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CHAPTER II STATUS OF NUTRITION The Definiton Of Status Of Nutrition Nutritional status is an expression of one or more aspects of nutriture an individual in a variable Meanwhile, according to Gibson (1990) states the nutritional status is a state body that is the end result of a balance of nutrients that enter into the body and utilization. Based on the classification of Harvard University, the state of child nutrition are classified,namely: a. over weight b. Good nutrition (well nourished) c. Malnutrition (under weight), which includes lack of calories and protein (NOA) level I and II Types of Nutritional Status Parameters 1.Age Based on the Center for Nutrition Bogor (1980), age limit used was a full year and for children 024 months are used in full. 4 months 5 days counted 4 months 3 months 27 days counted 3 months II. Weight Loss Weight determination was done by weighing.The tools used should meet the following requirements: (1) Easy to use and carried from one place to another, (2) Easily obtained and relatively inexpensive price, (3) Accuracy of a maximum weighing 0.1 kg, (4) readability scale , (5) Safe to weigh toddlers III. Height Height is the anthropometric measure both quite important.special of this measure is that size would increase height growth continues at a time until it reaches an optimal height. the height can be calculated by comparison of body weight and can override the age. IV. Head Circumference is used to determine intracranial volume and used to estimate the growth of the brain. V. Upper Arm Circumference This measurement reflects the growth and development of fat and muscle tissue that is not affected much by the state of body fluids than weight Standard Tables Upper Arm Circumference (lla) by Age Age Year 0 0 1 2 3 4 5 Month 6-8 9-11 - Standart (Cm) 85% (Cm) 14,75 15,10 16,00 16,25 16,50 16,75 17,00 12,50 13,25 13,50 13,75 14,00 14,25 14,50 70% (Cm) 10,50 11,00 11,25 11,50 11,60 11,75 12,00 VI. Skin folds Skinfold thickness of triceps and subscapular section describes the reflection of the body develop fat tissue under the skin, which reflects the adequacy of energy (Soetjiningsih, 1998). CHAPTER III Nutritional Status Assessment A.Direct assessment Assessment of nutritional status is directly divided into four assessments of anthropometric, clinical, biochemical, and biophysical. The valuation of each is as follows (Supariasa, et al, 2001): Anthropometrics In general, the significant size of the human body. Nutritional anthropometry associated with various kinds of measuring body dimensions and body composition of various age levels and nutrient levels. Infant and child anthropometry • BW / U • BB / PB or BB / TB • PB / U • composite index, BB / U, BB / TB, TB / U • Index LILA • LK / U • TLBK Anthropometry in adults 1. Body Mass Index IMT = BB(kg)/ TB (m)2 Categories: <17, very thin 17 to 18.4, skinny 18.5 to 25, normal 25.1 to 27, obese > 27, obese 2. Broca method A person classified as obese if the weight of 30% above ideal weight Normal weight = (TB (cm) - 100) kg Ideal body weight = 0.9 x BBnormal 3. Percentage Body Fat(PBF) Density of body fat: Male = 1.15810 - 0.0720 E Women = 1.16610 - 0.0632 E E = the final results of the measurement of fat in the biceps, triceps, subscapular, suprailiaka PFB: = ((4.95 / D) x 4.5) 100% A.2. Clinical • Assessment of nutritional status by looking at medical history and physical examination • Used to detect signs and symptoms of malnutrition A.3. Biochemistry Detecting subclinical deficiency 1. how laboratory / biochemical test static 2. Supported functional impairment testing, measuring the size of the functional consequences of a specific nutrient A.4 Biophysical Determination of nutrients in biophysics is a method of determining the nutritional status by looking at the ability of function, particularly the network, and view changes in tissue structure. B. Indirect assessment Assessment of nutritional status indirectly divided into 3 namely: food consumption survey, vital statistics, and ecological factors (Supariasa, 2001).The description of these three things are: B.1 Survey of food consumption It is a method of determining the nutritional status indirectly by looking at the number and types of nutrients consumed. 1. 24-hour recall method 2. Food record 3. Weighting method 4. Food frequency questionnary 5. Dietary history B.2. Vital Statistics Is to analyze the data some health statistics like mortality rates by age, morbidity and deaths from specific causes and other data relating to nutrition. B.3. Ecology Based on the expression of Bengoa said that malnutrition is a problem of ecology as a result of interaction of several physical factors, biological, and cultural environments.The amount of food available depends on the ecological circumstances such as climate, soil, irrigation, etc. QUALITY PROTEIN NUTRITION • Fitting AAE Content • Amino Acid Scoring • Protein Efficiency Ratio Per • Net Protein Utilization • NDpcals%