DIET Pada Sistem Neurobehavioral 1

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
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 intolerances
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
ghee/dairy,
bacon

VITAL ROLES OF SATURATED FAT
BrainSaturated 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 Cant function without saturated
fatsprotects against asthma
Immune System Enhanced by saturated
fatsfights infection
Essential Fatty Acids Work together with
saturated fats
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, butter
and 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 Enzymes
Probiotics
Cod liver oil/fish oil/EFAs
Magnesium
Calcium
Zinc
B6
Vitamins A, C, and E
CoQ10
Glutathione/NAC
Methylation: B12, folinic or 5MTHF, TMG/DMG
Transfer factor
Amino 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)
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 do
Grains, 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.
Fermented Foods Rich in Probiotics
Functions 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 Probiotics
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
Homemade
Bone & 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
Grandma
knew best
Bone Broths and Gelatin
Bone broth contains gelatin:
Gelatins 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

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