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8/10/2019 k.32 Dietary Supplement
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DIETARYSUPPLEMENT
Nutrition Dept
Faculty of Medicine,
University of Sumatera Utara
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definisi
Adalah makanan buatan yang ditujukan untuk
mencukupi kekurangan zat-zat gizi.
Bentuk : - kapsul
- kapsul lunak
- tablet
- bubuk
- cairan
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Kandungan
Makronutrien
Mikronutrienvitamin, mineral
Dapat tunggal atau kombinasi
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Zat gizi penting di dalam makanan
(dibutuhkan untuk kesehatan)
MakronutrienProtein
Karbohidrat
Lemak
Vitamin8 vitamin B (tiamin,
niacin, riboflavin, asam folat,Vitamin B 12, Vitamin B6,
Asam pantotenat, biotin)
Vitamin C
Vitamin A, D, E, K
air
MineralCa, Fe, Mg, Mn, Se,
Na, K, V, Bo, I, S, Cl,P, Cr, Cu, F, Mo, Zn
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Do YOUNeed a Dietary
Supplement?
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Perlu atau tidak ?
Kapan dibutuhkan ?
Seberapa banyak dibutuhkan ?
Siapa yang membutuhkan ?
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Invalid reasons
The belief that the food supply or soil contains
inadequate nutrients
The belief that supplements can provide energy The belief that supplements can enhance athletic
performance or build lean body tissue without physical
work or faster than work alone
The belief that supplements will help a person copewith stress
The belief that supplements can prevent, treat, or cure
conditions ranging from common cold to cancer
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Who needs supplements?
People with nutrient deficiencies
People with low food energy intake (
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People in certain stages of the life cycle whohave increase nutrient needs
People with limited milk intake and sun
exposure need vitamin D People who have disease, infection, or injuries
or who have undergone surgery that interfereswith intake, absorption, metabolism &
excretion of nutrients People taking medications that interfere with
the bodys use of specific nutrients
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Kondisi yang dapat menyebabkan
kekurangan zat gizi
Growth in
children
Old age alcoholism or
Drug addiction
reducing
diets
Increased
requirement
Low food
intake
Restricted
Food choice
Therapeutic
diets
VegetarianismIllnessPregnancy &
lactation
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Tidak dibutuhkan pada :
Orang dengan sumber zat makanan yg
mencukupi
Olah raga
Cukup istirahat dan tidur
Kehidupan teratur
Tdk stress
Bebas dr bhn pencemar (udara, mkn, air).
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Recommendations for
Nutrient Intake
Dietary Reference Intakes (DRIs)
Reference values of nutrients, primarily usedby nutrition & health professionals
Basis for assessing & planning diets of healthy people
federal nutrition & food programs
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What are the purposes of the DRIs?
To maintain nutritional adequacy
To promote health
To reduce risk of chronic disease To provide a measure for evaluating inadequacy
and/or excess
To assess intakes as distributions
Across population groups In individuals
To plan diets
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What are the different
DRI values?
Estimated Average Requirement : EAR
Recommended Dietary Allowance : RDA
Adequate Intake : AI
Tolerable Upper Intake Level : UL
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Estimated Average Requirement
Nutrient intake to meet the
requirement of halfthe
healthy people of an age &
gender
The MEDIAN
Basis for establishing an RDA
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Recommended Dietary Allowance
Nutrient intake to
meet the requirement
for nearly all(97-98%)healthy people of an
age & gender
Derived from an EAR
EAR + 2 standard
deviations
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5
5
2
25
3
35
4
45
5
5 5 2 25
N
umberofPeop
le
5
5
2
25
3
35
4
45
5
5 5 2 25
N
umberofPeop
le
EAR RDA
Actual Nutrient RequirementActual Nutrient Requirement
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Adequate Intake
Nutrient intake of healthy people assumedtobe adequate
Used when an RDA cannot be established Insufficient data to determine an EAR
Based on observed intakes, experimentaldata, etc.
When AIs are used, this reflects lack ofknowledge and need for more research
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Tolerable Upper Intake Level
Highest daily nutrient intake likely to poseno risk of adverse health effectsto almostall the general population
More is not always better!
Not a recommended level No established benefits of higher level
Increased risks at higher intakes
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safety
danger
Danger of
toxicity
Safety
Danger ofdeficiency
Tolerable Upper
Intake level
(UL)
The naive view vs the accurate view
of optimal nutrient intake
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Kebutuhan zat gizi
Sangat individual
Dipengaruhi tingkat kesehatan
Berdasarkan AKG untuk rata-rata orangIndonesia yang sehat
Dibedakan berdasarkan kelompok umur
dan jenis kelamin
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Vitamin A
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RETINOL :HATI, GINJAL, MENTEGA, KUNING TELUR,
SUSU, MINYAK IKAN
BETA KAROTEN :SAYURAN DAUN HIJAU TUA,
SAYURAN & BUAH BERWARNA KUNING, MINYAK
KELAPA SAWIT.
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Kandungan vit A dalam bahan makanan
Apel 1 buah 70 IU
Pisang 1 buah 90
Peach 1 buah 470Selada 100 g 446
Tomat 1 buah 1390
Brokoli cup 1090Bayam cup 7370
Wortel cup 19.150
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Vitamin E
Bahan makanan sumber :
Minyak nabati (kedele, jagung) dan
produknya (margarin)
Whole grain products, wheat germ.
Sayuran berdaun hijau tua.
hati, telur, kacang.
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Kandungan vit E/100 g bahan makanan
Kerang 37,5
Kentang goreng 1,5
Kacang 8,1
Minyak 14,7
Kol 2,4
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Vitamin C
Bahan makanan sumber :
Jeruk, anggur, lemon, jeruk nipis.
Strawbery dan berry lain, melon
Kol, brokoli, sayuran berdaun hijau,
Kentang, tomat
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Kandungan vit C (mg/100g) bahan makanan
Brokoli 39,6
Kembang kol 62,7Bayam 52,4
Wortel 30,3
Pisang 18,6Jeruk 64,3
Anggur 23,6
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KEBUTUHAN VITAMIN PERHARI
( RDA = RECOMMENDED DAILY ALLOWANCES )
VITAMIN PRIA WANITA
A 1000 IU 800 IU
D 5 ug 5 ug
E 3 mg 4 mg
K 80 ug 65 ug
B1 1,5 mg 1,1 mg
B2 1,7 mg 1,3 mg
B3 19 mg 15 mg
B5 4 7 mg 4 7 mg
B6 2,0 mg 1,6 mg
B12 2,0 mg 2,0 mg
C 60 mg 60 mg
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Konsumsi megadosis dapat membahayakan
Nutrient yang diperlukan sebaiknya didapat dari
bahan makanan.
Suplemen hanya digunakan jika memang
dibutuhkan
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Lemak
20%
Protein
15%
KH
65%
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Tujuan Nutritional support
Memastikan intake energi adekwat
mencegah kehilangan BB
Mencegah negative nitrogen balance penurunan imune respons & fungsi liver dapat
dicegah.
Agar level mikronutrient & trace element cukup
tidak terjadi defisiensi
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Medical foods
Formula lengkap
Formula tidak lengkap, mis produk modular
lemak, protein atau karbohidrat
Formula makanan khusus
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Getting The Variety of nutrients
Diet yang seimbang berdasarkan the Food GuidePyramid
Makanan yang bervariasi dapat menjamin
kecukupan zat gizi. Tidak ada satu bahan makanan yang
mengandung semua zat gizi dalam jumlah yangcukup.
Diperlukan bahan yang bervariasi untukmendapat makanan yang sehat
M i t i h lthFats, Oils Limit salt to < 6 grams
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Figure 18-7
Page 641
Food Guide Pyramid for Disease Prevention
Maintain a healthy
weight. be physically
active. Dont smoke.
Fats, Oils
& Sweets Limit salt to < 6 grams.
Reduce energy-rich foods high in sat. fat & sugar.
Use unsaturated fats instead of sat. or trans fats.
Drink alcohol in moderation, if at all.
Eat < 4 eggs per week. Eat red meat sparingly.
Eat fish frequently.
Eat nuts and legumes often.
Eat fruit in abundance.
Eat whole-grain breads,
cereals, rice, and pastas
instead of refined products.
Eat low-fat or fat-
free milk products.
Eat vegetables
in abundance.
Milk, Yogurt &
Cheese Group
Vegetable Group
Meat, Poultry,
Fish, Dry Beans,
Eggs & Nuts Group
Fruit Group
Bread, Cereal, Rice & Pasta Group
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Sayuran dan buah-buahan 5 porsi / hari
Hooper L Dietetic Guidelines :
diet in secondary prevention
of cardiovascular disease
(J Human Nutr Dietet 2001)
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Choose Food Instead ofSupplements
Food
Fun
Offers variety
Doesnt have to be expensive
Contains other healthful
substances
Safe
Supplements
Boring
Lacks variety
Can cost a lot of money
Doesnt contain other health
benefits
Can be dangerous to yourhealth
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If a little is good,
more is not necessarilybetter
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zzt 1208