gizi masyarakat
TRANSCRIPT
Community Nutrition: Basics & Principles
Dr Nugroho AbikusnoMedical Nutrition Dept
Trisakti University
MDGs
1. Eradicate extreme poverty and hunger2. Achieve universal primary education3. Promote gender equality and empower women4. Reduce child mortality5. Improve maternal health6. Combat HIV/AIDS, malaria & other diseases7. Ensure environmental sustainability8. Develop global partnership for development
Public Health problems
• Malnutrition consisting of• Under nutrition• Nutritional anemia• Vitamin A Deficiency• Over nutrition - Obesity
Vulnerability in life course
• Fetal period• Infancy & Early Childhood• School age• Adolescence• Young Adulthood including pregnancy and
lactation• Middle age• Old age
Nutrition Assessment
• Clinical examination• Anthropometry• Dietary assessment• Biochemical examination• Functional examination
Clinical examination
• Anamnesis on general health condition whether any possible complaints related to malnutrition
• Clinical examination from head to toes. Focus on complaints that may be related to malnutrition
Physical signs of malnutrition
• Under nutrition• Macro-nutrient deficiency• Marasmus (energy deficiency)• Kwashiorkor (protein deficiency)• Mixed
Physical signs
Marasmus• Old man face• Apathy• Dry, thin skin• Frail & thin
Kwashiorkor• Corn-strand hair• Crying• Boils• Pot belly• Oedema
Malnutrition (2)
• Micro-nutrient deficiency• Nutritional anemia• Iron deficiency• Vitamin B12 deficiency• Zinc deficiency
Physical signs of malnutrition
• Over nutrition/ obesity
Anthropometry
• Measurements:• Body Weight• Body Height• Arm circumference• Skinfold thickness• Knee height (proxy Body Height)
Anthropometry (2)
• Each measurement or index are valid & reliable indicators to measure nutrition status in each nutritionally vulnerable period in an individual’s life course
Anthropometry (3)Life course AnthropometryFetal period Fundal height
Weight gainInfancy & Early Child W/A; AC/ASchool age H/A; W/HAdolescence BMI by Age; BDEarly Adult BMIMiddle age BMIOld age BMI by KH (proxy)
BMI
• Body Mass Index = BW in kg/BH in m2• Criteria:• < 18.5 : under nutrition/under nourished• 18.5-23.9: normal• 24-29.9: over nutrition/over nourished• 30 and above: obese/obesity• 35 and above: morbid obesity
Waist circumference
• As risk of cardio-vascular disease:• Women: 70 cm• Men: 80 cm
Dietary assessment
• Food diary• Food Frequency Questionnaire• Weighted FFQ• Dietary Recall• Food leftover
Biochemical examination
• Malnutrition:• Macro-nutrient• Micro-nutrient
Metabolic syndrome
• Obesity• Hypertension• Diabetes• Dyslipidemia• NAFLD
Biochemical (2)
Nutrition Disorder BiochemicalKwashiorkor UN AlbuminObesity BS; BLP, SGPTNutritional anemia Iron; Folic acid; B12Vitamin A Deficiency
Vitamin A
Immunity Zinc
Functional examination
Nutrition Disorder
Test
Under nutrition Grip testThorax photo
Obesity Waist circumferenceOsteoporosis Bone densityVitamin A deficiency Night blindness
Terima Kasih.