Name

: Marelno Zakanito

Student ID

: 030.07.153

1. Nutrition is important for all stages of life cycle. Why nutrition of elderly becomes

important for Indonesia?

Because population growth is occuring especially in developing country, like Indonesia.
Aged above 60 is expected to increase from 8% to 20% in 2050 and Indonesia is the 4th
populatous country with nearly 247 million of population, nutrition itself is important for
increasing number of elderly in Indonesia because : Both innate and acquired immunity
weaken in elderly even those who are healthy, adequate nutritional status is essential for
efficient immune function,common micronutrient deficiency in elderly: Vitamin B (B12, B2),
iron, folate, vitamin A, vitamin D, zinc, vulnerability to malnutrition : poor diet, food
insecurity, lack of public health measures, low allocation of governments fund, differ by
region to region and even in the same country: more evidences needed, huge impact on health
care system and countrys economy, and Urgent need : Nutritional status assessment of
elderly and cost effective interventions
2. What is stunting?Briefly explain the consequences of stunting.
The definition of stunting according to the World Health Organisation (WHO) is for the
"height for age" value to be less than two standard deviations of the WHO Child Growth
Standards median.
Stunted growth in children has the following public health impacts apart from the obvious
impact of shorter stature of the person affected:

Greater risk for illness and premature death.

May result in delayed mental development and therefore poorer school

performance and later on reduced productivity in the work force.

Reduced cognitive capacity.

Women of shorter stature have a greater risk for complications during child birth
due to their smaller pelvis, and are at risk of delivering a baby with low birth
weight.

Stunted growth can even be passed on to the next generation (this is called the
"intergenerational cycle of malnutrition").

3. What is the best time to introduce the complementary feeding to the infant ? Please
explain briefly about nutrient gap and energy gap.
The best time to introduce the complementary feeding to the infant is six month old. The
transition from exclusive breastfeeding to family foods, referred to as complementary
feeding, typically covers the period from 6 to 18-24 months of age, and is a very
vulnerable period. WHO recommends that infants start receiving complementary foods at
6 months of age in addition to breast milk, initially 2-3 times a day between 6-8 months,
increasing to 3-4 times daily between 9-11 months and 12-24 months with additional
nutritious snacks offered 1-2 times per day, as desired.
Exclusive breastfeeding is no longer sufficient to meet all energy and nutrient needs by
itself. Breast milk covers all energy needs up to 6 months, but after 6 months there is
energy gap that needs to be covered by complementary food. The energy needed in
addition to breast milk is about 200 kcal per day in infants 6-8 months, 300 kcal per day
in infants 9-11 months, and 550 kcal per day in children 12-23 months of age. The
amount of food required to cover the gap increases as the child gets older, and as the
intake of breast milk decreases. Complementary food should provide sufficient energy,
protein, and micronutrients to cover energy and nutrient gap.
4. What biochemical indicators will you measure to know the vitamin A status of under
5 years old children in a village?
a. Retinol serum
b. Serum Retinol Binding Protein (RBP)
c. Serum retinyl ester
d. Isotop dilution
e. Relative dose response (RDR)
f. MRDR (Modified Relative Dose Response)

5. Why do pregnant women need iron supplements in developing countries?

Because at pregnancy iron needs was multiple for 3 times from normal condition but,
the intake of iron in pregnant women in developing countries doesnt catch up with
the needs, they didn't raise the uptake in other case pregnant women seems difficult to
raise the intake of iron because their appetie didnt higher enough or felling nausea so
they didnt eat well. Economical problem was one of non-medical reason why they
didnt meet the iron requierement.