Understanding Nutrition

Understanding Nutrition Chapter 17 Life Cycle Nutrition: Alcohol and the Later Years By A. Fellah, Ph.D.

The Aging of the U.S. Population Nutrition and longevity.

Nutrition and Longevity • In 2000, an estimated 70,000 people in U.S. were 100 years or older; by the year 2050, the number of centenarians is expected to grow more than tenfold. • Life expectancy: the average number of years lived by people in a given society. • Life span: the maximum number of years of life attainable by a member of a species. • Longevity: long duration of life.

The Age Wave About one in five Americans will be 65 years of age or older by the year 2030.

Increasing Longevity Fun with friends may increase longevity.

Life Expectancy Average length of life for Caucasian and African American males and females in the United States in 1900, 1940, and 1996.

Research in the field of aging is active-and difficult. The questions researchers are asking include: • To what extent is aging inevitable, and can it be slowed through changes in lifestyle and environment? • What role does nutrition play in the aging process, and what role can it play in slowing aging? • It seems that aging is inevitable, natural process, programmed into the genes at conception. • Nutrition can improve the quality of life in the later years.

U.S. Population Growth, 1960 to 1990 The “oldest old”—those over 85 years—are the fastest-growing age group in the United States. Between 1960 and 1990, the U.S. population grew 39 percent, but the population of those over 85 more than doubled. An estimated 25,000 Americans now living are 100 years old or older.

Observation of Elderly People • Health Habits: The physiological age reflects the health status and may or may not reflect the chronological age. • Physiological age:a person’s age as estimated from her of his body’s health and probable life expectancy. • Chronological age:a person’s age in years from his or her date of birth. • Influence of lifestyle behaviors on people’ health: • Sleeping regularly and adequately. • Eating well-balanced meals. • Engaging in physical activity regularly. • Not smoking. • Not using alcohol, or using it in moderation. • Maintaining a healthy body weight.

Manipulation of Diet • Energy Restriction in Animals. • Animals live longer and have fewer ageing related diseases when their food intakes are restricted. • The consequences of energy restriction: • Delay the onset, or prevention, of diseases (atherosclerosis). • Prolonged growth and development. • Improve blood glucose, insulin sensitivity, and blood lipids. • Energy Restriction in Human Beings: • Cut in energy intake by 10-20% may result in: • Drop in Body weight, body fat, and blood pressure. • Rise in HDL cholesterol.

The Aging Process • Stress: any threat to a person’s well-being: a demand placed on the body to adapt. • Stressors: environmental elements, physical or psychological, that cause stress. • Physical: alcohol abuse, drug abuse, smoking, pain, and illness. • Psychological: exam, divorce, moving, and death of loved one. • Stress response: the body’s response to stress, mediated by both nerves and hormones. • Healthy people over 100 years old who had higher intakes of vegetable showed less evidence of oxidative stress than people 70 to 99 years old.

Physiological Changes: • Body Composition: older people tent to lose bone and muscle and gain body fat. • Sarcopenis: loss of skeletal muscle mass, strength, and quality. • Optimal nutrition and regular physical activity can help maintain muscle mass and strength and minimize the change in body composition. • Immune System: • Reduction in function with age. • Compromised with nutrition deficiencies. • Old age and malnutrition make older people vulnerable to infection diseases.

Younger Woman’s Thigh Older Woman’s Thigh

GI tract:intestinal wall loses strength and elasticity with age. • Atrophic gastritis: condition affect ~1/3 of those over 60. • Inflamed stomach. • Increased bacterial growth. • Reduced HCl. • Reduced intrinsic factor. • Increased risk of nutrient deficiencies, notable by vitamin B12. • Tooth Loss: tooth loss and gum diseases are common in old age. • People without teeth have low intakes of fiber and vitamins and high intakes of saturated fat and energy. • Conditions requiring dental care: • Dry mouth, Eating difficulty, • No dental care within 2 years, Tooth or mouth pain, • Altered food selections, Lesions, sores, or lumps in mouth.

Sensory Losses and other Physical Problems: • They can interfere with the ability to obtain adequate nourishment. • Failing eyesight can make driving to the grocery store difficult. • Carrying bags of groceries may become a problem. • Taste and smell sensitivities tend to diminish with age. • Psychological changes: • Depression affecting ~ 6 million older adults. • Economic changes: • Poverty is a problem for ~ 20% of the people over age 65. • Social change: • Malnutrition most likely to occur among those living alone. • Loneliness is directly related to nutritional inadequacies.

Taste in Older Aged People Taste is less affected by age than are some other senses.

Energy and Nutrient Needs of Older Adults • Water: • Total body water decreases as people age, so even mild stresses such as fever or hot weather can precipitate rapid dehydration in old adults. • 6 glasses of water is needed to prevent dehydration. • Energy and Energy Nutrients: • The energy RDA for adults decreases slightly after age 50. • People must select mostly nutrient-dense foods, low in fat, sugars, and alcohol. • Many older people experience unintentional weight loss because of inadequate food intake.

Adults of all ages need 6 to 8 glasses of water per day.

Protein: • Must be obtained from low-kcalories sources of high-quality protein. • Lean meats, poultry, fish, and eggs • Low-fat milk products and legumes. • Support a healthy immune system and prevent muscle wasting. • Carbohydrate and Fiber: • Abundant carbohydrate is needed to protect protein fro being used as an energy source. • Eating high-fiber foods and drinking water can alleviate constipation. • Fat: • Cutting fat may help prevent or delay the development of cancer and atherosclerosis.

Vitamin and Minerals • Vitamin B12: • ~15% of elderly deficient of the vitamin B12. • Given the devastating neurological effects of a vitamin B12 deficiency, an adequate intake is imperative. • Vitamin D: • Fortified milk provides significant vitamin D. • Aging reduces the skin’s capacity of make vitamin D and the kidney’s ability to convert it to its active from. • 10 mg daily is recommended to prevent bone loss and to maintain vitamin D status.

Calcium: • 1200 mg is the daily recommendation. • Some older adults avoid milk and milk products, the addition of powdered non-fat milk to recipes may solve it. • Iron: • Iron deficiency anemia is less common in older adults. • People with low food energy intakes may have it. • Chronic blood loss from diseases and medicines, and poor iron absorption may lead to iron deficiency anemia.

Predictors of malnutrition in the elderly

Nutrition-Related Concerns of Older adults • Cataracts and Macular Degeneration: • Cataracts:thickening of the eye lenses that impair vision and can lead to blindness. • Macular degeneration: deterioration of the macular area of the eye that can lead to loss of central vision and eventual blindness. • The macula is a small, oval, yellowish region in the center of the retina that provides the sharp, straight-ahead vision so critical to reading and driving.

Arthritis: • Inflammation of a joint, usually accompanied by pain, swelling, and structural changes. • Osteoarthritis: • a painful, chronic disease of the joints that occurs when the cushioning cartilage in a joint breaks down; joint structure is usually altered, with loss of function (degenerative arthritis). • Rheumatoid arthritis: • a disease of the immune system involving painful inflammation of the joints and related structure.

The Aging Brain • Neurons: nerve cells; the structural and functional units of the nervous system. Neurons initiate and conduct nerve transmission. • Senile dementia: the loss of brain function beyond the normal loss of physical adeptness and memory that occurs with aging. • Alzheimer’s disease: a degenerative disease of the brain involving memory loss and major structural changes in neuron networks; also known as senile dementia of the Alzheimer’s type (SDAT), primary degenerative dementia of senile onset, or chronic brain syndrome.

Serotonin synthesis in the brain

Communication within the Brain

Food Choices and Eating Habits of Older Adults • Familiarity, taste, and health beliefsare most influential on older people’s food choices. • People 65 and older are more likely to diet in pursuit of medical goals such as controlling blood glucose and cholesterol. • Food Assistance Programs: • Congregate meals: nutrition programs that provide food for the elderly in a conveniently located setting such as a community center. • Valuable source of nutrients for >3 millions older adults.

Meals for Singles • Spend wisely: • Buying the right amount so as not to waste any food is a challenge for people eating alone. • Ultrahigh temperature: a process in which boxes of milk is exposed to temperature above those of pasteurization just long enough to sterilize the milk. • Milk can be stored unopened on a shelf for up to 3 months without refrigeration. • Be Creative: • Creative chefs think of various ways to use food when only large amounts are available.

Summary • Life expectancy in the United States has increased dramatically over the years. • Healthful eating practices, weight control, adequate sleep, regular physical activity, limited or no alcohol use and abstinence from smoking can enhance longevity. • Physiological, psychological, economic and social changes can impair nutritional status. • For the older age group, water, declining energy needs and regular physical activity need to be addressed

Summary • The vitamins and minerals of particular importance are Vitamin A, Vitamin D, Vitamin B6, Vitamin B12, zinc, iron, and calcium. • Supplements, prescribed by physicians, may be needed. • Special concerns of this age group include cataracts, arthritis Alzheimer’s disease and brain functioning. • By practicing stress management skills, maintaining physical fitness, and participating in interesting activities mature adults can grow old gracefully. • This diverse population group needs different nutritional programs to address their specific needs.

Understanding Nutrition