Anemia Pada Remaja: Tantangan dan Dampak

Dr. Helda Khusun

Disampaikan pada Seminar Anemia pada Remaja

Universitas Prof Dr HAMKA
22 January 2022
 ü STP: Teknologi Pangan dan Gizi, IPB
University
ü MSc: Community Nutrition, Fakultas
Kedokteran Universitas Indonesia
ü PhD: Public Health Nutrition,
University of Queensland

v Bekerja di SEAMEO RECFON sejak 1997, full

& part time
v Ketua Peminatan Gizi Komunitas, Prodi Gizi
S2 FKUI
HELDA KHUSUN
Outline
2. Karakteristik Remaja 4. Mengatasi Anemia

1. Masalah Gizi dan 3. Dampak anemia 5. Pesan Kunci

Anemia pada remaja
Masalah Gizi Remaja

Anemia Rematri:
32%

Source: Indonesia Basic Health Research 2007, 2013 and 2018

 Definisi Anemia

Suatu keadaan dimana jumlah sel darah merah atau konsentrasi

pengangkut oksigen dalam darah (hemoglobin) tidak memenuhi
kebutuhan fisiologis tubuh.
Keadaan kekurangan hemoglobin dalam darah karena kekurangan zat
gizi yang diperlukan untuk pembentukan hemoglobin (Depkes RI,
1998).
Anemia dialami jika konsentrasi hemoglobin (Hb)
´ <120 g/L (perempuan 15 tahun ke atas)
´ <130 g/L (laki-laki 15 tahun ke atas)
Sumber: WHO (2001)
Sesi 2 - Konsep Dasar Gizi dan Pentingnya Gizi bagi Remaja 7
 Gejala Anemia

4L: lemah, lelah, letih, lesu

Muka dan mata pucat
Kulit terlihat pucat
Denyut jantung cepat atau tidak teratur
Konsentrasi belajar menurun

Sesi 2 - Konsep Dasar Gizi dan Pentingnya Gizi bagi Remaja 8

Pengertian Remaja
Masa Remaja (adolescence) :
Periode transisi dari fase anak – anak ke fase dewasa.

PUBERTAS

Sesi 2 - Konsep Dasar Gizi dan Pentingnya Gizi bagi Remaja 9

Karakteristik masa remaja
• Pertumbuhan dan perkembangan fisik.
• “Growth spurt”
• Pematangan seksual
• Perubahan psikologis
• Pengembangan”Body image”
• Kebutuhan gizi remaja = dewasa
• Protein, mineral, vitamin
• Remaja pria umumnya memiliki lean body mass>skeleton dan adipose

Sesi 2 - Konsep Dasar Gizi dan Pentingnya Gizi bagi Remaja 10

Mengapa Remaja?
Mengapa Remaja
Mengapa Gizi dan Kesehatan Saat Remaja itu Penting?

• Remaja, khususnya remaja putri adalah calon ibu

• Ibu hamil yang kurang gizi berisiko:
• Melahirkan bayi Berat Badan Lahir Rendah (BBLR) < 2500 gram
• Meninggal saat melahirkan
• Komplikasi kehamilan dan persalinan
• Menghasilkan bayi yang mudah sakit dan mengalami kesulitan tumbuh kembang
• Keadaan yang akan berulang dan menjadi lingkaran yang tak berujung

Sesi 2 - Konsep Dasar Gizi dan Pentingnya Gizi bagi Remaja 14

Masalah Gizi Remaja

Anemia Rematri:
32%

Source: Indonesia Basic Health Research 2007, 2013 and 2018

Penyebab Anemia
pada remaja:
• Asupan makanan
rendah zat besi
• Penyakit infeksi
dan Kecacingan
• Kehilangan darah
saat menstruasi
Akibat Anemia (1)
Say NO to ANEMIA
Anemia mengakibatkan turunnya kinerja otak dan produktifitas
kerja

Kekurangan zat besi, dapat menggangu fungsi

otak pada anak dan remaja
(Pollitt et al. 1985, Ballin et al. 1992)

Sebagian besar studi menemukan bahwa Anemia

berhubungan dengan rendahnya konsentrasi dan
memori belajar
(Sachdev et al. 2005; Grantham-McGregor & Ani 2001)

Sesi 2 - Konsep Dasar Gizi dan Pentingnya Gizi bagi Remaja 17

Akibat Anemia (2)
Suatu studi menyebutkan bahwa terdapat
penurunan IQ sebesar 1.73 poin untuk setiap
penurunan 1g/L hemoglobin
(Stoltzfus et al. 2004)

Anemia dan berkurangnya fungsi otak berhubungan

langsung dengan rendahnya penghasilan di masa
depan (Basta et al. 1979; Galal et al. 2005)

Sesi 2 - Konsep Dasar Gizi dan Pentingnya Gizi bagi Remaja 18

Fakta Praktek Gizi/Kesehatan Remaja
Program Penanggulangan Anemia
Supplementasi TTD Perbaikan Diet Fortifikasi

• Solusi Jangka • Solusi Jangka • Solusi Jangka

Pendek Panjang Panjang
• Efikasi baik • Perlu edukasi gizi • Terpusat
• Efektifitas:?? • Perlu perbaikan • Saat ini: fortifikasi
keadaan sosio- Zat Besi pada
ekonomi tepung terigu

Bukti efikasi tersedia, effectiveness implementasi ??

Mencegah Anemia
Anemia dapat dicegah dengan mengkonsumsi bahan makanan kaya zat besi, asam
folat, B12 dan vitamin C.
Protein hewani TIDAK HANYA
kaya akan protein, namun juga
kaya zat besi dan vitamin B12.
Zat besi banyak terdapat
pada hati dan daging merah.
Sayuran hijau daun
kaya akan asam folat
Buah-buahan seperti jambu
biji, papaya, jeruk kaya
vitamin C yang membantu
penyerapan zat besi
Sesi 2 - Konsep Dasar Gizi dan Pentingnya Gizi bagi Remaja 25
Model Program Multi-Sektor untuk
Penurunan Anemia Remaja
 Best Practices in School-Based
Adolescent Health and Nutrition Promotion:
SEAMEO RECFON Experiences in
“Remaja ASIK”
(Aktif, Sehat, pIntar, Kreatif)

Indriya Laras Pramesthi, M.Gizi

SEAMEO RECFON (Regional Centre for Food and Nutrition)

Jakarta, February 21st 2018

Remaja ASIK is one of the program under:
“Model of partnership
to translate guidelines into practices
for optimal diet of Southeast Asian community”

Optimized Local-Specific Food Based Recommendation (FBR) to Reduce

Anemia among Adolescent School Girls
in Malang District, East Java, Indonesia

“Remaja ASIK”
(Aktif, Sehat, pIntar, Kreatif)
Active, healthy, smart and creative adolescents
 Program launching
and follow up action
meeting
Stages and Activities
of Remaja ASIK Effectiveness study (20-week
Intervention, including baseline &
endline survey)

IEC module
development

Trial for Improved

Practices (TIPs)

Training and workshop on

LP-Optifood analysis to
develop local specific FBRs
Dietary and
Market Survey
Development of Remaja ASIK IEC modules

Module for Module for

teacher students
(more on (more on
nutrition work sheet)
education
content and
lesson plan)
 Results
Percentage of weekly consumption
Control (n=133) Intervention (n=106)

Milk (3 portions/week) 32,3

78,3

Fruit (1 portion/day) 12,8

34

GLV (≥5 portions/week) 26,3

49,1

Vegetables (2 portions/day) 9
35,8

Plant protein (1 portion/day) 56,4

71,7

Liver (≥2 portions/week) 6,8

33
Animal protein (2 31,6
portions/day) 100

1. Improved dietary practice, i.e consumption of nutrient dense food groups and food item
2. There’s no significant differences between 2 groups (intervention and control) for Hb and
cognitive performance à Supplementasi TTD Rematri perlu diintegrasikan ke dalam
program edukasi
 Lessons Learnt
• See the benefit from our partners’ perspective and integrate with their vision and
mission
• Academe: source of area for community development both for lecturers and
students; joint research and published scientific papers; be a partnership program
that can add ‘credit’ during the accreditation
• DHO: activate school health program UKS, including Student Health Book (Buku
Rapor Kesehatan Siswa)
• School’s policy maker is the main actor behind the well-implemented weekly
intervention session.
• Introducing new program (nutrition education)by integrating into school existing
system is the best way to reach high compliance of attending intervention session
SEAMEO RECFON
NGTS Partnership
Nutrition Goes to School – Gizi untuk Prestasi

• Objective: to improve students’ learning outcomes

and active participation in school activities by
acquiring proper nutrition (AWESOME school
children)
• Settings: Primary and secondary schools, vocational
schools, Madrasa, Boarding schools, Special
Education Schools

Framework
 Implementation Stages of the Flagship Programs
INSTITUTIONALIZATION
School/ECE Center HAS
STRENGTHENING INTEGRATED
ORIENTATION School/ECE Center HAS NGTS/ECCNE in its
SOCIALIZATION regular activities, has
(School/ECE Center has IMPLEMENTED the
(School/ECE action plan with technical WRITTEN COMMITMENT
received CAPACITY
Center are BUILDING through assistance from partner to implement
EXPOSED to and RECFON, and NGTS/ECCNE, and
training, and create an conducted regular
NGTS/ECCNE) ACTION PLAN) documented the
activities MONITORING and
EVALUATION and report
to the local stakeholders

The implementation should be integrated with the existing government program

Strategies: Locus-based and beyond-locus based
 Orientation Phase_NGTS
• Capacity building for School Principal and
Teachers on Health and Nutrition of School
Children and Adolescent
• Face-to-face training: In 2020, the program
has reached nearly 400 teachers from 144
partner-schools in 6 location-focus
• Online training: (2017-2020) the program
has trained a total of nearly 10,000 teachers
and school principals from nearly 3000
schools in 34 provinces in Indonesia
Modul Gizi dan Kesehatan Anak Usia Sekolah dan Remaja
Strengthening
Phase_NGTS
Capacity Building for Academe/Professional

Post Graduate SEA Nutrition Leadership In-country

Training Online Training Program (SEA-NLP) Courses
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