diet pada sistem neurobehavioral 1.ppt

DIET/GIZI PADA SISTEM NEUROBEHAVIOUR 1

Atikah Proverawati

• AUTISM• RETARDASI MENTAL

• ADHD• KEJANG DEMAM

AUTISM

AUTISM

• SOSIAL → kurang aktif, menghindari kontak mata

• KOMUNIKASI → lemah dalam menerima bahasa dan mengutarakan pendapat

• KEBIASAAN YANG ANEH → mengulang gerakan, hand flapping, picky eating

• FISIKAL → konstipasi, diare, hiperaktif, fatigue, aches and pains, digestive pain and gas, difficulty sleeping, anxiety

PENYEBAB AUTISM

• Genetik → Involving the systems of detoxification, digestion, gut/brain barrier, inflammation, immune function.

• Lingkungan → racun, vaksinasi, defisiensi gizi, antibiotik

THE HEALTH OF THE GI SYSTEM DETERMINES FUNCTION OF BODY • Physical barrier of defense against bacteria,

viruses, etc.• The largest part of the immune system is

contained within the gut (70%)• Vitamins/minerals cofactors for enzymatic

reactions and metabolism, etc.• Nutrients are precursors for neurotransmitters • The greatest concentration of serotonin, 90%,

is found in the GI tract

©Julie Matthews, CNC 2007

HOW DIET CAN HELP - SUPPORT DIGESTION & BIOCHEMISTRY

• Leaky Gut and Gut Inflammation– Remove foods that inflame gut– Add foods that heal the gut– Add foods that supply beneficial bacteria

• Nutrient Deficiencies– Increase the quality of food and digestibility

• Yeast Overgrowth– Remove sugars– Remove starches– Add probiotic-rich foods

• Toxicity and Poor Detoxification– Avoid food additives– Avoid toxins in food supply and meal preparation

• Faulty Methylation and Sulfation– Remove phenolic foods– Improve methylation and sulfation through supplementation

Feeling Better >>> Learning BetterFeeling Better >>> Learning Better


BAHAN MAKANAN YANG HARUS DIHINDARI

• Artificial colors/flavors and preservatives

• MSG (hydrolyzed protein, yeast extracts)

• Pesticides

• Aspartame and other artificial sweeteners

• Trans fats (hydrogenated fat)

• Excessive/Refined Sugar

• Nitrates/nitrites (bacon, hotdogs, lunch meat)


MAKANAN SEHAT

• Whole foods

• Unprocessed

• Organic

• Fermented foods: rich in probiotics

• Grass-fed/pastured meat and eggs

• Good fats

• Free of food intolerancesQuality

is Key!

Quality is Key!



LEMAK• Brain development and brain function • Hormone balance and mood• Formation/fluidity of cell membrane• Creating energy in cell and helps burns fat• Reduces inflammation

Supplement with vitamin E to prevent oxidation of fats.

Omega 3 Omega 6 Omega 9 Saturated Fat

Borage oil (GLA) Evening primrose oil (GLA)

Black currant oil (GLA)

Nuts/seeds and their oil Hemp seeds/oil (GLA)

Grapeseed oil

Fish oil or

cod liver oil Flax seed oil

DHA and EPA supplements

AVOID Vegetable oil: canola, safflower, corn,

soy oils

Olive oil Avocado

Nuts/seeds

Coconut oil

Palm/Red Palm oil

Animal fats Ğ ghee/dairy,

bacon


VITAL ROLES OF SATURATED FAT Brain—Saturated fats are important for

development of the brain

Bones – Saturated fats help the body put calcium in the bones

Liver – Saturated fats protect the liver from poisons

Lungs – Can’t function without saturated fats—protects against asthma

Immune System – Enhanced by saturated fats—fights infection

Essential Fatty Acids – Work together with saturated fats

Coconut Oil:Coconut Oil:

• Contains many antifungal and antiviral components

• Anti-inflammatory effects

• More easily digested and absorbed

• Used immediately to create energy

• Enhances absorption of minerals

Coconut Oil:Coconut Oil:

• Contains many antifungal and antiviral components

• Anti-inflammatory effects

• More easily digested and absorbed

• Used immediately to create energy

• Enhances absorption of minerals


MANFAAT KOLESTEROL• Brain development and function

• Boosts mental performance

• Aids digestion

• Builds strong bones

• Builds muscle

• Building block for hormones

• Regulates your blood sugar

• Repairs damaged tissue

• Protects against infectious diseases


ZAT GIZI UTAMA BAGI PERKEMBANGAN OTAK

• Vitamin A - Cod liver oil; liver, butterand egg yolks from grass-fed animals

• Vitamin D - Cod liver oil; lard, butter and egg yolks from grass-fed animals

• Choline - Cod liver oil, egg yolks

• DHA - Cod liver oil; liver, butter, egg yolks from grass-fed animals

• Zinc - Red meat of grass-fed animals, shellfish

• Tryptophan - Meat of grass-fed animals

• Cholesterol - Dairy foods, eggs, seafood, meat of grass-fed animals


Vitamin A• Protein assimilation

• Calcium absorption

• Proper growth and healing

• Speech/language

• Vision

• Proper function of the glands

• Thyroid function

• Immune system function

• Production of stress and sex hormones

Vitamin D• Healthy bones• Proper growth• Mineral absorption• Muscle tone• Immune system function• Healthy nervous system • Cell function • Insulin production• Reproduction

Animal Fat (Grass-fed) is High in Vitamins A and D


Animal Products - Quality is essential

Grass-fed/pastured Commercial•Rich in DHA (brain development)

•Rich in Vitamin A •Rich in Vitamin D •Higher in CLA•Higher in Tryptophan (sleep and mood)

*Organic is not necessarily grass-fed

•Unhealthy animals - unhealthy food

•Inflammatory grains -create inflammatory food

•Low in Vitamins A and D•Low in anti-inflammatory fats

•Higher in arachidonic acid (inflammatory)



Protein• Protein (essential amino acids) building blocks for:

– Muscle and tissue growth and repair, neurotransmitters, immune responses, enzymes, detoxification

• Bio individuality - amounts vary. • Some children cannot process protein well:

– High ammonia, low HCl, low zinc, B6, or iron

Signs of protein deficiency: Stunted growth,lack of appetite, edema, suppressed immune system, muscle wasting, anxiety, sparse hair, dry skin


Avoid Soy

• Not good substitute for dairy

• Very difficult to digest

• Irritate the gastrointestinal tract

• Blocks absorption - calcium, magnesium, iron, copper and especially zinc - due to phytic acid and oxalates

• Blocks thyroid function

• Endocrine disruption in the reproductive hormones of both males and females


• When eggs (and dairy) are not tolerated, protein becomes limited • When nuts and beans are not tolerated, protein intake becomes even more

limited• Grains, nuts, beans, and other starches - inflammatory to the gut. • Difficult to be vegetarian with some diets, as meat is relied upon with SCD and

other diets. • Can be difficult to get enough protein

–Eat eggs if tolerated–Free form amino acids (5 grams amino acids = 30 grams dietary protein)

Note on Vegetarian Diets


Carbohydrates• Add complex carbohydrates: whole grains, vegetables, fruit,

starchy vegetables• Reduce refined carbohydrates: flour products (bread, crackers,

chips), cookies, pasta• Avoid Sugars: Refined sugar, honey, juices

– 4-5 grams per serving (1 teaspoon “sugars”) = 2 oz fruit juice, 2 tsp dried fruit, 1 TBSP ketchup

– Keep to 4 servings/day

• Sugar cravings - Yeast overgrowth, stress/anxiety (sensory sensitivity), and blood sugar imbalances All grains problematic for some

• All starches & sugars (except monosaccharides) problematic for some (SCD)


Digestive EnzymesDigestive Enzymes

Probiotics Probiotics

Cod liver oil/fish oil/EFAs Cod liver oil/fish oil/EFAs

MagnesiumMagnesium

CalciumCalcium

ZincZinc

B6B6

Vitamins A, C, and EVitamins A, C, and E

CoQ10CoQ10

Glutathione/NACGlutathione/NAC

Methylation: B12, folinic or 5MTHF, TMG/DMGMethylation: B12, folinic or 5MTHF, TMG/DMG

Transfer factorTransfer factor

Amino acidsAmino acids

Helpful Supplements


Nutrient-dense Foods• Sweet potatoes: beta carotene, vitamin C, magnesium, fiber

• Leafy greens: calcium, vitamin C, folic acid, beta carotene, magnesium, iron

• Whole grains: selenium, vitamin E, magnesium, B6

• Nuts and seeds: calcium, magnesium, iron, zinc, B6, vitamin E, folic acid

• Beans and legumes: folic acid, B6, zinc, iron

• Blackstrap molasses: iron, magnesium

• Organic liver: iron, vitamin C, B12, folic acid, beta carotene, vitamin A

• Hemp seeds: GLA, omega-3, vitamin E, L-arginine. All essential amino acid.

• Nettles (can make a tea ): calcium, magnesium, potassium, iron, antioxidants

• Kombu and seaweed: calcium, magnesium, iron

• Eggs, from pastured hens (if not sensitive): B12, vitamin A, B-vitamins, vitamin D, vitamin E, selenium, calcium, iodine, zinc, iron, choline

• Animal protein and fats (grass-fed): Vitamin A, vitamin D, DHA, tryptophan


Good ways to Boost Nutrient Levels

• Cook and puree orange vegetables (or any). Freeze in ice cube trays and add to smoothies

• Cook and puree any vegetables and add to meatballs, meat patties, meatloaf, or pasta sauce

• Cook allowable grains or gluten-free pasta in homemade broth

• Nettles can be consumed as a tea, or added to a homemade broth

• Seaweed - Add kombu or other sea vegetable to cooking grains, soups, tomato sauce, even boiling pasta


Juicing

• Higher concentration of nutrients – Chlorophyll and phytonutrients

• Get nutrients without needing to eat/chew vegetables • Children that like liquids, juices and smoothies

Add vegetable juice to smoothies. Add a bit of fruit to vegetable juice for flavor or added sweetness

Add supplements to vegetable juice (instead of fruit juices)

Preparation tip

Preparation tip

Start with Add as you evolve taste Go cautiously (high sugar)

•Cucumber•Celery•Fennel•Ginger•Lemon•Green apples

•Parsley, cilantro•Kale or other greens•Cabbage (ulcers)•Cranberries

•Carrot•Beet•Fruit: Apple, pear


Soaking “seeds” – easy to doGrains, nuts, seeds, beans

• Increases digestibility

• Reduces inflammatory response

• Breaks down phytic acid and oxalates

• Fermenting grains breaks down lectins

Nuts - Soak in water (with or w/o salt) for 7-12 hours. Drain and

refrigerate, use to make nut milk, or drain and dehydrate (eat or make nut butter)

Grains - Soak in water for 8-24 hours with 2 TBSP lemon juice

or vinegar. Drain and cook with fresh water.

Beans - Soak in water for 8-24 hours with hearty pinch of baking soda. Drain and cook with fresh water.

Preparation tip

Preparation tip


Fermented Foods – Rich in ProbioticsFunctions of good bacteria

– Regulate peristalsis and bowel movements– Break down bacterial toxins – Make vitamins needed and utilize: B1, B2, B3, B5, B6, B12, A and

K– Digest protein into amino acids (for use by the body)– Produce antibiotics and antifungals – Help breakdown sugars, lactose, and oxalates– Support immune system and increase number of immune cells– Balance intestinal pH– Protect against environmental toxins: mercury, pesticides,

pollution

Raw fermented foods contain billions of bacteria/serving!


Fermented Foods – Rich in ProbioticsDairy-free:• Raw sauerkraut • Beverages (contain yeast that kills candida):

• Kombucha • Coconut juice kefir• “Sodas” (hibiscus/rosehip tea with kefir starter)

• Nut milk yogurt

Dairy: Milk-based yogurt/kefir

Dairy-free:• Raw sauerkraut • Beverages (contain yeast that kills candida):

• Kombucha • Coconut juice kefir• “Sodas” (hibiscus/rosehip tea with kefir starter)

• Nut milk yogurt

Dairy: Milk-based yogurt/kefir


HomemadeBone & Vegetable Broths

• Grass-fed/pastured chickens or beef bones– Add 2 Tablespoons of vinegar - increases the calcium

and magnesium

• Vegetables, seaweed, greens, nettles• Nutrient dense, easy to assimilate nutrients

– trace minerals, amino acids, calcium, magnesium, potassium, iron

Cook grains, soups, and/or pasta in broths - nutrients will absorb into food

Preparation tip

Preparation tip

Grandmaknew bestGrandmaknew best


Bone Broths and Gelatin

Bone broth contains gelatin:

• Gelatin’s colloidal properties aid digestion of all foods

• Glycine: Sleep, detox environmental toxins,

component of glutathione, improves gastic acid

secretions and protein digestion

• Proline: Formation of connective tissue: skin, gut,

ligaments

• Broken down by DPPIV

• Free glutamate - potentially problematic for

glutamate sensitive children

Bone broth contains gelatin:

• Gelatin’s colloidal properties aid digestion of all foods

• Glycine: Sleep, detox environmental toxins,

component of glutathione, improves gastic acid

secretions and protein digestion

• Proline: Formation of connective tissue: skin, gut,

ligaments

• Broken down by DPPIV

• Free glutamate - potentially problematic for

glutamate sensitive children


Water and Salt• Purified Water

– Avoid tap water, fluoridated and chlorinated water– Get a water filter (point of entry, reverse osmosis, carbon block or ionic -

not Brita). Avoid bottled water (plastic and transportation).

• Nutritive Salt– Salt cravings - sign of nutrient deficiencies– Avoid stripped white “table salt” - may contain aluminum– Choose nutritive salt with trace minerals – Celtic Sea Salt or Himalayan crystal salt

• Sole - water and salt combine to make minerals ionic – They are highly absorbable, alkalizing, and help with elimination– Add 1 tsp to 8 oz glass of water– See Water and Salt, by Handel and Ferreira


Beginning and Evolving a Diet


Begin by Removing Artificial Ingredients

Avoid trans fats (hydrogenated oil, fried foods, margarine, mayo, commercial peanut butter)

Avoid artificial sweetener & high fructose corn syrup

Avoid artificial ingredients (artificial colors, flavors, and preservatives)

Avoid MSG (hydrolyzed vegetable/soy protein, autolyzed yeast, yeast extract, natural flavors)

Avoid Nitrates/nitrites


Food intolerances (IgG test and LEAP test)

MSG

Carageenan

Olestra

Lectins, oxalates and phytates from “seeds”(grains even non-gluten, bean, nuts, seeds)

Yeast, antibiotics, and some medications (NSAIDS)

Eliminate Foods, Additives and Factors that Irritate the GI Tract

MENCEGAH KERACUNAN DI DAPUR

Toxins Around the Kitchen Safer Cooking Alternatives

Avoid aluminum cans Buy in glass

Avoid storing in plastic Store in glass w/metal or plastic lid

Avoid Teflon, copper, and aluminum pans

Use stainless steel (attracts a magnet), cast iron or enameled cast iron

Avoid the microwave, do not reheat in plastic

Heat in oven or on stove

Avoid plastic wrap & aluminum foil Use wax paper or glass with lid


FOR PICKY EATERS• Always provide food child likes in addition to "new" food.• Only offer one new food at a time. • Include small portion of new food and serve everyone at the table.• Involve your children in food preparation of "new" food.• Small taste ~ 1/2 teaspoon. Let child determine amount.• Inform them. Let child know whether it is sweet, salty or sour. • Let them spit it out. • If at First You Don't Succeed, Try and Try Again! At least 15 times!• Try new food in a texture they prefer - crunchy, smooth, etc.• Avoid being emotionally “attached” - children sense anxiety.

– Keep mealtime calm. Visualize child eating/enjoying new foods.• Avoid forcing or pushing - maintain trust. • Choose rewards or other encouragement.• Make sure the whole family participates.• Make it fun!

RETARDASI MENTAL

RETARDASI MENTAL

• Jenis penyakit dan penyebabnya sangat banyak dan bervariasi

• Penatalaksanaan gizi/diet → bagian utama pendukung selama pengobatan

RETARDASI MENTAL

• Mental retardation is a condition diagnosed before age 18 that includes below-average general intellectual function, and a lack of the skills necessary for daily living.

FAKTOR2 YANG BERHUBUNGAN

• Predisposisi genetik• Faktor lingkungan, contoh nutrisi, radiasi dan

psikososial• Waktu terjadinya paparan

MENTAL VS NUTRISI

• Gangguan gizi yang berat dan yang berlangsung lama sebelum umur 4 tahun sangat mempengaruhi perkembangan otak dan dapat juga mengakibatkan retardasi mental.

• Keadaan dapat diperbaiki dengan memperbaiki gizi sebelum umur 6 tahun, sesudah ini meskipun anak diberikan dengan makanan bergizi, intelegensi yang rendah itu sudah sukar ditingkatkan.

BEBERAPA PENYEBAB RM YANG DAPAT DICEGAH

• Infeksi• Malnutrisi berat• Defisiensi yodium

TATALAKSANA GIZI

• Diet:– Memenuhi kebutuhan zat gizi harian → makanan

yang bergizi – Meningkatkan kecerdasan otak → “nutrisi otak”– Meningkatkan kemampuan skill makan

BEBERAPA NUTRISI OTAK• AA dan DHA:

– Asam Arakhidonat → kacang2an, daging, susu– DHA → salah satu bentuk asam lemak tak jenuh (misal: aneka

jenis ikan laut)• Protein:

– Zat pembangun/pembentuk sel dan DNA– Menyempurnakan pembentukan sel saraf– Bahan baku neurotransmitter (penghantar rangsang antal sel) →

perkembangan otak optimal• Yodium:

– Zat pembentuk kecerdasan– Bahan baku hormon tiroid

ATTENTION DEFICIT/HIPERACTIVITY DISORDER (ADHD)

ADHD

• Gangguan kurang perhatian• Tanda-tanda:

– Pemfokusan pada rangsangan yang tidak ada hubungannya tingkah laku yang meledak-ledak

– Terlampau aktif– Inkonsistensi– Kurang ulet

DIET ADHD• DIET FEINGOLD:

– Melarang konsumsi makanan yang mengandung:• Salisilat• Senyawa yang bereaksi silang dengan salisilat• Citarasa buatan, warna, dan pengawet

– Kekurangan: salisilat terkandung pada makanan yang bergizi dan disukai anak-anak, seperti: jeruk, anggur, kismis, apel, berry dan cherry

• DIET FEINGOLD YANG DIMODIFIKASI:– Hanya melarang konsumsi pengawet– Kekurangan: meningkatkan kesulitan dalam

pembelian dan penyiapan makanan

DAFTAR MAKANAN YANG MENGANDUNG SALISILAT

BAHAN MAKANAN BAHAN MAKANAN

Anggur Kentang

Apel Kopi

Ceri Teh

Jeruk Coklat

Lemon Gandum dan olahannya

Murbei Jagung dan olahnnya

Mangga muda Nektarin Kacang almond

Plum Cengkeh

Persik Terung ungu

Prem Mentimun

Stroberi Tomat

DAFTAR MAKANAN YANG MENGANDUNG BAHAN ADITIF

BAHAN MAKANAN BAHAN MAKANAN

Mie instant Permen dengan rasa dan warna buatan

Susu dalam kemasan siap minum Minuman dalam kemasan siap minum

Daging dan ikan yang diawetkan Selai dalam kemasan

Buah dalam kaleng Bumbu penyedap buatan

Sayur dalam kaleng Camilan dengan aroma, rasa dan warna buatan

DIET PENCEGAHAN ADHD

• Diet ideal = adekuat, kalori tidak berlebihan:– Rendah lemak– Tinggi kalsium– Tinggi karbihidrat kompleks (serat dan pati)

PENDIDIKAN GIZI BAGI KELUARGA/PASIEN

• TUJUAN:– Mengembangkan kebiasaan makan yang baik (pemilihan

diet seimbang):• Jadwalkan acara makan bersama keluarga sekali dalam sehari• Sertakan anak dalam penyiapan makanan• Dorong anak-anak untuk memilih salad segar dan ikan atau ayam

bakar/panggang daripada makanan goreng-gorengan• Buat snack bergizi tersedia setiap waktu, ketika anak ditinggal

sendiri di rumah setelah pulang sekolah• Pilih snack:

– Buah segar/kering– Popcorn– Keju rendah lemak– Jus buah– Kacang/bijian tak bergaram

– Mendorong kegiatan fisik:• Olahraga berkelompok • Olahraga aerobik individual

KEJANG DEMAM

KEJANG DEMAM

• Bangkitan kejang yang tejadi pada kenaikan suhu tubuh (suhu rektal lebih dari 38˚ C)

• Pada bayi dan anak usia antara 3 bulan dan 5 tahun

• Kejang: gangguan syaraf/step/stuip

KEJANG DEMAM

• CIRI:– Kedua kaki dan tangan kaku disertai gerakan2 kejut yang

kuat dan kejang2 selama 5 menit– Bola mata berbalik ke atas– Gigi terkatup– Muntah– Berhenti nafassejenak– Terkadang tidak bisa mengontrol pengeluaran BAB/BAK– Tidak sadarkan diri, dengan intensitas waktu kejang

bervariasi

• KOMPLIKASI:– Retardasi mental → o/k kejang terlalu lama → sel

otak rusak– Aspirasi

TATALAKSANA GIZI

• Memberikan keseimbangan air dan elektrolit• Agar cairan tubuh yang menguap o/k suhu

tinggi dapat cepat tergantikan:– Banyak minum (contoh: susu, teh, air putih)– Makan buah-buahan maupun jus– Makan makanan berkuah

• Makanan/minuman tidak diberikan langsung setelah kejang berhenti o/k berpeluang membuat anak tersedak

diet pada sistem neurobehavioral 1.ppt

Documents