Unit IV: Nutrition During Adult Years

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Unit IV Nutrition During Adult Years

• November 14, 2002
• NSC 301

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Adult Years

• Entering into adulthood and beyond
• -Begin to gain a sense of identity and core
  beliefs solidify
• -Forming life patterns career, marriage or
  single, children
• -Eriksons search for intimacy vs isolation

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Early Adult Years (20-45 years)

• Growth and Development
• Cognitive/emotional
• world view- what you hold true, what you believe
  about yourself and the world around you
• values- what drive your behaviors
• behaviors- values and beliefs put into action

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Early Adult Years
Behaviors
Values
World View
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Early Adult Years

• Physiology
• - Peak body function 20-30 yrs
• - Bone mass- peak density 20 yrs, accumulate up
  to early 30s
• -Muscle mass- growth continued if muscles used

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Early Adult Years

• b. Physiology
• -Emphasis maintaining physical status
• continue to build strength
• avoid excess weight gain
• OPTIMAL NUTRITION FULLEST HEALTH POTENTIAL

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Early Adult Years

• Energy and Nutrient Needs
• -RDAs and DRIs about the same as adolescence
• -Use the Food Guide Pyramid and adjust servings
  to meet calorie needs
• -May need to supplement Ca2 and Fe if caloric
  intake low

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Early Adult Years
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Early Adult Years

• Healthy Eating and Weight Management
• Eating plans
• -Focus on lifestyle change, not dieting
• -Watch portion sizes, adequate water
• -Eating at regular meal times

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Early Adult Years

• Physical Activity
• -Guidelines for physical activity
• 1 hour per day
• -Develop patterns of regular activity
• -Need to shift body composition from increased
  fat to increased lean body mass

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Early Adult Years

• Physical Activity
• -Benefits expend calories
• decrease body fat
• increased RMR
• decreases stress
• better sleep

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Early Adult Years

• From Guidelines to Groceries
• -Read food labels

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Early Adult Years

• From Guidelines to Groceries
• -Spend money on nutrient dense foods
• -Shop using Food Guide Pyramid
• -Shop from a list
• -Plan out some meals and purchase food
  accordingly

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Early Adult Years

• From Groceries to Meals
• - Learn to prepare more meals at home
• -Budget meals- usually costs less to eat at home
  than eat out
• -Follow food safety practices

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Middle Adult Years (45-65 yrs)

• -Beyond childbearing age
• -Two main goals promote health
• slow aging process

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Middle Adult Years

• Growth and Development
• Body Composition
• -Lean body mass decreases 2-3 per decade
• -RMR decreases, weight gain 10lbs per decade
• -Key is to decrease kcal AND continue to exercise

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Middle Adult Years

• Physiological Maturity
• -Women experience menopause around 45-55 yrs old
• -For men, gradual decrease in testosterone
  levels begin 40-50 yrs old
• -Men and women should continue to exercise
  (aerobic, flexibility, strength)

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Middle Adult Years

• Psychological Maturity
• -Security in housing and career
• -Eriksons phase VII generativity vs stagnation
• -Look for ways to stay younger
• -Fear of chronic disease

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Middle Adult Years

• Gender Differences
• -Men risk for coronary artery disease (CHD),
  until women reach menopause
• -Post menopausal women risk for DM Type 2 and
  osteoporosis than males (until men reach 80 yrs)

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Middle Adult Years

• Nutrition Needs/Dietary Recommendations
• Carbohydrates
• -complex CHO preferred, rich in fiber
• -Adequate fiber 20-30g/day
• soluble fiber- decreases blood cholesterol
• insoluble fiber- proper intestinal fxn,
  decreases risk of colon cancer

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Middle Adult Years

• Soluble Fiber Sources
• -oats, barley, legumes, fruits
• Insoluble Fiber Sources
• -wheat, cereals, vegetables

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Middle Adult Years

• Protein
• -Needed for maintaining body tissues
• -10-20 of calories per day
• -Increased protein diet not needed,
• may cause Ca2 in urine leading to
  osteoporosis

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Middle Adult Years

• Fat
• -Increased fat intake associated with CVD, DM,
  some cancers, and obesity
• -Trans fats in hydrogenated oils increase risk
  for CVD by increasing LDL-C
• -Focus on monounsaturated fats- olive oil,
  canola oil, peanut oil
• -Avoid saturated fats- meat, dairy, butter

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Middle Adult Years

• Fat- recommended intakes
• 30 of calories from fat
• 10 of calories from saturated fat, included in
  this is trans fats
• MUFAs- canola oil, olive oil

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Middle Adult Years

• Energy Needs-
• -Balance calorie input with energy output
• -Averages 1500-1700 for women,
• 2100-2300 for men
• -Use Food Guide Pyramid as a guide
• -Increased body weight associated with
  increased risk for CVD, hypertension, DM Type
  2, and some cancers

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Middle Adult Years

• Minerals
• - Ca2, P, Mg needed for bone health
• -Fe- womens needs decrease after menopause
  (18mg - 8mg)
• -Na above 6g/day may increase BP in sensitive
  individuals
• -K and Mg -if low may increase risk for high BP

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Middle Adult Years

• Vitamins
• -A,C,E,B-carotene- antioxidants that may help
  prevent cell damage
• -Vitamin C requirement increases with smokers,
  high aspirin use, and oral contraception use

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Middle Adult Years

• Supplements
• -Not usually needed in healthy adults
• -Watch upper limit (UL) for vit B6, A, D, and Fe
• -Possible indications for use
• calories
• surgery/burns

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Middle Adult Years

• Supplements
• -Indications for use (contd)
• bizarre diet habits
• diet restrictions due to food allergy
• vegans- B12
• illnesses that interfere with intake,
  absorption, metabolism or excretion of nutrients

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Middle Adult Years

• Exercise and Physical Fitness
• Positive Effects of Exercise
• -improves body composition
• -improves cardiovascular efficiency
• -improves serum lipid levels
• -tension reliever
• -psychological effects

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Middle Adult Years

• Development of Exercise Program
• -Talk with a doctor before beginning
• -Pick activities you enjoy
• -Include aerobic, strength, and flexibility
  activities
• -Womens Health Initiative study showed amount
  of activity strongly predictive of reduced risk
  of CVD

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Middle Adult Years

• Stress Management
• -Mind/body connection- one affects the other
• -Eustress- good stress new job, marriage, home,
  baby
• -Distress- bad stress death, loss of job,
  divorce
• -Negative stress can lead to nutrition issues

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Middle Adult Years

• Nutrition and Health Issues
• Menopause- women 45-55 yrs old
• -15 have hot flashes, anxiety, irritability
• -As estrogen decreases, risk of osteoporosis
  increases
• -Need adequate Ca21000-1200mg/day
• -Need adequate vit D

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Middle Adult Years

• Breast Cancer
• -Possible link between increased fat intake and
  incidence
• -Decrease fat, increase fiber, adequate
  B-carotene
• -Prostate cancer in men- may decrease risk with
  increased lycopene intake

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Middle Adult years

• Osteoporosis
• -Brittle bones
• -Increased risk in those with small frames,
  Caucasian or Asian descent, smokers, and post
  menopausal women
• -Adequate calcium intake

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Middle Adult Years

• Cardiovascular Disease
• -Risk factors
• obesity- BMI 30
• high BP- 140/90mmHg (normal 120/80)
• Elevated cholesterol-
• High LDL-C- 130-159mg/dl borderline,
  160-189mg/dl high, 189mg/dl very high

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Middle Adult Years

• Cardiovascular Disease
• -Risk factors (contd)
• low HDL-
• Diabetes
• DIET!!

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Middle Adult Years

• Causes of death in the United States

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Middle Adult Years

• Diabetes Type 2
• -Prevalence increasing in the US, in children
  also
• -Blood glucose levels high, abnormal CHO
  utilization
• -Need dietary changes, weight loss, exercise,
  limit alcohol

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Middle Adult Years

• Cancer
• -Second leading cause of death
• -Multiple diet components, some still being
  identified
• -To decrease colon cancer risk- increase fiber
  intake, increase intake of cruciferous vegetables
  (broccoli, cabbage, cauliflower)

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Middle Adult Years

• Cancer (contd)
• -Phytochemicals may have a protective effect
  (carotenoids, lycopene, isoflavones)
• -Increased polyunsaturated fat intake may
  increase cancer incidence

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Middle Adult Years

• Overweight and Obesity
• -New data reported in JAMA, Oct. 2002
• overweight (BMI 25-29.9) 64.5 of US population
• obese (BMI30) 30.5 of US population
• -Rates of overweight up almost 10 in the past
  three years

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Middle Adult Years

• Overweight and Obesity (contd)
• -Increases risk for CVD, DM, high BP, stroke,
  and cancer
• -Focus on lifestyle change- yo-yo dieting
  associated with increased mortality
• -Focus on healthy weight, may be ideal weight

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Middle Adult Years

• Overweight and Obesity (contd)
• -Estimating healthy body weight using Hamwi
  formula
• women 100lbs first 5 feet 5 lbs each
  additional inch
• men 106lbs first 5 feet 6 lbs each
  additional inch

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Middle Adult Years

• Overweight and Obesity (contd)
• -Example
• What is a healthy weight of a male who is 6
  feet tall?
• IBW 106 12(6) 178lbs 10

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Middle Adult Years

• Overweight and Obesity (contd)
• -Waist to hip ratio (apple vs pear)- measured at
  waists narrowest point and hips widest point
• -WH men at risk with 1.0
• women at risk with 0.8

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Middle Adult Years

• Overweight and Obesity (contd)
• -Calories for promoting weight loss
• Multiply current weight by 12, then subtract
  500 calories for gradual weight loss
• Ex Male, 72 inches, 215lbs (IBW178lbs)
• 215x12 2580 500 2080 calories
• (one pound 3500 calories)

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Middle Adult Years

• Hypertension
• -BP 140/90mmHg
• -Weight loss if needed
• -Decrease sodium to sensitive individuals
• - 1oz alcohol/day can increase BP

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Middle Adult Years

• Hypertension (contd)
• -DASH (Dietary Approaches to Stop Hypertension)
  diet
• focuses on increased fruit and vegetable
  intake, low fat dairy products, and decreased
  sodium intake

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Middle Adult Years

• Recommended servings in DASH diet
• -Grains grain products 7-8
• -Vegetables 4-5
• -Fruits 4-5
• -Low fat/nonfat dairy 2-3
• -Meat/fish/poultry
• -Nuts/seeds/beans 4-5

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Middle Adult Years

• Cigarette Smoking
• -STOP SMOKING
• -Greatest single preventable cause of illness
  and premature death
• -Increased risk for lung cancer, CVD, stroke

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Middle Adult Years

• Alcohol Abuse
• -Moderate intake of 1-2 drinks/day may decrease
  risk of CVD
• -Excess alcohol increases risk of CVD, liver
  disease, hypertension, cancers of liver, breast,
  and pancreas
• -Nutrient deficiencies in some B vitamins

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Next Time

• Nutrition and Health Promotion
• Chapter 17 Adult Nutrition Conditions and
  Interventions
• Skills and Competencies of Dietitians Practicing
  in Wellness Settings,
• JADA 2000