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"Padatnya penduduk: dan kemiskinan di daerah perkotaan berpengaruh negatif terhadap area kesehatan lingkungan. Permasalahan di area kesehatan lingkungan ini, jika dilihat dari dimensi sosial dan moral seperti perilaku menyimpang dengan kebiasaan mengkonsumsi alkohol, dapat meningkatkan risiko dan kerentanan seseorang terpajan suatu penyakit gangguan hati yaitu sirosis hepatis. Penulisan ilmiah ini bertujuan ui1tuk menggambarkan asuhan keperawatan pada klien sirosis hepatis.denga,nhipoalbuminemia di ruangrawaliPD Teratai Lantai 5 selatan RSUP Fatmawatidengan. pendekatan Keperawatan Kesehatan Masyarakat Perkotaan. Metode yang dilakukan dengan menggunakan studi kasus. Masalah kepera.watan pada pasien adalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh. Masalah. ini .·dapat memperburuk fungsi hati dan· keadaan umum pasien. Intervensiyang dilakukan dengan menganjurkan pasien diet putih telurdan ikan gabus, hal ini dapat dilihat dari basil albumin <;larah yang stabil, penurunan lingkar perut, dan penurunan berat badan. Diet putih telur dan mengokonsumsi ikan gabus merupakan diet yang dapat mencuk:upi kebutuhan protein dan meningkatkan albumin dalam. darah. Selain itu diet hati dan perawatan dirumah menjadi prinsip yang harus diterapkan untuk: menjaga timbulnya kembali masalah nutrisi pada pasien dengan sirosis hepatis.

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The population density and poverty have negative impact for urban environmental health areas. These problem, if we looked into social and morale dimensions were a deviant behaviours such as consumed alcohol habits, that could increase the risk and the vulnerability level of liver disorder diseases like liver cirrhosis. The purpose of this articles is to describe the required nursing care for liver cirrhosis petient with hypoalbuminemia in IPD’s Teratai on south 5 floor at RSUP Fatmawati by using a case-study method. The patient’s nursing care problems were to treat malnutrition or lack of proper nutrition to the body. These could aggravate liver fungtion and patient’s general condition. The applied intervention was done by recommending eggwhite and fish-cork diets, wich could shown the stable albumin level and blood, the reduction in abdominal circumference and weight loss as a results. These diets basically were to supply the required protein and increasing the albumin level on blood. Beside of that’s, the applied liver diets and the home nursing them selves also becoming the essential principles to prevent malnutrition on liver cirrhosis petients."

"Latar belakang: Saat ini, diet ketogenik menjadi salah satu penanganan epilepsi yang sulit terkontrol dengan obat anti-epilepsi (intraktabel) pada anak dan sudah mulai diterapkan di seluruh dunia.Diet ketogenik Modified Atkins Diet (MAD) adalah jenis diet ketogenik yang lebih tidak restriktif dengan prinsip yang sama dengan diet ketogenik yang klasik.Penelitian mengenai penggunaan diet ketogenik MAD pada anak dengan epilepsi intraktabel juga masih belum ada di Indonesia. Penelitian ini bertujuan untuk menilai pengaruh, efek samping, toleransi, tingkat kepatuhan, menu makanan diet ketogenik MAD yang mudah diterapkan pada anak dengan epilepsi intraktabel yang dipantau dalam waktu 6 bulan. Metode: Penelitian ini merupakan penelitian awal dengan uji klinis pre dan post treatment pada populasi anak dengan epilepsi intraktabel yang berobat ke Poliklinik Neurologi dan Nutrisi Penyakit Metabolik Anak Rumah Sakit Umum Pusat Nasional dr.Cipto Mangunkusumo Jakarta pada bulan November 2021 hingga Juni 2022. Hasil penelitian: Sebanyak 31 subyek penelitian memenuhi kriteria inklusi. Subyek yang menjalani diet ketogenik MAD pada bulan pertama 31 subyek (100%), bulan ke-3 13 subyek (41,9%), dan bulan ke-6 adalah 9 subyek (29%). Pengaruh diet ketogenik MAD terhadap median pengurangan frekuensi kejang pada bulan pertama 50%, p=0,144; bulan ketiga 62%, p=0,221; dan bulan keenam 83,3%, p=0,028. Efek samping diet ketogenik MAD yang paling sering adalah muntah dan diare. Tingkat ketidakpatuhan diet ketogenik MAD ditemukan pada 18 subyek (58,1%). Buku contoh menu diet ketogenik MAD untuk anak epilepsi intraktabel di Indonesia dibuat untuk memudahkan orangtua dalam menjalankan diet ketogenik. Simpulan: Pengaruh diet ketogenik MAD pada anak dengan epilepsi intraktabel yang ditunjukkan dengan penurunan frekuensi kejang (median) secara klinis pada bulan ke-1,3,6 dan bermakna secara statistik pada bulan ke-6. Penelitian dengan metode uji acak ganda tersamar dan jumlah sampel penelitian yang lebih besar, multisenter, waktu lebih lama serta menu diet ketogenik MAD khas Indonesia yang mudah diterapkan dan murah diperlukan untuk mendapatkan hasil penelitian yang lebih baik. Kata kunci: epilepsi, diet, ketogenik, modified atkins

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Background: At present, ketogenic diet has been explored as a potential treatment approach for intractable epilepsy (difficult to control with anti-epileptic drugs) in children, and is applied in various parts of the world. The Modified Atkins Diet (MAD) is a less restrictive type of ketogenic diet, while still maintaining the same principles as the classic ketogenic diet. However, no existing studies have been performed to evaluate the use of the MAD ketogenic diet in children with intractable epilepsy in Indonesia. This study aims to assess the influence, side effects, tolerance, degree of adherence, and menu of MAD ketogenic diet food that can be easily applied to children with intractable epilepsy during a 6-months monitoring period. Methods: This is a pilot pre- and post-treatment clinical trial involving children with intractable epilepsy treated at the Pediatric Neurology and Nutrition & Metabolic Diseases Outpatient Clinics at the Dr. Cipto Mangunkusumo General Hospital Jakarta treated between November 2021 and June 2022. Results: A total of 31 subjects met the inclusion criteria. There were 31 subjects receiving the MAD ketogenic diet in the first month (100%), followed by 13 subjects in the third month (41.9%), and 9 subjects in the sixth month (29%). The effect of ketogenic diet in reducing the frequency of seizures was 50% in the first month (p=0.144), 62% in the third month (p=0.221), and 83.3% in the sixth month 83.3% (p=0.028). The most frequent side effects of the MAD ketogenic diet were vomiting and diarrhea. Non-compliance to the MAD ketogenic diet was observed in 18 (58.1%) of subjects. A sample book of food menu complying to the MAD ketogenic diet for intractable epilepsy based on Indonesian delicacies was also created to ease parents to comply to the diet. Conclusions: Effect of the MAD ketogenic diet in children with intractable epilepsy was clinically observed as a decrease in the median frequency of seizures in the first, third, sixth month of the diet and statistically significant in the sixth month. Further multicenter double-randomized trials with larger sample size, longer observation period and the MAD ketogenic diet with indonesian menu (cheap and applicable) are also warranted to obtain more rigorous research results. Keywords: epilepsy, diet, ketogenic, modified atkins"

"he interaction of immune function and nutrition underlies the low-grade chronic inflammation involved in the etiology of many common obesity-associated and age-related chronic disease conditions. This close interaction is the genesis of the term immunonutrition, which represents a new interdisciplinary field of nutritional and medical research. Immunonutrition: Interactions of Diet, Genetics, and Inflammation introduces the breadth of this field, which implicates nutrition in both immune function and in the etiology, prevention, and treatment of common diseases influenced by inflammation and immune imbalance, including obesity, diabetes, heart disease, asthma, autoimmune diseases, and common forms of cance"

"Malnutrition has been responsible, directly or indirectly, for 60% of the 10.9 million deaths annually among children under five. Over two-thirds of these deaths, which are often associated with inappropriate feeding practices, occur during the first year of life (WHO, 2003). In UNICEF conceptual framework, two immediate causes of malnutrition are inadequate dietary intakes and diseases, and the underlying causes that lead to those two are inadequate access to food in the household, insufficient health services and an unhealthy environment, and inadequate care for children and women (UNICEF, 1998). Inadequate dietary intake is influenced by inappropriate feeding practice. Children who are not breastfed have repeated infections and grow less well than children who at least receive some breast milk (Daelmans and Saadeh, 2003). From six months onward, a child must have complementary food at six-month point, since breast milk alone no longer meets all nutritional needs. Delaying the switch over much beyond six months of age can cause a child's growth to falter. Thus, for optimal growth and development, a child needs to be fed frequently with energy-rich, nutrient-dense foods (UNICEF, 1998). However, the complementary foods do not easily fulfill the nutrient requirement a child needs. Problem nutrients are those for which there is the greatest discrepancy between their content in complementary foods and the estimated amount required by the child (WHO, 1998). Three strategies for obtaining needed amounts of problem nutrients are: optimization of nutrient intake from locally available food, micronutrient supplementation, and fortification of processed complementary foods (Dewey and Brown, 2003). The 541" World Health Assembly in 2001 not only recommended exclusive breastfeeding for six months as a global public health recommendation, but also recommended the widest possible use of indigenous nutrient-rich foodstuffs to improve complementary foods and feeding practice (Daelmans and Saadeh, 2003). In response to that recommendation, this study was aimed to develop a feasible dietary guideline for complementary feeding of infants aged 6-11 months that will used local food available. There have been some researches about developing dietary guideline in other countries for certain age group. This study was planned to develop a dietary guideline in one area of Indonesia where many of its children in the age group of 6-11 month were under nourished."

"Penelitian ini dilatarbelakangi belum adanya bukti statistik yang kuat bahwa antara diet rendah energi dan rendah karbohidrat dapat memperbaiki status IMT dan persen lemak tubuh di tempat penelitian dilaksanakan. Dengan diketahui perubahan yang optimal pada diet rendah karbohidrat dalam jangka waktu yang singkat, terdapat alternatif dalam pemilihan bentuk intervensi diet seseorang. Mengingat kebutuhan perbaikan status IMT dan penurunan persen lemak tubuh juga menjadi kepentingan tersendiri dalam upaya menurunkan resiko penyakit degeneratif.Sehingga tujuan penelitian ini untuk melihat perbedaan rata-rata berat badan, IMT dan persen lemak tubuh, sebelum dan sesudah perlakuan diet rendah energi dan diet rendah karbohidrat. Selain itu akan dilihat pula hubungan penurunan IMT dan persen lemak tubuh yang dikontrol umur, aktifitas fisik pekerjaan dan aktifitas fisik olah raga, pada kedua pelakuan diet tersebut.Penelitian ini merupakan penelitian kuasi ekperimental. Subjek sebanyak 70 orang, dibagi menjadi dua kelompok dan dilakukan intervensi makanan diet selama 14 hari. Kelompok 1 memperoleh diet rendah kalori 1300 kalori ( KH 52 % ; P 18 % ; L 31 %) dan kelompok II diet rendah karbohidrat 1400 kalori (KH ± 16 % ; P ± 22 % ; L ± 61 %) . Diet rendah karbohidrat menggunakan minyak zaitun sebanyak 80 % dan minyak canola 20 %. Diet rendah energi seluruhnya menggunakan minyak canola. Penelitian dilakukan selama waktu April -- Juni 2006, di Prima diet catering Jakarta. . Tempat ini adalah perusahaan catering khusus yang melayani catering antara lain untuk program penurunan berat badan. Subjek dipilih dan peserta catering yang mengikuti program penurunan berat badan dan mengikuti program makan sehari penuh melalui wawancara langsung. Subjek tidak memiliki penyakit dan dinyatakan sehat dengan sebelumnya menyertakan pemeriksaan laboratorium menyangkut kadar gula darah, kolesterol, asam urat , dan gangguan ginjal. Sebelum mengikuti program pada subjek dilakukan pemeriksaan tekanan darah menggunakan tensimeter merk NOVA , tinggi badan menggunakan microtaise " Stanley Maio " dan pengukuran berat badan, persen lemak tubuh total menggunakan BIA-OMRON. Kuesioner Baecke digunakan untuk menilai aktifitas fisik pekerjaan dan aktifitas fisik olah raga.Seluruh data diolah secara manual dengan menggunakan mesin hitung dan komputerisasi . Analisis menggunakan uji t dependen atau paired t test, untuk melihat perbedaan rata - rata variabel berat badan , status IMT dan persen lemak tubuh sebelum dan sesudah perlakuan diet rendah energi dan diet rendah karbohidrat. Uji Anova untuk menganalisa faiktor umur, aktifitas fisik pekerjaan dan aktifitas fisik olah raga, pada diet rendah energi dan diet rendah karbohidrat.Hasil uji bermakna bila p < 0,05.Hasil yang diperoleh adalah perubahan IMT dan persen lemak tubuh yang signifikan pada diet rendah karbohidrat. Penurunan berat badan pada diet rendah energi sebesar ∆ 0,73 kg ± 0,2531 kg lebih kecil dibanding pada diet rendah karbohidrat ∆ 5,88 kg ± 1,36 kg. Perubahan status IMT yang lebih sedikit juga terjadi pada diet rendah energi sebesar ∆ 0.3206 kglm2 ± 0.33968 kglm2 dibandingkan pada diet ∆ 2.0389 kglm2 f 0 .46109 kg/m2 . Perubahan persen lemak tubuh yang lebih sedikit terjadi pada diet rendah energi sebesar ∆ 0,1543 % dibandingakn diet rendah karbohidrat sebesar ∆ 2,0637 %.Namun karena keterbatasan waktu dan biaya, maka pada penelitian ini tidak dilihat pengaruh biokimia darah. Sehingga belum dapat diketahuinya pengaruh diet rendah karbohidrat terhadap perubahan profil lemak darah. Juga penelitian ini hanya dilakukan dalam waktu singkat yaitu 14 hari sehingga harus diteliti lebih lanjut keamanan fisiologis dan biokimia darah, jika diet rendah karbohidrat dilakukan dalam jangka waktu panjang.

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This research has a no background or supporting proven and strong statistic that low carbohydrate diet is able to recover a status of IMT together with fat body percentage at the survey held established.With acknowledgement of some optimized changes on low carbohydrate diet for a short term of period, there is an alternative for choosing the form of influences on individual diet. Considering the needs of IMT status recovery and the decrement of body fat percentage are becoming an important for lowering the risks of degenerative disease.

The objective of this research was to found the different meant of body weight, IMT status and body fat percentage, before and after low energy diet and low carbohydrate diet. The result controlled by age, work activities, and sport activities.

This research is a experimental quasi, which has two groups with a different treatment, during April - Juni 2006 at Prima Diet Catering Jakarta . 70 healthy subjeks, all female between 24 - 45 years, were given the diet foods are set into a different pattern. The composition of the 1300 low calory diet were follows : 52 % carbohydrate, 18 % protein and 31 % fat and another one with 1400 calory low carbohydrate were 16 % carbohydrate ; 22 % protein ; 61 % fat. The formula diet was supplemented for 14 days. The fat which was given form canola oil and olive oil. Subjeks were choosen from interviewing Prima Diet Catering's client, who was follow the weight management programe. Subjeks were healthy and proven by the laboratory checking. Before the intervention, subjeks were checking the blood pressure by NOVA tensymeter, heigh measured by microtoise " Stanley Maio " and body weight, body fat percentage measures bay BIA-OMRON. Baecke's qouesionaire for found the working activities and sport activities. From here, we will see the changes of IMT status and body fat percentage before the intervention.

The result from the above experiment is showing changes of IMT and body fat percentage with a significant on low carbohydrate diet . Low energy diet showed less weight loss ( 0,73 kg ± 0,2531 kg) compare with low carbohydrate diet (  5,88 kg ± 1,36 kg) . IMT status on low energy diet were  0.3206 kglm2 ± 0.33968 kglm2, compare with low carbohydrate diet 2.0389 kglm2 t 0 .46109 kglm2, as seen the biggest result . Body fat percentage were high changes in low carbohydrate diet  2,0637 %. And low energy diet were  0,1543 % .

Due to a limit of time and expenses, this research can not assist us to view a blood biochemist then unable to support the influences of low carbohydrate diet on the profile of fat blood. Nevertheless, the research only takes place for 14 days research, which requires a security of physiology if the diet takes longer"