Pengaruh Pemberian Zink terhadap Peningkatan Nafsu Makan dan Status Nutrisi pada Anak Malnutrisi Ringan Sedang

Abstract

Background Incidence of mild-moderate malnutrition has been increased by 19.6% based on Riskesdas 2013. Zinc, as an essential trace element is low in mild-moderate malnutrition children. One of several benefit of zinc is improving appetite, hence the additional administered of zinc associated with weight gain as well as changes in the nutritional status of mild moderate malnutrition children. Objective To analyse the effect of zinc supplementation on appetite, weight gain and changes in the nutritional status of mild-moderate malnutrition children. Methods A randomized, double-blind, placebo-controlled trial was conducted on March until April 2014 in several kindergartens in Medan. All children between 4 to 5 years of age having mild-moderate malnutrition were included the study. Zinc of 20 mg/5ml and placebo 5 ml were administered once daily for 2 to 4 weeks. Assesment of improved appetite with a 24 hour food recall using food model and nutri survey of 2007 to calculate the amount of calories. Weight and nutritional status changes were assesed using WHO growth chart 2006. Chi square and Mann Whitney test were used to compare the difference between groups . Results Of the 81 children who met criteria participated in this study, 40 children received placebo and 41 children received zinc. Children assesed 2 and 4 weeks after initiation of intervention realed significant number of children in group zinc developed improved appetite in comparison to placebo group ( 110 kcal vs 10 kcal, P= 0.001) ( 250 kcal vs 20 kcal, P= 0.001). The weight gain was a significant differences betweeen zinc and placebo for 2 weeks (0.1 kg vs 0.0 kg) and after 4 weeks (0.5 kg vs 0.0 kg, P= 0.001) and there was a significant difference between zinc and placebo 2 and 4 weeks to change the nutritional status mild-moderate malnutrition to the good nutritional status (P= 0.001). Conclusion Oral zinc supplementation improved appetite, weight gain and changes nutritional status in mild moderate malnutrition children.

Latar Belakang Angka kejadian Malnutrisi ringan sedang meningkat berdasarkan Riskesdas 2013. Zink merupakan trace element yang kadarnya mengalami penurunan pada anak malnutrisi ringan sedang. Terdapat beberapa manfaat dari zink salah satunya peningkatan nafsu makan, sehingga diharapkan dengan pemberian zink dapat menambah berat badan serta terjadi perubahan status nutrisi pada anak malnutrisi ringan sedang. Tujuan Untuk mengetahui manfaat zink terhadap peningkatan nafsu makan, berat badan serta perubahan status nutrisi pada anak malnutrisi ringan sedang Metode Penelitian dengan uji klinis dilakukan pada bulan Maret – April 2014 di tiga Taman Kanak-Kanak, Medan. Sampel adalah anak berusia 4 sampai 5 tahun mengalami malnutrisi ringan sedang. Zink diberikan dengan dosis 20mg/5ml dan plasebo 1 x sehari dikonsumsi 2 sampai 4 minggu. Dilakukan penilaian peningkatan nafsu makan dengan recall makanan 24jam dan model makanan serta perhitungan menggunakan nutri survey 2007, berat badan dan perubahan status nutrisi dinilai dengan menggunakan kurva WHO 2006. Untuk membandingkan perbedaan dua kelompok dengan menggunakan uji chi square dan Mann Whitney. Hasil Total 81 anak yang memenuhi kriteria, masing-masing 40 anak mendapat plasebo dan 41 anak mendapat zink. Peningkatan nafsu makan pada kelompok zink dibandingkan plasebo 2 sampai 4 minggu kkal, ( 110 kkal vs 10 kcal, P= 0.001) ( 250 kkal vs 20 kkal, P= 0.001) dan peningkatan berat badan pada kelompok zink dibandingkan plasebo pada 2 minggu (0.1 kg vs 0.0 kg) dan setelah 4 minggu (0.5 kg vs 0.0 kg, P= 0.001). Perubahan status nutrisi pada anak yang diberi zink dibandingkan plasebo 2 sampai 4 minggu mengalami perbedaan yang bermakna (p = 0.001) Kesimpulan Pemberian zink terbukti meningkatkan nafsu makan, berat badan serta perubahan status nutrisi pada anak malnutrisi ringan sedang