Embed Size (px)
Citation preview
Masalah gizi
• Gizi makro : - gizi kurang dan buruk - kegemukan
Masalah gizimikro
• Anemia
• GAKY
• Kurang vit A
• Lain :
seng, folat, selenium dsb.
Isu-isu
• Ruang lingkup dan Klasifikasi
• Metabolisme / Patofisiologi :
- Sifat
- Teknik assessment
- Spektrum gejala
- Prevalensi• Penanggulangan
Ruang lingkup dan klasifikasi
• Vitamin• Elemen / unsur (“mineral”)• Vitamin-like substance / marginal
compounds - choline - taurine - carnitine - myo-inositol - bioflavonoids - Coenzyme Q (ubiquinone) dsb.
Perkembangan pengetahuan tentang metabolisme
• Semakin banyak fakta terungkap seiring dengan perkembangan pengetahuan tentang metabolisme dan patofisiologi
• Sifat, teknik assessment, spektrum gejala dan upaya penanggulangan berkembang cepat.
Metabolisme besi
Metabolisme iodium
Metabolisme folat
Efek defisiensi folat di tingkat molekuler
Metabolisme seng
Sifat
•Bioavailibility •Amplification of action •Specivity •Homeostatis• Interaction
Bioavalibility
• Defined as the percent of the consumed mineral that enters via the intestinal absorptive cells and is used for its intended purpose.
• Bioavailibility includes not only how much of a consumed minerals enters the body, but also how much is retained and available for use.
Requirement and Allowance
Requirement
The lowest continuing intake of a nutrient that will maintain a specified criterion of adequacy
RDA (recommended dietary allowance)
The average daily amount of a nutrient considered adequate to meet the known nutrient needs of practically all healthy people.
Requirement and RDA
Nutrients and energy RDA
Nutrients and Risk of DeathN
utr
ient
Fun
ctio
n
100%
0%
Increasing concentration or intake of nutrient
Death DeathDeficiency Marginal Optimal Marginal Toxicity
DRI
Copyright 2005 Wadsworth Group, a division of Thomson LearningCopyright 2005 Wadsworth Group, a division of Thomson Learning
Ca Homeostatis
Zinc’s routes in the body
Interaction
Interactions among the trace minerals are common and often lead to nutrient imbalances.
An excess of one may cause a deficiency of another.
A deficiency of one may open the way for another to cause a toxic reaction.
A deficiency of one may exacerbate the problems associated with the deficiency of another.
Interlocking gear system
Mineral antagonism
Vitamin antagonisms
Vitamin mineral antagonism
Specivity
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
Spektrum gejala defisiensi besi
Serum transferrin receptor(sTfR)
Spektrum gejala GAKY
Prevalensi
Upaya penanggulangan
• Tidak Berbasis pangan
- suplementasi
• Berbasis pangan
- fortifikasi
- rekayasa
- edukasi
Suplementasi
• Petimbangkan interaksi
• Kemungkinan excess• Menekan gizimikro
lain• Petugas gizi
kesehatan harus kenal wilayahnya
Barbara Underwood (2003)
• Scientific progress and political commitment are key factors but .........
• Consumer and public acceptance is key to sustainable progress
