Penilaian Status Gizi

Hertanto 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.

Asupan

Pemanfaatan

Status Gizi

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

Nutritional Assessment : Individual

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

Penentuan Status Gizi

Langsung
- Biokomia - Biofisik - Antropometri - Klinik

Tak Langsung
- Survei konsumsi makanan - Statistik vital - Ekologi

Penyebab Gizi Kurang

Kurang Gizi Penyebab langsung

Asupan gizi

Infeksi
Yan Kes. dan sanitasi Tak memadai

Penyebab tak langsung

Pangan tak cukup

Pola asuh tak memadai

Pendidikan, Pengetahuan dan ketrampilan rendah

Masalah di masyarakat Pemberdayaan SDM kurang

Pengangguran, Inflasi, kurang pangan dan kemiskinan Akar masalah

Situasi Pol EK Sos

Patogenesis Penyakit Gizi

Asupan inadekuat Perubahan Biokimiawi

Gangguan Faali

Kelainan Anatomis (antropometri dan Klinis)

Generalized scheme for the development of a nutritional deficiency

Stage
1 2 3 4

Depletion stage
Dietary inadequacy Decreased level in reserve tissue store Decreased level in body fluids Decreased functional level in tissues

Method(s) used
Dietary Biochemical Biochemical Anthropometric/Biochemical

Decreased activity in nutrient-dependent enzyme

Biochemical

6
7 8

Functional change
Clinical symptoms Anatomical sign

Behavioral/Physiological
Clinical Clinical

Dietary survey
National level Household level
Food account
List recall

Individual level
Single 24 hour recall
Multiple 24 hour recall Food frequency

Food balance
sheet Market data base

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 in addition to emaciation and wasting:

Kwashiorkor - oedema

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

Kwashiorkor in addition to emaciation and wasting:

Kwashiorkor - dermatitis

sunburn-like sooty dermatitis

Kwashiorkor in addition to emaciation and wasting: loss of hair colour and texture characteristically miserable appearance

Kwashiorkor - hair

Kwashiorkor in addition to emaciation and wasting:

fatty infiltration of the liver pot-bellied appearance

Kwashiorkor fatty liver

GAKY

KVA

Xerophthalmia

Rickets

Beri-beri

Pellagra the niacin deficiency disease

Sunburn-like dermatitis in areas exposed to sunlight