Anatomi & fisiologi manusia pencernaan

Anatomi & Fisiologi Manusia

SISTEM PENGHADAMAN

Roz`ain

Syakirah

Izzah

Rabi`atul

What is Digestion?

• Digestion is a catabolic process in which large complex molecules (carbohydrates, lipids, proteins, nucleic acids) are broken down into simpler monomers (monosaccharides, glycerol and fatty acids, amino acids, and nucleotides) which can be absorbed by the body.

Function

Breakdown of ingested food

Absorption of nutrients into the blood

Production of cellular energy (ATP)

Constructive and degradative cellular activities

Types of Digestion

mechanical

no chemical change in the

food.

food is broken down into smaller pieces,

mixed with digestive juices secreted in the

body.

chemical

there is a chemical change

in the food.

hydrolysis reactions carried out by enzymes

contained within the digestive juices.

Proses Pencernaan

Ingestion PropulsionMechanicalDigestion

ChemicalDigestion

Absorption Defecation

Six Processes of Digestion

1.Ingestion – getting food into the mouth2.Propulsion – moving foods from one region of

the digestive system to another3.Mechanical digestion

– Mixing of food in the mouth by the tongue– Churning of food in the stomach– Segmentation in the small intestine

4.Chemical Digestion– Enzymes break down food molecules into their building

blocks– Each major food group uses different enzymes

• Carbohydrates are broken to simple sugars• Proteins are broken to amino acids• Fats are broken to fatty acids and alcohols

5.Absorption– End products of digestion are absorbed in the blood or lymph– Food must enter mucosal cells and then into blood or lymph

capillaries6.Defecation

– Elimination of indigestible substances as feces

Proses Pencernaan

Division of digestive system organs

Alimentary canal

continuous coiled hollow tube that runs

from the mouth to the anus

Accessory organ

secrete digestive juices by ducts

(exocrine glands) into the alimentary canal.

Alimentary Canal Organs

Mouth

Pharynx

Esophagus

Stomach

Small intestine

Large intestine

Anus

Accessory Digestive Organs

Salivary glands

Teeth

Pancreas

Liver

Gall Bladder

Mouth Oral Cavity (Ac)

• Mastication (chewing) of food

• Mixing masticated food with saliva

• Initiation of swallowing by the tongue

• Allowing for the sense of taste

Salivary Glands (Ac)

Salivary Glands:• Saliva-producing glands

– Parotid glands – located anterior to ears– Submandibular glands– Sublingual glands

Saliva:• Mixture of mucus and serous fluids• Helps to form a food bolus• Contains salivary amylase to begin starch digestion• Dissolves chemicals so they can be tasted

Teeth (Ac)• The role is to masticate (chew)

food• Humans have two sets of teeth

– Deciduous (baby or milk) teeth– 20 teeth are fully formed by age

two• Permanent teeth

– Replace deciduous teeth beginning between the ages of 6 to 12

– A full set is 32 teeth, but some people do not have wisdom teeth

• Types of teeth:Incisors - cuttingCanines - tearingPremolars – shearing, shreddingMolars - grinding

Tooth Structure• Crown – exposed part

– Outer enamel– Dentin– Pulp cavity

• Neck– Region in contact with the

gum– Connects crown to root

• Root– Periodontal membrane

attached to the bone– Root canal carrying blood

vessels and nerves

Pharynx (Al)

• Serves as a passageway for air and food

• Food is propelled to the esophagus by two muscle layers– Longitudinal inner layer– Circular outer layer

• Food movement is by alternating contractions of the muscle layers (peristalsis)

Esophagus (Al)

• Runs from pharynx to stomach through the diaphragm

• Conducts food by peristalsis (slow rhythmic squeezing)

• Passageway for food only (respiratory system branches off after the pharynx)

Liver and Gall Bladder (Accessory Organs)• Largest gland in the body• Composition

– Bile salts– Bile pigment (mostly bilirubin

from the breakdown of hemoglobin)

– Cholesterol– Phospholipids– Electrolytes

• Stores bile from the liver by way of the cystic duct

• Bile is introduced into the duodenum in the presence of fatty food

• Gallstones can cause blockages

Stomach

Stomach (Al)• Located on the left side of the abdominal cavity• Food enters at the cardioesophageal sphincter• Regions of the stomach

– Cardiac region – near the heart– Fundus– Body– Pylorus – funnel-shaped terminal end

• Food empties into the small intestine at the pyloric sphincter

• Rugae – internal folds of the mucosa• External regions

– Lesser curvature– Greater curvature

Function of Stomach

• Acts as a storage tank for food

• Site of food breakdown• Chemical breakdown of

protein begins• Delivers chyme

(processed food) to the small intestine

Pancreas (Ac)

• Produces a wide spectrum of digestive enzymes that break down all categories of food

• Enzymes are secreted into the duodenum• Alkaline fluid introduced with enzymes

neutralizes acidic chyme• Endocrine products of pancreas

– Insulin– Glucagon

Large Intestine (Al)

• Larger in diameter, but shorter than the small intestine

• Frames the internal abdomen• Cecum – saclike first part of

the large intestine• Appendix

– Accumulation of lymphatic tissue that sometimes becomes inflamed (appendicitis)

– Hangs from the cecum• Colon

– Ascending– Transverse– Descending– S-shaped sigmoidal

• Rectum• Anus – external body opening

Functions of Large Intestine• Absorption of water• Eliminates indigestible food from the body as feces• Does not participate in digestion or absorption of

digested food• Goblet cells produce mucus to act as a lubricant• Site of production of Vitamin K by symbiotic bacteria

which live off the remains of food that have not been digested or absorbed in the small intestine. These bacteria produce over 50% of fecal matter.

Small Intestine (Al)

• The body’s major digestive organ all digestion of food is completed in this organ

• Site of nutrient absorption into the blood• Duodenum (25cm = 10 inches) “12 finger widths

long”– Attached to the stomach– Curves around the head of the pancreas– Where bile and pancreatic juices enter the alimentary

canal• Jejunum (2.5m = 8 feet) “empty”

– Attaches anteriorly to the duodenum• Ileum (3.6m = 12 feet) “twisted”

– Extends from jejunum to large intestine

Small Intestine (Internal Structure)• Villi are small fingerlike

structures formed by the mucosa

• Give the small intestine more surface area for absorption

• Fold in the intestine are called circular folds or plicae circulares

• Deep folds of the mucosa and submucosa

• Do not disappear when filled with food

• The submucosa has Peyer’s patches (collections of lymphatic tissue)

Villi Internal Structure and Function

• Absorptive cells are found on the surface epithelium which are simple columnar microvilliated epithelium

• Blood capillaries are below the surface epithelium and this is where monosaccharides, amino acids, and nucleic acids enter into the blood stream and are taken to the liver for processing

• Lacteals (specialized lymphatic capillaries) where lipids are absorbed and eventually re-enter the blood stream to be taken to the liver for processing.

DIGESTION OF NUTRIENT

WHAT IS NUTRIENT?

• Substance in food that is used by the body to promote normal growth ,maintenance and repair.

• Divide into 6 categories major nutrient:carbohydrate,lipids,water and protein

minor nutrient:vitamin and mineral

WHAT IS DIGESTION?

• Process of breaking down ingested food into small molecule

• For example: -In mouth,salivary amylase convert starch to

maltose,maltotriose and a-dextrin -In stomach,pepsin convert protein to peptide -Lingual and gastric lipases convert

triglycerides into fatty acid,diglycerides and monoglycerides

DIGESTION OF CARBOHYDRATE

• Salivary amylase keep continue in stomach but then it was stop by acidic pH. So, just a few starches are broken down

• Starches that not already broken down into maltose,maltotriose and a-dextrins are cleaved by pancreatic amylase

• Although pancreatic amylase acts both on glycogen and starches but it doesn’t effect cellulose

• After amylase split starch into small fragment,a brush-border enzyme called a-dextrinase acts on the resulting a-dextrins,clipping off one glucose unit at a time

• Ingested molecules of sucrose,lactose and maltose (disaccharides)-are not acted on until they reach small intestine

• Sucrase breaks sucrose into molecule of glucose and fructose

• Lactase digest lactose into molecule of glucose and galactose

• Maltase split maltose and maltotriose into two or tree molecules of glucose,respectively

• Digestion of carbohydrate ends with production of monosaccharides,which the digestive system is able to absorb

DIGESTION OF PROTEIN

• Protein are fragmented into peptide by action of pepsin

• Enzyme in pancreatic juice-trypsin,chymotrypsin,carboxypeptidase and elastase-continue to break down protein into peptide

• Although all these enzyme convert whole protein into peptide,their action differ somewhere b’coz each split peptide bonds between different amino acid

• Trypsin,chymotrypsin and elastase all cleave the peptide bond between a specific amino acid and its neighbor

• Carboxypeptidase splits off the amino acid at the end of peptide

• Protein digestion is completed by two peptidase in aminopeptidase and dipeptidase

• Aminopeptidase cleaves off amino acid at the amino end of peptide

• Dipeptidase splits dipeptides into single amino acid

DIGESTION OF LIPIDS

• The most abundant lipids in diet are triglycerides,consist of molecule of glycerol bonded to three fatty acid molecule

• Enzyme that split triglycerides and phospholipids are called lipase

• Three type of lipases that can participate in lipid digestion are lingual lipase,gastric lipase and pancreatic lipase

• Triglycerides are broken down by pancreatic lipase into fatty acid and monoglycerides

• Large lipid globule containing triglyceride can be digested in the small intestine,and it undergo emulsification

• Emulsification-process in which large lipid globule is broken down into several small lipid globule.it involve bile

• The small lipid globule formed from emulsification provide a large surface area that allow pancreatic juice to function more effectively

DIGESTION OF NUCLEIC ACID

• Pancreatic juice contain two nucleases:ribonuclease which digest RNA and deoxyribonuclease which digest DNA

• Result of the action of this two nuclease are further digested by nucleosidases and phosphatase into pentose,phosphates and nitrogenous base

• These product are absorbed via active tansport

ABSORPTION

WHAT IS ABSORPTION?Passage of digested nutrients from gastrointestinal tract into the blood

or lymph

ABSORPTION OF MONOSACCHARIDES

• The capacity of small intestine to absorb monosaccharide is huge-an estimated 120 grams per hour

• As a result, all dietary carbohydrate that are digested normally are absorbed, leaving only indigestible cellulose and fiber in feces.

• Monosaccharides pass from the lumen through the apical membrane via facilitated diffusion or active transport.

-Fructose(found in fruit)-is transported via facilitated diffusion

-Glucose and galactose are transported into absorptive cells of the villi via secondary active transport that is coupled to the active transport of Na+

• Monosaccharide then move out of absorptive cells through their basolateral surface via facilitated diffusion and enter the capillaries of the villi

ABSORPTION OF AMINO ACIDS,DIPEPTIDES AND TRIPEPTIDES

• Protein is absorbed as amino acid via active transport, mainly occur in deodenum and jejunum

• Half of the absorbed amino acid are present in food and the other half come from the body itself as protein in digestive juice and dead cells that slough off the mucosal surface.

• 95-98% of the protein present in small intestine is digested and absorbed.

• Different transporter carry different type of amino acid

-some amino acid enter absorptive cell of the villi via Na+ dependent secondary active transport which is silmilar to the glucose transporter and the other amino acid are actively transported by themselves

• Amino acid move out of the absorptive cells via diffusion and enter capillaries of the villus

• :both monosaccharides and amino acid are transported in the blood to the liver by way of hepatic portal system.

ABSORPTION OF LIPID

• All dietary lipid are absorbed via simple diffusion• Because of emulsification and digestion;

triglycerides are mainly broken down into monoglycerides and fatty acid, which can be short-chain fatty acid or long-chain fatty acid

• Short-chain fatty acid are hydrophopic and small in size. Thus, they can dissolve in the watery instestinal chyme,pass through the absorptive cells via simple diffusion

• Long-chain fatty acid are large and hydrophobic and have difficulty being suspended in the watery environment of the intestinal chyme. So, bile salt help them to be more soluble

• Bile salt surround the long-chain fatty acid and forming tiny sphere called micelles.

• The micelles move from the interior of the small intestinal lumen to the absorptive cell.

• At that point, long-chain fatty acid diffuse out of the micelle into absorptive cells, leaving micelles behind the chyme

ABSORPTION OF ELECTROLYTE

• Electrolyte that are absorbed by the small intestine come from gastrointestinal secretions and some are part of ingested foods and liquids

• Recall that electrolyte are compound that separate into ions in water and conduct electricity

• Sodium ion are actively transported out of absorptive cells by basolateral sodium-potassium pump after they have moved into absorptive cells via diffusion and secondary active transport.

• Negatively charge bicarbonate,chloride,iodide and nitrate ion can passively follow Na+ or actively transported

• Calcium ion also are absorbed actively in a process stimulated by calcitriol

• Other electrolyte such as iron,potassium,magnesium and phosphate ions are absorbed via active transport mechanism

ABSORPTION OF VITAMINS

• Fat soluble vitamin A,D,E and K are included with digested dietary lipid and absorbed via simple diffusion

• Water-soluble vitamin such as B and C also absorbed via simple diffusion. However B12 combine with intrinsic factor produced by the stomach and combination is absorbed in the ileum via an active transport mechanism

ABSORPTION OF WATER

• the total volume of fluid that enter small intestine each day about 9.3 liters-comes from ingestion of liquid and from various gastrointestinal secretion

• The small intestine absorbs about 8.3 liters of fluid; the remainder passes into the large intestine, where most of the rest of it-about 0.9 liter

• Only 0.1 liter of water is excreted in the feces each day. Most is excreted via urinary sytem

• All water absorption in GI tract occur via osmosis from the lumen of the intestine through absorptive cells and into blood capillaries

• Because water can move across the intestinal mucosa in both direction, the absorption of water from small intestine depend on the absorption of electrolyte and nutrient to maintain osmotic balance with blood

• The absorbed electrolyte,monosaccharides and amino acid establish a concentration gradient for water that promote water absorption via osmosis

METABOLISMA

Metabolisma

• Tindak balas kimia yang berlaku dalam sel hidup yang membolehkan sel membesar dan membiak dan mengekalkan struktur mereka.

• Dibahagikan kepada dua jenis :

1) Katabolisme : menghasilkan tenaga, seperti pemecahan makanan dalam repirasi sel.

2) Anabolisme : memenggunakan tenaga untuk membentuk komponen sel seperti protein dan asid nukleik.

Laluan Metabolik

Metabolisma karbohidrat• T’dpt 3 jenis kmpln utama karbohidrat iaitu :a) Monosakarida – gula ringkas : glukosab) Disakarida – gula kompleks : maltosac) Polisakarida – gula kompleks y bsr : kanji,glikogen

• Laluan ini melibatkan pemecahan molekul-molekul karbohidrat di dalam organ hati, kerana hati menyimpan glukos.

• Glukosa merupakan monosakarida yang paling penting dalam metabolisme tubuh.

• Glukosa yang terkandung dalam nutrisi masuk ke dalam sistem sirkulasi atau ke dalam darah untuk dipindah ke sel-sel tubuh yang memerlukannya atau diubah pada hati menjadi molekul yang lain.

• Glukosa adalah sumber tenaga utama bagi sel-sel haiwan, dan merupakan satu-satunya sumber tenaga bagi manusia.

Lipid

•Lipid ialah sebatian organik yang mengandungi karbon, hidrogen, dan oksigen.•Jenis utama lipid adlh lemak, minyak, fosfolipid, dan steroid sprti kolesterol,testosteron,estrogen dan progesteron.•Lemak & minyak adlh cnth lipid y dtempatkan dlm kategori trigliserida, y t’diri drp 1 gliserol dan 3 asid lemak.

METABOLISMA LIPID

METABOLISMA PROTEIN

• Protein adalah molekul-molekul y bsr & kompleks.

• Monomer bgi protein adlh asid amino.• Sel badan akn mengeluarkan asid amino daripada

darah dan menggunakannya untuk membina protein, untuk kegunaan sendiri(enzymes, membranes, muscle protein) dan untuk mengeksport(mucus,hormones).

• ATP akan t’bentuk jika glukosa dan lemak tidak mencukupi atau jika kekurangan Asid amino.

METABOLISMA NUKLEIK ASID

• Asid nukleik merupakan sejenis makromolekul yang terdiri daripada rantaian nukleotida. Dalam biokimia molekul ini mampu membawa maklumat atau membentuk struktur dalam sel.

• Asid nukleik yang biasa termasuk asid deoksiribonukleik (DNA) dan asid ribonukleik

(RNA). Asid nukleik terdapat dalam semua benda hidup, kerana mereka terkandung

dalam segala sel. Asid nukleik juga terdapat di dalam virus.

• Metabolisme asid nukleik adalah proses yang mana nukleotida disintesis .

• Sintesis asid nukleik juga merupakan satu

mekanisme, anabolik umumnya melibatkan tindak balas

kimia fosfat, gula pentose, dan asas bernitrogen.

• Pemusnahan asid nukleik adalah prosedur katabolik umumnya melibatkan tindak

balas enzim.

Diet dan Pemakanan

Diet Seimbang • Pengambilan makanan yang mengandungi

semua nutrien seperti protein,karbohidrat,lemak, vitamin, garam mineral, dan air serta pelawas dalam kuantiti yang diperlukan.

Pemakanan• kajian berkaitan dengan pengambilan makanan

untuk proses pertumbuhan ,pemulihan dan pengawalan kesihatan.

Kumpulan Makanan Asas

Fungsi Kesan berlebihan Kesan kekurangan

Karbohidrat Membekalkan tenaga utama untuk keperluan badan

lebihan berat badan Marasmus(p’tumbuhan t’bantut)

Protein membentuk dan membaiki tisu, membentuk enzim, antibodi, hormon, agen pengangkut

lemak mningkat, paras kalsium drh t’jejas

penghasilan antibodi menurun & risiko jangkitan meningkat.Penyakit Kwasyiokor

Lemak membekalkan tenaga & pengekalan suhu, membekalkan asid lemak perlu, penyerapan vitamin larut lemak

lebihan berat badan Kekurangan berat badan

Garam Galian

• Dibahagikan kpd 2 kumpulan :- Makronutrien (dp’lukan dlm Kuantiti bsr)- Mikronutrien (dp’lukan dlm kuantiti kecil)

Makronutrien sumber fungsi Kesan kekurangan

Kalsium susu, keju, ikan bilis, bijirin

m’bina tlg & gigi yang kuat, mnolong pmbekuan drh, dp’lukan untk pengecutan otot & pmindahan impuls saraf.

riket,osteoporosis, p’darahan b’pnjangan.

Magnesium Bijirin,syrn hijau,susu, daging

Menjana enzim yang diperlukan untuk mengeluarkan tenaga dalam tubuh. Diperlukan oleh tubuh dalam pembentukan bahan genetik dan pertumbuhan tulang.

Otot lemah

kalium Susu, daging, pisang, sayuran hijau

Pemindahan impuls saraf, pengecutan otot Ganguan dlm sstm saraf

Fosforus Susu, daging, bijirin, telur

M’bntk tulang & gigi yang kuat, menggiatkan enzim-enzim yang diperlukan tubuh untuk menukarkan makanan kepada tenaga.

Tulang rapuh, kerosakan gigi.

Natrium Garam, daging, telur, susu

Mngekalkan keseimbangan air dlm bdn, mngekalkan tknn osmosis cecair dlm bdn.

Kekejangan otot

Mikronutrien sumber Fungsi Kesan kekurangan

Iodin Udang, kerang, makanan laut

M’bntk hormon tiroksina

Goiter, kretinisme pd knk-knk

Besi Hati, bayam, kacang, telur kuning

M’bntk hemoglobin Anemia

Florin Air minuman, teh, sayuran

Mengukuhkan enamel pd gigi

Karies gigi

Vitamin• Kumpulan sebatian organik yang diperlukan dalam kuantiti yang

kecil untuk memelihara dan mengekalkan kesihatan.

• Dikelaskan kepada 2 kumpulan :

a) Larut lemak: - tidak dapat dikumuh melalui air kencing tetapi disimpan dalam badan- vitamin A, D, E dan K.

b) Larut air: - tidak dapat disimpan dalam badan dan sebarang kuantiti berlebihan akan larut dalam air dan dikumuhkan keluar melalui air kencing.- Vitamin B kompleks dan vitamin C.

jenis sumber fungsi Kesan kekurangan

Vitamin C buah-buahan. memelihara tisu p’hubung, kshtn kulit & pemulihan luka yang cepat, mngkatkan ketahanan t’hdp jgkitan

skurvi ( gusi b’darah, kulit lebam, sendi bgkak)

Vitamin D Keju, mentega dan telur. m’bantu pnyerapan kalsium & fosforus, m’bina tulang dan gigi yang kuat

penyakit riket, karies gigi

Vitamin E sayuran hijau,minyak kelapa sawit.

memelihara kshtn sstm otot, saraf & sstm p’edaran darah, bhn p’oksidaan bgi asid lmk tepu

kemorosotan otot & saraf

Vitamin K hati,bayam dan kubis. m’bantu dalam pembekuan darah b’darah secara berlebihan

Vitamin A susu, tomato, lobak merah

Membina pigmen pada retina mata untuk penglihatan jelas pada waktu malam & memastikan p’tumbuhan sel epitelium kulit yang sihat.

rabun malam, kulit tidak yang sihat

Air• Merupakan 70% drp berat bdn manusia.• Peranan :a) Sbg pelarutb) Medium tndk bls kimia dlm bdn.c) Medium pengangkutan bhn mknn t’cerna, oksigen,

bhn p’kumuhan.d) Pengawalaturan suhu bdn : Bila kekurangan air, suhu

tubuh akan menjadi panas dan naik. Khdiran air akan m’bntu m’stabilkan suhu bdn.

e) Sbg pelincir : mngurangkan geseran tulang pd sendi.f) P’kumuhan : urea,asid urik & grm mineral b’lebihan

dsingkirkn melalui air kencing dan peluh.

TENAGA

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Tenaga Penting dalam Tubuh 1. Tenaga Kinetik:

Tenaga yang dibekalkan oleh sebatian ikatan bertenaga tinggi seperti ATP, ADP, dll.

2. Tenaga berpotensi:Tenaga yang tidak aktif disimpan di dalam badan dalam bentuk glikogen dan yang terdapat dalam makanan.

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Pengukuran Tenaga

1. Kalori: Jumlah tenaga haba yang

diperlukan untuk menaikkan suhu satu gram air sebanyak satu darjah celsius.

2. Kilokalori (Kcal)

Jumlah haba yang diperlukan untuk meningkatkan suhu 1 kg. air sebanyak sebanyak 1 darjah celsius.

3. Unit metrik yang digunakan ialah kilojoule(KJ)

1 Kilokalori (Kcal) = 4.184 KJ)

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Pengukuran Nilai Tenaga dalam Makanan

• Dengan menggunakan alat kalorimeter• Jumlah tenaga yang dihasilkan oleh setiap

sampel protein, lemak dan karbohidrat

1 g. Karbohidrat= 4 kcal

1 g. Lemak = 9 kcal

1 g. Protein = 4 kcal

1 g. Alkohol = 7 kcal

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Contoh Pengiraan 1

• Berapakah nilai tenaga yang dalam satu gelas susu beratnya 244g ? Jika dalam susu 100g susu mengandungi:4.9g CHO; 3.5g protein; 3.7g lemak; 0.6 mineral dan 1.2g vitaminCHO = 244/100 x 4.9g x 4kcal = 47.8 kcalProtein = 244/100 x 3.5g x 4kcal = 34.2 kcalLemak = 244/100 x 3.7g x 9kcal = 81.3 kcalJumlah nilai tenaga = 163.3 kcal

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Contoh pengiraan 2

Diet mengandungi 2200 kcal dan mengandungi 210g CHO, dan 120g lemak, kira:

• Berapakah jumlah g protein dalam sajian?• Kira peratus setiap nutrien [CHO, protein dan

lemak] dalam sajian?

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a. Jumlah g protein

• CHO membekal = 210 x 4 kcal = 840 kcal• Lemak membekal = 120 x 9 kcal = 1080 kcal • Protein = 2200 – (1080 + 840) = 280 kcal

Jumlah g protein = 280/4 = 70 g

b. Peratus CHO, Protein dan Lemak

Peratus CHO = 840/2200 x 100 = 38.2%

Peratus Lemak = 1080/2200 x 100 = 49.1%

Peratus Protein = 280/2200 x 100 = 12.7%

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Soalan:1. Potato crisps mengandungi 6.3 g protein, 35.9g lemak

dan 49.3 karbohidrat pada tiap-tiap 100 g. Kira nilai tenaga yang terdapat dalam 200 g potato crips?

2. Berapakah jumlah nilai tenaga dalam satu keping daging beratnya 90g jika dalam 100g daging mengandungi 15.3g protein, 18.8g lemak, 0.1g karbohidrat , 0.2g mineral 0.2 vitamins dan 65.5g air ?

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3. Diet Pak Ali membekal 2600 kcal sehari. Diet tersebut mengandungi 250g karbohidrat, 70g protein. Kira?

a. Berapakah jumlah g lemak dalam diet Pak Ali pada hari tersebut?

b. Kira peratus setiap nutrien (karbohidrat, protein dan lemak) yang terdapat dalam

diet Pak Ali ?

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Input TenagaTenaga/kilokalori yang terdapat dalam makanan

Output TenagaTenaga yang diperlukan @ digunakan oleh tubuh untuk beberapa perkara:• Kadar Metabolisme Asas [Basal Energy

Rate]• Aktiviti Fizikal• Pertumbuhan• Tindakan Spesifik Dinamik Makanan

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Bilakah Kadar Metabolisme Asas diukur?

1. Selepas 12 – 18 jam mengambil makanan terakhir.

2. Seseorang dalam keadaan rehat.

3. Dalam bilik yang sesuai, suhu selesa.

4. Kebiasaan diukur selepas bangun tidur waktu pagi.

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Pengukuran Penggunaan tenaga• Jumlah tenaga yang dijana @ digunakan

oleh tubuh dapat diukur secara langsung @ tidak langsung.

Kilorimetri Langsung• Individu diletakkan di dalam

kilokalorimeter /bilik khas• Kaedah sangat mahal. Cuma beberapa unit

terdapat di seluruh dunia• Di Malaysia hanya satu, terdapat di

Universiti Hospital.

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Kilorimetri Tak Langsung

• Kaedah yang lebih mudah• Diukur dengan menentukan penggunaan oksigen dan

pengeluaran karbon dioksida pada masa tertentu dengan menggunakan alat respirasi

• Dapat digunakan semasa individu berbaring rehat @ menjalankan berbagai aktiviti

• Pada setiap liter oksigen yang digunakan akan memerlukan 4.825 kilokalori tenaga.

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Kadar Metabolisme Asas [KMA]Basal Metabolisme Rate[BMR]

• Kadar Metabolisme Asas

- Jumlah tenaga yang diperlukan oleh tubuh untuk menjalankan proses-proses penting dalam tubuh.

- Kadar tubuh menggunakan tenaga untuk kekalkan fungsi penting untuk hidup.

• Kadar Metabolisme Rehat (KMR)

- Penggunaan tenaga pada keadaan yang sama kecuali selepas makan atau berlatih

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Kaedah mengira keperluan tenaga untuk KMA (Basal Metabolisme Rate)

1. Menggunakan anggaran 1 kilokalori/minit= 60 m/jam X 24jam/hari= 1440 kilokalori/hari

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2. Alat Respiratori Bebedict-Roth (Penggunaan O2)

Ali mengambil 1.08 liter O2 dalam masa 6 minit. Kira berapa jumlah keperluan tenaga KMA dalam sehari ? [Piawai 1 liter O2 = 4.825 kcal]

6 minit Ali mengambil 1.08 liter oksigen

1 jam (60 minit) = 1.08 x 60/6

= 10.8 liter Oksigen

Sehari (24 jam) = 10.8 liter x 24 jam

= 259.2 liter Oksigen

KMA = 259.2 x 4.825

= 1251 kcal.

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3. Berasaskan Berat badan, Umur & Jantina

• Lelaki< 50 tahun = 1.0 kcal/kg X BB/1 Jam> 50 tahun = 0.9 kcal/kg X BB/1 Jam

• Wanita< 50 tahun = 0.9 kcal/kg X BB/1 Jam> 50 tahun = 0.8 kcal/kg X BB/1 Jam

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Contoh:Kira berapakah jumlah tenaga untuk KMA dalam sehari bagi mereka yang berikut?

a. En. Adam berumur 45 tahun mempunyai berat badan 65 kgKeperluan tenaga KMA = 1 x 65 x 24 jam

= 1560 kcalb. Cik Fatimah berumur 26 tahun mempunyai berat

badan 46 kg.Keperluan tenaga KMA = 0.9 x 46 x 24 jam

= 993.6 kcal

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• Kira berapakah jumlah tenaga untuk KMA dalam sehari bagi mereka berikut?

1. En. Ramlee berumur 45 tahun mempunyai berat badan 65 kg ?2. Cik Fatimah berumur 25 tahun mempunyai berat badan 46 kg.3. Pak Adam berumur 66 tahun mempunyai berat badan 63 kg4. Mak Timah berumur 70 tahun mempunyai berat badan 81 kg.

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• WanitaBerat dalam Kg x 0.95 kcal x 24 jam

• LelakiBerat dalam Kg x 1.0 kcal x 24 jam

Contoh:• Aminah berumur 13 tahun dan berat badan 50 kg.

50kg x 0.95 kcal x 24 jam = 1140 Kcal

• Ramlee, berat badan 58 kg dan berumur 25 tahun58kg x 1.0 kcal x 24 jam = 1392 Kcal

4. Kaedah Pengiraan WHO. Gunakan Berat badan (dalam

kg)

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• Kira berapakah jumlah tenaga untuk KMA dalam sehari bagi mereka mengikut kiraan WHO?

1. En. Yunus berumur 48 tahun mempunyai berat badan 73 kg ?

2. Cik Rohani berumur 28 tahun mempunyai berat badan 53 kg.3. Hamidah berumur 35 tahun mempunyai berat badan

62 kg4. Halim berumur 70 tahun mempunyai berat badan

74 kg.

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Formula FAO/WHO untuk ukur REE[Resting Energy Expenditure]

Lelaki

3 - 9 22.7w) + 495

10 - 17 17.5w + 651

18 - 29 15.3w + 679

30 - 60 11.6w + 879

> 60 13.5w + 487

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Formula FAO/WHO untuk ukur REE bagi Wanita

3-9 22.5w + 499

10-17 12.2w + 746

18-29 14.7w + 496

30-60 8.7w + 829

> 60 10.5w + 596

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Latihan:1. Aminah mempunyai berat badan 50 kg. , berumur 18

tahun . Kirakan keperluan tenaga Aminah dalam sehari dengan menggunakan Formula REE ?= 14.7 w + 496= ( 14.7 x 50 ) + 496= 735 + 496= 1231 kcal/hari

2. Hamid mempunyai berat badan 78kg dan berumur 33 tahun. Kirakan keperluan tenaga dengan Formula REE?

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Faktor-Faktor yang mempengaruhi Kadar Metabolisme Asas seseorang

1. Komposisi tubuh- Kandungan tisu seseorang.- Tisu tanpa lemak (otot) : tinggi KMA- Tisu berlemak sedikit tenaga - Lelaki perlu KMA tinggi kerana mempunyai lebih tisu tanpa lemak.

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2. Keadaan Tubuh: Jalankan aktiviti Fizikal- 2 lelaki sama umur, tinggi & berat badan - Jalankan tugas fizikal yang berbeza. Seorang buruh dan

seorang akauntan- Buruh perlu banyak KMA berbanding akauntan kerana buruh

mempunyai otot-otot terbentuk berbanding akauntan3. Jantina:

- Lelaki lebih tenaga KMA berbanding wanita- Lelaki muda dewasa mempunyai 14% lemak daripada berat badan- Wanita muda dewasa mempunyai 23%- 32% lemak daripada berat badan

4. Tidur: Kurang tenaga KMA5. Malnutrisi: Tenaga KMA rendah

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6. Tekanan mental: lebih tenaga bagi orang. yang mengalami masalah mental

7. Suhu Tubuh- Kalau suhu tubuh tinggi KMA tinggi- Setiap 1 darjah tambahan suhu boleh tingkatkan 13 kcal KMA badan

8. Suhu persekitaran- suhu panas kita perlu KMA yang rendah- suhu sejuk kadar KMA tinggi bagi panaskan badan

9. Kehamilan- Tenaga KMA tinggi untuk menghamil bayi

300- 330 kcal lebih daripada wanita biasa- Ibu menyusu KMA tinggi bagi proses mengeluarkan susu

500- 550 kcal lebih daripada wanita biasa

10. Umur: Umur meningkat keperluan KMA menurun11. Merokok: lebih 10 peratus daripada orang tidak merokok

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Soalan:Norzalina 25 tahun, tinggi 1.63 m dan berat badan

65 kg. Berikut adalah jumlah kalori yang dimakan iaitu karbohidrat 190g; protein 120g dan lemak 93g mengikut 24-

jam dietary recallnya.

a. Dengan menggunakan data di atas kirakan:

(i) jumlah kalori dan tunjukkan peratus karbohidrat, protein dan lemak ? 

(ii) Peratus pengambilan makanan

b. Beri penjelasan tentang diet yang diamalkan oleh Norzalina mengikut perkiraan WHO menggunakan (i) berat badan dan (ii) norma REE

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(i) Jumlah pengambilan kalori:

a. karbohidrat = 190 X 4 kcal = 760 kcal

b. protein = 120 X 4 kcal = 480kcal

c. lemak = 93 X 9 kcal = 837 kcal

Jumlah = 2077kcal

(ii) Peratus pengambilan makanan

a. karbohidrat = 760/2077 X 100 = 36.6 %

b. protein = 480/2077 X 100 = 23.1 %

c. lemak = 837 /2077 X 100 = 40.3%

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• i. Berat badan dengan perkiraan WHO

= 0.95 kcal X kg (berat badan) X 24 jam

= 0.95 kcal X 65 kg X 24 jam

= 1482 kcal

ii. Berat badan berdasarkan Norm

= (14.7W) + 496

= (14.7 X 65 ) + 496

= 955.5 + 496

= 1451.5 kcal

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• Berdasarkan penjadualan Pemakanan Norzalina telah mengambil lebihan makanan:

• Mengikut kiraan berat badan mengikut Formula WHO

= 595 kcal [2077 – 1482]

• Mengikut keperluan norm

= 525.9 kcal [2077 – 1551.1 ]

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Menu 3000-4000kcal

114

Menu 4000-5000kcal

115

Menu 5000-6000kcal

Body Energy Balance

Slide 14.83

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

· Energy intake = total energy output (heat + work + energy storage)· Energy intake is liberated during food

oxidation

· Energy output

· Heat is usually about 60%

· Storage energy is in the form of fat or glycogen

Digestive Homeostasis Disorders

• ULCERS – erosion of the surface of the alimentary canal generally associated with some kind of irritant

• CONSTIPATION – a condition in which the large intestine is emptied with difficulty.

• Too much water is reabsorbed

• and the solid waste hardens

Digestive Homeostasis Disorders

Digestive Homeostasis Disorders

• DIARRHEA – a gastrointestinal disturbance characterized by decreased water absorption and increased peristaltic activity of the large intestine.

• This results in increased, multiple, watery feces.

• This condition may result in severe dehydration, especially in infants

Digestive Homeostasis Disorders

• APPENDICITIS – an inflammation of the appendix due to infection

• Common treatment is removal of the appendix via surgery

Digestive Homeostasis Disorders

• GALLSTONES – an accumulation of hardened cholesterol and/or calcium deposits in the gallbladder

• Can either be “passed” (OUCH!!) or surgically removed

Digestive Homeostasis Disorders

• ANOREXIA NERVOSA - a psychological condition where an individual thinks they appear overweight and refuses to eat.

• Weighs 85% or less than what is developmentally expected for age and height

• Young girls do not begin to menstruate at the appropriate age.

Digestive Homeostasis Disorders

• HEART BURN – ACID from the stomach backs up into the esophagus.

Sekian, Terima Kasih

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