Peranan Nutrisi untuk Kesehatan Remaja Putri

Peranan Nutrisi untuk
Kesehatan Remaja Putri Catur Saptaning W Sub Topik
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INTRODUCTION AVERAGE AGES OF PUBERTAL, COGNITIVE, & PSYCHOSOCIAL MATURATION NUTRITIONAL NEEDS IN A TIME OF CHANGE ENERGY AND NUTRIENT REQUIREMENT OF ADOLESCENT ENERGY BMR PROTEIN CARBOHYDRATE FAT DIETARY FIBER CALCIUM IRON ZINC FOLATE 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 : • 
• 
• 
• 
5/6/13 Energy
Protein
Vitamins
Minerals
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 •  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. 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 5/6/13 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 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 5/6/13 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. 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 5/6/13 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 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
5/6/13 Atau dapat ditentukan
Sesuai tabel kebutuhan dari 10-15% dari total
energi
protein maka untuk
perempuan usia 14
Protein
tahun kebutuhan
= 10% x 2054.4 kkal
proteinnya adalah 46
= 205.44 kkal : 4
gram/hari = 51.36 gram/hari 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 Karbohidrat = 50% x
(pilih salah satu
perhitungan total
energi) Dari contoh A maka
kebutuhan
karbohidrat
perempuan tersebut
dalam sehari adalah
5/6/13 •  = 50% x 2054.4 kkal (dari
rumus Harris Benedict)
•  = 1027.2 kkal : 4
•  = 256.8 gram/hari
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
5/6/13 Lemak
= 25% x 2054.4 kkal
= 513.6 kkal : 9
Catur Saptaning, S.Gz, = 57 gram/hari 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. 5/6/13 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. 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 5/6/13 Dietary intakes zinc
among adolescent
females range from 6.6
to 7.9 milligrams per
day. 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 : 5/6/13 • 
• 
• 
• 
• 
Margarine
Cakes, cookies, quick breads, and donuts
Salad dressing and mayonnaise
Nuts and seeds
Tomatoes 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. 5/6/13 The five most common sources of vitamin C among
adolescents are :
Orange and grapefruit; Fruit drinks; Ready-to-eat cereals;
Tomatoes; White
potatoes 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