DIETARY PATTERN AND TRADITIONAL FOOD CONSUMPTION (SOAMI) AMONG PREGNANT WOMEN IN WEST SERAM REGENCY MALUKU Citrakesumasari1*, Devintha Virani1, Andi Imam Arundhana1, Rifany Tiparisa2 1Nutrition Department, Faculty of Public Health, Hasanuddin University 2District Health Office, West Seram Regency *Corresponding email: [email protected] ABSTRACT It is essential to pay attention to the consumption of pregnant women due to the increasing of nutritional requirement in this period. Eating culture factor may also influence the consumption pattern, such as Soami consumption habit. This study aimed to identify how often pregnant women consume Soami as well as their food intake. The study was a cross-sectional analysis of 44 pregnant women in West Seram Regency during April 2018. Using a semi-quantitative food frequency questionnaire (Semi quantitative FFQ), Soami consumption data was collected from participants. Dietary intakes, both macro- and micronutrients, were also measured in this study. The average of respondents was from middle to lower socio-economic (>Rp100.000- <Rp 1.000.000) which was 63.6%. About 95.4% of pregnant women consumed Soami 2-3 times/day, and the rest once a day, while merely 18.2% of respondents consumed rice at least once a day. All macronutrients intake, such as energy, protein, fat, and carbohydrate, were below 75%, while only Vitamin A, Vitamin C, and Vitamin B6 reached a dietary recommendation. Consumption of Soami may contribute to the low dietary intake of pregnant women because this food was consumed every day and not combined with other foods. It is essential to provide education for those who live in this area and have the habit of consuming Soami regarding combination Soami with other foods during their meals to meet their nutritional requirements. Keywords: Traditional food, eating culture, Soami, pregnant women Introduction Indonesia is located in a very rich geographical area that consists of land, mountains and islands. Consequently, the availability of foods that can be consumed by local people is affected by these geographical conditions. Moreover, the way people respond to food access and household food security is also affected by the cultural and political socio-economic factors. Indonesia has a diverse ethnic, cultural, socio-economic and religious as well as beliefs, therefore, the eating habits and patterns of Indonesian local community is strongly affected by the diversity and geographical condition. Local food is one of the food sources that is easily accessible to the community, which gives a variety of colors to the Indonesian cuisine that are very diverse. However, local cuisine sometimes might need modifications to meet daily nutritional requirements, especially in vulnarable groups, such as pregnant women, lactating mother, andinfants.These groups plays significant role inthe first 1000 day of life which has become a global program as the best strategy to build healthy human resources including reducing the stunting rate. The first 1000 dayshas become a national agenda to optimize the improvement of health and nutrition services in the first 1000 day of life. One of the Indonesian traditional cuisines is Soami, which is consumed every day by the community from all age and social-economic groups in two villages in the West Seram sub- district. Seram in the western part of Maluku Province. Soami is made from cassava which is easily available at the household leveland do not require much preparation. Soami is made from cassava which is certainly rich in carbohydrates, howevwe, sometimes it is consumed by the community in an unbalanced manner, it means that Soami is only consumed with vegetables or only with side dishes or even as a single dish (without side dishes and without vegetables). If Soami can be use as a substitute for rice, it is certainly will become an advantage to reduce rice dependence by using local potential. Inbalanced dietary intake, especially in pregnant women, will affect their health and nutritional status as well as the pregnancy outcomes.Thus, will affect the efforts to improve public health nutrition problems, such as chronic energy deficiency (CED), nutritional anemia, low birth weight (LBW), poor nutritional status and stunting, and increase risk of degenerative diseases in the future. The West Seram Regency data shows that the anemia of pregnant women has increased very rapidly, namely 31.5% in 2013 and in 2016 62% of the total pregnant women did Hb examinations (West Seram District HealthProfile). The purpose of this study was to determine the Soami Consumption Pattern in Pregnant Women and the characteristics of pregnant women, and what sources of food that are consumed every day and to determine the amount of macro and micro nutrients intake. This research is important to conserve Soami as a local foodand fulfill the daily nutritional requirements of pregnant women, and also to optimize the non-rice-and-wheat basedlocal food. Materials and Methods This research was conducted in Telaga Piru village, Pulau Osi village, and Wael village, West Seram village, Seram village, of West Maluku Province in April because only in theseareas people are consuming Soami as their main dishes. This research is a descriptive study to get an overview of the consumption patterns of Soami in pregnant women. The population in this study were all pregnant women who consumed Soami residing in Telaga Piru village, Pulau Osi village, and Wael village, West Seram village, Seram villagewho were willing to participate in this study with exclusion criteria namely suffering from chronic infectious diseases and / or being treated in hospital and having their pregnancies checked by midwives village, with a total of 44 pregnant women. Pregnant women knowledge about Soami was measured using a knowledge questionnaire. The scoring scale used Guttman scale with criteria as follows: <60% low knowledge, 60-80% moderate knowledge, and> 80% high knowledge. Soami intake for pregnant women was measured by collecting the intake frequency data, meal times, types of food, the amount of food consumed in a day using semi-quantitative FFQ (SQ-FFQ) and characteristic data were obtained using a questionnaire. SQ-FFQ were measured using scoring system where, 0 = never; 0.07 = 1-3 times/month; 0.14 = 1 time/week; 0.43 = 2-4 times/week; 0.79 = 5-6 times/week; 1 = 1 time/day; 2.5 = 2-3 times/day; and 4 => 4 times/day. The 2013 Indonesian Recommended Dietary Allowance (RDA) was used as a reference. Intake was categorize as good if the consumption fulfill 80-110% of RDA. Data were processed using the SPSS program and presented in the form of narration and tabulation. RESULTS 1. Research Location West Seram District is part of the West Seram Regency and located in the southern part of West Seram Regency. With a total area of 5.393.43 Ha, with the following boundaries: North: Taniwel Subdistrict East: West Kairatu district West: Huamual and Waesala districts South: Sea Administratively, West Seram District is divided into 7 villages, 103 hamlets, with village development all of which are self-sufficient. In terms of community socialization, the West Seram District community is an agrarian society and has diverse cultures and needs to be carried out continuously by the Trustees to support the smooth and successful government activities and development. Most people in the West Seram sub-district live from livelihoods in the agricultural sector and most people embrace Islam. Judging from the condition of the region (geographical location), West Seram Subdistrict is very potential for agricultural development with an area of 5,393.43 ha which is mostly in the form of lowland land. However, in the research locations, especially the Osi Island Hamlet, which is located surrounded by sea and barren land due to many rocks, making it very difficult for local people to grow crops. In the research locations, the Telaga hamlet, Dusun Wael and Dusun Pulau Osi have a considerable distance from the district center of the city and do not have traditional markets or the like, so the community must go to markets located in the city center and the community must issue money of Rp. 15,000 - Rp. 20,000 (USD 1-2) only for transportation. 2. Respondents Characteristics Based on the characteristics in table 1, it was found that most pregnant women who consumed Soami in the West Seram sub-district were aged 20-35 years (84.1%) which were the adult age group. High school is the most recent education level taken by pregnant women in this area which is 43.2% and the work of pregnant women is mostly housewives or it can be said that it does not work (79.5%). Then around 63.6% of pregnant women have low household income. Other aspects show that half of them have low knowledge about Soami and 61.4% of pregnant women did not consume iron tablets. Table1. Characteristic Distribution of Pregnant Women Consuming Soami in West Seram District in 2018 Characteristics Frequency (N=44) Age [n(%)] < 20 years old 1 (2.3) 20 – 35 years old 37 (84.1) >35 years old 6 (13.6) Pregnancy [n(%)] 3rdTrimester 44 (100) Education [n(%)] Elementary School 10 (22.7) Junior High School 11 (25) Senior High School 19 (43.2) Diploma 1 (2.3) University 3 (6.8) Job [n(%)] Farmer 7 (15.9) enterpreneur 1 (2.3) private employee 1 (2.3) housewives 35 (79.5) Household income [n(%)] Low (< Rp.1.000.000,-) 28 (63.6) Medium (Rp.1.000.000 – Rp.1.900.000,-) 13 (29.5) High (> Rp.1.900.000,-) 3 (6.8) Soami Consumption [n(%)] Yes 44 (100) No 0 (0) Soami Consumption Frequency 1x /day 2 (4.5) 2-3x /day 42 (95.5) Knowledge about Soami [n(%)] Low 22 (50) Medium 21 (47.7) High 1 (2.3) Iron supplement consumption [n(%)] Yes 17 (36.6) No 27 (61.4) 3.