PREGNANCY

NUTRITIONAL ASPECT OF
PREGNANCY
Teaching Team of Nutrition Throughout Life Cycle
GIZ Department, Human Ecology Faculty
Bogor Agricultural University
2007
1
I. DEFINITION
Pregnancy :
It is the condition of having a developing
embryo or fetus in the body after union of
an ovum and spermatozoa. The period is
from conception to child-birth lasting 40
weeks or 280 days.
2
II. Weight Changes
1. The total number of weight gained in
pregnancy varies from one woman to another.
2. The normal weight gain for the average
Filipino woman is approximately 10-12 kg;
for the entire pregnancy.
a. Guide for Weight Gain
1st trimester – 1 lb. per month or 3 lbs. (1.1 kg)
2nd trimester – 2 lb per month or 6 lbs. (2.2 kg)
3rd trimester – 1 lb per week or 12 lbs. (5.0 kg)
3
Table Average weight gain during pregnancy in
industrialized countries
_____________________________________________________
Time of pregnancy (week)
Weight gain (kg)
------------------------------------------------------1 – 12
0
13 – 20
2.4
21 – 24
1.5
25 – 28
1.9
29 – 32
2.0
33 – 36
2.0
37 – 40
1.2
------------------------------------------------------------
Total
10 – 12
--------------------------------------------4
Weight gain :
week of pregnancy
kg/week
0-10 week
0,065 kg
10-20 week
0,335 kg
20-30 week
0,450 kg
30-40 week
0,335 kg
5
Recommended weight gain during pregnancy is
based on nutritional status before pregnant
Nutritional
status
Very low
IMT
Weight gain
(kg)
< 16,5
Low
16,5-19,7
13,0-18,0
Normal
19,8-26,0
11,5-16,0
Over weight
26,0-29,0
7,0-11,5
> 29,0
< 6,8
Obes
Twin
16,0-20,5
6
Component of maternal weight gain during pregnancy
Weight gain (g) at :
Maternal comp.:
Fat deposit
Interstitial fluid
Blood
Uterus
Breast
Total
Fetus component :
Fetus
Amniotic fluid
Placenta
Total
Total weight gain
10
week
20
week
30
week
40 week
310
0
100
140
45
595
2050
30
600
320
180
3150
3480
80
1300
600
360
5820
3345
1680
1250
970
405
7650
5
30
20
55
300
350
170
820
1500
750
430
2680
3400
800
650
4850
650
4000
8500
12500
7
Weight gain of the fetus :
15-16 week
: 10 g/week
17-27 week
: 85 g/week
28-36 week
: 200 g/week
37-38 week
: 70 g/week
8
Substances transferred to the fetus and placental
during pregnancy
Newborn (g)
Placental and
amniotic
fluid (g)
Total weight
3500
1450
Water
2530
1350
410
480
40
4
5.7
6.4
6.0
3.9
1.1
3.1
29.0
16.9
0.8
0.2
0.6
0.06
0.3
0.01
Protein
Fat
Sodium
Potassium
Chloride
Calcium
Phosphorus
Magnesium
Iron
9
III. NUTRITIONAL REQUIREMENT
DURING PREGNANCY
A.
ENERGY. -additional energy is required during
pregnancy for:
- the growth of the fetus; placenta and maternal
tissues and their maintenance; for the
increases in BMR; for better utilization of
dietary protein and good pregnancy outcome.
- The addition of 300 kcal/day during the second
and third trimesters of pregnancy is
recommended, while for the first trimesters is
180 kcal/day.
10
ENERGI (WKNPG, 2004):
Tambahan energi untuk ibu hamil :
- pertumbuhan bayi
- placenta dan rahim
- cadangan energi bagi ibu
- cadangan energi bagi ASI
- basal metabolisme
11
ESTIMASI AKE IBU HAMIL
Umur (th)
AKE (kkal/hari)
19-29
39-49
1900
1800
Wanita Hamil
Trimester 1
Trimester 2
Trimester 3
+ 180
+ 300
+ 300
12
ESTIMASI AKE IBU HAMIL
Tambahan AKE Wanita Hamil
Trimester 1
Trimester 2
Trimester 3
+ 180 kkal
+ 180 kkal cadangan dan 160 kkal
peningkatan pengeluaran energi
+ 180 kkal cadangan dan 270 kkal
peningkatan pengeluaran energi
13
ESTIMASI AKE IBU HAMIL
Tambahan AKE Wanita Hamil bukan angka
mutlak tetapi merupakan angka yang mendekati
Kecukupan untuk sebagian besar populasi
14
Components of protein & fat accumulated
during pregnancy (g)
Protein
Fetus
Placenta
Amniotic fluid
Uterus
Breasts
Blood
Maternal fat store
Total
440
100
3
166
81
135
0
925
Fat
440
0
4
4
12
20
3345
3825
15
Energy cost of pregnancy
 g protein x gross E (5.6 kcal/g)
= 925 x 5.6 =
5 200
 g fat x gross E (9.5 kcal/g)
= 3825 x 9.5 =
36 420
 O2 consumption
 Tissue synthesis &
26 200
maintenance that tissue
67 800
Efficiency 90%
74 580
=> 80 000
16
Energi
WHO Expert Group
Total
1950
-
1957
1973
1985
+40.000
+80.000
+80.000
1 st trimester
-
-
+ 150
+ 285
2 nd trimester
-
-
+ 350
+ 285
-
+ 350
+ 285
3 rd trimester
+ 450
17
B. Protein – increases by an average
of 17 g/day throughout pregnancy
- to meet the needs of the developing
maternal tissues;
- to support the growth of the fetus and
the placenta;
- for normal pregnancy and outcome;
- to protect against risk associated with
low protein intakes.
18
ESTIMASI ANGKA KECUKUPAN PROTEIN
IBU HAMIL:
Trimester 1, 2, 3
EAR = 0,9 g/ kg B/ hr
AKP = 1,1 g/ kg B/ hr
= + 17
19
Protein
WHO Expert Group
Total
1965
1973
1985
+925
+925
+925
1 st quarter
-
+1
+6
2 nd quarter
+6
+4
+6
3 rd quarter
+6
+8
+6
4 th quarter
+6
+9
+6
20
925 + 30% (2 SD birth weight) = 1 200 g
1200 x 100/70 = 1700 g protein
= 6 g protein /d
21
C. Vitamin A
• essential to the welfare of the
epithelial tissues including the skin
and the membranes that line
glandless ducts and passages of the
gastrointestinal, urinary and
respiratory tracts.
• The RDA of 475 RE/day for the
pregnant woman also accounts for
the Vitamin A storage in the fetal
tissues
22
- Vit. A dibutuhkan untuk integrasi sel
ephitelial
- Asam retinoat melalui
aktivasi reseptor asam
retinoat (RAR) dan reseptor retinoat X (RXR) dalam
nukleus mengatur ekspresi berbagai gen yang
mengkode untuk protein struktur, enzim, protein
matrik
- Asam retinoat juga berperan penting dalam
perkembangan embrio
- Asam retinoat juga penting dalam pembentukan
tungkai dan lengan, jantung, mata dan telinga.
- Retinoat penting untuk fungsi kekebalan
- Vitamin A penting untuk fertilitas
23
D. Vitamin C – an extra 10 mg/day is
recommended for the pregnant woman to
maintain the integrity or fetal membranes and
for tissues structure.
E. Thiamin, Riboflavin, and Niacin – are important
during pregnancy particularly with reference to
energy intake and carbohydrate, protein, and
lipid metabolism. Additional amounts of 0.3
mg, 0.6 mg and 3 NE/day for thiamin,
riboflavin, and niacin, respectively, are
recommended during the second and third
trimesters.(1mg Niacin =60mg tryptophan)
24
F.
FOLIC ACID :
the only nutrient for which the RDA during
pregnancy is more than twice the nonpregnancy levels.
The recommended intake for the pregnant
woman, which is a total of 600 µg daily or an
additional 200 µg/day is based on the folate
role in promoting normal fetal growth (DNA
synthesis) and in erythrocyte maturation.
25
G.
G.
Calcium
Kalsium
(Ca):
– an additional
of 150sebagai
mg or akomponen
total of
- allowance
Kalsium berperan
950 mg/day
tulang
dan gigi. is recommended to
promote
adequate
mineralization
- Kalsium
berfungsi
sebagai pengatur
metabolisme
darah, penghantar impuls saraf, produksi
of
the
fetal
skeleton
and
hormon produksi, aktivitas enzim, pengaturan
deciduous
teeth. pengaturan kontrkasi
permeable membran,
jantung, pemeliharaan keseimbangan elektrolit
26
an additional allowance of 150 mg Ca or a total
of 950 mg/day is recommended to promote
adequate mineralization of the fetal skeleton
and deciduous teeth.
27
•
ESTIMASI Angka Kecukupan Kalsium
IBU HAMIL
Umur
19-29
39-49
Wanita Hamil
Trimester 1
Trimester 2
Trimester 3
AK-Ca (mg/hari)
800
800
+ 150
+ 150
+ 150
28
H. Iron – the daily requirement of 41 mg is
higher than what can be provided by the
usual diet alone, thus, supplementation is
recommended. This amount is needed to
replace maternal iron losses, allowance for
the placenta. Infants are born with high
hemoglobin levels and with a supply of iron
stored in the liver.
I.
Iodine – an additional allowance of 25
µg/day is recommended so as not to
compromise the development of the fetus.
29
H. Iron (Fe):
the daily requirement of 41 mg is higher
than what can be provided by the usual
diet alone, thus, supplementation is
recommended. This amount is needed to
replace maternal iron losses, allowance
for the placenta. Infants are born with
high hemoglobin levels and with a supply
of iron stored in the liver.
.
30
ESTIMASI AK-Fe IBU HAMIL
-MASA KEHAMILAN (280 hari)
- Kehilangan basal
= 250
mg
- Janin dan plasenta
= 315 mg
- hemoglobin dan cadangan
= 500 mg
- Total
= 1100 mg
31
ESTIMASI AK-Fe IBU HAMIL
MASA KEHAMILAN (trimester 2 & 3 192 hari)
- trimester 1 kecukupan besi
= 26 mg/hari
- melahirkan
= 250
- cadangan
= 250 mg
- janin & plasenta
= 315 mg
- Total
= 565 mg
- tambahan besi rata trimester 2
= 2,7 mg/hari
- tambahan besi rata trimester 3
= 3,1 mg/hari
mg
32
ESTIMASI AK-Fe IBU HAMIL
MASA KEHAMILAN (trimester 2&3 192 hari)
- RDA trimester 2
= 42 mg/hari
- RDA trimester 3
= 47 mg/hari
- tingkat penyerapan besi
= 12 %
- RDA disesuaikan trimester 2
= 35 mg/hari
- RDA disesuaikan trimester 3
= 39 mg/hari
33
I. Iodium (I):
Fungsi Iodium:
- Iodium penting untuk sistem reproduksi
- Iodium penting untuk produksi hormon tiroid
yaitu
hormon
yang
dibutuhkan
untuk
perkembangan dan pertumbuhan saraf otot
pusat, pertumbuhan tulang, dan perkembangan
fungsi otak.
- Juga dibutuhkan untuk sel darah merah,
pernafasan sel dan menjaga keseimbangan
metabolisme tubuh.
34
an additional allowance of 25 µg/day
Iodium is recommended so as not to
compromise the development of the
fetus.
35
IODIUM
Selama hamil dan menyusui kebutuhan iodium dihitung
sebesar 3,5 ug/kg/hari.
Angka kecukupan iodium (AKI) (WKNPG, 2004)
ditentukan berdasarkan
AKI FAO/WHO 2001 yaitu 200 ug/hari
Batas aman iodium untuk wanita dewasa adalah 1100
ug/hari
Batas aman untuk BUMIL adalah 900 ug/hari
36
ESTIMASI AK-I IBU HAMIL
Kelompok
RDA
Wanita dewasa (Ug/hari)
150
Wanita hamil (Ug/hari)
Trimester 1
+50
Trimester 2
+50
Trimester 3
+50
37
J. Other nutrients :
1. Zinc – an extra intake of 3 mg/day or a
daily intake of 12 mg is recommended for
normal
fetal growth and development.
Zinc is important
in protein, RNA, and
DNA synthesis and in cell division and
differentiation.
38
ESTIMASI AK-Zn IBU HAMIL
Kelompok
RDA
Wanita dewasa (mg/hari)
9,8
Wanita hamil (mg/hari)
Trimester 1 + 1,2
11,0
Trimester 2 + 4,1
14,0
Trimester 3 + 10,2
20,0
39
J. Other nutrients :
2.
Sodium – the increase in extra cellular fluids
calls for an increase in body sodium, thus,
restriction of sodium intake is not recommended
as a routine procedure. Sodium restriction
stresses the renin-angiotensin - aldosterone
mechanism in order to maintain homeostasis.
The additional needs in pregnancy is 69 mg/day.
40
Table Increase in Recommended Dietary
Allowances to meet needs of pregnancy
Nutrients
1st trimester
2nd trimester
3rd trimester
Energy, kcal
180
300
300
Protein, kcal
17
17
17
Vitamin A, RE
25
25
25
Vitamin C, mg
10
10
10
Thiamin, mg
0
0.3
0.3
Riboflavin
0
0.6
0.6
Niacin, NE
0
3
3
Folate, µg
200
200
200
Calcium, mg
400
400
400
Iron, mg
41**
41**
41**
Iodine, µg
25
25
25
* FNRI
** Cannot be met by the usual diet, thus, supplementation is recommended.
41
Tabel . Angka Kecukupan Gizi Wanita Hamil *(or./hr)
Zat Gizi
Energi (kkal)
Protein (g)
Karbohidrat (g)
Serat Makanan (g)
Vit. A (RE)
Vit. D (ug)
Vit. E (mg)
Vit K (ug)
Tiamin (mg)
Riboflavin (mg)
Niasin (mg)
Asam Folat (ug)
Piridoksin (mg)
Vit. B12 (ug)
Vit C (mg))
Tidak
Hamil
1900
50
130
19-30
500
5
15
55
1,0
1,1
14
400
1,3
2,4
75
Hamil (+an zat gizi)
Tr 1
Tr 2
Tr 3
+180
+ 17
+300
+ 17
+300
+ 17
+300
+300
+300
+0,3
+0,3
+4
+200
+0,4
+0,2
+10
+0,3
+0,3
+4
+200
+0,4
+0,2
+10
+0,3
+0,3
+4
+200
+0,4
+0,2
+10
Hamil (total kecuk. Zat gizi)
Tr 1
Tr 2
Tr 3
2080
67
130
19-30
800
5
15
55
1,3
1,4
18
600
1,7
2,6
85
2200
67
130
19-30
800
5
15
55
1,3
1,4
18
600
1,7
2,6
85
2200
67
130
19-30
800
5
15
55
1,3
1,4
18
600
1,7
2,6
42
85
Tabel . Angka Kecukupan Gizi Wanita Hamil *(or./hr)
Zat Gizi
Kalsium (mg)
Fosfor (mg)
Magnesium (mg)
Fluor (mg)
Besi (mg)
Iodium (ug)
Seng (mg)
Mangan (mg)
Selenium (ug)
AIR (Ltr)
Natrium (mg)
Klor (mg)
Kalium (mg)
Tidak
Hamil
800
600
240
2,5
26
150
9,3
1,8
30
2,0
500
750
2000
Hamil (+an zat gizi)
Hamil (total kecuk. Zat gizi)
Tr 1
Tr 2
Tr 3
Tr 1
Tr 2
Tr 3
+150
0
+ 30
+ 0,2
+0
+ 50
+ 1,7
+ 0,2
+5
+150
0
+ 30
+ 0,2
+9
+ 50
+ 4,2
+ 0,2
+5
+150
0
+ 30
+ 0,2
+ 13
+ 50
+10,2
+ 0,2
+5
950
600
270
2,7
26
200
11
2
35
2,3
1500
2300
4700
950
600
270
2,7
35
200
13,5
2
35
2,3
1500
2300
4700
950
600
270
2,7
39
200
19,5
2
35
2,3
1500
2300
4700
43
• Umur ibu hamil : 19 -29 th; Berat Badan : 52 kg
( Sumber: Widya Karya Nasional Pangan dan Gizi - WKNPG, 2004)
• Untuk memenuhi kebutuhan dengan meningkatnya aktifitas fisiologis ibu hamil,
serta pertumbuhan dan perkembangan janin, diperlukan penyesuaian2 terhadap
kebutuhan energi dan zat2 gizinya! Terdapat peningkatan kebutuhan akan Energi
dan zat2 gizi (Tabel Angka Kecukupan Zat Gizi Untuk Wanita Hamil) (WKNPG,
2004) !
• Angka Kecukupan Gizi yang dianjurkan tersebut adalah untuk ibu yang sebelum
hamil kondisinya sehat, bukan yang mengalami kurang gizi !
44
KECUKUPAN :
Requirement = kebutuhan
Estimated Average Requirement = EAR
Reference Nutrient Intake = RNI
Recommended Dietary Allowances = RDA
Angka Kecukupan Gizi - AKG
45
IV. COMPLICATION OF
PREGNANCY/PROBABLE PROBLEM
A.
First trimester – mild nausea and vomiting due to
excessive hormone production.
B. Loss of appetite – remedied by giving high CHO foods
like cracker, jelly, and dry toast before arising. Fluids
should be taken between meals.
C. Pica – abnormal craving for food not fit for eating.
D. Constipation – give plenty of fruits and vegetables and
adequate fluid intake.
E. Overweight/Obesity – excessive weight gain increases
the incidence of toxemia and eclampsia.
F. Anemia – increase food rich in iron and take iron
supplement.
G. Toxemia of Pregnancy – characterized by high blood
pressure, albuminuria, and rapid weight gain due to
edema. Low sodium, high protein diet is
recommended.
46
V. FACTORS AFFECTING PREGNANCY
A. Age
Critical age for pregnancy is below 15 years
old and over 35 years. Mother who are
between 20 and 29 years of age have the best
outcome or pregnancy.
B. Parity
First pregnancy often complicated by toxemia
and by problem of labor and delivery.
C. Past obstetrical performance
D. Race
E. Social class as determined by income,
occupation and education
47
F. Smoking
It limit fetal development due to decreased
food intake of the mother and the effects of
carbon monoxide and nicotine.
G. Alcohol
Excessive alcohol consumption result to fetal
alcohol syndrome (with malformation :
physical and mental).
H. Heavy meals such as lead and mercury
This will result to brain damage.
48
49
VI. IMPACT OF NUTRIENT
DEFICIENCY
50
Defisiensi Energi
Kurang Energi Kronis (KEK):
Ibu hamil yang menderita KEK akan menghambat
pertumbuhan janin sehingga akan menimbulkan
resiko pada bayi dengan Berat Badan Lahir
Rendah (BBLR)
51
Defisiensi Protein
Kurang Energi Protein (KEP):
Ibu hamil yang menderita KEP akan menghambat
pertumbuhan janin sehingga akan menimbulkan
resiko pada bayi dengan Berat Badan Lahir
Rendah (BBLR)
52
Defisiensi Vitamin A
Kurang Vitamin A (KVA):
Vitamin A berperanan penting dalam :
Pembelahan dan pertumbuhan sel mukosa
Metabolisme besi, terutama dalam
P enggunaan kembali simpanan besi dalam
Hati (turnover besi)
Defisiensi : Menyebabkan keguguran dan BBLR
53
DEFISIENSI ASAM FOLAT
• Asam folat bagian penting sel darah merah
• Sebagai ko-enzim dalam metabolisme beberapa
asam amino
• Dampak defisiensi asam folat :
- gangguan pembelahan dan pertumbuhan sel
dan/atau plasenta
- timbulnya anemia megaloblastik
- defisiensi pada bulan-bulan pertama kehamilan
menyebabkan gangguan sistem syaraf fetus
54
Defisiensi Kalsium
KALSIUM:
- Berperan pada pembentukan tulang dan gigi.
- Defisiensi Kalsium pada BUMIL menyebabkan :
demineralisasi (pengambilan kalsium pada
tulang dan gigi)
beresiko terjadinya osteoporosis.
menurunnya kinerja fisik ,
menurunnya daya tahan tubuh
55
ANEMIA GIZI BESI ( Kurang Gizi Besi, KGB):
• Anemia karena rendahnya konsumsi makanan sumber zat
besi (termasuk pangan hewani, sumber heme-iron)
• Dapat dikoreksi melalui pemberian/supplementasi tablet
besi-folat (min 90 tablet selama hamil)
• Prevalensinya cukup tinggi (51%)
• Dampak anemia :
- Menurunnya kemampuan aktivitas fisik (letih, lesu) dan
produktivitas
- Pendarahan (hemorrhage), pre-eclampsia pada ibu
- Kematian ibu pada saat post-partum
- Hambatan pertumbuhan fetus dgn segala konsekuensinya
- Kegagalan pertumbuhan dan perkembangan fisik anak
- Anemia pada awal kehamilan  kerusakan otak
fetus secara permanen
- Meningkatnya kematian prenatal dan perinatal
56
BESI
Kurang Darah (KD)
Ibu hamil yang menderita KD akan menghambat
pertumbuhan janin sehingga akan menimbulkan
resiko pada bayi dengan Berat Badan Lahir
Rendah (BBLR), juga beresiko mengalami
pendarahan sebelum atau pada saat persalinan
yang dapat menyebabkan kematian ibu dan bayi
57
Defisiensi IODIUM
Gangguan Akibat Kurang Iodium (GAKI):
Dampak defisiensi :
Retardasi mental pada bayi yang dilahirkan,
Abnormalitas kognitif : bisu, tuli, dsb
Keguguran, karena iodium berperan penting
dalam fertilitas
58
DEFISIENSI ZINK
• Zink berperan dalam pembelahan sel dan sintesa protein
• Dampak defisiensi :
- Gangguan pertumbuhan jaringan
- Pendarahan selama dan setelah kehamilan
- Tekanan darah tinggi
- Gangguan pertumbuhan fetus
- Keguguran dan kematian perinatal
59
VII. PROGRAM PENANGGULANGAN MASALAH
GIZI SELAMA KEHAMILAN
• Suplementasi tablet besi-folat, (kadar besi 60 mg, asam
folat 250 ug), dikonsumsi minimal 90 tablet selama
kehamilan
• PMT bagi ibu hamil (pemberian makanan tambahan
kudapan atau makanan biasa dengan komposisi energi
600-70 Kcal dan protein 15-20 gram selama 90 hari
makan) sasaran keluarga miskin program JPS-BK untuk
mengatasi masalah KEK
•Pemantauan status gizi dan kesehatan melalui
pemeriksaan di Posyandu atau Polindes dengan
menggunakan KMS Ibu Hamil
60
VIII. PENYUSUNAN MENU IBU HAMIL
Susunan menu ditentukan :
- Kuantitas makanan
- Kualitas makanan
Saat BUMIL terjadi peningkatan kebutuhan zat gizi
untuk itu diperlukan tambahan zat gizi seperti
karbohidrat, lemak, protein , vitamin dan mineral.
Mengkonsumsi makanan beragam berarti
kekurangan zat gizi pada jenis makanan yang satu
akan dilengkapi olek jenis makanan lainnya.
61
MENU SEIMBANG:
Berdasarkan AKG perorang per hari yang
disederhanakan dalam bentuk bahan makanan
dengan memakai ukuran rumah tangga, dengan
mengkonsumsi makanan tersebut diperhitungkan
kebutuhan gizi BUMIL dapat tercukupi.
62
Susunan menu terdiri dari :
- Makanan pokok
Terdiri dari nasi, nasi jagung, tiwul, nasi tiwul,
umbi-umbian. Makan pokok memberi rasa
kenyang.
- Lauk
Terdiri dari daging, ikan, kacang-kacangan.
Lauk memberikan rasa nikmat
- Sayur dan buah
63
Langkah-langkah menyusun menu cara
sederhana
64
Pedoman Menu Sehari-hari menurut Kelompok Umur
dan Jenis Kelamin
No
1.
2.
Mkn
pokok
Lauk
Pauk
Sayur
Buah
Kudapan
(pm)
(pl)
(Pp)
(Ps)
(Pb)
(pk)
1-3
2.5
2
2
0.5
1
0.5
1
4-6
2
2
2
0.5
1
0.5
1
7-9
2.5
2
2
1
1
1
1
10-12
3
2
3
1
1
0.5
-
13-15
4
2
4
1
1
1
-
16-19
4
2
4
2
1
1
-
Kel. Umur
Susu
Anak-anak
Pria Remaja
Sumber : Depkes (1995)
65
Pedoman Menu Sehari-hari menurut Kelompok Umur
dan Jenis Kelamin
No
3.
4.
5.
Mkn
pokok
Lauk
Pauk
Sayur
Buah
Kudapan
(pm)
(pl)
(Pp)
(Ps)
(Pb)
(pk)
10-12
3
2
2
1
1
0.5
-
13-15
3
3
3
1
1
1
-
16-19
3
2
3
2
1
1
-
20-59
5
2
3
1
1
1
-
>=60
3
2
3
2
2
0.5
1
20-59
3
2
3
2
1
1
-
>=60
2
2
3
1
2
0.5
1
Kel. Umur
Susu
Wanita Remaja
Pria Dewasa
Wanita Dewasa
66
Pedoman Menu Sehari-hari menurut Kelompok Umur
dan Jenis Kelamin
Kel. Umur
Mkn
pokok
Lauk
Pauk
Sayur
Buah
Kudapan
Susu
6.
Wanita Hamil
(pm)
3
(pl)
3
(Pp)
4
(Ps)
2
(Pb)
2
(pk)
1
1
7.
Wanita
Menyusui
4
3
4
2
2
1
1
No
67
Keterangan :
• 1 Pm = 1 Porsi makanan pokok = 100g beras = 200g nasi
• 1 Pl = 1 Porsi lauk (daging, ikan atau telur) = 50g
• 1 Pp = 1 Porsi pauk (tempe, tahu dan hasil olahan) = 50g
• 1 Pb = 1 Porsi buah =100g
• 1 Ps = 1 Porsi sayuran
• 1 Pk = 1 porsi kudapan
• 1 Pu = 1 gls susu = 200g
• Untuk dewasa dan remaja ditambah 3 sdm gula dan 4 sdm
minyak goreng
• Untuk anak-anak:
* 1-3 tahun: 2 sdm gula & 2 sdm minyak goreng
* 4-6 tahun: 3 sdm gula & 2 sdm minyak goreng
* 7-12 tahun: 3 sdm gula & 3 sdm minyak goreng
1 sdm gula = 10 gram & 1 sdm minyak = 10 gram)
68
SUSUNAN MENU IBU HAMIL:
Nasi/pengganti
Lauk hewani
Lauk nabati
Sayuran
Buah-buahan
Kudapan
Susu
Air Minum lainnya
5-6 piring
4-5 potong
3-4 potong
2-3 mangkok
3 potong
1 porsi
1 gelas
6-8 gelas
600 g
200 g
150 g
300 g
200 g
69
Pesan Dasar Menuju Hidup Sehat
Bagi Ibu Hamil
•
•
•
•
•
•
•
•
Makanlah Aneka Ragam Makanan
Makanlah lebih banyak dan sering dari biasanya
Gunakan Garam beryodium
Makanlah makanan sumber zat besi
Biasakan Makan Pagi
Minumlah air bersih, aman dan cukup jumlahnya
Lakukan kegiatan fisik dan olahraga secara teratur
Hindari rokok dan minuman beralkohol
70