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According to the MOH (2002) in Macro Nutrition Improvement Program states

that chronic energy deficiency is a situation where mothers with chronic food
shortages lasting (chronic) which gives rise to health problems in the mother.
KEK can occur in women of childbearing age (WUS) and pregnant women
(pregnant women). KEK is the cause of the imbalance between intake and
expenditure to meet the needs of energy (Department of Nutrition and Public
Health FKMUI, 2007).
Chronic energy deficiency (CED) is a condition where girls / women are
malnourished (calories and protein) that lasts a long time or menahun.Risiko
Chronic Energy Deficiency (CED) is a condition in which girls / women have a
tendency to suffer from KEK. Someone said to suffer from the risk of KEK when
MUAC <23.5 cm.
2. Etiology
Factors Affecting KEK
1. Socioeconomic Factors
Socio-economic factors consist of:
a) Income Families
The level of income can determine the pattern of food. People with low economic
level will usually spend most of the revenue for a meal, while the high economic
level will be reduced spending on food. Income is a factor that most determines
the quality and quantity of dishes. The more money means having better food
obtained, in other words the higher the income, the greater the percentage of
that income to buy fruit, vegetables and some other foods
b) Education Mrs.
The educational background of a person is one of the important elements that
can affect the nutritional state due to the high level of education are expected to
knowledge / information about nutrition owned for the better.

c) Factors consumption patterns

Pattern of Indonesian food in general contains a source of heme iron (animal) low
and high sources of non-heme iron (plant-based), the food menu also contains a
lot of fiber and phytate which is a factor inhibiting the absorption of iron (FKMUI
Department of Nutrition and Public Health, 2007).
d) Factor behavior
Habits and views of women to food, in general, more women give special
attention to the head of the family and children. Pregnant women should

consume at least 3000 calories calories / day If the mother does not have any
bad habits such as smoking, addicts, etc., then the nutritional status of infants
who later bore is also good, and vice versa (Arisman, 2007).

2. Biological Factors
These biological factors of which consists of:

a) Age Pregnancy
Childbearing at young maternal age resulted in quality or too old fetus / child and
it also would be detrimental to the health of the mother (Baliwati, 2004: 3).
Because the mother is too young (less than 20 years) may be competition
between the fetus and the mother's diet itself is still in its infancy and the
hormonal changes that occur during pregnancy (Soetjiningsih, 1995: 96). So that
the best age is over 20 years old and less than 35 years, so expect the
nutritional status of pregnant women will be better
b) Distance pregnancy
The mother said too often give birth when the distance is less than 2
years. Research shows that when families can adjust the distance between the
birth of her child over 2 years, the child will have a higher probability of life and
her condition is healthier than children with birth spacing under 2 years.
(Aguswilopo, 2004: 5).
Distance bore too close will cause the quality of the fetus / child and it
also would be detrimental to the health of the mother. Mother did not get a
chance to improve his own body (the mother requires enough energy to recover
from giving birth). By containing the back it will cause nutritional problems of
maternal and fetal / infant conceived following. (Baliwati, 2004: 3).

c) Parity
Parity is a woman who had delivered a baby that can live (viable).
(Mochtar, 1998). Parity is classified as follows:

primipara is a woman who has never given birth once the fetus has reached
the limits of viability, without considering the fetus alive or dead at birth.
Multipara was a woman who had two or more pregnancies that ended when the
fetus has reached the limit of viability.

Grande multipara is a woman who has experienced five or more pregnancies

that ended when the fetus has reached the limit of pregnancy. Pregnancy with
short distances with previous pregnancies of less than 2 years / pregnancy too
often can lead to malnutrition because it can deplete the body's reserves of
nutrients as well as reproductive organs have not been back perfect as before
pregnancy (Department of Nutrition and KesmasFKMUI, 2007).
d) Weight gain during pregnancy
Weight more or less than the average weight for a certain age is a factor to
determine the amount of nutrients that must be given so that the pregnancy
goes smoothly. In developed countries the weight gain during hamil.sekitar 12-14
kg. If the mother is malnourished pertambahannya only 7-8 kg due to give birth
to babies with low birth weight (Erna, et al, 2004).
Weight gain during pregnancy is about 10-12 kg, whereas in the first trimester
increase of less than 1 kg, the second trimester is about 3 kg, and the third
trimester of about 6 kg. Weight gain is also simultaneously seeks to monitor fetal
Mother's chronic energy deficiency is that the size of the mother's arm
circumference <23.5 cm and with one or more of the following criteria:
a. Maternal weight before pregnancy <42 kg
b. Mother's height <145 cm
c. Maternal weight in the third trimester of pregnancy <45 kg
d. Body mass index (BMI) before pregnancy <17, 00
e. Mothers suffer from anemia (Hb <11 g%)
a. IEC regarding the KEK and the factors that influence it and how to mitigate
b. PMT Pregnant women are expected to be given to all pregnant women there.
KEK condition in pregnant women should be followed up before the pregnancy
reaches 16 weeks. Supplementary feeding of High Calorie and High Protein and
combined with the application of Small Portions but often, in fact it managed to
suppress the incidence of LBW in Indonesia .Penambahan 200-450 calories and
12-20 grams of protein from the mother needs is a number that is sufficient to
meet the needs fetal nutrition.
c. Fe tablet consumption during pregnancy
Pregnant women requirement to energy, vitamins and minerals increases
with maternal physiological changes, especially at the end of the second

trimester in which a process hemodelusi which causes an increase in blood

volume and affect blood hemoglobin concentration.
In normal circumstances it can be treated with iron tablets, but on the
state of malnutrition not only requires energy supplements also need vitamins
and iron supplements. The purpose of which is increased during pregnancy, low
intake of animal protein and high fiber consumption / phytate content of plants
and plant proteins is one of the causes of iron anemia.