Transcript adolescent_csw - catursaptaningwilujeng

CATUR SAPTANING W, S.Gz, MPH
ADOLESCENT
NUTRITION
ESPECIALLY FOR GIRLS
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, etc
7.
PROTEIN
8.
CARBOHYDRATE
9.
FAT
10.
DIETARY FIBER
11.
CALCIUM
12.
IRON
13.
ZINC
14.
FOLATE
15.
VITAMIN A, E, AND C
16.
CASES
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
Adolescent male have higher caloric than females. WHY?
Physical growth and development during puberty is sensitive to
energy and nutrient intakes.
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 multiply your BMR by
the appropriate activity factor, as
follows
If you are Sedentary - little or no exercise
Calorie-Calculation = BMR X 1.2
If
you are Lightly Active (light
exercise/sports
1-3
days/week)
Calorie-Calculation = BMR X 1.375
If you are Moderately Active (moderate
exercise/sports
3-5
days/week)
Calorie-Calculation = BMR X 1.55
If
you
are
Very
Active
(hard
exercise/sports
6-7
days/week)
Calorie-Calculation = BMR X 1.725
If you are Extra Active (very hard daily
exercise/sports & physical job or 2X day
training)
Calorie-Calculation = BMR X 1.9
BMR cont….
Example
of
You
are
14
years
You
are
153
Your
weight
is
48
Your BMR is 655 + (460.8) + (275.4) – (65.8) = 1325.4 calories
BMR
old
cm)
kg
Total Calorie Needs Example
If you are Lightly Active, multiply your BMR (1325.4) by 1.375 =
1822.4 Your total daily calorie requirement is therefore 1822.4 calories.
Note :
1
inch
=
2.54
cm.
1 kilogram = 2.2 lbs.
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 multiply your BMR by
the appropriate activity factor, as
follows
If you are Sedentary - little or no exercise
Calorie-Calculation = BMR X 1.2
If
you are Lightly Active (light
exercise/sports
1-3
days/week)
Calorie-Calculation = BMR X 1.375
If you are Moderately Active (moderate
exercise/sports
3-5
days/week)
Calorie-Calculation = BMR X 1.55
If
you
are
Very
Active
(hard
exercise/sports
6-7
days/week)
Calorie-Calculation = BMR X 1.725
If you are Extra Active (very hard daily
exercise/sports & physical job or 2X day
training)
Calorie-Calculation = BMR X 1.9
CARA MENENTUKAN BMR
1.
2.
Dengan Rumus Harris Benedict
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, tinggi badan 153 cm
dengan aktivitas ringan. Maka BMR-nya adalah
a. Perempuan = 0.95 x 48 x 24 = 1094.4 kkal
b. Perempuan = 25 kkal x 48 = 1200 kkal
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
FAO/WHO/UNU, BMR perempuan tersebut :
BMR = 12.2 (48) + 746 = 1331.6 kkal
dengan
rumus
Aktivitas
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 CONT…
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
1.Sesuai RDA
Protein = 0.85 x 48 kg = 40.8 gram = 41 gram/hari
2.Sesuai tabel kebutuhan protein maka untuk perempuan usia 14
tahun kebutuhan proteinnya adalah 46 gram/hari
3.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.
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.
Dari contoh A maka kebutuhan lemak perempuan
tersebut dalam sehari adalah
Lemak = 25% x 2054.4 kkal = 513.6 kkal : 9 = 57 gram/hari
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 CONT’…
 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 cont’…
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
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 CONT’…
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 :
a.Margarine
b.Cakes, cookies, quick breads, and donuts
c.Salad dressing and mayonnaise
d.Nuts and seeds
e.Tomatoes
Vitamin e cont’…
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
Source: Food and Nutrition Board, Institute of Medicine, National Academies. Dietary
Reference Intakes : Recommended Intakes for Individuals. Washington, DC. : National Academy
Press, 2000
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 :
a.Orange and grapefruit
b.Fruit drinks
c.Ready-to-eat cereals
d.Tomatoes
e.White potatoes
VITAMIN C CONT’…
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
Source: Food and Nutrition Board, Institute of Medicine, National Academies. Dietary
Reference Intakes : Recommended Intakes for Individuals. Washington, DC. : National Academy
Press, 2000
TUGAS
Telaah jurnal tentang zat gizi/peranan zat gizi pada remaja putri
pada fase menstruasi.
Format :
1.Telaah pendahuluan jurnal
2.Telaah hasil dan pembahasan jurnal
REFERENCES
1.
Brown, E.J. Nutrition Through The Life Cycle. (2sc ed). USA : Thomson
Wadsword. 2005