The science of nutrition 4th edition thompson manore vaughan chapter 19

Chapter 19 Lecture Chapter 19: Nutrition Through the Life Cycle: The Later Years © 2017 Pearson Education, Inc Older Adults • • Age 65 years and older Age ≥85 years: • • • • "Very elderly" or "oldest of the old" Fastest growing U.S population subgroup Average U.S life expectancy = 78.8 years Life span is the age to which the longest-living member of the species has lived © 2017 Pearson Education, Inc Aging Process: Theories • • • Aging occurs at the molecular, cellular, and tissue levels Programmed theories of aging Error theories of aging • • © 2017 Pearson Education, Inc Cell damage from environmental insults Linked to nutrient or energy status © 2017 Pearson Education, Inc Aging Process: Lifestyle Factors • Biological age can be influenced by personal choices â 2017 Pearson Education, Inc Smoking Excessive alcohol Obesity Sedentary Sensory Perception • Senescence: age-related processes that increase risk of disability, disease, and death • • Systems begin to slow and degenerate Declined odor, taste, and visual perception • • • Dysgeusia: abnormal taste perception Loss of visual acuity Support of family and friends helps older adults with food selection and preparation techniques © 2017 Pearson Education, Inc Gastrointestinal Function • • • Xerostomia: declined salivary production Dysphagia: difficulty swallowing foods Achlorhydria: low gastric HCl production, limits calcium, iron, folate, vitamin B 12 absorption • Gut microbiota changes ("aging gut"), resulting in • • • • • Increased inflammation Decreased immune function of GI tract Impaired functioning of gut mucosal cells "Anorexia of aging" Lactose intolerance © 2017 Pearson Education, Inc Body Composition • • • • • Increased body fat, sarcopenic obesity Decreased muscle and lean tissue Decreased production of hormones: testosterone and growth hormone Bone mineral density declines Adequate dietary intake and regular physical activity (strength/resistance training) help maintain muscle mass and strength © 2017 Pearson Education, Inc © 2017 Pearson Education, Inc Organ Function • • • • • • • Less adaptable to environmental or physiologic stressors Kidneys: less able to concentrate waste Liver: less efficient in breaking down drugs Pancreas: reduced blood glucose control Bladder control may decline Connective tissues and blood vessels become increasingly stiff and less pliable Neurons in the brain decrease: impaired memory, reflexes, coordination, learning ability © 2017 Pearson Education, Inc Micronutrients • Calcium and vitamin D requirements increase: poor calcium absorption and reduced vitamin D production in the skin • • • • • Iron needs decrease: reduced muscle mass; cessation of menstruation in women Zinc recommendations stay the same Vitamins C and E recommendations stay the same Adequate intake of B-vitamins (B12, B6, and folate) is a special concern Vitamin A should not be consumed in excess of RDA © 2017 Pearson Education, Inc © 2017 Pearson Education, Inc Supplements • • Older adults benefit from multivitamin/multimineral supplement Single nutrients in some cases • • • • Vitamin B12 Calcium Vitamin D High-potency supplements pose risks © 2017 Pearson Education, Inc Fluid • AI for fluid: same as for younger adults • • • • Men: 3.7 liters/day Women: 2.7 liters/day Impaired thirst mechanism Hypernatremia (elevated blood sodium levels) © 2017 Pearson Education, Inc Overweight and Obesity • • • • Increases severity and consequences of osteoarthritis Limits mobility Causes functional declines in daily activities Weight loss improves functional status © 2017 Pearson Education, Inc Underweight • • • Fewer protein reserves Risk for poor wound healing and a depressed immune response Geriatric failure-to-thrive: "the dwindles" © 2017 Pearson Education, Inc • The nine Ds of geriatric weight loss © 2017 Pearson Education, Inc Osteoporosis • • • • Diagnosed after menopause as estrogen levels sharply decline Males: linked to declining testosterone levels, steroid therapy, and alcohol abuse Most serious risk: hip fracture Osteoporosis treatment: vitamin D and calcium supplementation, resistance training, medications © 2017 Pearson Education, Inc Arthritis • • • One of the most prevalent chronic diseases Osteoarthritis: a disease of "wear and tear" Rheumatoid arthritis (RA): typically strikes younger adults, not associated with obesity or overuse syndromes Nontraditional treatments (glucosamine) â 2017 Pearson Education, Inc Additional Concerns • • • • Constipation—fluid and insoluble fiber Dental health issues may cause older adults to avoid healthful foods Vision disorder studies show beneficial effects of antioxidants Cognitive impairment (demetia): lower risk with antioxidants, certain unsaturated fatty acids, folate, vitamin B12, healthy weight © 2017 Pearson Education, Inc Medications • • • • • Interactions can be harmful, should be monitored Polypharmacy: more than five prescription medications at once Appetite effects Alters nutrient digestion and absorption Appropriate use of nutrient supplements can enhance the nutritional status of older adults © 2017 Pearson Education, Inc â 2017 Pearson Education, Inc Social Concerns • • Elder abuse and neglect Food insecurity and hunger Social isolation © 2017 Pearson Education, Inc Community Programs • • • • • • • Supplemental Nutrition Assistance Program (SNAP) Senior Farmer's Market Child and Adult Care Program Commodity Supplemental Food Nutrition Services Incentive Program Emergency Food Assistance Program End-of-life care © 2017 Pearson Education, Inc Minority Elderly • • • • • Require adaptations in current medical and social service interventions Increased risk for nutrition-related chronic diseases and complications Cultural awareness Flexible meal plans Effective communication © 2017 Pearson Education, Inc ... elderly" or "oldest of the old" Fastest growing U.S population subgroup Average U.S life expectancy = 78.8 years Life span is the age to which the longest-living member of the species has lived... Pearson Education, Inc Aging Process: Theories • • • Aging occurs at the molecular, cellular, and tissue levels Programmed theories of aging Error theories of aging • • © 2017 Pearson Education,... production in the skin • • • • • Iron needs decrease: reduced muscle mass; cessation of menstruation in women Zinc recommendations stay the same Vitamins C and E recommendations stay the same Adequate