1. CATUR SAPTANING W, S.Gz, MPH

2. 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

3.  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 INTRODUCTION

4. AVERAGE AGES OF PUBERTAL, COGNITIVE, & PSYCHOSOCIAL MATURATION

5.  The biological, psychosocial, and cognitive changes associated with adolescence have direct effects on nutritional status.  Increases needs for : Energy Protein Vitamins Minerals NUTRITIONAL NEEDS IN A TIME OF CHANGE

6. ENERGY AND NUTRIENT REQUIREMENT OF ADOLESCENT

7.  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. ENERGY

8. 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 BASAL METABOLIC RATE (BMR) FOR WOMEN

9. Example of BMR You are 14 years old You are 153 cm) Your weight is 48 kg Your BMR is 655 + (460.8) + (275.4) – (65.8) = 1325.4 calories Total Calorie Needs Example If you are Lightly Active, multiply your BMR (1325.4) by 1.375 = 1822.4Your total daily calorie requirement is therefore 1822.4 calories. Note : 1 inch = 2.54 cm. 1 kilogram = 2.2 lbs. BMR cont….

10. 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 BASAL METABOLIC RATE (BMR) FOR MEN

11. 1.Dengan Rumus Harris Benedict 2.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 CARA MENENTUKAN BMR

12. 3. Cara FAO/WHO/UNU Sumber : FAO/WHO/UNU 1985 Berdasarkan contoh soal A maka sesuai dengan rumus FAO/WHO/UNU, BMR perempuan tersebut : BMR = 12.2 (48) + 746 = 1331.6 kkal

13. 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

14. 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

15.  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

16. PROTEIN CONT… 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, 8 th 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.

17. 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

18.  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. CARBOHYDRATE

19. 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

20.  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. FAT

21. Dari contoh A maka kebutuhan lemak perempuan tersebut dalam sehari adalah Lemak = 25% x 2054.4 kkal = 513.6 kkal : 9 = 57 gram/hari

22.  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. DIETARY FIBER

23.  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. CALCIUM

24. The DRIs for iron for male and female aloescents are : IRON 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.

25.  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. IRON CONT’…

26.  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. ZINC

27.  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

28. The DRI for folate is : Folate cont’… Source: Food and Nutrition Board, Institute of Medicine, National Academies. Dietary Reference Intakes : Recommended Intakes for Individuals. Washington, DC. : National Academy Press, 2000

29. The DRI for vitamin A is : VITAMIN A Source: Food and Nutrition Board, Institute of Medicine, National Academies. Dietary Reference Intakes : Recommended Intakes for Individuals. Washington, DC. : National Academy Press, 2000

30. The top five dietary sources of vitamin A in the diets of adolescent are :  Ready-to-eat cereal  Milk  Carrots  Margarine  Cheese VITAMIN A CONT’…

31.  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

32. The DRIs for vitamin E for adolescents are : Vitamin e cont’… Source: Food and Nutrition Board, Institute of Medicine, National Academies. Dietary Reference Intakes : Recommended Intakes for Individuals. Washington, DC. : National Academy Press, 2000

33.  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

34. The DRIs for adolescents are : VITAMIN C CONT’… Source: Food and Nutrition Board, Institute of Medicine, National Academies. Dietary Reference Intakes : Recommended Intakes for Individuals. Washington, DC. : National Academy Press, 2000

35.  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 TUGAS

36. 1.Brown, E.J. Nutrition Through The Life Cycle. (2sc ed). USA : Thomson Wadsword. 2005 REFERENCES