Pencegahan dan Penanganan

Masalah Gizi

GUSKHUR
AKPER MUHMAMMADIYAH CIREBON
1
 Human growth is influenced by
1. Biological determinants :
sex, intra uterine environment, birth
order, birth weight, parental size,
genetic constitution

2. Environmental :
Nutrition, Climate, living condition,socio-
economic condition, diseases,
psychological factor etc
 Nutritional status
A body condition as result of nutrients
intake and utilization
Keadaan tubuh akibat dari keseimbangan antara konsumsi dan
pemanfaatan zat gizi.

1. Normal
2. Malnutrition
 Undernutrition
 Overnutrition
 Specific deficiency dan imbalance
 Nutritional Assessment

•  Interpretation of information from :

1) Anthropometric measurement,
2) Biochemical laboratory,
3) Clinical examinations

•  Individual vs community
Nutritional Assessment Methods:

1. Anthropometric measurements
2. Biochemical laboratory examination
3. Clinical examinations
4. Dietary methods
5. Ecological factors assesment

No 1,2,3 = direct assessment

4,5 = indirect assessment
Nutritional assessment method
ABCD

A : Anthropometry
B : Biochemical methods
C : Clinical methods
A. Anthropometry

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 NUTRITIONAL ANTHROPOMETRY

à measurements of variations of the

physical dimensions and gross
composition of human body at different
age and degrees of nutrition
•  Anthropometry is the measurement of
body size, weight, and proportions.
•  can be sensitive indicators of health,
development, and growth in infants and
children.
•  Overnutrition → overweight / obese
•  Undernutrition → PEM, wasting,
stunting
 *Anthropometric Measurements =
picture of human growth at different age
level (from fetus to adulthood):

•  height/length, weight
•  upper arm circumference (UAC/LILA)
•  head circumference
•  BMI (body Mass Index)
•  Skinfold thickness

è raw measurements do not mean

anything, if not compared to
REFERENCE or STANDARDS.
 Length, stature and head
circumference
•  Length :
- children < 24 months or 24-36 months who
can not stand erectly without assistance.
- 2 persons are required to measure
recumbent length with the child in supine
position.
- Frankfort position
 STUNTING
•  Low length for age
•  Failure to achieve expected length
•  Indicator of past growth failure.
•  Associated with chronic insufficient
protein energy intakes and or frequent
or prolonged infection
 WEIGHT-FOR HEIGHT
•  Identify children who are wasted.
•  Measure of current nutrition
•  Is a good index when difficult to
determine the exact ages of children.
•  Identify children suffering from current
undernutrition or wasting.
•  Good measured for evaluating nutrition
intervention program or the effects of
seasonal changes in food supply.
STUNTED WASTED
 •   Plot hasil pengukuran BB dan PB berdasarkan usia
anak ke dalam kurva pertumbuhan:

•   Contoh:
Anak perempuan, 18 bulan,
BB=10 kg; PB=80 cm

Assesment:
BB//U = 10 kg (p10-p25)
PB //U= 80 cm (p10-p25)
BB ideal = 11 kg

BB actual x 100%
BB ideal
= 10/11 x 100%

= 90,9% (status gizi normal)

 Indikator Pertumbuhan
Z-score
TB/U BB/U BB/TB BMI/U

Di atas +3 Obese Obese

(kegemukan) (kegemukan)
Di atas +2 Overweight Overweight
(BB lebih) (BB lebih)
Di atas +1 Possible risk of Possible risk
overweight of overweight
(Berisiko (Berisiko
BB lebih) BB lebih)
Median
(nol) Gizi Baik
Di bawah -1

Di bawah -2 Perawakan BB kurang Gizi kurang Gizi kurang

pendek

Di bawah -3 Perawakan BB sangat Gizi buruk Gizi buruk

sangat pendek kurang
 Malnutrition
A pathological state resulting from a relative or absolute
deficiency or excess of one or more essential nutrients.

Undernutrition
resulting from the consumption of an inadequate quantity of food,
over an extended period of time

Overnutrition
resulting from the consumption of an excessive quantity of food,
over an extended period of time

Specific deficiency
Relative or absolute lack of an individual nutrient
 Penyebab Gizi Kurang
(undernutrition)

Kurang Gizi

Penyebab Infeksi
Asupan gizi
langsung

Yan Kes.
Pangan tak Pola asuh tak dan sanitasi
Penyebab tak
cukup memadai Tak memadai
langsung

Pendidikan, Pengetahuan dan ketrampilan rendah

Masalah di
masyarakat Pemberdayaan
SDM kurang

Pengangguran, Inflasi, kurang pangan dan kemiskinan

Akar masalah
Situasi Pol EK Sos
 OBESITY
overnutrition

Obesitas merupakan
penimbunan jaringan lemak
tubuh secara berlebihan
 Etiologi Overnutrition
Psikologi Genetik

Lingkungan
Metabolik
Obesitas
Mutasi gen :
MC4R (hipotalamus)

Obat-obatan :
- Steroid
Neuro psikologik
- antidepresan
 B. Biochemical methode
•  provide the most objective and quantitative
data on nutritional status.
•  can detect nutrient deficits long before
anthropometric measures are altered and
clinical signs and symptoms appear.
•  Direct (static test) : nutrient / metabolite in
blood, urine, or body tissue (e.g. albumin,
calcium, vitamin A etc)
•  Indirect (functional test) : dark adaptation,
impairment of immune status.
A. Protein status
B. Iron status, ex: anemia (kurang Fe)

C. Mineral status, ex: kurang iodium, kurang ca

D. Vitamin status, ex: kurang vit A

E. Blood chemistry test (Bilirubin, ALAT, ASAT,

cholesterol, etc.)
C. CLINICAL SIGNS

- physical
- related to inadequate nutrition
- to be done by experienced persons
- lack of specificity
 Severe malnutrition

A. Marasmic B. Kwashiorkor C. Marasmic - Kwashiorkor

Severe Protein Energy Malnutrition
Xerophthalmia
Beri-beri
 Pellagra - the niacin deficiency
disease

Sunburn-like dermatitis in areas exposed to sunlight

F
Goitre
Cretinism
Thanks