Bardosono, MSc, short for Tati, was invited to attend the international congress entitled “Nutrition: from Laboratory research to clinical studies”as key speaker. The journey to Mashhad Iran, is a journey she will never forget.

Why did you travel to Mashhad?

At first I did not believe that I was invited to give a talk in the first International Congress Nutrition: From Laboratory Research to Clinical Studies in Mashhad Iran, September 6–8, 2017. Not until an email reached me to ascertain that the invitation was real. Preparation was made for the presentation only, while for the visa was only bothered to make a new photo wearing hair cover. Other things were arranged well by the committees from Mashhad University of Medical Sciences.

Where did you stay?

After flying more than half day from Jakarta to Mashhad via Doha, I arrived early in the morning in International Shaheed Hashem-inejad airport of Mashhad and being fetched up right under the airplane stairs by the committees, and again everything were well arranged. And, we were escorted to the hotel nearby the congress venue, Pardisan Hotel.

How did you get around the city?

To go to the congress venue and back to the hotel was arranged by the committees’ buses. Although it was not far or only 15 minutes walk, however to the hot climate than it was safer to ride a bus. During the congress, the committees also provide us to visit interesting places before inviting us for dinner. During my extra day staying in Mashhad, I joined the group of two Italian guys from the UNESCO to visit the market to find unique germs. We were accompanied by two appointed students (i.e. medical and dentistry) to ride in their private car and continued by metro and public bus. It was Friday, and it is a public holiday for the Iranian instead of Sunday. Thus all the public transportations were crowded.

Tell us about the places you visit in Mashhad?

First day, we visited the Kang-village. It was an old village built in the foothills of the Binalod Mountain. We had to climbed the stairways all the way to the top to pass all the houses with closed doors with almost no windows. The village has been built in such a way that the yard for each house is on the roof another. Tiredness for climbing the stairway architectural design of this village was paid by having very beautiful scenic view of the hills.

Second day, we visited Holy Shrine of imam Reza. We rode a bus but had to walk to be able to enter the mosque compound. It is a big and beautiful mosque full with visitors who can pass the praying area to go to the museum inside the mosque. Lots of Muslim do their prayer and listening to the priest afterward. All the prayers are provided by dinner from the mosque. Every night they cook for thousand portions of meal.

The third day, we dressed up for the formal dinner invited by the committee. Before going to the venue, we visited a carpet gallery and being explained to different type of Persian carpet. They all looked very beautiful but do not ask for the price, because it could be similar to the price of a car. After that we went to a nice hotel for a formal dinner.

The fourth day, we had a half-day congress, so we could go shopping. We went to a nice mall and do some shopping for saffron (the most expensive spice in the world), tea and special dates. Then the committees took us to Ferdowsi Mausoleum before having dinner at Shandiz the country-side of Mashhad.

The last day was the best part, because we could by our own visit some shops and market plus having high tea and lunch in unique places, and also visited the Health Science Campus. We hunted for the germs through small shops and market, and we could by other things too, of course. The market is called bazaar Reza.

What kind of clothes did you pack for this trip?

Iran is an Islamic country. We have to wear clothes that cover our head and body. And they prefer to wear non-colorful clothes, and black is the favorite one. But the youngsters not very strict about it, they are free to half-cover their head and wearing any modern clothes as long it covers their body.

Where can foodies go in Mashhad?

Well, at first I was shock to find meals during breakfast, lunch and dinner. But when I pushed myself to try them, wow, they are all so tasty and delicious. The loose rice that would be hard to chew in my mind, they are not. They provided vegetables salad with thousand-island dressing, and the meat (lamb or chicken) was cooked as kebab or curry that were so tender to chew. The best meal was the sashlik or barbeque of several lamb back ribs put in a sword-like stick. Do not forget to try their special-made ice cream…yummy.

What were the Iranian people like?

Iranian people are so nice and kind. They are very honest and friendly. I miss them already. But most of them (taxy driver, shop attendance, etc) do not speak English.

Any tips for traveler going to Mashhad?

Before traveling to Mashhad, it is better to read the book of Mashhad outlook (provided at INA) in which will tell you about communications, transports, local-customs, taboos (e.g. man and woman do not shake hands), and to do shopping and how to pay, because they do not accept foreign credit cards and prefer paid by cash in Iranian currency (rial or toma). You can exchange your US dollar or Euro in the banks or official money exchange centers, but not in the hotel.

Lastly, what do you love more about this trip?

How you are welcomed and how they are treated you nicely and warmly will make you want to come back to Mashhad and other places in Iran. Iran is a safe country but still being abandoned by the US but not by the European countries.

Tati

Healthy Fasting Happy Life

One of the most important element during Ramadan is fasting. It is a founding principle of Islam and obligatory for moslem's people to fast during this times.

A big part of Ramadan is the food. Different assumption emerged on what type of food (Tajil) should be consume first after Iftar, the breaking of the fast. Is it something sweet? or savoury? Sometimes, we can not control the hunger and consume too many food during Iftar.

We breakdown how to keep healthy during fasting.

What happen with your body during fasting?

In the fasting state your body will developed energy from its storage. In the first 6-9 (six-nine) hours, the energy will be developed from the energy storage in the liver (glycogen) and then after that, the body will look for energy from body storage by mean of gluconeogenesis. In Gluconeogenesis the body will breakdown its protein from the muscle and lipid from body fat.

How to fast safely during Ramadan?

In the fasting month of Ramadan, to successfully fast the whole month in a healthy and happy state, we need to manage our daily diet, as well as our activity. Started from Sahur, it is recommended to eat most of your carbohydrate from the complex one. Why? The complex carbohydrate will be slowly changed to energy, as for the simple carbohydrate will be immediately changed into energy. So, the complex carbohydrate will make us stay energized longer, before the body breakdown its storage. At break fasting, the first two words are “go slow”. Start with something sweet from the simple carbohydrate, as it will raised immediately blood glucose and served the immediate energy. After that, we can eat our main course. Make sure that your meals during the fasting month is in a balance diet.

Exercise during Ramadan? When is the best time to do the exercise? Should it be limited?

Exercise during the fasting month of Ramadan is safe, and the best time to do the exercise is 1-2 hours before breakfasting. Why is this the best time? It is because that we will be able to change our energy and fluid loss immediately. Should our exercise be limited during the fasting month of Ramadan? Not really, as long as your body accept your daily exercise. We can measure our body acceptance of the exercise by calculating our pulse, our breath frequencies and fatigue. Start low and slow in exercising at the few days in the early month, then add gradually the days after.

Is Fasting can be a healthy diet to lose weight?

Yes, fasting is one of the way to lose weight. We can start by consuming enough energy for our daily life, make sure that our daily meal is in balance diet, along with the limitation of salt, oil (fried food) and simple carbohydrate (sugar) consumption. Choosing the food type and the processing of the food is another way to start your diet. In example, fish and poultry is a good source for lean protein, choose them to avoid fat. Sugar, syrup and flour are the source of simple carbohydrate, avoid them because excess of this food will be stored in our body as fat. A variety in colour of vegetable and fruit are a good source for vitamins and minerals. In processing the food, try to avoid frying and the use of oils, margarine and butter. Boiling, stewing and steaming is the best way to process food to lose weight.