Peranan Nu isi untuk Kesehatan Remaja Pu...

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


AVERAGE AGES OF PUBERTAL, COGNITIVE, & PSYCHOSOCIAL MATURATION


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


ENERGY AND NUTRIENT REQUIREMENT OF ADOLESCENT


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


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


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.


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


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


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


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


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


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.


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


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


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


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.


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.


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.


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.


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


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.


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


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


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



VITAMIN A

The top five dietary sources of vitamin A in the diets of adolescent are :

Ready-to-eat cereal

Milk

Carrots

Margarine

Cheese


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


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



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


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



REFERENCES 1. Brown, E.J. Nutri&on Through The Life Cycle. (2sc ed). USA : Thomson Wadsword. 2005


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