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NUTRISI DAN GIZI BURUK

Diah Krisnansari
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Fakultas Kedokteran dan Ilmu-ilmu Kesehatan Universitas Jenderal Soedirman PurwokertoE-
mail: sari_fkunsoed@yahoo.com
ABSTRACT
Malnutrition, withs 2 constituents of protein–energy malnutrition and micronutrient
deficiencies, continuesto be a major health burden in developing countries. It is globally the
most important risk factor for illness anddeath, with hundreds of millions of pregnant
women and young children particularly affected. In Indonesia,
Protein Energy Malnutrition (PEM) and micronutrient deficiencies are still one of the most i
mportant and urgent health problems in the community, in which the underfive children are
among the most vulnerable. Apart from marasmusand kwashiorkor (the 2 forms of protein–
energy malnutrition), deficiencies in iron, iodine, vitamin A and zinc arethe main
manifestations of malnutrition in developing countries. In these communities, a high
prevalence of poordiet and infectious disease regularly unites into a vicious circle. The high
prevalence of bacterial and parasiticdiseases in developing countries contributes greatly to
Protein Energy Malnutrition (PEM) and micronutrientdeficiencies there. Similarly, Protein
Energy Malnutrition (PEM) and micronutrient deficiencies increases one’s susceptibility
to and severity of infections, and is thus a major component of illness and death from disease.
Protein Energy Malnutrition (PEM) and micronutrient deficiencies is consequently the most i
mportant risk factor for theburden of disease in developing countries. Although
nutrition treatment protocols for severe malnutrition have inrecent years become more
efficient, most patients (especially in rural areas) have little or no access to formal
health services and are never seen in such settings. Interventions to prevent protein– energy
malnutrition range from promoting breast-
feeding to food supplementation schemes, whereas micronutrient deficiencies would best bea
ddressed through food-based strategies such as dietary diversification through home gardens
and small livestock.
Keywords
: nutrition, protein energy malnutrition), micronutrient deficiencies
PENDAHULUAN
Malnutrisi yaitu gizi buruk atau KurangEnergi Protein (KEP) dan
defisiensimikronutrien merupakan masalah yangmembutuhkan perhatian khusus terutama
dinegara-negara berkembang, yang merupakanfaktor risiko penting terjadinya kesakitan
dankematian pada ibu hamil dan balita
1
.
DiIndonesia KEP dan defisiensi mikronutrien juga menjadi masalah kesehatan penting danda
rurat di masyarakat terutama anak balita
2
.Kasus kematian balita akibat gizi buruk
kembali berulang, terjadi secara masif dengan wilayahsebaran yang hampir merata di seluruh
tanah air.Sejauh pemantauan yang telah dilakukan temuankasus tersebut terjadi setelah anak-
anakmengalami fase kritis. Sementara itu, perawatanintensif baru dilakukan setelah anak-
anak itu benar-benar tidak berdaya. Berarti sebelumanak-anak itu memasuki fase kritis,
perhatianterhadap hak hidup dan kepentingan terbaiknyaterabaikan
3
.Kejadian gizi buruk perlu dideteksisecara dini melalui intensifikasi
pemantauan pertumbuhan dan identifikasi faktor risiko yangerat dengan kejadian luar biasa
gizi seperticampak dan diare melalui kegiatan surveilans.Prevalensi balita yang mengalami
gizi buruk di
Artikel ini akan menjelaskan tentang arti dari kata “nutrisi” dan
menjelaskan fungsi nutrisi itu sendiri. Artikel ditulis dengan bahasa singkat
namun cukup menjelaskan dan mudah dipahami.
Beberapa ahli memberikan penjelasan mengenai pengertian nutrisi adalah
ikatan kimia yang diperlukan oleh tubuh untuk melakukan fungsinya yang
berupa energi. Selain itu energi juga dapat membangun dan memelihara
jaringan dalam tubuh serta mengatur proses kehidupan. Nutrisi digunakan
untuk makanan sebagai pembentuk energi, dimana setiap jaringan dalam
tubuh bekerja dengan baik. Nutrisi juga dapat dikatakan sebagai suatu proses
organism yang menggunakan objek utamanya yaitu makanan yang sering
dikonsumsi dalam kondisi yang normal, dengan menggunakan proses
degesti, absorsi serta metabolisme yang pada nantinya akan membuang
beberapa zat yang memang tidak digunakan oleh tubuh.

Fungsi Nutrisi Bagi Tubuh


Berdasarkan pengertian Nutrisi itu sendiri , zat ini memang menjadi asupan
utama bagi tubuh seseorang dalam melakukan berbagai kegiatan sebagai
pembentuk energi penting. Fungsi nutrisi itu sendiri juga beragam seperti
sebagai proses pengambilan zat-zat makanan yang penting, sebagai subtansi
organik yang dibutuhkan organisme untuk bergerak normal. Namun nutrisi
sangat berbeda dari makanan yang kita makan tiap harinya, nutiri adalah apa
yang terkandung dalam makanan tersebut. Nutrisi juga berperan aktif sebagai
asupan makanan yang sehat bagi tubuh, tubuh setidaknya mengkonsumsi
beberapa jenis makanan setiap harinya. Tidak lantas kita menyepelekan
nutrisi, sebab tidak semua makanan memiliki nutrisi.
I weigh about 80 kilograms.
Most of that, let’s say 64 percent, is water -- though you can’t tell by looking.
I mean, as organisms go, I like to think that I look fairly solid.
After water, the next largest proportion of me is protein, about 16% -- not just in my
muscles, but also in things like the tiny sodium-potassium pumps in my neurons, and
the hemoglobin in my blood, and the enzymes driving the chemical reactions in every one
of my 37 trillion cells.
Then another 16% of me is fat, which I’m totally OK with;
Four percent of me is minerals, like the calcium and phosphorus in my bones, and the iron in
my blood;
and 1 percent is carbohydrates, most of which is either being consumed as I talk to you,
or is sitting around as glycogen waiting to be used.
But here’s the thing: It’s not like I just ate 80 kilograms of food and then all this happened.
Instead, my body, like yours, is constantly acquiring stuff, extracting some of it to
keep, burning some of it for energy, and getting rid of the rest.
But even the stuff that my body does hold onto doesn’t last forever. Some of the chemicals
that I absorb in my food eventually become a part of me. But enzymes wear out, and
membranes
break down, and DNA gets oxidized. So, they get discarded.
And then I need more of those chemicals to reconstruct the material that I’ve lost.
As a result, over the course of my lifetime, my cells will synthesize somewhere between
225 and 450 kilograms of protein …
That’s like 3, or 4, or 5 separate me’s -- just made of protein.
And all of the protein and fat and carbohydrates nucleic acids that
make up me, of course, come from food.
Every organism has to keep taking in and breaking down food, to keep resupplying itself with
the raw materials it needs to survive.
And all that activity requires energy, which we also gain from food.
So, how do our bodies actually convert what we eat into energy and raw materials?
The answer is a neverending series of reactions that are dedicated to doing two vital, and
totally contradictory, things:
One set of chemical reactions destroys the reactants that you give them, reducing big,
complex substances into molecular rubble.
And the other set reassembles that rubble into new and bigger products that are put
together again to make you.
So our bodies are constantly reinventing themselves -- in a perpetual state of loss, but also
always rebuilding.
And even though all of this is happening at the cellular level, its consequences could hardly
be larger.
These two sets of reactions are where everything that we’ve learned so far -- about the
digestive,
endocrine, circulatory, and respiratory systems -- really starts to come together.
Together, these processes make up your metabolism.
Now the sciencey word metabolism has come to have a meaning in popular speech,
but metabolism isn’t just one thing.
People talk about metabolism as meaning, like, how fast your body burns the fuel in your
food, or how high your personal energy level is.
And that’s fine for use by personal trainers and fitness magazines.
But physiologically, metabolism really describes every single biochemical reaction that goes
on in your body.
And maybe more importantly, it reconciles two conflicting chemical processes that are
always, simultaneously underway inside of you.
One of those chemical forces is anabolism.
Anabolic reactions construct things and consume energy.
These are the processes that take the small monomer building blocks in your food -- like
monosaccharides and fatty and amino acids -- and build them into bigger, more complex
polymers like carbs, and fats, and proteins that are used in your cells.
Then, when you need new building blocks, or you need to release some energy, those
polymers
in your body, or new ones in your food, get broken up -- by catabolic reactions.
The processes of catabolism break down bigger molecules, and in breaking their bonds,
release
the energy you need to stay warm, and move around, and provide your cells with fuel … to
build the polymers back up again.
To be honest, your metabolism is a lot like Sisyphus. It works really hard. But it is never
finished.
And the boulder that your inner Sisyphus is always pushing uphill and watching fall back
down? That’s nutrients -- the molecules that your body is forever breaking up, and
then rebuilding, only to have them break apart again.
And these nutrients -- the materials your body needs to build, maintain and repair itself
-- come in six major groups.
By volume, the majority of what we consume -- and what makes up our bodies -- is water,
so that’s maybe the most vital nutrient.
Then there are vitamins, compounds that come in either fat-soluble or water soluble forms.
They aren’t used as building blocks or for energy, but they’re essential in helping
the body make use of other nutrients that do do those things.
Vitamin C, for example, helps improve iron absorption, while vitamin K is crucial to
blood clotting, and some B vitamins are important in the production of ATP from glucose.
Minerals, like vitamins, they don’t provide fuel, but they have all sorts of other functions.
Calcium, magnesium, and phosphorus harden bones and teeth, while iron is, of course,
crucial in hemoglobin. Plus, potassium, sodium, and chlorine help maintain your body’s pH
balance and are used in action potentials.
So water, vitamins, and minerals are all … necessary.
But the three major nutrients that everyone always talks about -- the ones you find on
food labels, from oatmeal to Pop-Tarts -- are carbohydrates, lipids, and proteins.
Most of the carbohydrates you’ve ever eaten
-- with the exception of lactose in milk -- originally came from plants.
Mono- and disaccharides come from fruits, honey, sugar beets and sugar cane, while
polysaccharide
starches come from veggies and grains.
The main thing you need to know is that the monosaccharide glucose is the be-all-end-all
molecular fuel that your cells need to make ATP.
ATP being the molecule that your cells use to drive anabolic reactions, when they need
to make new polymers or get anything else done -- whether that’s operating a sodium-
potassium
pump, or detaching the head of a myosin filament to contract a muscle.
But ATP is too unstable to store, so cells often store energy in the form of glucose,
which they can then catabolize and convert to ATP when they need it.
Now, some of your cells can get their energy from fats. But many of the most important
ones, like your neurons and red blood cells, feed exclusively on glucose. So most of the
carbs that your intestines absorb are converted to glucose for that reason.
But, if it’s not needed right away, that energy can also get stored as glycogen in
your liver and muscles, or converted to glycerol and fatty acids to make triglyceride fats.
And even though there seems to be a marketing war going on against dietary fats,
we most definitely need them.
The fats in your adipose tissue store energy, of course, but they also store fat-soluble
vitamins, and cushion your organs.
Lipids also form the myelin that insulates the neurons in your brain and throughout your
body, as well as the oil in your skin, and they provide the vital calorie content found in breast
milk.
But there are other important lipids, like cholesterol, which is the precursor to things
like testosterone and estrogen...
...and, of course, phospholipids, which form the cell membrane in every single one of the
three-dozen-or-so-trillion cells you have.
Now, if you’re into eating meat, a lot of the fat that you ingest might come from that.
But guess what: Plants have fat too.
Plants use lipids for energy storage just like we do, except they do it in fruits, and
nuts, and seeds. Which, when you think of it, are kind of like plant breast milk -- it’s
food for their growing babies.
Either way, though, when you eat lipids, your body breaks down triglycerides into glycerol
and fatty acids.
Those molecules can then be processed and used in the making of ATP. Or they might be
converted into other kinds of fatty acids, which your cells can then re-assemble into
your very own triglycerides or phospholipids.
And your liver happens to be great at converting one fatty acid into another, but there are
some it just can’t synthesize.
For example, omega 6 and 3 fatty acids are called essential fatty acids, because your
body can’t make them, so they have to be ingested.
They get turned into all kinds of useful molecules, like the ones used for synapse formation in
the brain, and for signalling inflammation during the healing process.
But -- if carbohydrates provide energy, and fats insulate and store energy, then just
about everything else is done with proteins.
They form the bulk of your muscle and connective tissue, but they’re also what the ion
channels
and pumps are made of in your neurons and muscle cells, and they make up your enzymes,
which are responsible for pretty much every chemical reaction in your body.
In other words, your body runs on protein, and pretty much is protein.
Nutritionally speaking, meats, dairy products, eggs, legumes, nuts, cereals are particularly
high in protein. But because everything we eat was once alive, and every cell of every
living thing contains protein, as long as you’re eating whole foods, you’re at least
partially re-stocking your protein supplies.
Now it might seem like you’d have eat muscle to make muscle, or eat enzymes to make
enzymes,
but that’s not how it works.
Since all of your proteins are made up of just 20 amino acids, the differences between
the thousands of unique proteins are simply in the sequence of those amino acids.
And, of course, you have a specialized molecule that knows just which amino acids to put
together
in what order to make a certain protein.
It’s called DNA.
When you consume some hamburger, for example, the protein actin in the meat gets
catabolized
into its component amino acids, which gets mixed up with all the amino acids from the
other proteins in the meat -- like the collagen and elastin and titin and myosin -- as well
as all the protein from the bun and the tomato and the mayonnaise.
Those amino acids then get reassembled using anabolic reactions into your very own, but
somewhat different, proteins, as defined by your DNA.
Each cell is like a picky little Gordon Ramsay and it has to have every amino acid needed
-- every ingredient present -- before it will even think about starting to make a protein.
And just like with your lipids, your cells can improvise, and convert some amino acids
to others if they’re missing an ingredient.
However, there are nine essential amino acids that you cannot make from others, and have to
eat.
Now lots of foods don’t provide every essential amino acid, but when you combine foods,
like
beans and rice, or pasta and cheese, you do get all of the essential amino acids. Which
is important because, remember: after water, you are mostly made of protein. On the order of
16%
But what about the one percent of you? The carbohydrates?
How that tiniest fraction of you ends up creating all of the energy, is what we’ll discover next
time.
But for now, you’ve learned all about the vital nutrients -- including water, vitamins,
minerals, carbs, fats, and proteins -- as well as how anabolic reactions build structures
and require energy, while catabolic reactions tear things apart and release energy. And
together, these competing forces form the wonderfully conflicted process known as
metabolism.
Thank you to our Headmaster of Learning, Linnea Boyev, and thanks to all of our Patreon
patrons
whose monthly contributions help make Crash Course possible, not only for themselves,
but for everyone, everywhere. If you like Crash Course and want to help us keep making
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This episode was filmed in the Doctor Cheryl C. Kinney Crash Course Studio, it was written
by Kathleen Yale, edited by Blake de Pastino, and our consultant is Dr. Brandon Jackson.
It was directed by Nicholas Jenkins, edited by Nicole Sweeney; our sound designer is
Michael
Aranda, and the Graphics team is Thought Cafe.