Community Nutrition: Basics &

Principles
Dr Nugroho Abikusno
Medical Nutrition Dept
Trisakti University
MDGs
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria & other diseases
7. Ensure environmental sustainability
8. Develop global partnership for development

Public Health problems
Malnutrition consisting of
Under nutrition
Nutritional anemia
Vitamin A Deficiency
Over nutrition - Obesity
Vulnerability in life course
Fetal period
Infancy & Early Childhood
School age
Adolescence
Young Adulthood including pregnancy and
lactation
Middle age
Old age
Nutrition Assessment
Clinical examination
Anthropometry
Dietary assessment
Biochemical examination
Functional examination

Clinical examination
Anamnesis on general health condition
whether any possible complaints related to
malnutrition
Clinical examination from head to toes. Focus
on complaints that may be related to
malnutrition
Physical signs of malnutrition
Under nutrition
Macro-nutrient deficiency
Marasmus (energy deficiency)
Kwashiorkor (protein deficiency)
Mixed

Physical signs
Marasmus
Old man face
Apathy
Dry, thin skin
Frail & thin
Kwashiorkor
Corn-strand hair
Crying
Boils
Pot belly
Oedema



Malnutrition (2)
Micro-nutrient deficiency
Nutritional anemia
Iron deficiency
Vitamin B12 deficiency
Zinc deficiency
Physical signs of malnutrition
Over nutrition/ obesity
Anthropometry
Measurements:
Body Weight
Body Height
Arm circumference
Skinfold thickness
Knee height (proxy Body Height)

Anthropometry (2)
Each measurement or index are valid &
reliable indicators to measure nutrition status
in each nutritionally vulnerable period in an
individuals life course
Anthropometry (3)
Life course Anthropometry
Fetal period Fundal height
Weight gain
Infancy & Early Child W/A; AC/A
School age H/A; W/H
Adolescence BMI by Age; BD
Early Adult BMI
Middle age BMI
Old age BMI by KH (proxy)
BMI
Body Mass Index = BW in kg/BH in m2
Criteria:
< 18.5 : under nutrition/under nourished
18.5-23.9: normal
24-29.9: over nutrition/over nourished
30 and above: obese/obesity
35 and above: morbid obesity
Waist circumference
As risk of cardio-vascular disease:
Women: 70 cm
Men: 80 cm
Dietary assessment
Food diary
Food Frequency Questionnaire
Weighted FFQ
Dietary Recall
Food leftover
Biochemical examination
Malnutrition:
Macro-nutrient
Micro-nutrient

Metabolic syndrome
Obesity
Hypertension
Diabetes
Dyslipidemia
NAFLD

Biochemical (2)
Nutrition Disorder Biochemical
Kwashiorkor UN Albumin
Obesity BS; BLP, SGPT
Nutritional anemia Iron; Folic acid; B12
Vitamin A
Deficiency
Vitamin A
Immunity Zinc
Functional examination
Nutrition
Disorder
Test
Under nutrition Grip test
Thorax photo
Obesity Waist circumference
Osteoporosis Bone density
Vitamin A deficiency Night blindness
Terima Kasih.