Lecture 19: Adult Nutrition Flashcards
When does adulthood span?
From early 20s to early 60s
When is early adulthood?
20s-30s
What occurs during early adulthood?
Becoming independent, leaving home, employment/career, choosing a partner, having children, renewed interest in nutrition
When is midlife?
40s
What occurs during midlife?
Family responsibilities, work, managing schedules, awareness of one’s mortality
When is the sandwich generation?
50s
What occurs during the sandwich generation?
Multigenerational care (children and aging parents), maintaining career, possible health issues or prevention of
When is later adulthood?
Early 60s
What occurs during later adulthood?
Transition to retirement, more leisure and physical activity time, food choices and nutrition become forefront particularly in the case of chronic disease
Malnutrition can result from…
Genetic factors, disease states as well as poor diet
What hormonal changes occur for females during adulthood?
Climacteric changes - end of reproduction (approx. 50y)
- Perimenopause -> Menopause
What hormonal changes occur for males during adulthood?
Testosterone levels and muscle mass in males will decline after age 30 years
What is perimenopause?
Transitional phase between normal menstruation and menopause
What is perimenopause characterised by?
Differences in cycle length, hormonal fluctuations (decline in estrogen)
What are symptoms of perimenopause?
- Hot flushes
- Mood disturbance
- Menstrual cycle disturbance (heavy bleeding)
- Fatigue
- Anxiety/Depression
Why is it important to recognise perimenopause symptoms?
Because perimenopause causes many risk factors for chronic disease changes
- decrease in estrogen is the cause for most of these risk factors
What risk factors for chronic disease changes does perimenopause cause? (5)
- Accelerated bone loss
- Increase in abdominal fat (central adiposity)
- Changes in lipid profile
- Altered glucose metabolism
- Increased risk of CVD
What is the main focus for perimenopause treatment?
Focus on prevention of chronic disease risks:
- Excess weight
- Altered lipids
- Risk of CVD
How do we prevent bone loss?
Look at dietary intake of calcium, Vitamin D status
- Supplementation?
How do we prevent excess weight, altered lipids, risk of CVD?
Through healthy eating and activity advice
What is the average age that menopause starts?
51 years
What is menopause?
- Stop having monthly periods
- Ovaries stop working as there is no more eggs
What can menopause be caused by?
Ovaries being removed (surgical menopause), or could be from chemotherapy or radiation
What can earlier menopause be caused by?
Smoking or hysterectomy
What is menopause earlier than normal caused by?
Premature ovarian insufficiency = before 40 years old
What are the first signs of menopause?
Periods being closer together or further apart, they could become heavier
- Could also see hot flushes and sweats (most women don’t see this until periods have stopped)
What causes most of the symptoms of menopause?
the fallen estrogen
Other than period changes and hot flushes, what are other symptoms of menopause?
Sleep disturbances, joint pain and fatigue, heightened anxiety, mood changes, vaginal dryness, overactive or discomfort in bladder
How long do symptoms last?
5-10 years
50% of women in their 60s are…
still experiencing symptoms and 10% of these women’s explain these as being severe
Menopause will affect every women with…
Varying severity
What are ways to help menopause symptoms?
- Menopausal Hormone Therapy
- Improving diet
- Regular exercise
- Stop smoking
- Psychological treatments
What is Menopausal Hormonal Therapy? (MHT)
a treatment that supplements estrogen, often combined with progesterone, to relieve symptoms of menopause
When does bone mass decline?
At around 40 years of age
What does risk of osteopenia and osteoporosis depend on?
PBM achieved by later 20s
What energy balance is typical in adulthood?
Positive energy balance
What changes in adiposity do we see in adulthood?
- Increased visceral fat
- Increased ectopic fat
What proportion of kiwis are consuming the recommended amount of vegetables per day?
11% (1 in 9)
What proportion of kiwis are consuming the recommended amount of fruit per day?
44.9%
What proportion of kiwis are consuming the recommended amount of both vegetables and fruit per day?
6.7%
What is the vegetable recommendations for 19-50 year olds?
Men = 6
Women = 5
What is the fruit recommendations for 19-50 year olds?
2 for Men and Women
What is the vege recommendations for 51-70 year olds?
Men = 5.5
Women = 5
What is the fruit recommendations for 51-70 year olds?
2 for both Men and Women
Women going through menopause need more of what?
Milk and Milk products
What percent of adults drink alcohol?
80%
What percent of NZ adults drink hazardously?
20%
What percent of women vs men drink hazardously?
Men = 22%
Women = 10%
What age groups have the highest prevalence of hazardous drinking?
18-24 year olds and 25-34 year olds
- Slight peak again at 45-54 year olds
What is the alcohol guideline in general?
There is no safe level
What are the alcohol recommendations for women?
- No more than 2 std drinks a day
- No more than 10 std drinks per week
What are the alcohol recommendations for men?
- No more than 3 std drinks a day
- No more than 15 std drinks per week
How many alcohol free days should there be a week for both men and women?
At least 2
Alcohol use is a risk factor for…
Cancer
- Linked to the most prevalent types of cancer (e.g. bowel, breast)
What is the best alcohol consumption for cancer prevention?
No threshold for the effects of alcohol on cancer have been identified and therefore abstinence is the best for cancer prevention
What percent of deaths from cancer in NZ are due to alcohol use?
1 in 25 (for persons <80 years)
Of the cancer deaths caused by alcohol, which type is the most common?
Breast cancer
More than 1/3 of breast cancer deaths from alcohol were due to an average consumption of less than…
2 std drinks per day
What is Gastro-Oesophageal Reflux Disease (GORD)?
Declining ability of the lower esophageal splinter to close
causing leakage of stomach contents into the esophagus - The most common GI symptom in adults
Who are at the highest risk of GORD?
- Pregnant women
- Smokers
- Adults with high alcohol intake
- Overweight adults
What are the main symptoms of GORD?
- Acid reflux
- Heartburn
What is the treatment for mild symptoms of GORD?
Lifestyle changes:
- Smaller meals
- Avoid trigger foods
- Raising head of bed
- Maintain healthy weight
- Stop smoking
What are trigger foods of GORD?
High fat, spicy, caffeine or alcohol
What is the treatment for severe symptoms of GORD?
Medicine or surgery
What is the general use of supplements in adults?
- Intended to supplement the diet only
- Food first approach
- Deficiencies unlikely in healthy individuals that eat a balanced diet including foods from all food groups
In 2008/09 what percent of adults were taking some form of supplement?
48%
What is the dietary supplement industry worth globally?
> 150 billion USD
- Expected annual growth rate of 8.9%
When importing supplements what is there a risk of?
Supplement contamination
How can supplements be contaminated?
- Glass shards, bacteria, doping substances
- With steroids
- Dose - invalid claims
When working with supplements what do health professionals need to be aware of?
“stacking”
What supplement group is most used by NZ groups?
Oils (fish and plant)
Is the regular use of supplements used more frequently in younger or older adults?
Older adults
What is the first eating statement? (NZ Guidelines)
Enjoy a variety of nutritious foods every day including:
- Plenty of vegetables and fruit
- Grain foods, mostly whole grain and those naturally high in fibre
- Some milk and milk products, mostly low and reduced fat
- Some legumes, nuts, seeds, fish and other seafood, eggs, poultry and/or red meat with the fat removed
What is the second eating statement? (NZ Guidelines)
Choose and/or prepare foods and drinks:
- with unsaturated fats instead of saturated fats
- with little or no added sugar
- that are low in salt, if using salt choose iodised
- that are mostly ‘whole’ and less processed
What are examples of unsaturated fats?
Canola, rice bran or vegetable oil, margarine
What are examples of saturated fats?
Butter, cream, lard, dripping, coconut oil
What is the third eating statement? (NZ Guidelines)
Make plain water your first choice over other drinks
What is the fourth eating statement? (NZ Guidelines)
If you drink alcohol, keep your intake low
What is the fifth eating statement? (NZ Guidelines)
Buy or gather, prepare, cook and store food in ways that keep it safe to eat
- Take extra care if you are pregnant
What is the sixth eating statement? (NZ Guidelines)
Encourage, support and promote breastfeeding
What does the healthy plate model show?
1/3 Grains
1/3 Vegetables
1/6 Fruits
1/6 Milk and Milk Products
1/6 Legumes
