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PENGANTAR
     ILMU GIZI DASAR

       Oleh: Suyatno, Ir. MKes.
           http://suyatno.blog.undip.ac.id.
            e-mail: suyatno@undip.ac.id



Bagian Gizi - Fakultas Kesehatan Masyarakat
          Universitas Diponegoro
                 Semarang
Pendahuluan
• We are what we eat.
• Please tell me what you eat so I can tell you who
  you are
• Ilmu yang mempelajari hal ikhwal makanan
  dikaitkan dengan kesehatan tubuh (kegunaan)
  disebut Ilmu Gizi.
• Kata “gizi” berasal dari bahasa Arab “ghidza”
  yang berarti makanan.
• Dengan demikian, di satu sisi ilmu gizi berkaitan
  dengan makanan, sedangkan di sisi yang lain
  berkaitan dengan tubuh manusia.

                                                      2
Pengertian
• Lusk (1931): Nutrition may be defined as the sum of
  processes concerned in the growth, maintenance and
  repair of the living body as a whole or its
  constituents parts.
• Mary Swartz (1935): Nutrition deals with the science
  laws governing the requirement of human being for
  maintenance, growth, activity, reproduction and
  lactation.
• Todhunter (1967): Nutrition deals with: (a) the
  scientific lows governing the requirement of human
  being for maintenance, growth, activity,
  reproduction and lactation; (b) all that makes man a
  healthy, functioning, creative human being through
  well chosen diet.                                  3
Sejarah Perkembangan Ilmu Gizi

                                        Science of
                                        Nutrition

                            Diet and
                            Longevity

               Diet
               In Disease

   Survival

   Early Man   Greeks        16-th        20-th
               (Yunani)     Century      Century

                                                     4
Sejarah Ilmu Gizi
• 400 B.C. -- Hippocrates, the "Father of Medicine", said to
  his students, "Let thy food be thy medicine and thy medicine
  be thy food". He also said “A wise man should consider
  that health is the greatest of human blessings.”
• 400 B.C. -- Foods were often used as cosmetics or as
  medicines in the treatment of wounds. In some of the early
  Far-Eastern biblical writings, there were references to food
  and health. One story describes the treatment of eye
  disease, now known to be due to a vitamin A deficiency, by
  squeezing the juice of liver onto the eye. Vitamin A is stored
  in large amounts in the liver.
• 1500’s – Scientist and artist Leonardo da Vinci compared
  the process of metabolism in the body to the burning of a
  candle.                                                        5
• 1747 – Dr. James Lind, a physician in the British Navy,
  performed the first scientific experiment in nutrition. At that
  time, sailors were sent on long voyages for years and they
  developed scurvy (a painful, deadly, bleeding disorder). Only
  nonperishable foods such as dried meat and breads were taken
  on the voyages, as fresh foods wouldn’t last. In his experiment,
  Lind gave some of the sailors sea water, others vinegar, and the
  rest limes. Those given the limes were saved from scurvy. As
  Vitamin C wasn’t discovered until the 1930’s, Lind didn’t
  know it was the vital nutrient. As a note, British sailors
  became known as “Limey’s”.
• 1770 -- Antoine Lavoisier, the “Father of Nutrition and
  Chemistry” discovered the actual process by which food is
  metabolized. He also demonstrated where animal heat comes
  from. In his equation, he describes the combination of food
  and oxygen in the body, and the resulting giving off of heat and
  water.
                                                              6
• Early 1800’s – It was discovered that foods are
  composed primarily of four elements: carbon, nitrogen,
  hydrogen and oxygen, and methods were developed for
  determining the amounts of these elements.
• 1840 -- Justus Liebig of Germany, a pioneer in early
  plant growth studies, was the first to point out the
  chemical makeup of carbohydrates, fats and
  proteins. Carbohydrates were made of sugars, fats
  were fatty acids, and proteins were made up of amino
  acids.




                                                       7
• 1897 – Christiaan Eijkman, a Dutchman working with
  natives in Java, observed that some of the natives
  developed a disease called Beriberi, which caused heart
  problems and paralysis. He observed that when
  chickens were fed the native diet of white rice, they
  developed the symptoms of Beriberi. When he fed the
  chickens unprocessed brown rice (with the outer bran
  intact), they did not develop the disease. Eijkman then
  fed brown rice to his patients and they were cured. He
  disovered that food could cure disease. Nutritionists
  later learned that the outer rice bran contains vitamin
  B1, also known as thiamine.

                                                        8
• Dr. William Beaumont and Alexio St. Martine in the
  19th century:
   – He determined the stomach is not a grinder
   – There is no spirit in the body directing some of the
     foods to 'good' purposes, and discarding the 'bad'
   – digesting takes place by digestive juices secreted
     from the stomach
   – foods are digested all at the same time but at
     different rates, not separately and sequentially, as
     was thought.
   – stomach rumblings are just stomach contractions
   – fat is digested slowly

                                                            9
• The 20th century became the era of the Golden Age of
  Nutrition.

• 1912– E.V. McCollum, while working for the U.S.
  Department of Agriculture at the University of
  Wisconsin, developed an approach that opened the way
  to the widespread discovery of nutrients. He decided to
  work with rats rather than large farm animals like
  cows and sheep. Using this procedure, he discovered
  the first fat soluble vitamin, Vitamin A. He found that
  rats fed butter were healthier than those fed lard, as
  butter contains more Vitamin A.


                                                         10
• 1912 – Dr. Casmir Funk was the first to coin the term
  “vitamins” as vital factors in the diet. He wrote about
  these unidentified substances present in food, which
  could prevent the diseases of scurvy, beriberi and
  pellagra (a disease caused by a deficiency of niacin,
  vitamin B-3). The term vitamin is derived from the
  words vital and amine, because vitamins are required
  for life and they were originally thought to be amines --
  compounds derived from ammonia.
• 1930’s – William Rose discovered the essential amino
  acids, the building blocks of protein.
• 1940’s – The water soluble B and C vitamins were
  identified.

                                                          11
• 1940’s -- Russell Marker perfected a method of synthesizing
  the female hormone progesterone from a component of wild
  yams called diosgenin.
• 1950’s to the Present -- The roles of essential nutrients as part
  of bodily processes have been brought to light. For example,
  more became known about the role of vitamins and minerals as
  components of enzymes and hormones that work within the
  body.
• 1968-- Linus Pauling, a Nobel Prize winner in chemistry,
  created the term Orthomolecular Nutrition. Orthomolecular is,
  literally, "pertaining to the right molecule". Pauling proposed
  that by giving the body the right molecules in the right
  concentration (optimum nutrition), nutrients could be used by
  people to achieve better health and prolong life. Studies in the
  1970's and 1980's conducted by Pauling and colleagues
  suggested that very large doses of vitamin C given
  intravenously could be helpful in increasing the survival time
  and improving the quality of life of terminal cancer patients. 12
Ruang Lingkup Ilmu Gizi

 input          proses           output            outcome
                             Pertumbuhan sel
Makanan        Dicerna,      Pemeliharaan sel      Pertumbuhan
dimakan        Diserap,      Memperlancar fungsi   Fisik &
(dikonsumsi)   Metabolisme   Anatomis &            mental/Kecer
                             Faal/tubuh            -dasan,
                             Menghasilkan energi   Produktivitas




                                                           13
Nutrients
• Nutrients: substance obtained from food and
  used in the body to promote growth,
  maintenance, and repair
• Most of the required nutrients are harmful
  when consumed in excessive amount.
• In USA most widely used estimates of
  nutritional requirements are the
  Recommended Dietary Allowances (RDAs)
Nutrients Cont
• Approximately 40 nutrients are required by
  the human body.
• Required Nutrients: amino acids, vitamins,
  minerals, energy, carbohydrates, nitrogen,
  water.
Nutrients
• Six Classes
  –   Carbohydrates
  –   Fats (lipids)
  –   Proteins
  –   Vitamins
  –   Minerals
  –   Water
Nutrients
• Three provide energy nutrients: carbohydrate, fat,
  protein
• Carbohydrate and fat are the major energy yielding
  nutrients, protein becomes major fuel only when others
  are not available
• Vitamins do not provide energy but facilitate the
  release of energy
• Minerals yield no energy but regulate the release of
  energy
Nutrients Groups:
• Macronutrients : Protein Carbohydrate Fat
• Micronutrients : Vitamin Mineral
Simple classification of dietary constituents

Constituent            Use
Water                  To provide body fluid and to help regulate
                       body temperature
Carbohydrates          As fuel for energy for body heat and work
Fats                   As fuel for energy and essential fatty acids
Proteins               For growth and repair
Minerals               For developing body tissues and for
                       metabolic processes and protection
Vitamins               For metabolic processes and protection

Indigestible and       To form a vehicle for other nutrients, add
unabsorbable           bulk to the diet, provide a habitat for
particles, including   bacterial flora and assist proper elimination
fiber                  of refuse
                                                                  18
Some Important Principles

• Adequacy: enough of all essential nutrients, fiber
  and energy
• Balance: don’t rely on one type of food for
  everything
• Energy Control: don’t overeat
• Moderation: not too much or too little of anything.
• Variety: the spice of life; include a large number
  of different foods in your diet.
Beberapa Pengertian Penting:
• Proses gizi (nutrition) : proses dari organisme dalam
  menggunakan bahan makanan melalui proses pencernaan,
  penyerapan, transportasi, penyimpanan, metabolisme dan
  penggunaan zat untuk pemeliharaan hidup, pertumbuhan,
  fungsi organ tubuh dan produksi energi.
• Keadaan Gizi (Nutriture): keadaan yang diakibatkan oleh
  keseimbangan antara konsumsi dan penyerapan gizi disatu
  pihak dan penggunaan oleh organisme di pihak lain, atau
  keadaan fisiologik akibat dari tersedianya zat gizi dalam
  seluler tubuh
• Status gizi (Nutritional Status): tanda-tanda atau penampilan
  yang diakibatkan dari nutriture yang dilihat melalui variabel
  tertentu (indikator status gizi) seperti berat, tinggi dll.


                                                                  20
Kualitas Gizi

                                      Over
 Intake   Intake                     Normal                Kebutuhan
Pangan    Zat Gizi                   Under                 Gizi (AKG)
                                     Death

          100%
            fungsi

                                      optimal


                        defisiensi                 toksisitas

                     kematian                             kematian


                                     Intake Gizi
                                                                        21
Gizi Baik = Gizi seimbang
         (Asupan zat gizi = Kebutuhan zat gizi)



Garis
normal



            Asupan                 Kebutuhan




                                                  22
Kurang Gizi = Gizi tidak seimbang
         (Asupan zat gizi < Kebutuhan zat gizi)



Garis
normal

             Asupan




                                 Kebutuhan



                                                  23
Gizi Lebih = Gizi tidak seimbang
          (Asupan zat gizi > Kebutuhan zat gizi)



 Garis
 normal
                                   Kebutuhan



             Asupan


                                                   24
Macam Status Gizi:
• Status Gizi Normal: keadaan tubuh yang mencerminkan
  kesimbangan antara konsumsi dan penggunaan gizi oleh tubuh
  (adequate)
• Malnutrition: keadaan patologis akibat kekurangan atau
  kelebihan secara relatif maupun absolut satu atau lebih zat
  gizi.
  Ada empat bentuk:
   – Under nutriton: kekurangan konsumsi pangan secara relatif
     atau absolut untuk periode tertentu
   – Specific deficiency: kekurangan zat gizi tertentu, misalnya
     kekurangan iodium, Fe dll
   – Over nutrition: kelebihan konsumsi pangan untuk periode
     tertentu
   – Imbalance: keadaan disproporsi zat gizi, misalnya tinggi
     kolesterol karena tidak imbangnya kadar LDL, HDL dan
     VLDL.
                                                              25
Depletion Stage                Methode (s) Used
1. Dietary inadequate                Dietary
2. Decreased level in reserve tissue Biochemical
   store
3. Decreased level in body fluids    Biochemical

4. Decreased functional level in     Anthropometric/bioche
   tissues                           mical
5. Decreased activity of nutrient-   Biochemical/molecular
   dependent enzyme or mRNA          technique
   for some protein
6. Functional change                 Behavioral/physiological

7. Clinical symptoms                 Clinical
8. Anatomical sign                   Clinical
                                                         26
Sistem Pangan dan Gizi
• Subsistem Pangan: panen s/d sebelum konsumsi
• Subsistem Gizi : konsumsi s/d status gizi

Subsistem Gizi:
• merupakan resultante dari sub sistem sebelumnya
• dicerminkan oleh status gizi berkaitan dengan
  penyerapan dan penggunaan gizi oleh tubuh


                                               27
Tahapan yang terjadi di
          Subsistem Gizi
• Pencernaan makanan: dari mulut s/d usus
• Penyerapan: proses zat gizi masuk ke dalam darah
  dan diangkut ke sel-sel
• Pemecahan dan sintesis zat gizi di dalam sel
• Penggunaan zat gizi
• Penyimpanan kelebihan zat gizi sebagai cadangan
• Pembuangan bahan-bahan yang tidak diperlukan


                                                 28
Pada proses pencernaan makan,
       perlu diperhatikan:
• Kesehatan alat pencernaan (gigi, mulut, lambung
  dan usus)
• Keberadaan Enzim:
   – Amilase untuk mencerna pati
   – Lipase untuk mencerna lemak
   – Laktose untuk mencerna laktosa
• Daya cerna makanan:
   – besarnya energi yang bisa dihasilkan manusia dari
     bahan pangan sangat tergantung dari digestibility.
   – Energi yang diabsorbsi dari bahan karbohidrat sebesar
     98 %, lemak sebesar 95 % & protein sebesar 92 %.
                                                         29
Pada tahap penyerapan zat gizi,
       perlu diperhatikan :
• Keberadaan parasit (cacing) & infeksi (diare)
• Inhibitor, mis:
  –   Tripsin inhibitor pada kedelai
  –   Goitrogenik menghambat penyerapan Iodium
  –   Fitat mengkelat Ca, Fe, Mg dan Zn
  –   Avidin mengahambat penyerapan biotin
  –   Kacang kedelai mengandung enzim
      lipoksidase/lipoksigenase yg dpt menghamcurkan
      karoten (Antivitamin A)
                                                 30
• Enhancer, mis:
  – Penyerapan Fe lebih baik jika ada protein
  – Vitamin C membantu penyerapan Fe
    (mereduksi besi feri menjadi fero dalam usus
    halus sehingga mudah diabsorpsi )
  – Vitamin C juga membantu absorpsi kalsium
  – Penyerapan vit. ADEK dibantu oleh lemak
  – Laktose diperlukan agar kapur dapat diabsorbsi



                                                 31
Pada pemecahan dan sintesis zat
    gizi, perlu diperhatikan:
• Keberadaan zat gizi mikro/vitamin sebagai
  kofaktor dan koenzim:
   – Thiamin, Niasin dan riboflavin merp komponen enzim
     yang diperlukan dalam oksidasi karbohidrat, lemak dan
     protein utk menghasilkan tenaga
• Keberadaan Enzim:
   – Insulin : gula darah   gula otot
• Pengaruh antar zat gizi:
   – Karbohidrat diperlukan dalam metabolisme lemak yang
     normal
                                                         32
Pembuangan bahan-bahan yang
      tidak diperlukan:
• Melalui:
  – Feses: air, sisa dari karbohidrat, lemak, protein
  – Urin: air, sisa dari mineral, protein/asam amino,
    alkohol, kelebihan vitamin larut air
  – Keringat: air, mineral
  – Paru-paru: air, karbondioksida



                                                   33
Terkait dengan penggunaan zat
          gizi oleh tubuh:
• Kelebihan zat gizi dari kebutuhan akan disimpan:
   – Energi dirubah menjadi lemak, meyebabkan kegemukan
   – Vitamin larut lemak akan disimpan di hati
• Kekurangan energi di dalam makanan akan
  menyebabkan protein dipergunakan sebagai tenaga,
  shg dapat mengurangi jaringan protein:
   – Konsumsi karbohidrat cukup akan menghemat protein
     tubuh > reaksi gluconeogenesis bisa dihindarkan
• Semua zat gizi penting dalam proses pemecahan dan
  sintesis zat gizi, shg jika makanan tersusun seimbang
  akan dihasilkan kesehatan sempurna                34
Penggunaan Zat Gizi oleh Tubuh:
1. Basal metabolisme:
   yaitu untuk memenuhi kebutuhan zat gizi minimal
   untuk menjalankan proses tubuh yang vital.
   Faktor yang mempengaruhi
   –   Ukuran tubuh/komposisi
   –   Seks
   –   Umur
   –   Tidur
   –   Suhu tubuh
   –   Kondisi fisiologis
   –   Status gizi
                                                 35
2. Physical activity:
   – Banyaknya zat gizi/energi yang dibutuhkan tergantung
     jenis aktivitas
3. Pembangunan/pemeliharaan dari
  sel/jaringan:
   – Protein untuk pembangun sel pada masa pertumbuhan
     dan juga untuk pergantian sel rusak/pemeliharaan sel.
   – Jaringan tulang dan gizi: Ca dan P
4. Pengatur/Regulator:
   – Vitamin/mineral dibutuhkan sebagai kofaktor/koenzim




                                                             36

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Ilmu gizi-pengertian-dan-ruang-lingkup

  • 1. PENGANTAR ILMU GIZI DASAR Oleh: Suyatno, Ir. MKes. http://suyatno.blog.undip.ac.id. e-mail: suyatno@undip.ac.id Bagian Gizi - Fakultas Kesehatan Masyarakat Universitas Diponegoro Semarang
  • 2. Pendahuluan • We are what we eat. • Please tell me what you eat so I can tell you who you are • Ilmu yang mempelajari hal ikhwal makanan dikaitkan dengan kesehatan tubuh (kegunaan) disebut Ilmu Gizi. • Kata “gizi” berasal dari bahasa Arab “ghidza” yang berarti makanan. • Dengan demikian, di satu sisi ilmu gizi berkaitan dengan makanan, sedangkan di sisi yang lain berkaitan dengan tubuh manusia. 2
  • 3. Pengertian • Lusk (1931): Nutrition may be defined as the sum of processes concerned in the growth, maintenance and repair of the living body as a whole or its constituents parts. • Mary Swartz (1935): Nutrition deals with the science laws governing the requirement of human being for maintenance, growth, activity, reproduction and lactation. • Todhunter (1967): Nutrition deals with: (a) the scientific lows governing the requirement of human being for maintenance, growth, activity, reproduction and lactation; (b) all that makes man a healthy, functioning, creative human being through well chosen diet. 3
  • 4. Sejarah Perkembangan Ilmu Gizi Science of Nutrition Diet and Longevity Diet In Disease Survival Early Man Greeks 16-th 20-th (Yunani) Century Century 4
  • 5. Sejarah Ilmu Gizi • 400 B.C. -- Hippocrates, the "Father of Medicine", said to his students, "Let thy food be thy medicine and thy medicine be thy food". He also said “A wise man should consider that health is the greatest of human blessings.” • 400 B.C. -- Foods were often used as cosmetics or as medicines in the treatment of wounds. In some of the early Far-Eastern biblical writings, there were references to food and health. One story describes the treatment of eye disease, now known to be due to a vitamin A deficiency, by squeezing the juice of liver onto the eye. Vitamin A is stored in large amounts in the liver. • 1500’s – Scientist and artist Leonardo da Vinci compared the process of metabolism in the body to the burning of a candle. 5
  • 6. • 1747 – Dr. James Lind, a physician in the British Navy, performed the first scientific experiment in nutrition. At that time, sailors were sent on long voyages for years and they developed scurvy (a painful, deadly, bleeding disorder). Only nonperishable foods such as dried meat and breads were taken on the voyages, as fresh foods wouldn’t last. In his experiment, Lind gave some of the sailors sea water, others vinegar, and the rest limes. Those given the limes were saved from scurvy. As Vitamin C wasn’t discovered until the 1930’s, Lind didn’t know it was the vital nutrient. As a note, British sailors became known as “Limey’s”. • 1770 -- Antoine Lavoisier, the “Father of Nutrition and Chemistry” discovered the actual process by which food is metabolized. He also demonstrated where animal heat comes from. In his equation, he describes the combination of food and oxygen in the body, and the resulting giving off of heat and water. 6
  • 7. • Early 1800’s – It was discovered that foods are composed primarily of four elements: carbon, nitrogen, hydrogen and oxygen, and methods were developed for determining the amounts of these elements. • 1840 -- Justus Liebig of Germany, a pioneer in early plant growth studies, was the first to point out the chemical makeup of carbohydrates, fats and proteins. Carbohydrates were made of sugars, fats were fatty acids, and proteins were made up of amino acids. 7
  • 8. • 1897 – Christiaan Eijkman, a Dutchman working with natives in Java, observed that some of the natives developed a disease called Beriberi, which caused heart problems and paralysis. He observed that when chickens were fed the native diet of white rice, they developed the symptoms of Beriberi. When he fed the chickens unprocessed brown rice (with the outer bran intact), they did not develop the disease. Eijkman then fed brown rice to his patients and they were cured. He disovered that food could cure disease. Nutritionists later learned that the outer rice bran contains vitamin B1, also known as thiamine. 8
  • 9. • Dr. William Beaumont and Alexio St. Martine in the 19th century: – He determined the stomach is not a grinder – There is no spirit in the body directing some of the foods to 'good' purposes, and discarding the 'bad' – digesting takes place by digestive juices secreted from the stomach – foods are digested all at the same time but at different rates, not separately and sequentially, as was thought. – stomach rumblings are just stomach contractions – fat is digested slowly 9
  • 10. • The 20th century became the era of the Golden Age of Nutrition. • 1912– E.V. McCollum, while working for the U.S. Department of Agriculture at the University of Wisconsin, developed an approach that opened the way to the widespread discovery of nutrients. He decided to work with rats rather than large farm animals like cows and sheep. Using this procedure, he discovered the first fat soluble vitamin, Vitamin A. He found that rats fed butter were healthier than those fed lard, as butter contains more Vitamin A. 10
  • 11. • 1912 – Dr. Casmir Funk was the first to coin the term “vitamins” as vital factors in the diet. He wrote about these unidentified substances present in food, which could prevent the diseases of scurvy, beriberi and pellagra (a disease caused by a deficiency of niacin, vitamin B-3). The term vitamin is derived from the words vital and amine, because vitamins are required for life and they were originally thought to be amines -- compounds derived from ammonia. • 1930’s – William Rose discovered the essential amino acids, the building blocks of protein. • 1940’s – The water soluble B and C vitamins were identified. 11
  • 12. • 1940’s -- Russell Marker perfected a method of synthesizing the female hormone progesterone from a component of wild yams called diosgenin. • 1950’s to the Present -- The roles of essential nutrients as part of bodily processes have been brought to light. For example, more became known about the role of vitamins and minerals as components of enzymes and hormones that work within the body. • 1968-- Linus Pauling, a Nobel Prize winner in chemistry, created the term Orthomolecular Nutrition. Orthomolecular is, literally, "pertaining to the right molecule". Pauling proposed that by giving the body the right molecules in the right concentration (optimum nutrition), nutrients could be used by people to achieve better health and prolong life. Studies in the 1970's and 1980's conducted by Pauling and colleagues suggested that very large doses of vitamin C given intravenously could be helpful in increasing the survival time and improving the quality of life of terminal cancer patients. 12
  • 13. Ruang Lingkup Ilmu Gizi input proses output outcome Pertumbuhan sel Makanan Dicerna, Pemeliharaan sel Pertumbuhan dimakan Diserap, Memperlancar fungsi Fisik & (dikonsumsi) Metabolisme Anatomis & mental/Kecer Faal/tubuh -dasan, Menghasilkan energi Produktivitas 13
  • 14. Nutrients • Nutrients: substance obtained from food and used in the body to promote growth, maintenance, and repair • Most of the required nutrients are harmful when consumed in excessive amount. • In USA most widely used estimates of nutritional requirements are the Recommended Dietary Allowances (RDAs)
  • 15. Nutrients Cont • Approximately 40 nutrients are required by the human body. • Required Nutrients: amino acids, vitamins, minerals, energy, carbohydrates, nitrogen, water.
  • 16. Nutrients • Six Classes – Carbohydrates – Fats (lipids) – Proteins – Vitamins – Minerals – Water
  • 17. Nutrients • Three provide energy nutrients: carbohydrate, fat, protein • Carbohydrate and fat are the major energy yielding nutrients, protein becomes major fuel only when others are not available • Vitamins do not provide energy but facilitate the release of energy • Minerals yield no energy but regulate the release of energy Nutrients Groups: • Macronutrients : Protein Carbohydrate Fat • Micronutrients : Vitamin Mineral
  • 18. Simple classification of dietary constituents Constituent Use Water To provide body fluid and to help regulate body temperature Carbohydrates As fuel for energy for body heat and work Fats As fuel for energy and essential fatty acids Proteins For growth and repair Minerals For developing body tissues and for metabolic processes and protection Vitamins For metabolic processes and protection Indigestible and To form a vehicle for other nutrients, add unabsorbable bulk to the diet, provide a habitat for particles, including bacterial flora and assist proper elimination fiber of refuse 18
  • 19. Some Important Principles • Adequacy: enough of all essential nutrients, fiber and energy • Balance: don’t rely on one type of food for everything • Energy Control: don’t overeat • Moderation: not too much or too little of anything. • Variety: the spice of life; include a large number of different foods in your diet.
  • 20. Beberapa Pengertian Penting: • Proses gizi (nutrition) : proses dari organisme dalam menggunakan bahan makanan melalui proses pencernaan, penyerapan, transportasi, penyimpanan, metabolisme dan penggunaan zat untuk pemeliharaan hidup, pertumbuhan, fungsi organ tubuh dan produksi energi. • Keadaan Gizi (Nutriture): keadaan yang diakibatkan oleh keseimbangan antara konsumsi dan penyerapan gizi disatu pihak dan penggunaan oleh organisme di pihak lain, atau keadaan fisiologik akibat dari tersedianya zat gizi dalam seluler tubuh • Status gizi (Nutritional Status): tanda-tanda atau penampilan yang diakibatkan dari nutriture yang dilihat melalui variabel tertentu (indikator status gizi) seperti berat, tinggi dll. 20
  • 21. Kualitas Gizi Over Intake Intake Normal Kebutuhan Pangan Zat Gizi Under Gizi (AKG) Death 100% fungsi optimal defisiensi toksisitas kematian kematian Intake Gizi 21
  • 22. Gizi Baik = Gizi seimbang (Asupan zat gizi = Kebutuhan zat gizi) Garis normal Asupan Kebutuhan 22
  • 23. Kurang Gizi = Gizi tidak seimbang (Asupan zat gizi < Kebutuhan zat gizi) Garis normal Asupan Kebutuhan 23
  • 24. Gizi Lebih = Gizi tidak seimbang (Asupan zat gizi > Kebutuhan zat gizi) Garis normal Kebutuhan Asupan 24
  • 25. Macam Status Gizi: • Status Gizi Normal: keadaan tubuh yang mencerminkan kesimbangan antara konsumsi dan penggunaan gizi oleh tubuh (adequate) • Malnutrition: keadaan patologis akibat kekurangan atau kelebihan secara relatif maupun absolut satu atau lebih zat gizi. Ada empat bentuk: – Under nutriton: kekurangan konsumsi pangan secara relatif atau absolut untuk periode tertentu – Specific deficiency: kekurangan zat gizi tertentu, misalnya kekurangan iodium, Fe dll – Over nutrition: kelebihan konsumsi pangan untuk periode tertentu – Imbalance: keadaan disproporsi zat gizi, misalnya tinggi kolesterol karena tidak imbangnya kadar LDL, HDL dan VLDL. 25
  • 26. Depletion Stage Methode (s) Used 1. Dietary inadequate Dietary 2. Decreased level in reserve tissue Biochemical store 3. Decreased level in body fluids Biochemical 4. Decreased functional level in Anthropometric/bioche tissues mical 5. Decreased activity of nutrient- Biochemical/molecular dependent enzyme or mRNA technique for some protein 6. Functional change Behavioral/physiological 7. Clinical symptoms Clinical 8. Anatomical sign Clinical 26
  • 27. Sistem Pangan dan Gizi • Subsistem Pangan: panen s/d sebelum konsumsi • Subsistem Gizi : konsumsi s/d status gizi Subsistem Gizi: • merupakan resultante dari sub sistem sebelumnya • dicerminkan oleh status gizi berkaitan dengan penyerapan dan penggunaan gizi oleh tubuh 27
  • 28. Tahapan yang terjadi di Subsistem Gizi • Pencernaan makanan: dari mulut s/d usus • Penyerapan: proses zat gizi masuk ke dalam darah dan diangkut ke sel-sel • Pemecahan dan sintesis zat gizi di dalam sel • Penggunaan zat gizi • Penyimpanan kelebihan zat gizi sebagai cadangan • Pembuangan bahan-bahan yang tidak diperlukan 28
  • 29. Pada proses pencernaan makan, perlu diperhatikan: • Kesehatan alat pencernaan (gigi, mulut, lambung dan usus) • Keberadaan Enzim: – Amilase untuk mencerna pati – Lipase untuk mencerna lemak – Laktose untuk mencerna laktosa • Daya cerna makanan: – besarnya energi yang bisa dihasilkan manusia dari bahan pangan sangat tergantung dari digestibility. – Energi yang diabsorbsi dari bahan karbohidrat sebesar 98 %, lemak sebesar 95 % & protein sebesar 92 %. 29
  • 30. Pada tahap penyerapan zat gizi, perlu diperhatikan : • Keberadaan parasit (cacing) & infeksi (diare) • Inhibitor, mis: – Tripsin inhibitor pada kedelai – Goitrogenik menghambat penyerapan Iodium – Fitat mengkelat Ca, Fe, Mg dan Zn – Avidin mengahambat penyerapan biotin – Kacang kedelai mengandung enzim lipoksidase/lipoksigenase yg dpt menghamcurkan karoten (Antivitamin A) 30
  • 31. • Enhancer, mis: – Penyerapan Fe lebih baik jika ada protein – Vitamin C membantu penyerapan Fe (mereduksi besi feri menjadi fero dalam usus halus sehingga mudah diabsorpsi ) – Vitamin C juga membantu absorpsi kalsium – Penyerapan vit. ADEK dibantu oleh lemak – Laktose diperlukan agar kapur dapat diabsorbsi 31
  • 32. Pada pemecahan dan sintesis zat gizi, perlu diperhatikan: • Keberadaan zat gizi mikro/vitamin sebagai kofaktor dan koenzim: – Thiamin, Niasin dan riboflavin merp komponen enzim yang diperlukan dalam oksidasi karbohidrat, lemak dan protein utk menghasilkan tenaga • Keberadaan Enzim: – Insulin : gula darah gula otot • Pengaruh antar zat gizi: – Karbohidrat diperlukan dalam metabolisme lemak yang normal 32
  • 33. Pembuangan bahan-bahan yang tidak diperlukan: • Melalui: – Feses: air, sisa dari karbohidrat, lemak, protein – Urin: air, sisa dari mineral, protein/asam amino, alkohol, kelebihan vitamin larut air – Keringat: air, mineral – Paru-paru: air, karbondioksida 33
  • 34. Terkait dengan penggunaan zat gizi oleh tubuh: • Kelebihan zat gizi dari kebutuhan akan disimpan: – Energi dirubah menjadi lemak, meyebabkan kegemukan – Vitamin larut lemak akan disimpan di hati • Kekurangan energi di dalam makanan akan menyebabkan protein dipergunakan sebagai tenaga, shg dapat mengurangi jaringan protein: – Konsumsi karbohidrat cukup akan menghemat protein tubuh > reaksi gluconeogenesis bisa dihindarkan • Semua zat gizi penting dalam proses pemecahan dan sintesis zat gizi, shg jika makanan tersusun seimbang akan dihasilkan kesehatan sempurna 34
  • 35. Penggunaan Zat Gizi oleh Tubuh: 1. Basal metabolisme: yaitu untuk memenuhi kebutuhan zat gizi minimal untuk menjalankan proses tubuh yang vital. Faktor yang mempengaruhi – Ukuran tubuh/komposisi – Seks – Umur – Tidur – Suhu tubuh – Kondisi fisiologis – Status gizi 35
  • 36. 2. Physical activity: – Banyaknya zat gizi/energi yang dibutuhkan tergantung jenis aktivitas 3. Pembangunan/pemeliharaan dari sel/jaringan: – Protein untuk pembangun sel pada masa pertumbuhan dan juga untuk pergantian sel rusak/pemeliharaan sel. – Jaringan tulang dan gizi: Ca dan P 4. Pengatur/Regulator: – Vitamin/mineral dibutuhkan sebagai kofaktor/koenzim 36