Peranan Nutrisi untuk Kesehatan Remaja Putri. Catur Saptaning W

Peranan Nutrisi untuk Kesehatan Remaja Putri

Catur Saptaning W

Sub Topik

1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14.  15. 

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

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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


AVERAGE AGES OF PUBERTAL, COGNITIVE, & PSYCHOSOCIAL MATURATION

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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

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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.

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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

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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

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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

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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


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

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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

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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

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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


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


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

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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


CARBOHYDRATE Karbohidrat = 50% x (pilih salah satu perhitungan total energi)

Dari contoh A maka kebutuhan karbohidrat perempuan tersebut dalam sehari adalah

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•  = 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. 5/6/13


FAT Dari contoh A maka kebutuhan lemak perempuan tersebut dalam sehari adalah

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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.

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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


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.

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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


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.


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


FOLATE The DRI for folate is :

LIFE-‐STAGE GROUP

FOLATE (μg/day)

Female 9 – 13 years

300

14 – 18 years

400


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

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VITAMIN

A The DRI for vitamin A is : LIFE-‐STAGE GROUP

VITAMIN A (μg/RAE/d)


600

14 – 18 years

700


600

14 – 18 years

900


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VITAMIN A The top five dietary sources of vitamin A in the diets of adolescent are : Ready-to-eat cereal Milk Carrots Margarine Cheese

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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 :

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•  •  •  •  • 

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


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


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.

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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)


45

14 – 18 years

65


45

14 – 18 years

75


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REFERENCES

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

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Peranan Nutrisi untuk Kesehatan Remaja Putri. Catur Saptaning W

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