{"id":4906,"date":"2022-02-07T09:00:00","date_gmt":"2022-02-07T02:00:00","guid":{"rendered":"https:\/\/ahligizi.id\/blog\/?p=4906"},"modified":"2022-02-02T19:37:15","modified_gmt":"2022-02-02T12:37:15","slug":"apa-itu-stunted-obesity","status":"publish","type":"post","link":"https:\/\/ahligizi.id\/blog\/2022\/02\/07\/apa-itu-stunted-obesity\/","title":{"rendered":"Apa itu Stunted Obesity?"},"content":{"rendered":"\n

Kejadian stunted<\/em> di masa anak-anak sering dikaitkan dengan meningkatnya kejadian obesity di masa remaja atau dewasa. Hal ini memiliki beberapa penjelasan atau mekanisme yang potensial. Bukti epidemiologi mendukung adanya hubungan antara anak stunted<\/a><\/em> dengan kejadian obesitas sentral dan timbulnya penyakit kronis di masa yang akan datang. Mari kita simak lebih lanjut pada artikel berikut.<\/p>\n\n\n\n

Definisi<\/h2>\n\n\n\n

Stunted obesity adalah obesitas dengan latar belakang stunted, dimana individu mengalami kurang gizi yang menyebabkan stunted pada awal kehidupan dan gizi lebih pada masa remaja.<\/strong><\/span> Kondisi ini banyak terjadi pada kelompok urbanisasi yang mengalami stunted pada masa anak-anak dan obesitas setelah mengalami proses transisi pola makan dan aktivitas fisik. Kemudahan akses pangan dan transportasi, produksi dan penyiapan makanan, serta konsumsi makanan olahan yang padat energi memiliki kontribusi pada perubahan pola makan tersebut.\u200b1\u200b<\/sup><\/span><\/p>\n\n\n\n

Baca : Prevalensi Stunting 2019<\/a><\/strong><\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Studi Terkait Stunting dan Obesitas<\/h2>\n\n\n\n

Banyak studi yang mendemonstrasikan perubahan metabolisme yang terjadi pada anak stunted<\/em> sehingga mengakibatkan terjadinya obesity di masa yang akan datang. Beberapa bukti menunjukkan bahwa terjadi ketidakseimbangan antara penyimpanan lemak yang cenderung lebih besar dibandingkan dengan penyimpanan massa otot pada anak stunted <\/em>selama catch-up <\/em>tumbuh kembang dari balita hingga menuju remaja saat proses pemulihan dari kekurangan gizi. Hal ini dipicu karena anak stunted<\/em> secara signifikan memiliki fasting respiratory quotient <\/em>(RQ) yang lebih tinggi sehingga menyebabkan oksidasi lemak menjadi lebih rendah, dan lemak yang tidak teroksidasi harus disimpan di dalam tubuh dan penyimpanan lemak ini cenderung disimpan di bagian sentral sehingga memicu terjadinya obesitas sentral<\/span><\/strong>.\u200b2\u200b<\/sup><\/span><\/p>\n\n\n\n

Menurut teori Flatt, penurunan oksidasi lemak akan diikuti dengan peningkatan oksidasi karbohidrat yang dapat memicu peningkatan rasa lapar. Meningkatnya rasa lapar dapat memicu meningkatnya asupan energi (hyperphagia<\/em>) yang dapat menyebabkan kenaikan berat badan. Hal ini konsisten dengan pengamatan sebelumnya yang menyatakan bahwa adanya percepatan peningkatan berat badan selama masa pubertas pada anak-anak dengan stunted <\/em>yang mengkonsumsi tinggi lemak<\/span><\/strong>.\u200b2,3\u200b<\/sup><\/span> Selain itu, pengeluaran energi pada anak stunted<\/em> cenderung lebih rendah apabila dibandingkan dengan anak yang tidak stunted<\/em> terutama pada remaja putri, sehingga memperbesar risiko terjadinya obesitas.<\/span><\/strong> Terlebih lagi apabila anak tersebut memiliki genetik obesitas yang diturunkan dari kedua orangtuanya.\u200b4\u200b<\/sup><\/span><\/p>\n\n\n\n

Lebih Lanjut : Gizi Buruk, Obesitas, dan Sistem Imun<\/strong><\/a><\/p>\n\n\n\n

Mekanisme Stunted Obesity<\/h2>\n\n\n\n

Asupan energi yang rendah pada saat masa pertumbuhan diketahui dapat memicu menurunnya somatic growth<\/em> dan menurunkan kadar Insulin-like Growth Factor <\/em>(IGF-1) yang menyebabkan meningkatnya kadar kortisol dibandingkan dengan insulin. Perubahan hormonal ini memicu rendahnya pembentukan massa otot, stunting, dan beberapa manifestasi dari kekurangan gizi. Tingginya kadar kortisol juga berhubungan dengan penimbunan lemak di sentral tubuh seperti cushing disease<\/em> dan obesitas truncal<\/em> sehingga dapat meningkatkan waist to hip ratio <\/em>(WHR) pada perempuan dan wanita stunted<\/em>. Rendahnya kadar IGF-1 dapat juga menjelaskan kenaikan WHR, karena kadar IGF-1 berbanding terbalik dengan diameter abdominal saginattal dan jaringan lemak viseral sehingga apabila kadar IGF-1 rendah mungkin akan mengganggu lipolisis<\/span><\/strong>.\u200b5\u200b<\/sup><\/span><\/p>\n\n\n\n

Pengaruh lingkungan dan sosioekonomi juga turut mempengaruhi terjadinya obesitas pada anak stunted<\/em>. Lingkungan dengan tingkat sosioekonomi yang rendah menunjukkan kecenderungan kadar IGF-1 yang rendah, tingginya kadar kortisol, dan kekurangan asupan zat gizi baik makronutrien maupun mikronutrien yang sering diikuti dengan tingginya kejadian infeksi sehingga akan menimbulkan defisiensi zat gizi<\/span><\/strong>.\u200b5\u200b<\/sup><\/span> Defisiensi seng merupakan salah satu dampak yang ditimbulkan dari hal tersebut. Defisiensi seng dapat memicu obesitas di masa yang akan datang karena meningkatkan penumpukan lemak dan menurunkan massa otot accrual <\/em>dan seng juga berperan dalam pengaturan nafsu makan terkait dengan stimulasi produksi hormon leptin<\/span><\/strong>.\u200b6\u200b<\/sup><\/span> Transisi pola asupan makan pada saat remaja pun juga menjadi faktor pemicu terjadinya obesitas karena terjadi perubahan pola makan yang semula mengkonsumsi traditional food<\/em> menjadi gemar western food<\/em> yang memiliki karakteristik tinggi lemak, tinggi gula serta rendah serat.\u200b7\u200b<\/sup><\/span><\/p>\n\n\n\n

Perubahan fisiologi yang terjadi pada saat remaja yang dikarenakan growth spurt<\/em> juga menyebabkan perubahan komposisi tubuh terutama pada remaja putri. Pada saat remaja putri mengalami pubertas akan cenderung mengalami penumpukan lemak tubuh dibandingkan dengan remaja putra. Namun penumpukan lemak cenderung lebih besar pada remaja putri stunted<\/em> dibandingkan dengan remaja putri yang tidak stunted<\/em>.\u200b8\u200b<\/sup><\/span><\/p>\n\n\n\n

Referensi<\/h2>\n\n\n\n
  1. \n
    1. <\/div>
    Tzioumis E, Adair LS. Childhood Dual Burden of Under- and Overnutrition in Low- and Middle-inCome Countries: A Critical Review. Food Nutr Bull<\/i>. Published online June 2014:230-243. doi:10.1177\/156482651403500210<\/a><\/div>\n <\/div>\n<\/li>
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    Hoffman DJ, Martins PA, Roberts SB, Sawaya AL. Body fat distribution in stunted compared with normal-height children from the shantytowns of S\u00e3o Paulo, Brazil. Nutrition<\/i>. Published online September 2007:640-646. doi:10.1016\/j.nut.2007.06.006<\/a><\/div>\n <\/div>\n<\/li>
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    Rachmi CN, Agho KE, Li M, Baur LA. Are stunted young Indonesian children more likely to be overweight, thin, or have high blood pressure in adolescence? Int J Public Health<\/i>. Published online October 4, 2016:153-162. doi:10.1007\/s00038-016-0905-x<\/a><\/div>\n <\/div>\n<\/li>
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    4. <\/div>
    Hoffman DJ, Sawaya AL, Coward WA, et al. Energy expenditure of stunted and nonstunted boys and girls living in the shantytowns of S\u00e3o Paulo, Brazil. The American Journal of Clinical Nutrition<\/i>. Published online October 1, 2000:1025-1031. doi:10.1093\/ajcn\/72.4.1025<\/a><\/div>\n <\/div>\n<\/li>
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    Sawaya AL, Martins PA, Grillo LP, Florencio TT. Long-term Effects of Early Malnutrition on Body Weight Regulation. Nutrition Reviews<\/i>. Published online July 2004:S127-S133. doi:10.1111\/j.1753-4887.2004.tb00082.x<\/a><\/div>\n <\/div>\n<\/li>
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    Weisstaub G, Hertrampf E, L\u00f3pez de Roma\u00f1a D, Salazar G, Bugue\u00f1o C, Castillo-Duran C. Plasma Zinc Concentration, Body Composition and Physical Activity in Obese Preschool Children. Biol Trace Elem Res<\/i>. Published online July 26, 2007:167-174. doi:10.1007\/s12011-007-0026-8<\/a><\/div>\n <\/div>\n<\/li>
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    7. <\/div>
    Symington EA, Gericke GJ, Nel JH, Labadarios D. The relationship between stunting and overweight among children from South Africa: Secondary analysis of the National Food Consumption Survey \u2013 Fortification Baseline I. S Afr Med J<\/i>. Published online December 16, 2015:65. doi:10.7196\/samj.2016.v106i1.9839<\/a><\/div>\n <\/div>\n<\/li>
  8. \n
    8. <\/div>
    Martins PA, Hoffman DJ, Fernandes MTB, et al. Stunted children gain less lean body mass and more fat mass than their non-stunted counterparts: a prospective study. Br J Nutr<\/i>. Published online November 2004:819-825. doi:10.1079\/bjn20041274<\/a><\/div>\n <\/div>\n<\/li><\/ol><\/section>\n\n\n\n
      \n\n\n\n\n\n\n\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

      Kejadian stunted di masa anak-anak sering dikaitkan dengan meningkatnya kejadian obesity di masa remaja atau dewasa. 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