diet and nutrition in adults Flashcards
What is nutrition?
Processes for living organisms to receive and use materials from the environment to promote vital activities
For good health, prevention of disease and recovery from illness
Eat well, be well
How is our food choice determined?
Age Gender State of health Mood Socioeconomic factors (ads, income, environment, transport, social status) Geographical location Culture Religion Cost Availability Personal preferences
What are some dietary habits?
Long standing preferences
Strong opinions
Effective advice for change
What are different models of change?
Knowledge, attitude, behaviour
Capability, opportunity, motivation
Environment, access, support
What are adult nutrient needs?
Energy requirements decline from 19+ and again from 50+
Due to decrease in lean body tissue which grt fall in basal metabolic rate
Usually become less active
Need same fat, fibre, carb, vitamin, mineral intake
Except Fe until menopause, Vit A and B, potassium and zinc for immunity and wound healing
Therefore more nutrient dense foods required
What are the guideline daily amounts?
Women- 2000 calories, 260g carbs (30g), 70g fat (20g), 45g protein, 25-30g fibre, 6g salt
Men- 2500 calories, 300g carbs (30g), 95g fat (30g), 55g protein, 25-30g fibre, 6g salt
Salt= Na x 2.5
Gender differences as men have more muscle and less fat so different energy expenditure
What are some recommendations?
Eat wholemeal or high fibre Have a wide variety of fruit/veg Cut fat off meat, skin off poultry, fish w/o batter, cook w/o fat Semi-skimmed milk, low fat yogurt Have unsaturated oils/spreads Have low fat/sugar options
However, some low fat options have high sugar
How might someone eat healthy on a budget?
Plan, list, buy in quantities you’ll use Use supermarket brands Buy fruit/veg regularly (markets) Beware of processed foods Have high starch meals Buy lean meat and mix w veg to go further Tinned/frozen fish and meat is cheaper Cook carefully and reduce fuel use
What are recommended daily amounts of alcohol?
Less than 14 units a week spread out over more than 3 days
Should have some alcohol free days
Can increase ab weight, stroke, high BP, cancer, liver disease, mental health problems, smoking
No alcohol when pregnant
Why is cholesterol important?
Provides structure and function of cell membranes
Precursor to steroid and adrenocortical hormones
Involved in forming bile acids
Needed in neural tissue
1/3-1/2 made in liver, rest from diet
High levels of LDL are more important for disease compared to HDL
If someone smokes, their LDLs become stickier and HDLs decrease
Sat fat raises LDLs and polyunsat lowers LDLs and HDLs
What should be considered for pregnant women?
Correlation between nutrient intake and birth weight
Need folic acid for neural tube development
Need to watch out for excess Vit A for birth defects and oily fish for mercury and Vit A levels
Iron
What might affect a mans fertility?
Low levels of zinc
High levels of alcohol and smoking
During menopause what should be considered?
Any weight gain can have risks of CVD, diabetes and cancer (prev thought pre- [pear] and post- [apple])
Soy protein has phytoestrogens which mimics oestrogen which is reduced in menopause, can reduce symptoms (hot flushes etc) and complications
Risk of osteoporosis in older people so need to supplement with Ca, Vit D and activity
Must have <1.5mg/day Vit A to stop bone #
Vit D declines due to exposure of sun
What is the body mass index?
Healthy weight for height
W (kg) / h x h (m)
Healthy is 18.5-24.9
However, measure of fat so overestimates with muscular build and underestimates in older (less muscle)
How should obese people lose weight?
Rapid weight loss not recommended
Don’t reduce consumption by more than 500kCal/day
Toxins such as DDT and pesticides in fat tissue are released to quickly
What are different veg names?
Lactoovo- plant, dairy and eggs
Lacto- plant and dairy
Vegan- plant only
What can be substituted in veg diets?
Fortified soya and plant products instead of dairy
Pulses, nuts and seeds instead of meat
Vit B12 needs to be supplemented
GIT needs to adapt to non-haem Fe which can bind to non starch polysaccharides
Religious reasons- buddhism (lactoovo veg)
Economic, environmental, ethical reasons
Health benefits- lower risk of CHD, stroke and cancer, less sat fat, more complex carbs, more fruit/veg (antioxidants)
However is this just diet but also lifestyle?
When does a person start ageing?
Once 25 years old
Frailty due to physiological changes, Malnutrition
Nutrition contributes to health and recovery illness
Death due to infection, disease, accident or gradual degenerative process
What are the nutritional requirements for older people?
Women- 2000-2200kcal/day from ages 15-75, 1900kcal/day from 75+
Men- 15-35 (2500-3000), 35-65 (2500-2900), 65-75 (2350), 75+ (2100)
Activity declines as age
BMR decreases
Should eat nutrient dense food
If house bound- increase Vit D all year round
Is there malnourishment in older people?
Generally nutrient deficient due to ill health, self neglect
Specific nutrient deficiency due to eg. Less Fe, no meat as a result of poor teeth, limited mastication
Sub-clinical malnutrition- poor diet, not clinically obvious, body stores depleting
Underweight- leads to morbidity/mortality
Lack of metabolic reserves for infection response
Overweight- young elderly
Eg. Osteoarthritis of knee
What might lead to malnutrition in the elderly?
Failing sight/smell/taste
Dental problems (oral discomfort)
Loss of appetite
Less salivary secretion (Sjögren’s syndrome, xerostomia, chemotherapy)
Bowel problems (less gut motility and inactivity)
Osteoarthritis/porosis (less strength, reduced nutrient absorption)
Physical disability (mobility for shopping)
Extreme age (frailty)
Dysphagia (MS, MND, CV- leads to liquid diet)
Mental issues (dementia- forget, confusion)
Leads to soft, bland diet- indigestion
Need to have smaller nutrient dense meals and enhance flavours w/o salt or sugar
What is PEG feeding?
Percutaneous endoscopic gastrostomy
Feed through tube into stomach
How should malnutrition be prevented in the elderly?
Dehydration- account for spills (6-8 glasses)
~can lead to headache, constipation, UTIs, confusion
Home care assistants- buy and prepare
Meals on wheels- consider nutritional content
Lunch clubs- social contact, ideal
Institutions- puréed food unappetising, tastes similar, sip feeds (fortified drinks)
What was the SACN position statement 2021?
Looked at nutrition, health and changes with age
Dietary intakes and nutritional status
Nutrition society published overview in British journal of nutrition
Concluded need for RCTs and longitudinal studies
How is food labelling better?
Trading standards
Traffic light system Guideline daily amounts More choice Best before- quality Use by- safety (more risk to listeria etc due to transplants, drugs, cancer affecting immune system)
How are adults categorised?
19-64- adults
65-74- young old
75+- old old
What does the NDNS show about adults nutrition?
2018/19, follow up 2020
Sugary drinks falling
Fruit/veg (33, 40, 27% meeting 5 a day, follow up even less)
Saturated fat above
Free sugars reducing but still above
Vitamins, minerals, blood folate, fibre all below
Oily fish below
Large range of red and processed meat but decreasing
Follow up showed alcohol increase
Trends towards healthier
