Penilaian Status GiziHertanto W Subagio

Acuan :

1. Supariarsa IDN, Bakri B, Fajar I : Penilaian Status Gizi EGC – 2002. Bab 2, 3 dan 4 2. Gibson RS 2005. Principles of nutritional assessment

Istilah

• Gizi

• Ilmu Gizi (WHO)

• Zat Gizi

• Keadaan Gizi / Status Gizi

• Salah Gizi

• Penilaian status gizi

Gizi• Asal kata (Mesir) ghidza (dieja ghidzi) =

makanan• Terjemahan resmi (KUBI) dari nutrition (english)• Istilah Nutrisi = dipakai di bidang Peternakan /

Kedokteran Hewan

Ilmu Gizi (WHO)

• ilmu yang mempelajari

‘proses yang terjadi pada organisme hidup untuk mengambil dan mengolah zat-zat padat dan cair dari makanan yang diperlukan untuk memelihara kehidupan, pertumbuhan, berfungsinya organ tubuh, dan menghasilkan energi’

Zat Gizi

• = Nutrient • Unsur / senyawa organik dan anorganik yang

diperlukan untuk memelihara kehidupan, pertumbuhan, berfungsinya organ tubuh, dan menghasilkan energi

• Pada Hewan disebut nutrisi• Pada Tumbuhan disebut zat hara

Keadaan Gizi / Status Gizi• Keadaan tubuh sebagai resultante dari asupan

zat gizi dan pemanfaatannya di dalam tubuh.

Status Gizi

PemanfaatanAsupan

Community Nutritional assessment

• To map out the magnitude and geographical distribution of malnutrition

• To discover and analyze the ecological factors that are directly or indirectly responsible

• and where possible to suggest appropriate corrective measures, preferably capable of being applied with continuing community participation

Preliminary step for further action

• Interpretation of information from dietary, laboratory, anthropometrics and clinical studies

Nutritional Nutritional Assessment :Assessment :

IndividualIndividual

Penentuan Status Gizi

• Langsung - Biokomia - Biofisik - Antropometri - Klinik

• Tak Langsung - Survei konsumsi makanan - Statistik vital - Ekologi

Penyebab Gizi Kurang

Kurang Gizi

Pangan tak cukup

Pola asuh takmemadai

Yan Kes. dan sanitasi Tak memadai

Asupan gizi Infeksi

Pendidikan, Pengetahuan dan ketrampilan rendah

PemberdayaanSDM kurang

Situasi Pol EK Sos

Pengangguran, Inflasi, kurang pangan dan kemiskinan

Akar masalah

Masalah di masyarakat

Penyebab tak langsung

Penyebab langsung

Patogenesis Penyakit Gizi

Asupan inadekuat

Perubahan Biokimiawi

Gangguan Faali

Kelainan Anatomis (antropometri dan Klinis)

Generalized scheme for the development of a nutritional deficiency

Stage Depletion stage Method(s) used

1 Dietary inadequacy Dietary

2 Decreased level in reserve tissue store Biochemical

3 Decreased level in body fluids Biochemical

4 Decreased functional level in tissues Anthropometric/Biochemical

5 Decreased activity in nutrient-dependent enzyme Biochemical

6 Functional change Behavioral/Physiological

7 Clinical symptoms Clinical

8 Anatomical sign Clinical

Dietary survey

National level

• Food balance

sheet

• Market data base

Household level

• Food account

• List recall

Individual level

•Single 24 hour recall

•Multiple 24 hour recall

•Food frequency

•Food diary record

•Weighed assessment

Gibson RS 1990. Principles of nutritional assessment

Vital statistics

• IMR

• 1 – 4 yrs MR

• Cause specific morbidity rate

• Cause specific mortality rate

etc.

Assessment of ecological factors

• Socio - Economic factors

• Cultural influences

• Food Productions

• Health and educational services

Clinical Assessment

• Medical history

- interview

- medical record

• Physical examination

- indicating a probable deficiency of one or more nutrients

- indicating a combination with other factors

- not related to nutritional status

Laboratory Assessment

is used primarily to detect subclinical deficiency states

is becoming increasingly important with the growing emphasis on preventive medicine

can be used to supplement other methods

often affected by biological and technical factors

Type :

• Static biochemical test

• Functional test

Test of physical function The main purpose is to assess

alteration in function associated with inadequate

- dark adaptation - physical performance - capillary fragility - nerve accommodation

Nutritional Anthropometry

measurement of the variations of the physical dimensions and the gross composition of the human body at different age levels and degrees of nutrition

widely used in the assessment of nutritional status, particularly when a chronic imbalance between intakes of protein and energy occurs

Two types :

-growth measurements

-Body composition measurement : body fat, fat free mass

Malnutrition

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

•Overnutrition

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

•Undernutrition

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

•Specific deficiency

Relative or absolute lack of an individual nutrient

•Imbalance

Disproportion among essential nutrients

overnutrition

Undernutrition

Severe Protein Energy Malnutrition

Kwashiorkor - oedemaKwashiorkor – in addition to emaciation and wasting:

oedema, especially of arms and legs masks emaciation and wasting easy tissue damage can lead to gangrene

Kwashiorkor - dermatitisKwashiorkor – in addition to emaciation and wasting:

sunburn-like sooty dermatitis

Kwashiorkor - hairKwashiorkor – in addition to emaciation and wasting:

loss of hair colour and texturecharacteristically miserable appearance

Kwashiorkor – fatty liverKwashiorkor – in addition to emaciation and wasting:

fatty infiltration of the liver pot-bellied appearance

GAKY

KVA

Xerophthalmia

Rickets

Beri-beri

Pellagra – the niacin deficiency disease

Sunburn-like dermatitis in areas exposed to sunlight