Kuliah Gizi -Antropometri Singkat

7/24/2019 Kuliah Gizi -Antropometri Singkat

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Nutritional Status Assessment


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Nutritional status important aspect fornormal & sick children

Nutritional assessment result: Nutritional status -

overweight/obese

- wellnourished - mild- severe

Growth & Developtmental process

Sick children : course ! prognosisof the disease


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"orrelation between nutritional

status and immunological status

Severe #$% : immunologic def ----

'ospital malnutrition :- hospital sta( - cost -

recover( process


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)sage of Anthropometr( *+,

#edical services

%ublic health purposes

esearch


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)sage of anthropometr( *.,

ndividu :+0to determine

nutritional state

.0to detect nutriens defisienc(

10to monitor ph(sical growth

the results : relevant intervention


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)sage of anthropometr( *1,

Population: communit(nutritional status

the results : government polic(


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Nutritional assessment in clinic "linical e2amination

Dietar( Anal(sis

Anthropometr( measurements

3aborator( investigations


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"linical e2amination

Anamnesis *Dietar( 'istor(,

%h(sical e2amination *insp4 palp4 perc4auskl,

Simple anthropometr( measurements*564 5'4 '"4 #)A",


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%h(sical findings

Severe malnutrition : obvious #ild-moderate : non specific

Simple nutritional clinical findings 7rgans abnormalit( related to

nutritional deficienc(


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#arasmus:

irritabilit(4 pale shrunken & wi8ened

face * 9orang tua

susah, normal hair subcutaneus fat *-,

promints bones muscles h(po/atroph(

liver/spleenenlargement


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;washiorkor:

apath(4 lethargi4ir ritabilit(

moon face4 palesparse4 thin4 elasticit( hair*9spt rambut


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Dietar( anal(sis

Supporting e2amination

Assessment of foods =uantit( & =ualit(

- nterview methods - >oodmodels - Dail( food record

0 .? hours recall metode

0 1-@ da(s


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5eneficial

>eeding problem Abnormal eating habit

>oods allerg( >eeding skill development disorder Disadvantages : less

acurate & practice


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Anthropometric

Anthropometri :measurementof numerous ph(sical

dimention of human bod( in various age#easurement:

to obtain values/raw datas

*564 '4 '"4 etc,


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Anthropometric

nde2es: combination ofmeasurement results eg: 56/age4'/age

ndicators: cut off pointof inde2es e0g : c0o0p for

severe #$% 56/': @BC


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#easurement : - Data base for obtain inde2es& indicator -eliable - eproducible

- "ould be the result ofobservation


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Nutritional assessments usinganthropometr( depend on :

- methods

- standart reference- cut off points -clasification


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5od( weight- simplest parameter

- eas( to measure &

reproducible -inde2 for present nutritional status


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'ow to #easure

no/less cloths

no shoesspring/beam balance


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Accurac( -children : B0E kg - infants

: B0+ kg


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5od( weight/age

Simplest

eflect recent nutritional status

6idel( use in determining %$#

Disadvantage: does not take into account

height

"hildren with low weight/age do not

alwa(s wasting


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"hronic malnutrition

56/age and '/age : low

%roportional

Geneticall( short

Severe malnutrition prevalence

might be over estimated


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;artu #enu


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3ength/'eight

- simple parameter- eas( to measure& reproducible

- with 56 give significant information- indicated

chronic nutrients deficienc(


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'ow to measure

nfant & children less than . (ears+0ecumbent length

.0)sing wooden measuring board

10>ace upward ?0'eadtowards the fi2 end E0Fhe bod(parallel to the long a2is of the

board 0Shoulders bladesshould rest against the surfaceof the board


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'ow to measure

"hildren . (ears - adult:

+0Standing position using stadiometer

.03ooking straight ahead with >rankfurt planehori8ontal

10Shoulders rela2ed

?0Arms at sidesE03eg straight and knees together

0>eet flat and with heels almost together


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6eight/height

Gives a reasonabl( accurate estimate ofbod( wasting: +056sensitive to rapid change in food

suppl(4 while height remains constant4changing onl( slowl(

.0"hildren E (ears4 the relationship

of 56 to ' is nearl( constant4regardless of se2 & ras


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1056/' is relativel( independent of childHsage4 which is often difficult to

ascertain reliabl(

?0Fhere are good internationall( accepted

and globall( applicable reference values of56 for height of this group

E0#inistr( of 'ealth has agreed to use inde256/' as measurement of nutritional statusin primar( health care


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56/5'

Girls onl( upto +1I cm height

5o(s onl( up to +?E cm height

Advantage: need no agedata


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56/5' value corespondens to EB thcentiles assumed as normal/ade=uatenutritional status

Fhe wider the value from EB thcentiles occurred the more severe

malnutrition *over/deficienc(, happen


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"entiles :N"'S : %E under nutrition %JE over nutrition

6'7-N"'S : %1 under nutrition %J@ over nutrition

"D" .BBB : %IE under nutrition %IE- %JE wellnourished %JE over weight

K Score :#inistr( of 'ealth : - 1 SD -- . SD : severe malnutrition - . SD L - +SD : moderate malnutrition

! + SD - ! . SD : 6ellnourished


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ndices combination

"hild No0+

56/age : - . SD

F5/age : - . SD &! . SD

56/' : - . SD

D/ : underweight withnormal stature


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"ommon error in measurement

#easurement $rror

General nade=uate instrument4 estless child4 eading4

recording

5od( weight oom cold4 no privac(4 Scale not calibrated to

8ero4 Sub


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'ead circumference

nterfere b( nutritional status up tothe age of 1 months

outine measurement MM detect/screenneurologic disorders

using non elastic band


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nterpretation

'" Eth centiles or - . SD

probabl( chronic malnutrition inintrauterine or infant or child period


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#id-upper arm circumference

)seful if : +0No data of56 & 'eight .056 & 'eight can notbe measured precisel(

$2amples patients with -organomegal( - edema

- h(drocephalus


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#id upper arms circumference

"hildren +-E (ears #)A" perse can showed nutritional

status 3eft arm #iddle between acromion-olecranon

)sing non elastic band *6'7/"A$, Divided in to 1 colors: green4 (ellow

and red


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nterpretation: ++0E cm

: severe malnutr *red, ++0E-+.0E cm: mild-mod *(ellow, +.0E cm :

normal *green,

#)A"/age: IE-+BBC :normal @B-IEC : mild-mod

malnutrition @BC : severemalnutrition


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Skin fold thickness

Almost +/. bod( fat is in subcutaneustissue

Fotal bod( fat can be estimated #easurement using "aliper esults plotting in curve/standard


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%oint out/eflect : - %resentnutritional status & bod(

- Amount of reserve energ(

- Fogetherwith 56/5' inde2 -- chronicmalnutrition


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5od( mass inde2

uatelet inde2 M 56 *;g,/'. *m, Age & se2 dependent in interpretation 'igh correlation with fat bod( mass

mportant for medical complication riskidentification

ecommended b( 6'7 *+JJ@,4 N' *+JJI,4

as gold standard for measurement of obesit( inchildren and adolescent


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5# L 7bese child


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Eth percentile : under nutrition

IEth percentile : overweightJEth percentile : obese

#ale bo(4 aged (ears56 ?B kg4 ' +1B cm

5# M ?B/+01.M .10* %-J@ ,

D/ : 7besit(

5# 7bese child


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eference growth chart

Fo plot the result of measurement to

determine nutritional status

3ocal

nternational

%ercentile Standard Deviation Score *K score,


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.0 Oumadias

-+I (ears of age

n correlation with age and se2

5ased on stud( in school age children inOakarta +J

1rd& J@thpercentiles not available


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10Pa(ah 'usaini

Aged L +? (ears

5ased on studies done in several

provinces 1rd& J@thpercentile not available


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nternational

N"'S +0 )sed in )SA

in +J@@ .0 5ased on stud( in

white population 10 #ainl( breast fed

children ?0 Eth& JEthpercentile


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6'7-N"'S +0N"'S adopted

b( 6'7 for international use +JI1.0based on data from several sources

10ncludes 1rd& J@thpercentiles

?05est used for children +B (earsbecause of differences in age of peak

height velocit( for some population *eg0

Asians,


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"D" .BBB Growth chart evised growth chart4 consist of + chart

*I for bo(s & I for girls, Aged .-.B (ears

5oth breast fed and formula fed infants

ncludes 5# for age


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7ther classification

Gomes*+JE,

5ase on 6t for ageQDoes not distinguish

between wasting and

stunting6ellcome

*+J@B,

5ase on 6t for ageQ

6ith or without edema

6aterlow

*+J@.,

5ase on 6t for ageQ

't for ageQ

Q $2pressed as C median because the 'arvard reference was used


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;lasifikasi status gi8i

"ategor( 56/age '/age #)A"/age 56/' #)A"/'

6ellnourished +BB-IB +BB-JE +BB-IE +BB-JB +BB-IE

#ild %$# IB-B JE-IE IE-@B JB-@B IE-@E

Severe %$# B IE @B @B @E

+03okakar(a Antropometri Depkes +J@? & %uslitbang Gi8i +J@I


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Nutritional status assessment

Child A , Male, 2 yrsBW : 10 kg ( < P!

" : #$ %m (& P2$!

Nutritional status :BW'A & 10'12) ( *+!"'A & #$'#* ( +*$!BW'" & 10'122( #2! &

Mild M-P

N l


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Nutritional status assessment

Child B, male, 2 yrsBB : 10 kg ( < P!

.B : *# %m (< P! &

/.N.-

Nutritional status :

BW'A & 10'12) ( *+!"'A & *#'#* ( #+!

BW'" & 10'10#(+2)!& Wellnourished


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Growth chart for specific condition

Neurologic/orthopedic problems

Genetic abnormalities/s(ndromes

%remature infants


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Special conditions

Neurologic/orthopedic problems

Genetic abnormalities/s(ndromes

%remature infants

5 im n d n n n k b s


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5agaiman dengan anak obese

Thank You

Kuliah Gizi -Antropometri Singkat

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