Upload
doantram
View
227
Download
0
Embed Size (px)
Citation preview
Peranan Nutrisi untuk Kesehatan Remaja Putri
Catur Saptaning W
Sub Topik 1. INTRODUCTION 2. AVERAGE AGES OF PUBERTAL, COGNITIVE, & PSYCHOSOCIAL MATURATION 3. NUTRITIONAL NEEDS IN A TIME OF CHANGE 4. ENERGY AND NUTRIENT REQUIREMENT OF ADOLESCENT 5. ENERGY 6. BMR 7. PROTEIN 8. CARBOHYDRATE 9. FAT 10. DIETARY FIBER 11. CALCIUM 12. IRON 13. ZINC 14. FOLATE 15. VITAMIN A, E, AND C
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
INTRODUCTION
For girls is defined as the period of life between 10.5 and 14.0 years of age.
It is an especially important time in the life cycle for nutrition education since dietary habits adopted during this period are likely to persist into adulthood
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
AVERAGE AGES OF PUBERTAL, COGNITIVE, & PSYCHOSOCIAL MATURATION
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
NUTRITIONAL NEEDS IN A TIME OF CHANGE
The biological, psychosocial, and cognitive changes associated with adolescence have direct effects on nutritional status.
Increases needs for : • Energy • Protein • Vitamins • Minerals
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
ENERGY AND NUTRIENT REQUIREMENT OF ADOLESCENT
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
ENERGY
• Energy needs of adolescents are influenced by • Activity level, basal metabolic rate, and increased
requirements to support pubertal growth and development
ENERGY
• Adolescent male have higher caloric than females. WHY? ENERGY
• Physical growth and development during puberty is sensitive to energy and nutrient intakes. ENERGY
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
BASAL METABOLIC RATE (BMR) for women
Harris Benedict Formula for Women -‐ STEP 1 • BMR = 655 + (9.6 X weight in kilos) + (1.8 X height in cm) -‐ (4.7 X age in years)
• Harris Benedict Formula for Women -‐ STEP 2
• To determine your total daily calorie needs, now muleply your BMR by the appropriate acevity factor, as follows
If you are Sedentary -‐ lihle or no exercise Calorie-‐Calculaeon = BMR X 1.2 If you are Lightly Aceve (light exercise/sports 1-‐3 days/week) Calorie-‐Calculaeon = BMR X 1.375 If you are Moderately Aceve (moderate exercise/sports 3-‐5 days/week) Calorie-‐Calculaeon = BMR X 1.55 If you are Very Aceve (hard exercise/sports 6-‐7 days/week) Calorie-‐Calculaeon = BMR X 1.725 If you are Extra Aceve (very hard daily exercise/sports & physical job or 2X day training) Calorie-‐Calculaeon = BMR X 1.9
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
BASAL METABOLIC RATE (BMR) for women
Example of BMR You are 14 years old You are 153 cm) Your weight is 48 kg Your BMR is 655 + (460.8) + (275.4) – (65.8) = 1325.4 calories
Total Calorie Needs Example If you are Lightly Aceve, muleply your BMR (1325.4) by 1.375 = 1822.4 Your total daily calorie requirement is therefore 1822.4 calories.
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
BASAL METABOLIC RATE (BMR) for men
Harris Benedict Formula for Men -‐ STEP 1 BMR = 66 + (13.7 X weight in kilos) + (5 X height in cm) -‐ (6.8 X age in years) Harris Benedict Formula for Men -‐ STEP 2 To determine your total daily calorie needs, now muleply your BMR by the appropriate acevity factor, as follows
If you are Sedentary -‐ lihle or no exercise Calorie-‐Calculaeon = BMR X 1.2 If you are Lightly Aceve (light exercise/sports 1-‐3 days/week) Calorie-‐Calculaeon = BMR X 1.375 If you are Moderately Aceve (moderate exercise/sports 3-‐5 days/week) Calorie-‐Calculaeon = BMR X 1.55 If you are Very Aceve (hard exercise/sports 6-‐7 days/week) Calorie-‐Calculaeon = BMR X 1.725 If you are Extra Aceve (very hard daily exercise/sports & physical job or 2X day training) Calorie-‐Calculaeon = BMR X 1.9
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
CARA MENENTUKAN BMR 1. Dengan Rumus Harris Benedict 2. Cara cepat (dengan 2 cara) :
a. Laki-‐laki = 1 kkal x kg BB x 24 jam Perempuan = 0.95 kkal x kg BB x 24 jam b. Laki-‐laki = 30 kkal x kg BB Perempuan = 25 kkal x kg BB
• Contoh: A) Remaja putri umur 14 tahun dengan BB = 48 kg, enggi badan 153 cm dengan akevitas ringan. Maka BMR-‐nya adalah a. Perempuan = 0.95 x 48 x 24 = 1094.4 kkal b. Perempuan = 25 kkal x 48 = 1200 kkal 5/6/13 Catur Saptaning, S.Gz,
MPH_Kebidanan_2013
3. Cara FAO/WHO/UNU Kelompok Umur BMR laki-‐laki BMR Perempuan
0 – 3 th 60.9 BB – 54 61.0 BB -‐ 51
3 – 10 th 22.7 BB + 495 22.5 BB + 499
10 – 18 th 17.5 BB + 651 12.2 BB + 746
18 – 30 th 15.3 BB + 679 14.7 BB + 496
30 – 60 th 11.6 BB + 879 8.7 BB + 829
≥ 60 th 13.5 BB + 487 10.5 BB + 596
Sumber : FAO/WHO/UNU 1985
Berdasarkan contoh soal A maka sesuai dengan rumus FAO/WHO/UNU, BMR perempuan tersebut :
BMR = 12.2 (48) + 746 = 1331.6 kkal
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
AkEvitas Laki – laki Perempuan
Sangat ringan *) 1.30 1.30
Ringan **) 1.65 1.55
Sedang **) 1.76 1.70
Berat **) 2.10 2.00
Sumber : *) Mahan, L.K dan M.T Arlin, 2000, Krause’s Food, Nutrition & Diet Therapy **) Muhilal, Fasli Jalal dan Hardinsyah, 1998, Angka Kecukupan Gizi yang Dianjurkan Widya Karya Pangan dan Gizi VI
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
Jadi total ENERGI untuk perempuan tersebut (berdasarkan rumus) : - Rumus Harris Benedict :
Total energi = 1.55 x 1325.4 = 2054.4 kkal - Rumus cepat :
a. Total energi = 1.55 x 1094.4 = 1696.32 kkal b. Total energi = 1.55 x 1200 = 1860.0 kkal
- Rumus FAO/WHO/UNU : Total energi = 1.55 x 1331.6 = 2063.9 kkal
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
PROTEIN Protein needs of adolescents are influenced by the amount of protein required to maintain existing lean body mass, plus allowances for the amount required to accrue additional lean body mass during adolescent growth spurt.
The 2002 DRI report sets the RDA for protein intake for females and males aged 9 -13 years at 0.95 g/kg/day, and at 0.85 g/kg/day for 14 – 18 year-old
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
PROTEIN LIFE-‐STAGE GROUP PROTEIN (gram)
AGE (years) Grams/day
Females
11-‐14 46
15-‐18 44
19-‐24 46
Males
11-‐14 45
15-‐18 59
19-‐24 58
Source : Data taken from E.J Gong and F.P.Heard,”Diet, Nutrition, and Adolescent”. In M.E. Shils, J.A.Olson, and M.Shike(eds.), Modern Nutrition in Health and Disease, 8th ed. Philadelphia : Lea&Febinger,1994; and 1989 Recommended Daily Allowences, 10th ed. Of the RDAs, Food and Nutrition Board, Commission on Life Sciences. Washington DC : National Academy Press, 1989.
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
Dari contoh A maka kebutuhan protein perempuan tersebut dalam sehari adalah
Sesuai RDA
Protein
= 0.85 x 48 kg
= 40.8 gram
= 41 gram/hari
Sesuai tabel kebutuhan protein maka untuk perempuan usia 14 tahun kebutuhan proteinnya adalah 46 gram/hari
Atau dapat ditentukan dari 10-15% dari total energi
Protein
= 10% x 2054.4 kkal
= 205.44 kkal : 4
= 51.36 gram/hari
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
CARBOHYDRATE
Carbohydrates provide the body’s primary source of dietary energy.
Dietary recommendations suggest that 50% or more of total daily calories should come from carbohydrate
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
CARBOHYDRATE
Dari contoh A maka kebutuhan karbohidrat
perempuan tersebut dalam sehari adalah
Karbohidrat = 50% x (pilih salah satu perhitungan total energi) • = 50% x 2054.4 kkal (dari
rumus Harris Benedict) • = 1027.2 kkal : 4 • = 256.8 gram/hari
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
FAT The human body requires dietary fat and essential fatty acids for normal growth and development.
The 2002 DRIs for fat intake for children and adolescent, indicate that 4 – 18-year-olds should consume 25 – 35% of total calories from fat.
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
FAT Dari contoh A maka
kebutuhan lemak perempuan tersebut dalam sehari adalah
Lemak
= 25% x 2054.4 kkal
= 513.6 kkal : 9
= 57 gram/hari 5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
DIETARY FIBER Dietary fiber is important for normal bowel function and may play a role in thr prevention of chronic diseases such as certain cancer, coronary artery disease, and type 2 diabetes mellitus.
Adequate fiber intake is also thought to reduce serum cholesterol levels, moderate, blood sugar levels, and reduce the risk of obesity.
The American Academy of Pediatrics (APP) Committee on Nutrition has recommended that dietary fiber intakes among children and adolescent should be 0.5 grams per kilogram of body weight.
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
CALCIUM Achieving an adequate intake of calcium (Ca) during adolescent is crucial t0 physical growth development. Calcium is the main constituent of bone mass.
Female adolescent appear to have the greatest capability to absorb calcium at about the time of menarche, with Ca absorption rate decreasing from then on.
The DRI for calcium for 9 – 18-year-olds is 1300 milligrams per day.
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
IRON The DRIs for iron for male and female aloescents are :
LIFE-‐STAGE GROUP IRON (mg/day)
Females
9 – 13 years 8
14 – 18 years 15
Males
9 – 13 years 8
14 – 18 years 11
Source: Reprinted with permissionfrom Dietary References Intakes: Recommended Intakes for Individuals, by the National Academy of Sciences. Courtesy of The National Academy Press, Washington, D.C.
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
IRON
The two types of dietary iron are heme iron, which is found in animal products, and nonheme iron, which is found in both animal and plant-based foods
Irons needs of an adolescent are highest after menarche in females
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
ZINC
Zinc is particularly important during
adolescent because of its role in the synthesis RNA and protein, and its role as a cofactor in
over 200 enzymes
Dietary intakes zinc among adolescent
females range from 6.6 to 7.9 milligrams per
day.
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
FOLATE Adolescent have increased
requirements for folate during puberty
Folate in the form of folic acid is twice as bioavailable as other
forms of folate
Folic acid is the form of folate added to fortified cereals, breads, and other refined grain products
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
FOLATE The DRI for folate is :
LIFE-‐STAGE GROUP FOLATE (μg/day)
Female
9 – 13 years 300
14 – 18 years 400
Males
9 – 13 years 300
14 – 18 years 400
Source: Food and Nutrition Board, Institute of Medicine, National Academies. Dietary Reference Intakes : Recommended Intakes for Individuals. Washington, DC. : National Academy Press, 2000
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
VITAMIN A The DRI for vitamin A is : LIFE-‐STAGE GROUP VITAMIN A (μg/RAE/d)
Female
9 – 13 years 600
14 – 18 years 700
Males
9 – 13 years 600
14 – 18 years 900
Source: Food and Nutrition Board, Institute of Medicine, National Academies. Dietary Reference Intakes : Recommended Intakes for Individuals. Washington, DC. : National Academy Press, 2000
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
VITAMIN A
The top five dietary sources of vitamin A in the diets of adolescent are :
Ready-to-eat cereal
Milk
Carrots
Margarine
Cheese
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
VITAMIN E
Vitamin E is well known for its antioxidant properties, a role that becomes increasingly important as body mass expands during adolescent.
The five most commonly consumed sources of vitamin E among adolescents are : • Margarine • Cakes, cookies, quick breads, and donuts • Salad dressing and mayonnaise • Nuts and seeds • Tomatoes
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
VITAMIN E
The DRIs for vitamin E for adolescents are : LIFE-‐STAGE GROUP VITAMIN E (μg/d)
Female
9 – 13 years 11
14 – 18 years 15
Males
9 – 13 years 11
14 – 18 years 15
Source: Food and Nutrition Board, Institute of Medicine, National Academies. Dietary Reference Intakes : Recommended Intakes for Individuals. Washington, DC. : National Academy Press, 2000
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
VITAMIN C Vitamin C is involved in the synthesis of collagen and other connective tissues.
Vitamin C plays an important role during adolescent growth and development.
The five most common sources of vitamin C among adolescents are :
Orange and grapefruit; Fruit drinks; Ready-to-eat cereals; Tomatoes; White potatoes
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
VITAMIN C The DRIs for adolescents are : LIFE-‐STAGE GROUP VITAMIN C (mg/d)
Female
9 – 13 years 45
14 – 18 years 65
Males
9 – 13 years 45
14 – 18 years 75
Source: Food and Nutrition Board, Institute of Medicine, National Academies. Dietary Reference Intakes : Recommended Intakes for Individuals. Washington, DC. : National Academy Press, 2000
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
REFERENCES 1. Brown, E.J. Nutri&on Through The Life Cycle. (2sc ed). USA : Thomson Wadsword. 2005
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013
5/6/13 Catur Saptaning, S.Gz, MPH_Kebidanan_2013