Personal Report on Analyzing the Risk of Malnutrition

Febriyani 1102005109

The world has enough food for everyone, but millions of people face a life sentence of hunger and malnutrition the hidden reason so many die
(Save the Children Fund, 2012)

Malnutrition = too much or too little food energy or nutrients. In general, malnutrition actually consist of

undernutrition and overnutrition - Undernutrition: protein-energy micronutrient deficiencies malnutrition and

- Continues to be a major public health problem throughout the developing world, particularly in southern Asia and subSaharan Africa. - High prevalence of bacterial and parasitic diseases in developing countries

- Malnutrition is consequently the most important risk factor for the burden of disease in developing countries - Direct cause of about 300 000 deaths per year and is indirectly responsible for about half of all deaths in young children.

- Obesity is a global health problem in the present era

- Obesity has reached epidemic proportions globally, with more than 1 billion adults overweight

- at least 300 million of them clinically obese - and is a major

contributor to the global burden of chronic disease and disability.

- insufficient supply of protein, carbohydrates and fat - severe and chronic infections producing diarrhea, helminthic infections - decreased food intake because of anorexia - decreased nutrient absorption - increased metabolic requirements and direct nutrient losses - immunologic deficiency in the humoral and cellular subsystem from protein deficiency and lack of immune mediators - Metabolic disturbances: impaired intercellular degradation of fatty acids because of carbohydrate deficiency

- disorder of the homeostatic control of energy balance

- Resistance to leptin - TNF, another cytokine that relays information from fat to brain - Alterations in PPAR transcription factors which promote

lipogenesis also may have a role in obesity

- Genetic susceptibility, environmental, food intake, and physical activities.

Name : Febriyani Age : 20 years old Anthropometry Body weight Body height BMI Waist Circumference Hip circumference Middle-upper arm Circumference Subcutaneous fat

Sex Job

: Female : student

: 52 kg : 160,5 cm : 20,18 : 73 cm : 93,2 cm : 26 cm : - Triceps - Biceps - Subscapula - Suprailliaca

: 18 :8 : 7,8 : 15,8

- Calculate Basal Metabolic Rate(BMR) using harris benedict equation For women BMR = 655.1 + 9.65W + 1.85H - 4.68A = 655.1 + 501,8 + 296.925 93,6 = 1.360.225 kcal - Calculate Physical Activity based on the categories. The physical activity is categorized to light activities with constanta 1,56. PA = 0,56 x BMR = 0,56 x 1360.225 = 761,726 kcal

- Calculate Thermic Effect of Food TEF = 10% x Basal Metabolic Rate = 10% x 1360.225 = 136,0225 kcal - Calculate Total Energy Requirement TER = BMR + PA + TEF = 1.360,225 + 761,726 + 136,0225 = 2.257,9735 kcal

Nutrient Content Energy Protein Fat

Analysed Value 1662.3 kcal 59.9(15%) 49.9 g(27%)

Recommended Value/Day 2025.6 kcal 59,8 g(12 %) 68.7 g(< 30 %) 82% 100% 73%

Percentage Fulfillment

carbohydr.
dietary fiber Alcohol PUFA Cholesterol Vit. A Carotene

239.3 g(59%)
13.5 g 0.3 g 7g 328.5 mg 1222.4 g 4.9 mg

289.2 g(> 55 %)
30.0 g 10 g 800.0 g -

83%
45% 70% 153% -

Vit. E (eq.)

4.8 mg

12.0 mg

40%

Vit. B1
Vit. B2 Vit. B6 tot. fol.acid Vit. C Sodium Potassium

0,6 mg
0,9 mg 1.3 mg 128.7 g 30,4 mg 2239.7 mg 1173.2 mg

1.0 mg
1.2 mg 1.2 mg 400.0 g 100.0 mg 2000.0 mg 3500.0 mg

65%
76% 112% 32% 30% 112% 45%

Calcium
Magnesium Phosphorus Iron

516.6 mg
377.4 mg 1173.2 mg 10.3 mg

1000.0 mg
310.0 mg 700.0 mg 15.0 mg

52%
122 % 168 % 69 %

Analyzing Risk of Malnutrition: Personal Report 1-Febriyani

Subjective Global Assessment (SGA) a. Past history of weight within last 6 months (0) maintain; (1) reduce <10%; (2) reduce 10% b. Past history of food intake within last 5 days (0) maintain; (1) reduce <50%; (2) reduce 50% c. Disturbance on GI tract (0) normal; (1) sick, anorexic; (2) vomit, diarrhea d. Functional capacity (0) normal; (1) reduce/suboptimal; (2) bed ridden 2wks e. Metabolic stress (0) light; (1) moderate; (2) heavy f. Muscle wasting/subcutan fat (0) Nut st. Normal; (1) light; (2) moderate; (3) heavy SGA (0) Good nutrition status;(1-2) light malnutrition;(> 3) heavy malnutrition

Nutrition Status based on BMI Body mass index (BMI) is equal to weight per height square (kg/m2). The BMI of Febriyani is 20,18 which is categorized into normal.
Energy Adequacy Based on Nutrisurvey2007 calculation, the usual energy intake from food has not fulfill the total energy requirement, or in other words inadequate. The percentage fullfillness is only 82%.

- Keep the protein in enough intake. Increase the carbohydrate a little bit more to reach the recommended value needed by the body. - Try to balance the energy intake with the total energy requirement per day by consuming more variety of foods, such as fruits and vegetables(vitamin C, vitamin E, etc). - Increase the physical activities by doing sport, walking, and so on, regarding subcutaneous fat can be categorized to moderate

Name : I Gst Agung Dwi Mahasurya Sex : Laki-Laki Age : 21 years old Status: Student Anthropometry Body height : 172 cm Berat weight : 65 kilogram BMI : 21,97 Waist Circumference : 74 cm Hip Circumference : 93 cm Midupper arm circumference : 26 cm Subcutaneous fat : - biceps :3 - triceps :5 - Subscapula : 8 - suprailliaca : 8

- Calculate Basal Metabolic Rate (BMR) using Harris-Benedict equation. For men BMR = 66,5 + (13,7 x body weight) + (5,03 x body height) - (6,75 x A) = 66,5 + (13,7 x 65) + (5,03 x 172) - (6,75 x 21) = 66,5 + 890,5 + 865,16 - 141,75 BMR = 1.680,41 kcal

- Calculate Physical Activity(PA), based on the categories. In this case, categorized into light activity. PA = 30 % x BMR = 30 % x 1.680,41 = 504,123 kcal

- Calculate Thermal Effect of Food (TEF), which is 10% from the BMR. TEF = 10% x BMR = 10% x 1.680,41 kcal TEF = 168,041 kcal

- Calculate Total Energy Requirement (TER) : TER = BMR + PA + TEF = 1.680,41 kcal + 504,123 kcal + 168,041 kcal TER = 2352,574 kcal

Nutrient

Analysed

Recommended

Percentage

Content
Energy Protein Fat carbohydr. dietary fiber Alcohol

Value
2929.6 kcal 169.3 g(24%) 150.6 g(46%) 218.0 g(30%) 9.4 g 0.0 g

Value/Day
2036.3 kcal 60.1 g(12 %) 69.1 g(< 30 %) 290.7 g(> 55 %) 30.0 g -

Fulfillment
144 % 281 % 218 % 75 % 31 % -

PUFA
Cholesterol Vit. A Carotene

25.9 g
801.6 mg 673.5 g 0.0 mg

10.0 g
800.0 g -

259 %
84 % -

Vit. B1 Vit. B2 Vit. B6 tot. fol.acid

1.1 mg 1.8 mg 1.8 mg 214.1 g

1.0 mg 1.2 mg 1.2 mg 400.0 g

106 % 151 % 154 % 54 %

Vit. C
Sodium Potassium Calcium Magnesium Phosphorus Iron

28.6 mg
482.5 mg 2030.1 mg 311.8 mg 328.0 mg 1678.0 mg 13.9 mg

100.0 mg
2000.0 mg 3500.0 mg 1000.0 mg 310.0 mg 700.0 mg 15.0 mg

29 %
24 % 58 % 31 % 106 % 240 % 93 %

Zinc

13.2 mg

7.0 mg

189 %

Analyzing Risk of Malnutrition: Personal Report 2-I GA D Mahasurya Subjective Global Assessment (SGA) a. Past history of weight within last 6 months (0) maintain; (1) reduce <10%; (2) reduce 10% b. Past history of food intake within last 5 days (0) maintain; (1) reduce <50%; (2) reduce 50% c. Disturbance on GI tract (0) normal; (1) sick, anorexic; (2) vomit, diarrhea d. Functional capacity (0) normal; (1) reduce/suboptimal; (2) bed ridden 2wks e. Metabolic stress (0) light; (1) moderate; (2) heavy f. Muscle wasting/subcutan fat (0) Nut st. Normal; (1) light; (2) moderate; (3) heavy SGA (0) Good nutrition status;(1-2) light malnutrition;(> 3) heavy malnutrition

Nutrition Status based on BMI Body mass index (BMI) is equal to weight per height square (kg/m2). The BMI of I Gst Agung Dwimahasurya is 21,97 which is categorized into normal.
Energy Adequacy Based on Nutrisurvey2007 calculation, the usual energy intake from food already fulfill the total energy requirement, even much more than needed around 44%. It may conclude that the intake from food is over for balancing energy requirement.

- Notice the protein and fat consumption to keep the protein and fat in balance with the value needed by the body. - Try keeping the energy intake in balance with the total energy requirement per day. Increase the physical activities. - Consume foods which contain more micronutrients. - Pay attention on the balance of food intake to avoid overconsumption or deficiency, by consuming more variety of foods.

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