nutrisi pada bayi dan anak (blok nutrisi 2010)
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NUTRISI
Oleh:Dian Ramawati, M. Kep., Ns.
Jurusan KeperawatanUniversitas Jenderal Soedirman Purwokerto
Pada Bayi dan Anak
Tujuan Pembelajaran
Mahasiswa mengetahui pengertian nutrisi untuk bayi dan anakMahasiswa mengetahui macam-macam nutrisi untuk bayi dan anakMahasiswa mampu memahami perubahan kebutuhan nutrisi dari usia bayi sampai dengan usia remajaMahasiswa memahami cara menghitung kebutuhan nutrisi pada bayi dan anakMahasiswa memahami strategi pemenuhan kebutuhan nutrisi pada bayi dan anak sesuai dengan tahapan tumbuh kembang, jenis kelamin, dan usia.
Mengapa nutrisi sangat penting?
Memenuhi kebutuhan energi untuk aktivitas sehari-hari
Mempertahan seluruh fungsi organ tubuh
Penting untuk pertumbuhan dan perkembangan
Manfaat terapeutik : pencegahan dan penyembuhan penyakit
Nutrisi Pada Bayi
Pertumbuhan yang cepat pada otak dan sistem tubuh (1 tahun pertama):
– Peningkatan BB 200%
– Peningkatan panjang tubuh 55%
– Peningkatan lingkar kepala 40%
– Berat otak bertambah 2 kali lipat
Nutrisi Bayi Baru Lahir
ASI sampai dengan bayi berusia 6 bulan (rekomendasi internasional), dapat diberikan 10 -12 kali/hari
Susu formula, dapat diberikan sampai dengan 480 ml/hari
Kebutuhan kalori neonatus: 108 kcal/kgBB/hari
Manfaat ASI untuk Bayi
Imunitas alami (>100 komponen).
Menurunkan angka kejadian infeksi telinga, gastroenteritis, penyakit pernafasan dan bakteremia.
Mudah didapatkan dan siap digunakan.
Mengurangi resiko pemberian makan yang berlebihan
Meningkatkan kedekatan ibu dan bayi.
Tahapan kandungan gizi ASI
Kolostrum : 2-4 hari, berwarna kekuningan, kaya akan protein, vitamin, dan Ig A.
ASI transisi : sd. 2 minggu kelahiran, banyak mengandung lemak dan kaya kalori.
ASI matur : mengandung 90% air
Kandungan ASI : lemak, protein, vitamin
Standar Emas Makanan Bayi
Inisiasi Menyusui Dini (IMD) : 1 jam setelah kelahiran
Pemberian ASI eksklusif sd bayi 6 bulan
Pemberian MP-ASI lokal (buatan rumah tangga) selama 90 hari berturut-turut
Mempertahankan pemberian ASI sd. Anak berusia 2 tahun
Kandungan Gizi dalam MP-ASI
Bayi 6-12 bulan : 250 kalori, 6-8 gram protein
Anak usia 12-24 bulan : 450 kalori, 12-15 gram protein
Kebutuhan gizi bayi usia 6-12 bulan : 650 kal dan 16 gram protein
Kebutuhan gizi anak usia 12-24 bulan : 850 kal dan 20 gram protein
Kandungan Gizi ASI
ASI usia bayi 6-12 bln : 400 kal dan 10 gram protein
ASI usia 12-24 bln : 350 kal dan 8 gram protein
(Pedoman umum pemberian MP-ASI lokal tahun 2006, Depkes RI)
Manfaat Pemberian ASI untuk Ibu
Memperlambat proses ovulasi (kehamilan)
Membantu menurunkan berat badan setelah melahirkan
Mencegah perdarahan post partum
Menurunkan resiko terjadinya kanker payudara
Monitoring Pemberian ASI
Kenaikan BB bayi lebih stabil dan konsisten
Keb nutrisi total : 80-100 ml ASI/KgBB
Kapasitas lambung bayi 90 ml
Waktu pemberian ASI setiap 2-3 jam
Setiap pemberian 10-20 menit/setiap sisi payudara
Bayi puas menyusu : hisapan melambat atau tertidur
Susu Formula untuk Bayi
3 bentuk:– Siap diminum – paling mahal, tidak
membutuhkan air .– Konsentrate – Dicampur dengan air (50-50).– Bubuk – Dicampur denan air sesuai aturan.
Komposisi Susu Formula
Kandungan kalori: 20 calories/oz (0.67 calories/cc).Kandungan Protein: rasio of protein nabati dengan kasein 60:40 atau sama dengan ASI.Lemak: paling banyak tersedia ~50% kalori dari lemak jenuh dan asam lemak tak jenuh.Karbohidrat: laktosa, mineral (Ca, Zn, Mg).Mikronutrient: vitamin and mineral yang lebih tinggi dibandingkan ASI.
Susu Formula Khusus
Kedelai: untuk vegetarian, defisiensi laktose, galactosemia.
Tanpa Laktose: bahan dasar susu sapi
Protein hydrolysate: untuk bayi yang mengalami alergi atau tidak dapat mencerna protein
Bayi prematur: terdiri dari protein nabati, susu sapi dan protein serta calcium yang tinggi, 20-50%.
CACFP Meal Pattern Requirements for InfantsBirth through 3 months
4 through 7 months 8 through11 months
Breakfast 4-6 fl. oz. Formula1 or Breast milk2,3
4-8 fl. oz. Formula1 or Breast milk2,3
0-3 Tbsp. Infant cereal1,4
6-8 fl. oz. Formula1 or Breast milk2,3
and2-4 Tbsp. Infant cereal1
and1-4 Tbsp. Fruit or Vegetable or both
Lunch or Supper
4-6 fl. oz. Formula1 or Breast milk2,3
4-8 fl. oz. Formula1 or Breast milk2,3
0-3 Tbsp. Infant cereal1,4
0-3 Tbsp. Fruit or Vegetable or both4
6-8 fl. oz. Formula1 or Breast milk2,3
and2-4 Tbsp. Infant cereal1;and/or1-4 Tbsp. Meat, Fish, Poultry, Egg Yolk, Cooked Dry Beans or peas; or ½ -2oz. Cheese; or 1-4 oz (volume) Cottage Cheese, or 1-4 oz (weight) Cheese Food, or Cheese spread; and1-4 Tbsp. Fruit or Vegetable or both
Supplement(Snack)
4-6 fl. oz. Formula1 or Breast milk2,3
4-6 fl. oz. Formula1 or Breast milk2,3
2-4 fl. oz. Formula1 or Breast milk2,3
or 100% Fruit Juice5; and0-1/2 Bread4,6 or 0-2 Crackers4,6
1 Infant formula and dry infant cereal must be iron-fortified.2 It is recommended that breast milk be served in place of formula from birth through 11 months.3 For some breastfed infants who regularly consume less than the minimum amount of breast milk per feeding, a serving of less than the minimum amount of breast milk may be offered, with additional breast milk offered if the infant is still hungry.4 A serving of this component is required when the infant is developmentally ready to accept it.5 Fruit juice must be full-strength.6 Bread and bread alternates must be made from whole-grain or enriched meal or flour.
Kebutuhan Nutrisi Bayi
Vitamin D : 200 IU per hari (2 bln pertama)
ASI : setiap 2-3 jam diberikan
Finger foods : usia 6-7 bulan
Jus buah : 180 ml/hari
Cereal : usia 4-6 bulan
Susu formula : maks. 960 ml/hari
Buah dan sayur : 6-8 bulan
Daging, ikan, ayam : usia 8-10 bulan
Telur dan keju : 12 bulan
Pemberian makan pada bayi
4-6 bln – rasa baru.
– Berikan bubur susu dengan zat besi.
6-7 bln – duduk dengan bantuan.
– Berikan sayuran dan buah.
8-9 bln – kemampuan motorik halus.
– Berikan makanan camilan dengan protein.
10-12 bln – berdiri, belajar mengambil makanan
– Berikan makanan lunak, ajari makan sendiri.
12-18 bln – peningkatan kemandirian.
– Stop susu dg botol, gunakan sendok dan gelas
18 bln -2 th – pertumbuhan melambat, mjd kurang tertarik dg makanan
– Ajari anak makan sendiri.
2-3 th – asupan bervariasi, mulai memilih makanan.
Developmental Skills
Birth through 5 months:• Suck/swallow reflex• Tongue thrust reflex• Rooting reflex• Gag reflex • Poor control of head,
neck, trunkSERVE LIQUIDS ONLY
•Breastmilk•Infant formula with iron
Developmental Skills,
continued4 months through 7 months:• Tongue thrust and rooting reflexes begin to
disappear • Gag reflex diminishes• Can transfer food from front to back of
tongue to swallow• Begin to see an up-and-down munching
movement of the jaw• Sits with support• Has good head control
ADD SEMISOLID FOODS
•Infant cereal with iron
•Strained vegetables*
•Strained fruit*
•Progress to thicker texture and add in meats*
*may be started later in the age range
Developmental Skills, continued
8 months through 11 months:• Moves food from side-to side in mouth
• Begins to curve lips around rim of cup
• Begins to chew in rotary pattern (diagonal movement of the jaw as food is moved to the side or center of the mouth) ADD MODIFIED TABLE FOODS
•Mashed or diced soft fruit or soft-cooked vegetables•Strained meat/poultry or mashed egg yolk •Mashed cooked beans or peas•Cottage cheese, yogurt, or cheese strips•Crackers or pieces of soft bread•Breastmilk, iron-fortified formula or fruit juice in a cup
Eating and FoodBehaviors of Infants
Caregivers and Parents:Provide the right foods to promote good health.
Decide what to serve and when to introduce new foods.
Determine the kinds and types of food and textures to introduce.
Offer older infants appropriate finger foods when they can enjoy and manage them.
Tips:
Feed infants the foods you want them to love when they get older.
Provide a variety of nutritious foods.
Make mealtime relaxed and enjoyable.
Feeding the Baby for the First YearBabies
Age:When Babies Can: Serve:
Birth through 3 months
Only suck and swallow LIQUIDS ONLYBreastmilkInfant formula with iron
4 months through 7 months
Draw in upper or lower lip as spoon is removed from mouth
Move tongue up and downSit up with supportSwallow semisolid foods
without chokingOpen the mouth when they see
foodDrink form a cup with help, with
spilling
ADD SEMISOLID FOODSInfant cereal with ironStrained vegetables*
Strained fruit*
*may be started later in the age range
8 months through 11 months
Move tongue from side to sideBegin spoon feeding
themselves with a spoonBegin to chew and have some
teethBegin to hold food and use their
fingers to feed themselvesDrink from a cup with help, with
less spilling
ADD MODIFIED TABLE FOODSMashed or diced soft fruitMashed or soft cooked vegetablesStrained meat/poultry or mashed egg
yolkMashed cooked beans or peas
Cottage cheese, yogurt, or cheese stripsCrackers or pieces of soft breadBreastmilk, iron-fortified formula or fruit
juice in a cup
Food Safety and Infant Feeding
Infants are particularly sensitive to food borne disease. Their immature digestive system cannot fight bacteria as well as adults.
•Common symptoms of food borne illness (nausea, vomiting, and diarrhea) can be deadly for the infant.
•To keep it safe, remember the following Infant Food Safety tips . . .
Infant Food Safety Tips:
Wash hands before preparing or feeding foods.Use clean utensils.Transfer baby food to a dish – don’t serve baby from the jar – and discard leftovers from the dish.Refrigerate leftover food in the jar – label with the date and discard 2 days after opening.
Infant Food Safety Tips, continued:
Check that the safety button tin the lid of a baby food jar is down and ”pops” when opened.Discard formula or breastmilk left in a bottle after feeding.Avoid honey for the first year.
Breast Fed Babies in Childcare
Breastfeeding is the best source of food for a baby’s first year of life.
Supporting a breastfeeding mother helps to sustain the duration of breastfeeding.
Safe and sanitary handling is important for breastmilk as well as formula, so . . .
Handle it with care!
Nutrisi Pada Anak (1-6 tahun)
1-2 th: rata-rata tumbuh 12 cm, BB naik 3.5 kg.
Pertumbuhan melambat pada usia 4 tahun.– 6-8 cm/th– 2-4 kg/th
Perkembangan otak bertambah 3 kali lipat pada usia 6 tahun.
CACFP Meal PatternBreakfast
Components Ages 1-2 Ages 3-5 Ages 6-12
Milk
Milk, fluid ½ cup 3/4 cup 1 cup
Vegetables and Fruits
Vegetable(s) and/or fruit(s) or
Full strength fruit or vegetable juice or an equivalent quantity of any combination of the above
¼ cup
¼ cup
½ cup
½ cup
½ cup
½ cup
Grains/Breads
Bread or
Cornbread, biscuits, rolls, muffins, etc., or
Cold dry cereal or
Cooked cereal or
Cooked pasta or noodle products or
Cooked cereal grains or an equivalent quantity of any combination of grains/breads
½ slice
½ serving
¼ cup or 1/3 oz
¼ cup
¼ cup
¼ cup
½ slice
½ serving
1/3 cup or ½ oz
¼ cup
¼ cup
¼ cup
1 slice
1 serving
3/4 cup or 1oz.
½ cup
½ cup
½ cup
CACFP Meal Pattern: Lunch and Supper
Components Ages 1-2 Ages 3-5 Ages 6-12Milk
Milk, fluid ½ cup 3/4 cup 1 cup
Vegetables and Fruits
Vegetable(s) and/or fruit(s), 2 or more ¼ cup total ½ cup total ¾ cup total
Grains/Breads
Bread or
Cornbread, biscuits, rolls, muffins, etc., or
Cooked pasta or noodle products or
Cooked cereal grains or an equivalent quantity of any combination of breads/grains
½ slice
½ serving
¼ cup
¼ cup
½ slice
½ serving
¼ cup
¼ cup
1 slice
1 serving
½ cup
½ cup
Meat and Meat Alternates
Lean meat, poultry, or fish or
Cheese or
Eggs or
Cooked dry beans or peas or
Peanut butter or soy nut butter or
Other nut or seed butters or
Peanuts or soy nuts or tree nuts or seeds* or
Yogurt, plain, or sweetened and flavored or an equivalent quantity of any combination of the above meat and meat alternates
1 oz
1 oz
1 egg
¼ cup
2 tbsp.
½ oz = 50%
4 oz
1 ½ oz
1 ½ oz
1 egg
3/8 cup
3 tbsp.
½ oz = 50%
6 oz
2 oz
2 oz
1 egg
½ cup
4 tbsp.
1 oz = 50%
8 oz
CACFP Meal Pattern: SnackComponents (Choose any 2 components) Ages 1-2 Ages 3-5 Ages 6-12
Milk
Milk, fluid ½ cup ½ cup 1 cup
Vegetables and Fruits
Vegetable(s) and/or fruit(s), or
Full-strength fruit or vegetable juice or and equivalent quantity of any combination of the above
½ cup
½ cup
½ cup
½ cup
¾ cup
¾ cup
Grains/Breads
Bread or
Cornbread, biscuits, rolls, muffins, etc., or
Cold dry cereal or
Cooked cereal or
Cooked pasta or noodle products or
an equivalent quantity of any combination of grains/breads
½ slice
½ serving
¼ cup or 1/3 oz
¼ cup
¼ cup
½ slice
½ serving
1/3 cup or ½ oz
¼ cup
¼ cup
1 slice
1 serving
¾ cup or 1 oz
½ cup
½ cup
Meat and Meat Alternates
Lean meat, poultry, or fish or
Cheese or
Eggs or
Cooked dry beans or peas or
Peanut butter or soy nut butter or
Other nut or seed butters or
Peanuts or soy nuts or tree nuts or seeds* or
Yogurt, plain, or sweetened and flavored or an equivalent quantity of any combination of the above meat and meat alternates
½ oz
½ oz
½ egg
1/8 cup
1 tbsp.
½ oz
2 oz or ¼ cup
½ oz
½ oz
½ egg
1/8 cup
1 tbsp.
½ oz
2 oz or ¼ cup
1 oz
1 oz
1 egg
¼ cup
2 tbsp.
1 oz
4 oz or ½ cup
Developing Healthy Habits
Offer a variety of healthy foods and snacks.Encourage fruit and vegetable intake.No junk food snacking.Limit intake of juices ( 4 oz per day).Increase intake of water (no soda).Encourage low fat dairy products (3-4 servings/ day).Make fun physical activity a habit.Limit TV to no more than 1 to 2 hours per day.Track growth and development carefully.Be a good role model.
Developmental Skills
ONE-YEAR-OLD CHILDRENThey may grow less quickly than during infancy. They may eat less, but they tend to eat frequently throughout the day. They get better at feeding themselves, although spills should still be expected. They drink from a cup with help.
How Children Grow and Develop
At 1 year old– Teething occurs – Playing consists of imitating others– One-year-olds use and understand the
words “me,” “mine,” and “no”– They recognize their names – They can make two to three word sentences
Developmental Skills, continued .....
Two-year olds can:Fold napkinsScrub fruits and vegetablesWipe tablesSnap fresh beansTear lettuce and salad greensBreak bread for stuffing
How Children Grow and Develop
At 2 years old– Two-year-olds have a high energy level– They develop skills including walking,
running, and eye-hand coordination– They are curious and want to do things for
themselves– 2-year-olds still use sucking, mouthing,
and tasting to explore – Children can speak in two to five
word sentences
Developmental Skills, continued
Three-year olds can:Pour liquids into a batterMix muffin batterShake a milk drinkSpread peanut butter on breadCrack hard cooked eggs
Eating and Food Behaviors
of ToddlersTips:
Don’t serve large
amounts of juice.
Offer sweet and
sugary foods only
rarely.
Caregivers and Parents:Know that appetite ups and downs are normal and usually relate to growth.
Allow children to stop eating when they indicate they are full
Know that now is the time when food preferences are being firmly established.
Realize that children are usually willing to try new foods.
Feeding Responsibility: Caregivers & Parents
Select and buy foods, including new foodsChoose meal and snack timesPrepare & present the food attractivelyExpect a standard of behavior at the tableMake mealtime pleasantSet a good example
Feeding Responsibility: Child
Decides what foods they will eat
Determines how much they will eat
Chooses whether or not they will eat
Transitional Feeding/Eating
How do you handle the transition between infant and toddler on the CACFP meal pattern?
Serving Meals Family-Style
Introducing Family-Style Meals Provide a table and play dinnerware so the children
can practice. Show the children the proper way to set the table.
Practice proper table etiquette; emphasize using “please” and “thank you”.
Keep food safety in mind (if the cup falls on the floor, it must be washed).
Remember these tips:
Children enjoy helping with "grown up" activities. Let them assist with each of the four components of family-style meals as it will boost their self-esteem. The four components are:
•Table setting
•Self-serve
•Food preparation
•Cleanup
Begin with something simple like table setting. Then allow children to help with a small snack, and always encourage them to clean up after themselves.
Family Style Meals
Food SafetyFood Safety
NutritionNutrition Child Development
Family Style Meals
FOOD SAFETY
Handwashing Keep Foods Safe to Eat
Hot Foods HOT/Cold Foods COLD
Introducing New Foods
Introducing New Foods
Think about timing
Be positive
Keep trying
Tip:
Did you know that children
may need to
encounter a new food 12 times
before they actually eat
it?
Child Development
Family Style Meals
How Children Grow and Develop
Between 3 and 5 years of age– Preschoolers enjoy art, pretend and music
and dramatic play.– Children begin to use a fork or spoon well. – As they get older, sharing toys and
belongings becomes easier.– Attention spans continue to
grow with the child’s age.
Eating and Food Behaviorsof Preschoolers
Caregivers and Parents:Realize that erratic eating habits are normal.
Provide healthy meals and snacks in order to build a strong foundation for a lifetime of good eating habits.
Tips:
Preschoolers enjoy learning abut
food.
With proper supervision, they can help prepare simple meals and
snacks.
Books, videos, storytelling and
discussion groups are excellent ways
to teach good nutrition!
Allow input on what is served.
A Closer Look at Eating Habits
Eating Habits are formed in early childhood.
Good eating habits do not just happen, they must be learned.
Childcare Providers Support
Positive Eating Habits by:
Successful introduction of new
foods.
Encouraging favorable attitudes
toward food.
Encouraging good eating habits.
Encouraging Favorable Food Attitudes
and Good Eating Habits
Be sensitive to children’s needs.Help children feel ready to eat.Get children interested and involved.Make eating a pleasure.Foster positive feelings.Check out the
Mealtime Memo on Feeding Toddlers
Food Matching GameActivity
Nutrients are Needed for Growth and Development
Nutrition is the process by which our bodies take in and use food.
The best way to ensure good nutrition is to choose a variety of foods.
Check out the Mealtime Memo on Nutrition & Cognitive Development!
Nutrients Needed for Growth and Development
Carbohydrates– Supply energy 4
kcal per gram (90 kcal/KgBB or 1800 cal/day)
– Provide fiber if whole grain
– Made up of 2 types
• Complex• Simple
Proteins– Supply 4 kcal per
gram (13-19 g/day)
– Build and repair body tissue
– Help antibodies fight infection
Nutrients Needed for Growth and Development
Fats– Supply 9 kcal per gram (< 30% daily
intake)– Carry fat-soluble vitamins A, D, E, and K– Provide a feeling of fullness since fats
take longer to digest
– Tips About Fat• Serve reduced- or low-fat milk to
preschoolers, ages 2 and older.• Do not restrict all fats in children’s diets.
Nutrients Needed for Growth and Development
Vitamins– Needed by body in
small amounts– Help release
energy from nutrients
Minerals– Needed in small
amounts– Help in making
strong bones and teeth & healthy red blood cells
Water (100 ml/KgBB/day)– Essential for life– Is part of every
living cell– Helps maintain
body temperature– Is the medium for
metabolism– Transports
nutrients and body substances
– Acts as a lubricant
What is a Portion Size?
Nutrient Contributions from MyPyramid
“Empty” Calories
Protein, Iron, Phosphorous, and Zinc
Fiber, Potassium, and Vitamins A&C
Complex Carbohydrates, Fiber, Iron, Thiamin, and Niacin
Fiber, Potassium, and Vitamins A&C
Calcium, Protein, some B-vitamins, and Vitamins A&D
Keeping a Daily Record of Meals
TIP
Be sure to record menu
components in your log each
day!
Nutrition Education Why?
To get children involved in activities with food and eating.
To encourage them to try new food.
To help them establish a lifetime of good eating behavior.
Check out the Mealtime Memo on Preventing Obesity Part I!
Nutrition Education
How? Plan activities that match children’s
abilities and interests (developmentally appropriate).
Build on what a child already knows. When?
– Plan simple activities before trying harder ones.
The Parent FactorEstablish regular communication with parents on activities, progress, and how they can support healthy eating concepts at home.
Take a look at the Mealtime
Memo on Preventing
Obesity Part II!
“DEVELOPMENTALLY APPROPRIATE!”
For all Ages and Stages
Child Development
Children make decisionsChildren socializeLearn to listen to internal cuesPractice daily living skills
Child Development
NutritionNutrition
Family Style Meals
Nutrition Nutrition
Must follow the meal patternMust put all foods on the tableChildren can try new foodsChildren learn to enjoy a variety of foods
Skills for Serving Self
SKILLS FOR SERVING SELF
Hold and physically pass bowls or pitchers Make sure someone receives them.Judge space for bowls or pitchers.Efficiently use serving utensils.
SKILLS FOR SERVING SELF
•Teachers direct table conversations and model behavior.
•Children wait their turn.
•Children balance serving containers
•Children spoon food from a serving dish without using fingers.
Adolescent Growth Spurt
Physiological growth stage (Tanner staging) rather than chronological age, is the best indicator for establishing requirements or evaluating intake.
Females: 11-14 years:
– Grow 8.4 - 9.0 cm/year.
– Girls deposit more total body fat.
Males: 13-16 years:
– Grow 9.5 - 10.3 cm/year.
– Boys deposit more muscle mass.
– Boys tend to gain more weight at a faster rate and skeletal growth continues longer than girls.
Obesity in Childhood and Adolescents
>20% of children/adolescents are overweight.
Increased by 50-100% over last 20-30 years:
– More sedentary lifestyle and behavior (TV/video games).
Prevalence increasing more rapidly among African-Americans.
Obese children and adolescents become obese adults.
Recent reports indicate 8-45% of newly diagnosed pediatric pts with diabetes are diagnosed with type 2.
Obesity:Health Consequences
Cardiovascular disease risk
Type 2 diabetes (epidemic)
Hypertension
Orthopedic
Sleep apnea
Gall bladder disease/steatohepatitis
Psychosocial problems
Pediatric ObesityEtiology and Treatment
Etiology:
– Genetic predisposition: 80% risk if both parents obese
– Environment
– Dietary intake
– Physical activity / sedentary activity
Treatment:
– Multidisciplinary and comprehensive
– Formal behavior modification
– Family-based
Eating Disorders in Adolescents
An estimated 20% of teens engage in some type of abnormal eating.
5% of high schools girls have been diagnosed with an eating disorder.
Adolescents are frequent users of OTC diet pills.
Multiple factors contribute: thin “ideal” , family pressure, exhibiting body control.
Disease Prevention Developing Healthy Eating Habits
Discourage dieting and obsession with weight.Pack healthy lunch at least twice a week.Limit fast food eating out.Encourage a balanced diet.5 servings of fruits/vegetables a day.Encourage low fat dairy products (3-4 / day).Prepare meals that kids and teens enjoy.Encourage teens to learn to cook healthy food.Teach kids and teens label reading.Be a role model.
TABEL Z-SCORE
Tabel Z-Score untuk status gizi anak Indonesia (WHO, 2005)
Tabel Z-Score berdasarkan buku bagan MTBS 2008.
What Is BMI?
• Body mass index (BMI) = weight (kg)/height (m)Body mass index (BMI) = weight (kg)/height (m)22
• BMI is an effective screening tool; it is not a BMI is an effective screening tool; it is not a diagnostic tooldiagnostic tool
• For children, BMI is age and gender specific, so For children, BMI is age and gender specific, so BMI-for-age is the measure usedBMI-for-age is the measure used
• Body mass index (BMI) = weight (kg)/height (m)Body mass index (BMI) = weight (kg)/height (m)22
• BMI is an effective screening tool; it is not a BMI is an effective screening tool; it is not a diagnostic tooldiagnostic tool
• For children, BMI is age and gender specific, so For children, BMI is age and gender specific, so BMI-for-age is the measure usedBMI-for-age is the measure used
For Children, BMI Changes with Age
Boys: 2 to 20 years
BMI BMI
BMI BMI
Example: 95th Percentile
Age BMI 2 yrs 19.3 4 yrs 17.8 9 yrs 21.013 yrs 25.1
BMI-for-Age Cut offs
> 95th percentile Overweight
85th to < 95th Risk of overweight percentile
< 5th percentile Underweight
Calculating BMI with the Metric System
Formula: weight (kg)/[height (m)]2
Calculation: [weight (kg)/ height (cm)/
height (cm)] x 10,000
Example: A child’s weight=16.9 kg and height=105.4 cm
BMI = [16.9 kg / 105.4 cm / 105.4 cm] x 10,000 = 15.2
Disease Prevention Developing Healthy Eating Habits
Discourage dieting and obsession with weight.Pack healthy lunch at least twice a week.Limit fast food eating out.Encourage a balanced diet.5 servings of fruits/vegetables a day.Encourage low fat dairy products (3-4 / day).Prepare meals that kids and teens enjoy.Encourage teens to learn to cook healthy food.Teach kids and teens label reading.Be a role model.
Nutritional Concerns in Childhood and Adolescents
Malnutrition and poverty.
Growth spurt-onset of menses for girls-changes in body size/image.
Food fads, vitamins, athletes.
Eating disorders: anorexia and bulimia nervosa.
Overweight and obesity.
Hyperlipidemia and heart disease.
Bone mineralization and osteoporosis.
Thank You! Any Questions?
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