Nutrition and Lifecycle II

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Nutrition and Lifecycle II

• Lecture 14
• March 12, 2009
• Dr. Quadro

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AGING

• Inevitable, natural process!
• It is the result of cumulative effects of all
• biochemical and physiological changes
• that occur in a living organism and its
• constituents (cells, organs, systems)
• over time.
• Changes occur also in response to the interplay
  of
• genetic and environmental events.

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Demographic Trends and Aging

• Number of elderly (65) in the US will double by
  2030 to more than 70 million people.
• Improved life expectancy as a result of better
  prenatal and postnatal care and improved means of
  combating diseases in older adults.

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More statistics

• In the US, life expectancy is 73 years for men
  and 75 years for women.
• Maximum life span (maximum age at which people
  die) is 130 years.

• Healthy life style (good diet, exercising,
  healthy environment) can slow the process of
  aging.

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15-90 reduction
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Physical Changes

• Physical changes of aging can affect
• -Food Intake
• Body Composition
• Strength and Energy
• Saliva
• Teeth

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Physical Changes

• Digestion
• Fat Intolerance
• Lactose Intolerance
• Constipation
• Thirst
• Taste and Smell
• Eyesight

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Physical Changes

• Other systems that are affected by normal aging
• - Liver function
• - Kidney function
• - Basal metabolism
• - Hormone production/metabolism
• - Higher order functions (brain)
• - Circulatory system

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Aging at the cellular level

• Impairment of DNA replication
• Impairment of cellular proliferation
• Loss of viability of the cell
• Reduced rate of DNA repair
• Free radical damage
• Reduced rate of protein synthesis and catabolism

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• Experimental rodent studies
• Moderate dietary restriction extends lifespan of
  the animals studied compared to control animals
  fed ad libitum
• -complete dietary restriction
• -selective removal of individual macronutrients
  (fat, protein, carbohydrate)
• -selective removal of individual micronutrients
  (vitamin A, E)

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• Good nutrition
• can retard and ease
• the aging process.

This can help to prolong life up to the maximum
life span, but cannot extended it further!
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Aging and Nutritional Needs

• Older adults do need to pay attention to quality
  and quantity of food.

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Calories

• Energy needs are reduced (reduced basal
  metabolism due to loss of lean tissues and
  decreased physical activity)

• Caloric needs decrease about 5 per decade after
  age of 50

• Select nutrient-dense food
• Plan regular exercise

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Calorie Imbalance

• Weight Gain
• Risk For Many Health Problems
• Weight Loss
• Risk For Malnutrition
• Dont go below 1200 calories

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Proteins

• Proteins are important for
• Maintain Healthy Cells Wound Healing
• Sustain Immune System Enzymes
• Prevent Muscle Wasting Hormones
• Adults need 0.8 g/kg (RDA)
• Elderly may need 1.0 to 1.25 g/kg due to
  inefficient digestion and absorption

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Fat

• Fat Source of energy, biological
• membranes, carrier for vitamins, hormones and
  intracellular messenger
• Fat digestion and absorption is not impaired
• Too much fat increases disease risk. Thus, limit
  fat to 30 or less of total calories
• Limit fat intake by choosing lean, cooking lean,
  and limiting added and hidden sources of fat

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Carbohydrates

• Carbohydrate Foods Provide Energy
• 50-60 Of Total Calories From Carbohydrate
• Absorption is slightly reduced
• 6 or more Bread, Cereal, Rice or Pasta Servings
  Daily

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Fiber

• Soluble and insoluble fiber
• Food as source of fiber
• Cereals, vegetable and fruits, seeds, food
  additives
• It facilitates normal GI functions (constipation,
  diverticulosis), reduces colon cancer risk,
  coronary heart diseases risk (lowers
  cholesterol), slows carbohydrates utilization,
  help with weight control
• 6 servings of nutrient-dense, fiber rich whole
  grains and fortified cereals-

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Vitamins and Minerals

• Elderly tend to have low dietary intakes of some
  vitamins and minerals
• Vitamin B6, B12, D
• Folate
• Magnesium
• Zinc
• Iron
• Calcium

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Vitamin/Mineral Supplements

• Dont take large doses
• Supplements can not make up for a poor diet
• Supplements not Replacements

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Water

• Elderly have increased risk of dehydration
• Body water decreases with age
• Medications increase water loss
• Thirst mechanism not as effective
• Decreased mobility to reach fluids
• - 6-8 cups of water daily (30ml/kg)

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Medications

• Follow recommendations regarding medications and
  eating
• Some medications need to be consumed with foods,
  others need to be consumed on an empty stomach
• Some medications interact with foods, nutrients,
  or can affect appetite

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Aging and Nutritional Needs

• Increase of specific nutrients

• Reduced stomach acidity (calcium, iron, vitamin
  B12)
• Decline in vision (antioxidant such as
  b-carotene, lutein, vitamin E)
• Reduced exposure to sunlight (vitamin D)

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Aging and Nutritional Needs

• Reduce specific nutrients

• Decline in hepatic functions (vitamin A)
• Risk of cardiovascular diseases (fat)

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Nutritional needs of older adults

• 3 servings of low-fat dairy products
• 2 or more servings of meat bean group
• (beans, fish,eggs and lean cuts meat and poultry)
• 5-6 servings of fruits and vegetables
• 6 or more servings of nutrient-dense,
• fiber-rich whole grains and fortified cereals
• 8 glasses of water or noncaffeinated fluids

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Food pyramid for Healthy Aging
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Nutrition-Related Problems of Older Adult

• Functional decline in almost every organ (intake,
  absorption, storage, utilization and excretion of
  nutrients)

• Chronic diseases (heart diseases, cancer,
  diverticulosis, vascular diseases, osteoporosis,
  diabetes, oral cavity diseases, neurological
  diseases, depression)

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Health problems associated related to aging are
preventable
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Aging and Nutrition Status

• Older people vary in their social, economic,
  functional capacities and physical condition.
• Most older people live at home, are fully
  independent, and have a good quality of life.
• Some others have problems with the Activity of
  Daily Living (ADL) and are at risk of
  malnutrition

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Factors Influencing the Nutritional Status of
Older Adults

• Socioeconomic
• Cultural Beliefs
• Poverty
• Level of education
• Access to health care
• Institutionalization

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Factors Influencing the Nutritional Status of
Older Adults

• Physiological
• Dietary intake
• Lack of appetite
• Inactivity/Immobility
• Poor taste or smell
• Alcohol or drug abuse
• Chronic diseases

• Polypharmacy
• Disability
• Oral health problems

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Factors Influencing the Nutritional Status of
Older Adults

• Psychological
• Loneliness
• Cognitive impairment
• Dementia
• Depression
• Loss of spouse
• Social isolation

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Factors Influencing the Nutritional Status of
Older Adults

• Environmental
• Inadequate housing
• Inadequate cooking facilities
• Lack of transportation
• Lack of access to health services

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Federal Elderly Nutrition Program(ENP)

• Specific goals
• Low cost nutritional meal
• Opportunity for social interaction
• Nutrition education and shopping assistance
• Counseling and referral to other social and
  rehabilitation services
• Transportation services

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AGING WELL

• Life advantages

• Genetic potential
• Continue desire for new knowledge and experiences
• Socialization, intimacy and family integrity
• Prudent diet
• Avoidance of substance abuse
• Acceptable living arrangements
• Access to health care

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Tips For A Healthy Diet

• Include A Variety Of Food Following The Food
  Guide Pyramid
• Avoid Empty Calorie Foods
• Use Fresh Fruits For Desserts
• Encourage Snacks If Food Intake Low
• Drink WATER
• Intolerances

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Tips If Appetite Declines

• Eat Meals At Regular Times
• Big Meal Earlier
• 5-6 Smaller Meals
• Physical Activity To Increase Appetite

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Tips If Smell and Taste Decline

• Use Herbs and Spices
• Use Flavors
• Use Visual Clues
• Colors
• Shapes
• Temperature
• Textures

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Tips If Chewing and Swallowing Decline

• Moisten Food (Gravies or Sauces)
• Serve A Beverage With Meal
• Eat Slowly And Chew Thoroughly
• Be Sure Dentures Fit Properly
• Maintain As Normal Of A Diet As Possible
• Soft High Protein Foods
• Precut, Mash, Shred Foods

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Tips If Emotional And Social Factors Decrease
Food Intake

• Serve Food Attractively
• Use A Variety Of Flavors, Color, Temperature,
  Shapes and Texture
• Dont Serve Same Foods Every Day
• Make Surroundings Pleasant
• Invite A Friend Over
• Eat Out Occasionally

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