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1. lron Deficiency
2. Vitamin A Deficiency
3. lodine lleficiency
4. Malnutrition
Malnutrition: Obesity:
lncreased of body weight caused by an
l. Undernutrition
excess accumulation of body fat
2. Overnutrition ----+ Obesity
Over weight
lncrcased of body weight caused by an increase
of lean body mass without excess accumulation
lndonesia
of fat
Double Burden
Pre adipocarte diffrentiation
Etiology of Obesity
16 Weeks: Multi Factorial and complex
Diffrenthtion of embryonic cell which
contain lipoprotein lipase
30 weeks
Fat depooitlon doesn't commence
3th trimester
Rapid accumulation of fat
Total body fat in full term infant 400 gr (16% BW)
- 80% synthezise
- 20% FFA transPlacentallY
- hypertrophyl hYPerPlasia
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Enviroment J***ou
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Positif energy balanced
storcd as adipose tissue obes.tyand rerevision
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Ghildren ;
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Excessive energy intake
lnadequate exercise (scdentary life style)
low metabolic rab to body composition and mass
increased insulin sensitivity
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Timing of Solid Food lntroduction and
Risk of Obesity The Role of maternal Obesaty in Early Pregnancy
in Preschool-Aged Ghildren
prevalence of childhood obesity:
847 infants
t. 67% br€astfed, 33% formula-fed. 2 yeas 9,5o/o
2. 3 years, 75 childrcn (9%) were obese' 3 years 14,8o/o
3.1. BF , OR 1,t (95% Cl 0,3 -4,4)
3.2. Formula lnfant 4 years 14,8o/o
lntroduction of solid foods < 4 months + 30,3% if the children had
6 times than BF, OR 6.3 (95% Cl 2.3- 6.91 obese mother.
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Genetic
- oen mutatlon: leotin2
' propiomrilanocortin (POilC),
brohormone convertase (PCSKt)
ieseptor melanocortin 4 lMC4Rl
+ (130 obese 42 mutasi,2003)
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Rapidly lncrease
Obesity and syndrorne
Jakarta 1:
Syndrome Signs 6 - 18 years: 6,7%
Boy:3,1%
P€der-Willi short sbhrre, $afl hands and f€et, almond€haped Girl i 10,2 %
ete, mund fa@. hypogonadim, d4 delay
Girls Obese
3 to 5 years 2Ao/"1o39.9o/"
fuskesdas 2010r 6 to 'll year€ to 59.906
il0olo
12 to 20 years 600/o
No diftence :
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ilenstrual lrregularity
Depression and social stigmatization.
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the risk of metab syndr 1
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{. ldentification:
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iHow to assess obesity to measure body fatt : I
What we have to do I
example
o BMI=Wt(kg)IHta(m2)
For example,
a BMI-for-age pere,entile of >95% means that the
child's weight is greater than that of >95o/o of other
children of the same age and sex.
+ FromlfteCDC:
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2. Assessment:
sH Medical Risk : Child gro',vth, Family history
Behavior Risk: sedentary, physical activity
Attitudes : concern to motivation
Energy proportion
lnfanb S 2 year€ child >2 vears
Carbohydrate S5-S5% 55_60"/
Protein i1-2go/o IO-ZA;j
Fat 35- 50% <3v/o
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Calorie = ideal body weight (Kg) X RDA
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1. Obeelty b chronic dis...+ Metabolic syndrome
3. Management:
3.1. Diet modification
THAl,lK YOU
3,2. lncrease of physical activity
3.3. Behavioral changes
3.4. Medications
3.5. $urgery
'1.
lnvolvlng all family naembers
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