Efek Kognitif

Pada Stunting
Mia Milanti Dewi
Divisi Neurologi Anak Department Ilmu Kesehatan Anak
FK Unpad/RSHS
OUTLINE
01
Pendahuluan
04 Nutrisi yang mempengaruhi
kognitif

02
Anatomi otak
05 Kognitif pada anak stunting

03
Faktor yang mempengaruhi
kognitif
2
PENDAHULUAN

• 2018 : > 150 juta anak stunted

• Negara ekonomi rendah, menengah à ↑
• Efek terhadap kognitif?

3
Alam MA 2020. PLoS ONE 15(1): e0227839.
Kathryn G. Dewey; Khadija Begum (2011). Long-term consequences of stunting in early life. , 7(Supplement s3), 5–18. doi:10.1111/j.1740-8709.2011.00349.x
Anatomi Otak

5
7
Lobus Frontal

Medial •Girus cingulate (sistim limbik)

•Girus frontal superior : self awareness

Lateral •Girus frontal superior

•Girus frontal inferior : proses bahasa

Orbital •Koordinasi, mengkontrol emosi dan

reaksi

8
• Mengetahui kata
melalui gerakan dan
sensoris
• Mengenal bahasa
melalui gerakan spt
sucking, grasping,
melihat & mendengar
9
• Berpikir secara simbolis,
menggunakan kata &
gambar.
• Egosentris
• Proses bahasa & berpikir
lebih baik.

10
Berpikir secara logis & konseptual,
terencana.

Berpikir secara induktif

11
Mulai berpikir secara abstrak,
filosofi, etis, sosial, politik.

Berpikir secara deduktif.

12
Faktor yang
mempengaruhi
kognitif

13
Jirout J, Crouch JL, Turnbull K, Gu Y, Cubides M, Garzione S, dkk.How lifestyle factors affect cognitive and executive function and the ability to learn in children.Nutrients 2019:11;1-29
Jirout J, Crouch JL, Turnbull K, Gu Y, Cubides M, Garzione S, dkk.How lifestyle factors affect cognitive and executive function and the ability to learn in children.Nutrients 2019:11;1-29
Nutrisi dan kognitif

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Makronutrien

Mikronutrien

Nyaradi17 A
 • Short memory
Carbohydrate • Learning

• Brain
Lipid • Retina
• Memory & Learning

• Motoric impairment
Protein • Learning

Savarino et al. Giovanni Savarino1*, Antonio Corsello2,3 and Giovanni Corsello1. Macronutrient balance and micronutrient amounts through growth and 18
developmentItalian Journal of Pediatrics (2021) 47:109
 omega-3 vitamin
folic acid
fatty acids B12

choline iron iodine

zinc

Nyaradi19 A
Iron & Cognitive

2
0
Ferreira An, Never P, Gozzelino R. Multilevel impacts of iron in the brain : the cross talk between neurophysiological mechanisms, cognition, and social behavior. Pharmaceuticals 2019;12(126):2-26
Ferreira An, Never P, Gozzelino R. Multilevel impacts of iron in the brain : the cross talk between neurophysiological mechanisms, cognition, and social behavior. Pharmaceuticals
2019;12(126):2-26
Gangguan pada fungsi
motorik, memori, prilaku,
belajar & kognitif

Terjadi perubahan
morfologi sel saraf,
mielinasi ↓,
synaptogenesis,
sintesis
neurotransmitter ↓

Ferreira An, Never P, Gozzelino R. Multilevel impacts of iron in the brain : the cross talk between neurophysiological mechanisms, cognition, and social behavior. Pharmaceuticals
2019;12(126):2-26
Jirout J, Crouch JL, Turnbull K, Gu Y, Cubides M, Garzione S, dkk.How lifestyle factors affect cognitive and executive function and the ability to learn in children.Nutrients 2019:11;1-29
Savarino et al. Giovanni Savarino1*, Antonio Corsello2,3 and Giovanni Corsello1. Macronutrient balance and micronutrient amounts through growth and developmentItalian Journal of Pediatrics
(2021) 47:109
 2
4
Algarin C, Nelson CA, Peirano P, Westerlund A, Reyes S, Lozoff B. Iron deficiency anemia in infancy and poorer cognitive inhibitory control ata age 10 years.developmental medicine & child neurology. 2013:44;453-8
 25
Algarin C, Nelson CA, Peirano P, Westerlund A, Reyes S, Lozoff B. Iron deficiency anemia in infancy and poorer cognitive inhibitory control ata age 10 years.developmental medicine & child neurology. 2013:44;453-8
Iodine & Cognitive

2
6
Velasco I, Bath SC, Rayman MP. Iodine as essential nutrient during the first 1000 days of life.Nutrients 2018;10(290):1-16
Velasco I, Bath SC, Rayman MP. Iodine as essential nutrient during the first 1000 days of life.Nutrients 2018;10(290):1-16
Choudhry H, Nasrullah M. Iodine consumption and cognitive performance: Confirmation of adequate consumption. Food Sci Nutr. 2018;6:1341–1351.
Med J Indones. 2019;28:39

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 Neuronal
Migration

Neurogenesis
Zinc & Cognitive

Synaptogenesis

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Kognitif pada stunting

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Maltnutrisi Stunting Kognitif ↓

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 STUNTING

early-onset persistent early-onset recovered late-onset persistent late-onset recovered

(first stunted at 1–6 months and (first stunted at 1–6 months and (first stunted at 7–24 months and (first stunted at 7–24 months and
persisting at 60 months), not stunted at 60 months), persisting at 60 months), not stunted at 60 months),

lower cognitive scores

(-2.10 (95% CI: -3.85, -0.35))
compared with those who
were never stunted.
3
4
Alam MA 2020. PLoS ONE 15(1): e0227839.
 ● Stunting, is connected with age-long reduction in cognitive and academic achievement.

Impact of stunting on early childhood cognitive development in Benin: evidence from Demographic and Health Survey Michael Ekholuenetale1*, Amadou Barrow2 , Charity Ehimwenma Ekholuenetale3 and Godson Tudeme4 Ekholuenetale et al. Egyptian Pediatric Association Gazette (2020) 68:31
Savarino et al. Giovanni Savarino1*, Antonio Corsello2,3 and Giovanni Corsello1. Macronutrient balance and micronutrient amounts through growth and developmentItalian Journal of Pediatrics (2021) 47:109
 Hubungan Stunting dengan Gangguan Kognitif pada Usia Remaja Awal di
Kecamatan Jatinangor

26% stunting

26% MMSE abnormal

Hubungan bermakna antara stunting dengan

gangguan kognitif pada usia remaja awal

Hubungan Stunting dengan Gangguan Kognitif pada Usia Remaja Awal di Kecamatan Jatinangor Rafa Fathia Suhud, Eddy Fadlyana, Elsa Pudji Setiawati, Siti Aminah, Rodman TariganSari Pediatri 2021;23(2):115-20
SIMPULAN Stunting akan
memperberat
kognitif
Nutrisi
Mempengaruhi
Kognitif

Pencegahan sangat
penting

4
0
INTRODUCTION

TERIMA KASIH

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