Adult & Elderly: Nutrient Req Flashcards
most nutrient RDA studies are conducted on:
young healthy adults
What are the 3 age categories for RDAs for the elderly? Why do we need different categories? (2)
<50, 51-70, 70+
- changes in body, metabolism, activity -> changes in nutrient needs
- greater heterogeneity as age increases
As age increases, the ____ amongst the population will increase. What factors cause this? (5)
heterogeneity (more variation)
- diff diets
- diff body composition
- diff metabolism & nutrient absorption
- diff activity levels
- chronic disease/drug intake
How would chronic disease impact nutrient requirements? (3)
- may impair absorption/metabolism -> need more
- may need drug intake -> also impair -> need more
- need to fight infection/illness/repair body -> need more
What are issues with assessing protein needs in elderly with N balance studies? (2)
only determine balance: does not give information on REDISTRIBUTION of protein in body
muscle has SLOW TURNOVER RATE; study done over few days, not long enough to see effect
How do energy req change with age? Why? (2)
SAME kcal/kg FFM, but LESS needed since
- decreased lean body mass
- more sedentary
do protein requirements change in elderly?
Current recommendation: no (same 0.8g/kg)
BUT: recent studies suggest higher amount (1.2g/kg) can reduce LBM loss, or even reverse!
How does water requirement change with age?
No change in AI
as age increases, LBM (increase/decrease), leading to lower ____. Therefore the requirements for ___ will (increase/decrease).
decrease
BMR
energy
decrease
What happens to LBM with age?
once over 50, lose 1-2% LBM per year
In what case would elderly people be recommended to limit protein intake?
those with severe kidney disease
What were the resutls and recommendations of the PROT-AGE study?
- increase protein intake to 1-1.2g/kg is beneficial: can prevent or reverse LBM loss
- recommend resistance exercise (need 1.2g/kg/day protein for athletes)
- chronic disease patients need even more; up to 1.5g/kg/day (*except kidney disease)
What happens to carb requirement in elderly? Why?
No change
brain shrinks -> but no significant decrease in glucose oxidation rate
(total body gluc ox rate only about 10% less than young adults)
Does fibre requirement change in elderly age? Why or why not?
same requirement (14g/1000kcal) - based on median energy intake *may be slightly LESS - elderly have lower energy req
The loss of muscle mass/function in elderly is known as: ____. Is this preventable/reversible?
sarcopenia
ingestion of increased protein -> improves resistance/function
+resistance exercise will amplify effects
Elderly with less ____ are (more/less) responsive to protein supplementation
LBM
less
Sarcopenia and ____ are 2 common conditions in the elderly, and result in:
cachexia
loss of muscle mass
____ is more severe than frailty or sarcopenia, and results from:
cachexia chronic illness (cancer, heart failure)
How are sarcopenia and cachexia related?
2 different conditions, but some overlap
both lead to LBM loss and frailty
cachexia more severe, usually LEADS TO sarcopenia -underlying condition
(most cachexia patients have sarcopenia)
but not all sarcopenia patients have cachexia
Diagnosis of sarcopenia:
low muscle mass
low muscle function (strength, phys performance)
definition/causes of cachexia:
complex metabolic syndrome with multiple underlying causes
multifactorial
- sedentary (bedrest)
- endocrine disease
- malnutrition
- organ failure
- adverse drug rxn
- deconditioning
- inflammatory status
Characteristics of cachexia:
- inflammation
- weight loss (clinical feature)
- rapid muscle loss (protein breakdown), with or without fat loss
- insulin resistance
How is cachexia treated?
special nutrition for metabolic alterations caused by the condition, to deal with loss of muscle mass/function
The key feature of cachexia is ____
the clinical symptom of cachexia is: ____
What is a strong predictor of poor outcomes in the patient?
inflammation weight loss (5% or more in past year) weight loss (more -> worse outcome)
