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1Nutrition and Aging Provided Courtesy of Nutrition411.com Review Date 11/13G-0510
2Physiological Changes Associated With Aging Changes in body compositionBody composition—lose bone and muscle, gain fatAs we age, we lose lean body mass. Reduced muscle mass includes skeletal muscle, smooth muscle, and muscle that affects vital organs (the loss of heart muscle is the most important). Also observed is a reduction in cardiac capacity and impaired cardiac function.Changes also occur in organs. Aging can slow the body’s immune response. A decrease in basal energy metabolism is seen. To avoid weight gain, it is necessary to reduce calorie intake or increase activity to maintain energy balance. As we lose lean body mass, we also lose water (72% of total body water is lean muscle mass).Total body fat generally increases with age. As we age, fat tends to deposit around the middle section and vital organs. In more advanced years, weight declines.Bone density decreases. Women lose much more bone mass after menopause. Severe osteoporosis can become serious and debilitating. Men are susceptible as well. Fractured bones may mean limited mobility and a decline in food intake. Vertebral compression fractures can change chest configuration and make it difficult to eat and breathe.The digestive process slows as we age.
3Physiological Changes Associated With Aging (cont’d) Changes in body compositionDecline in immune systemImmune system—declines with age, compromised by nutritional deficiencies
4Physiological Changes Associated With Aging (cont’d) Changes in body compositionDecline in immune systemChanges in gastrointestinal tractGastrointestinal tract—intestinal tract loses strength and elasticity, hormone secretions change, constipation and atrophic gastritis
5Physiological Changes Associated With Aging (cont’d) Changes in body compositionDecline in immune systemChanges in gastrointestinal tractDental problemsTooth loss—chewing difficulty or painful dentures
6Physiological Changes Associated With Aging (cont’d) Changes in body compositionDecline in immune systemChanges in gastrointestinal tractDental problemsSensory lossesSensory losses—poor eyesight, decline in taste and smell sensitivity, decline in sense of thirstSensory changes may include a decline in sight and peripheral vision, hearing, smell, and taste. The losses are gradual and usually affect nutritional intake and health status.Loss of vision and hearing can result in social isolation. Vision changes may lead to less activity, and inability to see well enough to cook and grocery shop. Changes in smell and taste are more obvious. If food does not taste or smell good, we may not eat it. If we have to cut back on flavor, we tend not to eat. It is suggested that you try new foods with a variety of flavors.Sometimes the problem is the soft diet and not diminished taste buds. It sometimes helps to steam food rather than cooking foods to a mushy state. Also experiment with herbs and spices.
7Other Issue for Older Adults Eating aloneChanges in support system and/or environmentPolypharmacyEating aloneIt sometimes is difficult to prepare food for one person. Or for individuals who are not used to preparing food, such as a widowed man, it may seem overwhelming.Changes in the support system may necessitate moving. An unfamiliar environment may affect food intake.Use of multiple medications (polypharmacy) may affect mood and intake, which may result in side effects that affect nutritional status.
8Nutrients of Concern for Older Adults FluidWaterWith age, the ability to notice thirst decreases.
9Nutrients of Concern for Older Adults (cont’d) FluidCaloriesCaloriesWith age, the need for calories generally decreases. Excess body fat, especially around the abdomen, is common. Calorie needs change because of more body fat and less muscle mass. Less activity also can decrease calorie needs. If a person eats too few calories, they risk missing out on nutrients. The solution is to eat a variety of nutrient-dense foods.
10Nutrients of Concern for Older Adults (cont’d) FluidCaloriesProteinProteinProtein helps build muscles, organs, and tissues. It keeps the immune system working and is part of many enzymes and hormones. Protein needs generally do not change as we get older, unless an individual has a chronic disease. Protein absorption may decrease with aging. To meet protein needs, choose high-quality protein and include lean-protein foods or legumes with lunch and dinner.
11Nutrients of Concern for Older Adults (cont’d) FluidCaloriesProteinFatFatReducing fat intake is reasonable and is the easiest way to cut calories. Sometimes, a low-fat diet is needed for individuals with a chronic disease.
12Nutrients of Concern for Older Adults (cont’d) FluidCaloriesProteinFatFiberFiberFiber is the nondigestible portion of a plant. When high-fiber foods are combined with water intake, this can result in a decreased need for laxatives and stool softeners. Fiber may help lower blood cholesterol.It is important to increase fiber intake gradually. Individuals should eat a variety of fruits, vegetables, and whole grains to increase fiber intake.
13Nutrients of Concern for Older Adults (cont’d) FluidCaloriesProteinFatFiberFolateFolateFolate is a B vitamin that helps make new cells. Folate, along with vitamins B6 and B12, may help heart health by maintaining normal levels of homocysteine in the blood. Several medications may decrease folate’s actions in the body, which means that people should eat more of this nutrient and/or take supplements. Folic acid is a form of folate. To get folate, choose fortified cereals, consume oranges, drink orange juice, eat grains daily, choose leafy greens, and include legumes in the diet.
14Nutrients of Concern for Older Adults (cont’d) FluidCaloriesProteinFatFiberFolateVitamins B12 and DCalciumVitamin B12Vitamin B12 helps to maintain nerve tissue. It is found mostly in animal proteins. It requires a particular stomach acid for the body to use it. This stomach acid decreases with age, so we are less able to absorb B12 from foods. A vitamin B12 shot or supplement is sometimes given, if needed. Good food sources of vitamin B12 are meat, poultry, fish, eggs, and dairy products. Low levels of vitamin B12 are associated with memory loss and even hearing loss.Calcium and vitamin DVitamin D works with calcium to maintain healthy bones. Our skin makes vitamin D from sunlight, but this production decreases as we age. Supplements are perhaps the most practical way to get calcium and vitamin D. Individuals should choose calcium citrate plus vitamin D.
15Nutrients of Concern for Older Adults (cont’d) FluidCaloriesProteinFatFiberFolateVitamins B12 and DCalciumZincZincZinc is used for wound healing and is one the nutrients that may help slow the progression of age-related macular degeneration.
16Energy and Nutrient Needs WaterEnergyProteinWhole grains and fiber-rich foodsFatVitamins and mineralsWater: Mild fever or hot weather may cause dehydration. A good estimate is 30 milliliters fluid/kilogram (kg) of body weight for older adults (more or less in some circumstances).Energy: Metabolism slows with aging. If energy consumed is not reduced or physical activity is not increased, weight gain may result.Protein: Protein intake is suggested at 1 gram/kg body weight. Protein is important for the immune system and to prevent muscle wasting.Whole grains and fiber-rich foods: Individuals should have whole grains three times daily. Fiber-rich foods include fruits, vegetables, nuts, and legumes.Fat: Individuals should eat less fat from animal sources and less trans fat, and more fat from liquid forms of fat.Vitamins and minerals: Individuals should select nutrient-dense foods, such as whole grains, fruits, vegetables, lean meats, and low-fat dairy products to obtain adequate vitamins and minerals.
17Health Concerns of Older Adults CancerHeart diseaseHypertensionDiabetesOsteoporosisMacular degeneration/vision problemsArthritisAlzheimer’s diseaseWhen people age, they often develop chronic diseases. Many or these diseases have nutrition-related consequences or are treated by dietary changes. Cancer, heart disease, and hypertension can affect the general population, but osteoporosis, macular degeneration, arthritis, and Alzheimer’s disease are typically concerns of older adults.
18Common Nutrition-Related Diseases in Older Adults Vision ProblemsCataracts—thickening of eye lensMacular degeneration—deterioration of the center of the retina, which is responsible for straight-ahead visionAntioxidants in foods may protect against vision loss
19Common Nutrition-Related Diseases in Older Adults (cont’d) ArthritisOsteoarthritis—cushioning cartilage in joint breaks downRheumatoid arthritis—disease of the immune system with painful inflammation of the jointsOverweight can affect arthritisResearch on diet and arthritis is ongoing. Certain nutrients, including omega-3 fatty acids, are pinpointed as ways to improve arthritis pain. Current recommendations are to eat an overall healthy diet and exercise as possible to achieve or maintain body weight.
20Common Nutrition-Related Diseases in Older Adults (cont’d) Alzheimer’s DiseaseA healthy diet can help promote brain healthResearch on a connection between diet and Alzheimer’s disease is ongoing
21Common Nutrition-Related Diseases in Older Adults (cont’d) OsteoporosisLoss of bone density, resulting in fracturesMore common in women than menDiet and exercise can help treat osteoporosis, but may not prevent it in older adultsPeak bone mass develops by around 30 years of age. From age 30 on, bone loss begins. Diet and exercise can help prevent continued bone loss. Some new mediations may help rebuild bone density.
22Calcium Sources Bok choy Broccoli Calcium-fortified juices and cereals Canned fish with bonesCottage cheeseFortified soy beverageKaleMilkYogurt
23Promoting Bone Formation (all ages) Participate in weight-bearing activitiesAvoid smokingConsume calcium-rich foods or supplementsConsume adequate vitamin D
24Calcium Requirements Age Calcium Equivalent (mg/day) (dairy servings/day)9-18 years1300 mgfour19-50 years1000 mgthree50+ years1200 mgThese values apply to both genders.mg=milligram
25Vitamin D Requirements AgeEquivalent(IU/day)9-50 years600 IU51-70 years70+ years800 IUVitamin D guidelines were increased in 2011.IU=international unit
26Eating Patterns for Older Adults Several similar dietary recommendations exist for disease prevention and management of chronic diseases:Dietary Guidelines for AmericansMyPlateDASH Eating PatternDietary Guidelines for Americans provides general nutrition guidelines. MyPlate and the DASH Eating Pattern provide specific menu patterns.
27Dietary Guidelines for Americans, 2010 Balance calories to manage weightIncrease some foods:Fruits and vegetablesWhole grainsLean meats, seafood, and other protein foodsReduce some foods:SodiumSaturated fat, trans fats, and cholesterolAdded sugar and refined grainsBuild healthy eating patternsThese guidelines are science-based advice for Americans 2 years of age and older. The guidelines are issued as least every 5 years by law (Public Law , Title III, 7 US Code 301). They serve as a government vehicle to speak with one voice.The guidelines are essentially dietary guidance issued by the federal government, which were reviewed by the Secretaries of Agriculture and Health and Human Services.
28Balance Calories to Maintain Weight Prevent and/or reduce overweight and obesity through improved eating and physical activity behaviorsControl calorie intake to manage weightConsume fewer calories from foods and beveragesIncrease physical activity and decrease time spent in sedentary behaviors
29Food and Food Components to Reduce Reduce sodium intake to less than 2300 mg:Some people (those older than 51 years of age, individuals with chronic kidney disease, diabetes, or hypertension, and African Americans) should reduce sodium intake to 1500 mg/dayConsume less than 10% of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acidsConsume less than 300 mg/day of dietary cholesterol
30Food and Food Components to Reduce (cont’d) Keep trans fatty acid consumption as low as possible by limiting foods that contain sources of trans fatsReduce the intake of calories from solid fats and added sugarsLimit foods that contain refined grains, especially those that contain solid fats, added sugars, and sodiumIf alcohol is consumed, do so in moderationSources of trans fats include partially hydrogenated oils and other solid fats.Alcohol intake: Moderation means one drink/day for women and two drinks/day for men (only individuals of legal drinking age).
31Food and Nutrients to Increase Increase fruit and vegetable intakeEat a variety of vegetables, especially dark green, red, and orange vegetables, beans and peasConsume at least one-half of grains as whole grainsIncrease intake of fat-free or low-fat milk and milk products, including:YogurtCheeseFortified soy beverages
32Food and Nutrients to Increase (cont’d) Choose a variety of protein foods, including:SeafoodLean meat and poultryEggsBeansSoy productsUnsalted nuts and seeds
33Food and Nutrients to Increase (cont’d) Increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultryReplace protein foods that are higher in solid fat with choices that are lower in solid fats and calories and/or are sources of oilsUse oils to replace solid fats when possible
34Food and Nutrients to Increase (cont’d) Choose foods that provide more potassium, dietary fiber, calcium, and vitamin DThese foods include:VegetablesFruitsWhole grainsMilkMilk products
35Building Healthy Eating Patterns Select an eating pattern that meets nutrient needs over time at an appropriate calorie levelAccount for all food and beverages consumed and assess how they fit within a total healthy eating patternFollow food safety recommendations when preparing and eating foods to reduce the risk of foodborne illness
36Dietary Guidelines and Aging Individuals older than 50 years of age should consume 1500 mg sodium or less per dayIndividuals older than 50 years of age should consume foods fortified with vitamin B12, such as:Fortified cerealsDietary supplements
37DASH Eating PatternA diet pattern that meets the Dietary Guidelines for Americans:High in fruit and vegetablesLow in saturated fatLow in sodiumHigh in potassiumHigh in fiber
39Nutrition for Aging Follow the DASH eating pattern or MyPlate Enjoy whole grains, fruits, vegetables, and low-fat dairy products daily in recommended portionsExercise at least 30 minutes most days of the week
40ReferencesCenter for Nutrition Policy and Promotion. Dietary Guidelines for Americans US Dept of Agriculture Web site. Accessed November 23, 2013.Chernoff R. Geriatric Nutrition: The Health Professionals Handbook. 3rd ed. Sudbury, MA: Jones and Bartlett; 2006.US Dept of Agriculture. MyPlate. ChooseMyPlate Web site. Accessed November 23, 2013.