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Nut 1 Semester 2 > Life Stages > Flashcards

Life Stages Flashcards

1
Q

*FOUR benefits of breast milk for infants

A
  1. Provides vitamins, minerals, and macros in right proportions for healthy baby development.
  2. Contains bifidobacteria and prebiotic oligosaccharides to help:
    - colonise digestive tract
    - build immune system.
  3. Breastfeeding ensures best possible health, developmental and psycho-social outcomes (oxytocin - bonding).
  4. Reduces risk of conditions such as eczema, asthma and food allergies.
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2
Q

*FOUR benefits of breastfeeding for mothers

A
  1. Breast milk is cheap and convenient.
  2. Delays return of regular ovulation, lengthening
    birth intervals (prolactin inhibits GnRH release to delay ovulation).
  3. Conserves iron stores (= energy and cognition).
  4. Studies show protection against breast and
    ovarian cancer (↓ oestrogen and ↓ ovulation).
  5. Aids post-birth weight loss due to increased energy expenditure (uterus back to pre-pregnancy shape).
  6. Supports mother-baby relationship (oxytocin release).
  7. Assists in a swifter recovery from symptoms of postpartum depression (PPD). Homeopathy recommended for PPD.
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3
Q

*List THREE key postpartum nutrients and explain their importance.

A

Mg: nervous system health, energy, depleted during times of stress (just like vit C).
Vit C: collagen and wound healing. Placenta leaves big wound in the body. Also, tears during labour. Iron absorption - Fe needs increase post-partum. Depleted during times of stress.
Probiotics: colonistaion of baby’s gut flora to pass onto baby during labour and birth plus breast milk.

Also Fe, Zn and EFAs.

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4
Q

*What would you recommend to a new mother to help establish her breastfeeding?

A
  1. Find breast-feeding support before birth.. Dula or milk club. To check latch…
    2 Hydration
  2. Galactogogues: Fennel seeds or tea to promo lactation
  3. Spend as much time as poss with baby skin-to-skin… to establish the bond (increases oxytocin).
  4. Breast feed on demand (supply and demand).
  5. Pump milk so partner can feed in night.
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5
Q

*How can you tell if a baby is ready for introduction of solids?

A

Normally around six month mark.
1. Sit up straight unassisted
2. Show interest in food - grab it and push food in mouth.

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6
Q

*Which foods should a mother be avoiding when breastfeeding?

A
  1. Alcohol (affects feeding, sleepy)
  2. Caffeine (dehydrates / decreases milk production)
  3. Cruciferous veg, garlic and onions can make baby a bit gassy.
  4. Spicy foods.
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7
Q

*What foods should be avoided when weaning a child?

A
  1. Sugar, honey
  2. Processed foods
  3. Avoid soy-containing foods (hard to digest)
  4. Cow’s milk
  5. Canned veg (full of sodium, hard for immature baby’s kidneys).
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8
Q

*List contributing factors for childhood obesity.

A
  1. Highly processed eg ready-made meals
  2. High in sugar
  3. Inactivity
  4. Simple carbs
  5. Emotional eating
  6. Low vit D
  7. No time outside
  8. Too much time on screens and inside.
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9
Q

*What would you recommend to a parent who has a ‘picky eater’?

A

Children have innate intutition.
Follow their innate hunger and sateity cues.
Present selection of healthy foods to choose from… Let them decide. Encourage mindful eating. No screens. Growing own food. Cooking with them.

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10
Q

*What factors can influence food intake in adolescents?

A
  1. Growth spurts
  2. Alcohol and drugs experimentation.
  3. Peer pressure - self-consicious and insecurity.
  4. TV ads
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11
Q
  • Explain why iron needs increase during adolescence.
A
  1. Fe requirements increase as blood volume increases at times of growth (also preg)
  2. As boys develop lean muscle mass
  3. Girls’ menstruation
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12
Q

*Describe energetics of ageing.

A
  1. Dry (wrinkles, dry skin, joint pain) - include more mucilagenous, liquid hydrating foods eg soups.
  2. Coldness (fatigue, cold hands and feet, reduced circulation).

Warm foods, lightly spiced to aid digestion.

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13
Q

*List TWO of contributing factors for sarcopenia.

A
  1. Inactivity - house or bed bound
  2. Poor nutritional status - malnutrition (viscious cycle)
  3. Hormonal changes affecting appetite, gastric emptying and satiety; gut motility.
  4. Inflammation
  5. Lower BMR
  6. Ability to cook to get the right /sufficient food affecting nutritional status
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14
Q

*What can cause malnutrition in elderly?

A
  1. Hormonal changes affecting appetite, gatric emptying and satiety; gut motility.
  2. Isolation eg bereavement
  3. Oral health eg dentures
  4. Lower HCL
  5. Dysphagia
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15
Q

*Describe changes that occur in GI tract in elderly.

A
  1. Low B12 Less Intrinsic Factor to help absorb B12**.
  2. Lower HCL affecting absorption. Contributes to SIBO affecting B12.
  3. Gut inflammation and changed microbiome.
  4. Fewer digestive enzymes
  5. Hormonal changes affecting gastric emptying and satiety; gut motility due to low fibre leading to indigestion.
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16
Q

*Describe relevance of telomeres to ageing.

A
  1. Telomeres = specific DNA-protein structures found at both ends of each chromosome.
  2. Normal cellular process,
  3. Small portion of telomeric DNA lost with each cell division.
  4. Biological clock to determine aging.
  5. When length reaches critical limit undergoes senescence and / or apoptosis.
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17
Q
  • What can increase telomere aging?
A
  1. Smoking
  2. Poor diet
    Shorter telomeres = risk factor for cancer.
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18
Q

*How does NAD+ affect ageing

A

Primary anti-aging molecules. Activates SERT genes (anti-aging genes). Regular exercise, sleep, fasting (min 12 hours overnight).

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19
Q

How to naturally increase NAD+ levels?

A
  1. Avoid alcohol and smoking.
  2. Avoid over-eating
  3. Fasting good.
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20
Q

*Why is CoQ10 a helpful nutrient for elderly?

A
  1. Potent antioxidant esp important for CVD protection and atheroschlerosis. Depletes as we age esp with statins.
  2. Vital for mitochondrial funciton and ATP.
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21
Q

*Describe benefits of dandelion root tea in elderly?

A

Herb for digestion.
1. Stimulates digestive juices
2. Stimulates HCL and bile production
3. Liver and gallbladder support.
4. Therefore great for digestion and assimilaiton of foods. 5. Great for peristalsis and regulating bowel movements.

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22
Q

*Explain Valter Longo’s dietary advice for longevity.

A
  1. Based on daily fasting of minimum 12 hours plus periodic fasting esp for chronic diseases (stimulates apoptosis and gives body a break).
  2. Mostly plant-based diet with some fish x 2 per week. Can increase animal protein from age 65 to include eggs and goat’s milk/cheese to protect against sarcopenia.
  3. Eat foods at the “table of your ancestors” to aid digestion and absorption. Esp good for AI issues.
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23
Q

Why is breast milk perfect baby food?

A
  1. 88% Water
  2. Carbs: 6-7% lactose [more than in cow’s milk apparently]. Easily digested by infants and enhances Ca absorption and growth/dev of skeleton
  3. Lipids: (3-5%) linoleic (n-6) and linolenic (n-3) acid as well as arachidonic (AA) acid and DHA.
  4. Protein: (< 1%). Mostly alpha-lactalbumin and whey.
  5. Enzymes: For macros digestion. Certain enzymes can transport nutrients such as Zn, Se, Mg.
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24
Q

How does colostrum aid baby’s immunity?

A
  1. Secretory IgA protects infant from infections against
    which mother has developed immunity    .
  2. Maternal antibodies inactivate pathogenic bacteria within baby’s digestive tract. Partly why breast-fed infants have fewer intestinal infections than formula-fed infants.
  3. Laxative effect to expel wastes accumulated in digestive tract during foetal development.
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25
Q

What factors influence a baby’s immunity?

A
  1. Breast milk and colostrum = 700 species of bacterial microbiota.
  2. Birth type ie vaginal and breast milk play role of early bacterial colonisation in GIT (and other areas) of infant.
  3. An infant’s bacterial profile directly
    related to that of its mother.
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26
Q

What does colostrum contain?

A

88pc water. 12 pc serum containing:
1. High in secretory IgA, vitamin A and zinc
2. Provides bifidus factors, which favour growth of
friendly bacterium lactobacillus bifidus in infant’s GIT so that other, harmful bacteria cannot gain a foothold there.
3. Lactoferrin = iron-binding protein prevents bacteria from accessing Fe to grow. Also aids Fe absorption and kills some bacteria directly.
4. Protein lactadherin fights off
diarrhoea-causing infant virus (rotavirus).
5. Several other growth factors and enzymes stimulate digestive tract dev and protect against infections.

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27
Q

How does breast milk protect against allergies?

A

Prevents or delays occurrence of:
1. atopic dermatitis
2. cow milk allergy
3. wheezing in early childhood when compared to formula-fed infants(due to large amounts of casein in formula).

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28
Q

What diseases does breast milk protect against (compared to formula-fed)?

A
  1. CVD (possible links to oxytocin release which causes vasodilation).
  2. Lower blood cholesterol as adults.

Formula cannot imitate unique nutrient composition and protective factors of breast milk.

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29
Q

Minerals contained in breast milk?

A
  1. Calcium: for bone growth.
  2. Fe in small amounts but high bioavailability. NB Fe only transferred to baby in third trimester. Issue for pre-term babies.
  3. Zn

Low in sodium, which is benefit for immature kidneys.

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30
Q

Why delay cord clamping?

A

At birth, one third of a baby’s blood is outside its body (umbilical cord). Delay until cord stops pulsating so babies get:

  1. 30% more iron-rich blood
  2. Oxygen
  3. Erythrocytes, leukocytes and stem cells.

Leave navel to air dry and let stump fall off on its own

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31
Q

*Key postpartum nutrients for mother?

A
  1. Protein: breast milk production and replenish reserves.
  2. Fe: increase blood volume (anaemia in pregnancy = common) and counter fatigue.
  3. Zinc: reduced Zn = PPD risk. Ovarian hormone production (FSH). Reduces PPD.
  4. B vits: ATP production (B1, B2, B3, B5)
    B2 leads to PPD protection.
    a) Folate needed for lactation production. Easily depleted.
    b) B12 = DNA production cofactor, myelination (nervous system development). Depleted by nitrous oxide in labour.
  5. EPA/DHA: neural and eye foetal deveopment. Risk of losing DHA from brain tissue in pregnancy, breastfeeding.
  6. Mg: ATP production. Absorbed by foetus in pregnancy & lactation. Low levels can contribute to PPD.
  7. Vit C: Co-factor for collagen synthesis
    (wound healing postpartum).
    a) Increases absorption of non-haem iron.
    b) Depleted in times of stress (adrenals).
    c) Synthesis of thyroxine and adrenal steroid hormones (postpartum thyroiditis)
  8. Vit D: role in commensal bacterial colonisation and reduces risk of PPD.
  9. Probiotic foods: 5Ks.
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32
Q

How much extra protein does a lactating mum need?

A

11g per day
Pumpkin and hemp seeds - high in proteins, minerals (hemp also EFAs).

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33
Q

Energetics of pregnancy?

A

Time of moisture (consider amniotic fluid).

Pregnancy: feel more hungry, emotional, lethargic, and
congested (all signs of excess moisture).

If mastitis = sign of excess heat.

NB Damp is a sign of stagnation.

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34
Q

What damp-forming foods to avoid during pregnancy?

A
  1. Damp-forming food (dairy, refined sugars, processed foods).
  2. Excess fluids, cold green smoothies, mucilaginous foods (e.g. okra).
  3. Sweet and high water content fruits (e.g. melons, ripe bananas).
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35
Q

Foods to eat during pregnancy?

A

Drying foods: wholegrains, legumes and generally
lighter, drier, crunchier foods.

Warmth counteracts moisture so consume warm food and drinks and small amounts of culinary herbs and spices will be balancing.

Newborn baby also damp (childhood is moist life stage). An infant needs breastmilk, warmth, comfort and sleep.

Mango suitable for all energetic profiles. Ditto avo, olives in olive oil. Will aid microbiome. Sweet potato, whole grain rice, saurkraut 5ks. Prebiotic foods eg asparagus, artichoke… dandelion greens.

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36
Q

Are energy requirements during lactation high or low?

A

High. Higher than during pregnancy.

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37
Q

What happens if mother skips meal during lactation?

A

Increases cortisol and lowers oxytocin and prolactin. Eat three meals and hydrate.

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38
Q

What can cause thirst during breastfeeding?

A

Thirst can be due to low EFAs in breastfeeding.

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39
Q

What does caffeine do to a baby while lactating?

A
  1. Enters breast milk to make infant irritable and wakeful.
  2. Large doses of caffeine interfere with bioavailability of iron from breast milk. Also affect Ca levels.
  3. Eliminate coffee consumption. Increases stress.
  4. Chocolate, soft drinks and tea also contain caffeine, so avoid
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40
Q

Why avoid smoking during lactation?

A
  1. Reduces milk volume, so smokers may produce too little milk to meet their infant’s energy needs.
  2. Milk contains nicotine which alters its smell and flavour.
  3. Infants gain less weight.
  4. Higher risk of sudden infant death syndrome
41
Q

How to increase milk supply?

A
  1. Galactagogues - fenugreek or fennel seed tea; 2–3 cups/day [also encourage menstruation].
  2. Hydration.
  3. Milk supply increases in line with demand.
    Best way = to feed more.
  4. Avoid stress - can lower production. Drink chamomile or lemon balm tea to reduce.
  5. Additional fluid is usually not needed for breast-fed babies.
42
Q

Three problems with formula milk

A

Breast milk composed of 100s of substances — over 100 fats alone compared to:

  1. Highly processed ingredients: sugar or lactose** (NB lactose is sweet), non-fat dried milk, refined veg oils, whole list of synthetic nutrients.
  2. Can have GM elements (except organic)
  3. Lacks key substances for development and growth
  4. No antibodies for immune protection.
  5. Soy-based formula: soy protein, sugar and refined oils
  6. Heavy metals and other nasties found in infant formula eg phthalates.
  7. Additives to infant formula, such as iron, DHA,
    AA and lab-made folic acid are problematic.
  8. Heat damages protein in formulas forming
    advanced glycation end products (bio-marker
    implicated in ageing and development of many degenerative diseases), as well as compromising nutritional value.
43
Q

What are Advance Glycation End Products?

A

AGEs. Created by dry heat treatment causing reaction bewteen lipids and sugars. Cause serious diseases eg cancers, T2DM, CVD, PCOS, accelerated aging (chronic inflammation).

Full fat cream cheese, also feta cheese is full of these. Cottage cheese can be tolerated. If have AI propensity then can trigger it.

44
Q

Risks of weaning too early (or late)?

A

Increases *allergies risk**.

Breastfeeding whilst weaning (6–12 months) can protect
from allergenic foods via antibodies in breastmilk.

45
Q

What foods to give while weaning?

A

6 months: thin porridge with breast milk; sieved vegetables and fruits.
6-8 months: textured vegetables and fruits, protein, iron-rich foods
8+ month holds own bottle Whole (soaked) grains, pieces of soft, cooked vegetables / fruit, lean meats, fish, casseroles,eggs, mashed legumes(soaked / cooked well), yoghurt.

Essentially fruit and vegetables but in different stages of mashedness.

46
Q

Stages of weaning?

A
  1. From six months: introduce single ingredient foods one at a time with 3–4–day intervals to observe any food reactions.
  2. Poss allergic reactions (eggs etc) around 12 months of age.
  3. Do introduce peanuts between 4–11 months to prevent allergy formation in children with a family history of allergies.
  4. Continue breastfeeding alongside solids.
  5. Probiotics can be given to children to strengthen immune system.
47
Q

Three stages of food mushi-ness

A
  1. Offer very small amount of puréed (runny consistency) vegetables on a spoon.
  2. Increase to smooth paste
  3. Mashed or minced food.
48
Q

THREE foods to avoid during weaning and early childhood

A
  1. Concentrated sweets, baby food desserts
  2. Products containing sugar alcohols can cause
    diarrhoea, e.g. glycerol, sorbitol, mannitol, xylitol
    and hyperactivity, gut dysbiosis and generally toxic.
  3. Avoid educating taste buds to expect sweet things. Sweetness cause T2DM.
  4. Canned vegetables — contain too much sodium, sugar or preservatives, and are nutritionally inferior to fresh / frozen produce.
  5. Honey should never be fed to infants because
    of risk of botulism (a rare but serious bacterial infection)
  6. Soya products — hard to digest and contain compounds with oestrogen-like compounds (‘isoflavones’).
  7. Cow’s milk
49
Q

What’s wrong with cow’s milk?

A

Consumption before 12 months:

  1. Iron deficiency anaemia (impairs iron absorption).
  2. Deficiency of linoleic acid (low in cow’s milk).
  3. Gastrointestinal blood loss (can cause occult blood in infants).
  4. Type 1 diabetes (in genetically predisposed infants)
  5. General siide effects eg runny nose
50
Q

How much does a child grow each year?

A

Age 1 to adolescence a child typically grows:

  1. Taller by 2–3 inches
  2. Gets heavier by 5–6 pounds each year.
51
Q

Aside from weight and height what two changes will a child undergo?

A
  1. Brain development: cognitive abilities, language,
    emotional and social development.
  2. Neurons grow longer dendrites and axons, allowing more connections, or synapses, with other cells.
  3. Increase in bone density and muscle mass.
  4. Most organs at 12 months remarkably similar to adults, except for reproductive organs.
52
Q

Why shouldn’t give kids sweet stuff (taste-bud related)

A

Children will reach for healthy foods if their taste buds have not been spoiled by sweets and other refined carbohydrates.

53
Q

THREE causes of childhood obesity

A
  1. Eating highly processed and hyperpalatable foods (sugary cereal, ready meals, soft drinks, crisps, high fat and calorie fast food).
  2. Reduced energy expenditure eg TV watching
  3. Mindless eating.
  4. Less time spent outside,
  5. Bigger food portions, both at home and in restaurants.
  6. Gut dysbiosis (eg antibiotics, not breast-fed).
54
Q

Why is iron important in childhood?

A

Iron deficiency anaemia .

Avoid by:
1. Staying away from processed foods
(ready meals, sugary snacks, soft drinks, crisps).
2. Cow’s milk inhibits absorption of iron by calcium and casein.
3. Optimising digestion and gut health: probiotic and
prebiotic rich foods, chewing food well.

Vitamin and mineral needs of children increase with age.

55
Q

Which fibre aids bowel movement?

A

Insoluble fibre eg pectin

56
Q

Iron deficiency symptoms

A

Fatigue, listlessness, irritability, loss of appetite, apathy, impaired learning, slow growth rates, pallor, tachycardia, spooning of nails.

57
Q

Issue with refined carbs for adolescents?

A

High refined carbs and low fibre = acne due to effect of insulin on sebum production which leads to oily skin).

58
Q

Fat intake in adolescents?

A

<= 30–35% of total caloric intake.

59
Q

Why are EFAs important in adolescence?

A
  1. Production of sex hormones (testosterone, oestrogen,
    progesterone).
  2. Needed for skin, hair and nail health (consider teenage acne).
    Include healthy fats: nuts and seeds, oily fish, avocado, olives and olive oils.
60
Q

What micronutrients needed during adolescence?

A
  1. Calcium
  2. Iron
  3. Zinc
  4. Protein
  5. B vitamins
  6. Selenium

Nutrients that support growth, metabolism and reproductive health crucial.

61
Q

Why is calcium important in adoclesence years?

A

Bone development

Ca requirements reaches peak during these years.

Include bone supportive nutrients:
1. vit D
2. Mg rich foods (almonds, barley, leafy greens, legumes).

62
Q

Why do iron requirements increase in adolescence?

A
  1. Blood volume increases with growth.
  2. Female menstruation,
  3. Males as their lean body mass develops.

Include non-haem iron foods eg almonds,
apricots, avocado, sunflower, pumpkin seeds as
well as vitamin C-rich foods to aid absorption (broccoli, citrus fruits, peppers, rosehips, strawberries, sweet potatoes etc.)

63
Q

FIVE characteristics of unhealthy aging

A
  1. Lowered hormone levels eg sex hormones, growth hormone.
  2. Immunity: dysregulation of innate and adaptive immune function. Tap your thymus gland daily to keep active (T-cells).
  3. Loss of skin integrity due to reduced lipids, leading to desquamation.
  4. Decreased bone density and muscle mass.
  5. Heart valves and arteries stiffen (= less flexible).
  6. Decrease in renal function (GFR declines).
  7. Reduced chest wall compliance and alveolar recoil.
  8. Neurological function declines (with neuron atrophy).
  9. GIT: affected by reduced stomach acid, dysphagia and reduced taste sensation.
64
Q

Senescence?

A

Deterioration with age

65
Q

What shortens telomere length?

A

Smoking
Poor diet can increase pace.

66
Q

What lengthens telomeres?

A

Meditation
Low stress
Good diet…

67
Q

How does body composition change with age?

A
  1. Fat mass and visceral fat increase
  2. Lean muscle mass decreases
68
Q

Sarcopenia?

A
  1. Age-related loss of muscle mass, strength
    and function ie decreasing mobility, falls risk, fractures, lowering metabolic rates and increasing risk of death.
  2. Accelerates with decreased physical activity.

Solution: Weight-bearing exercises to slow loss of muscle pace and retain bone mineral density.

69
Q

FIVE things that contribute to sarcopenia?

A
  1. Sedentary lifestyle
  2. Lack of exercise
  3. Prolonged bed rest: muscle disuse causes large decline in muscle size and strength.
  4. Body composition changes with age.
  5. Poor nutritional status (reduced protein and energy intake).
  6. Hormonal changes (low testosterone, oestrogen, growth hormone, as well as insulin resistance.
  7. Inflammation (↑interleukin-6 and CRP).
  8. **Chronic diseases (e.g. cancer, heart failure)
70
Q

What effects energy balance with aging?

A
  1. Age-related loss of lean muscle mass affects body composition therefore BMR.
  2. BMR lowered as physical activity declines.
  3. Raised fat mass increases risk of CVD, diabetes and obesity, which influences energy balance.
  4. Infections may increase energy demands.
71
Q

What causes malnutrition in old age?

A
  1. Reduced intake of food: changes in taste and smell (sometimes due to medications, cigarette smoking or Alzheimer’s), alterations in gastric hormones regulating appetite and motility, depression and bereavement, as well as social isolation.
  2. Cachexia (side effect for cancer or COPD).
  3. Stroke / dementia can lead to dysphagia
    difficulty eating / swallowing). Can lead to aspiration pneumonia (a leading cause of death amongst nursing home residents).
72
Q

What causes poor oral health?

A
  1. Poor nutritional status eg high refined sugars, low antioxidants.
  2. Dentures (problems chewing); amalgams (risk of dental infections).
  3. Xerostomia (dry mouth): causing difficulty chewing and swallowing, whilst also impacting oral microbiome and reducing salivary IgA. This increases risk of oral thrush, which can reduce taste.
73
Q

What are the consequences of malnutrition x4?

A
  1. Loss of muscle mass and strength.
  2. Loss of mucosal integrity leading to malabsorption.
  3. Impaired immune function.
  4. Psychological impact: apathy / depression.
74
Q

THREE factors that affect food choices in elderly?

A
  1. Physiological ie regular functioning ie how systems of the body work together:
    - decreased visual acuity
    - joints problems
    - hand tremors
    - hearing
    - anorexia
    dementia.
  2. Social / psychological: reluctance to go shopping,
    isolation, depression, fear, bereavement.
  3. Economical: isolation, low income.
  4. Reduced appetite: CCK increases with ageing, resulting in increased satiation after meals and delayed gastric emptying.
75
Q

What changes happen in GI tract x3 to the elderly?

A

Achlorydia (HCL) therefore lower intrinsic factor for B12 and bile/digestive juices. Low Fe and Ca absorption. CCK rises with age therefore eat less and delayed gastric emptying.

  1. Parietal cell intrinsic factor production declines with age.
  2. Achlorhydria (reduced stomach acid) can lead to:
    - Poor digestion, absorption and biliary excretion
    (low HCl also impairs bile flow and pancreatic function).
    - Vitamin B12 deficiency (HCl and IF)
    - SIBO and other intestinal bacterial infections.
    - Iron deficiency (due to impaired absorption).
  3. CCK increases with ageing, resulting in increased satiation after meals so less food is eaten and delayed gastric emptying. SIBO risk and slowed motility.
  4. Gastric motility can also be impaired.
76
Q

Which CV changes occur in aging x2?

A
  1. Thickening / stiffening of arteries: leading to increased systolic blood pressure.
  2. Decreased maximum heart rate.
  3. Increased left ventricular muscle mass (also due
    to hypertension) = CVD predictor.
77
Q

How to improve heart health in elderly x 3 suggestions?

A
  1. Increase bitter foods (nutrient dense, antioxidants, anti-inflammatory, high fibre [cholesterol], phytonutrients (flavanoids, polyphenols), BSR, BP reduction (beetroot).
  2. Increase heart nourishing foods eg garlic and rosemary (circulation).
  3. Encourage regular aerobic exercise.
  4. Whole foods, rich in antioxidants.
78
Q

Renal aging x 3?

A
  1. Kidney cortex volume decreases.
  2. Number of renal cysts increases
  3. Nephrosclerosis increases with age, with a
    decline in nephron numbers and GFR.
79
Q

What can reduced kidney structure and function lead to?

A
  1. Problems with urinary excretion
  2. Difficulties regulating sodium concentration in body.
80
Q

THREE neurological changes in old age?

A
  1. Cognition, coordination, steadiness, gait decline.
  2. Depression often undiagnosed as symptoms confused with other illnesses. Loneliness, bereavement and other losses, not having a goal and purpose of life are foundation of depression.
  3. B vitamins deficiency (esp B6, B9, B12) = cognitive impairment, contribute to raised homocysteine which is a risk factor in pathogenesis for Alzheimer’s
81
Q

Immune in elderly changes

A

Dysregulation of innate and adaptive immune function:

  1. Progressive decline in T-lymphocyte function.
  2. Decline in cell-mediated immunity. Increases risk and severity of infections and cancer incidences.
  3. Nutritonal deficiencies:
    a) **Low protein = reduced lymphocyte proliferation = increased risk of infection.
    b) Micronutrient deficiencies (A, C, E, Zn, Se, Fe) reduce immunity.
82
Q

How does skeletal system age x2?

A
  1. Bone Mineral Density gradually declines. Risk factor for osteoporosis (and fractures).
    NB accelerated in women (menopause + oestrogen).
  2. Cartilage:
    a) decreases its water content
    b) changes to extracellular matrix structure ie collagen
    fibres cross-linking (making cartilage stiffer),
    c) reduced delivery of nutrients to cartilage.
    d) Intervertebral discs lose their height limiting movement.

Solution:
- Regular weight-bearing exercise can support bone density and cartilage health.
- Vitamin C to support cartilage (makes collagen = vital for cartilage).

83
Q

What supplement to give for energy in old age?

A

NAD+
Essential co-factor in all living cells involved in fundamental biological processes.

NAD+ depletion = hallmarks of ageing and
may underlie eg metabolic disorders, cancer and neurodegenerative diseases.

84
Q

How to increase NAD+ levels in old age x 3?

A
  1. Exercise
  2. Sleep.
  3. Fasting
  4. Nutrition: nourishing avocados, green leafy
    veg, fish, nuts, cremini mushrooms, fermented foods.
85
Q

x3 benefits/functions of melatonin?

A
  1. Chemotoxicity reducing agent
  2. Anti-ageing substance
  3. Modulates immune defence (e.g. NK cells).
  4. Tumour surveillance agent.
  5. Potent antioxidant.
  6. Regulates circadian rhythm.
86
Q

How to increase melatonin x3?

A
  1. Increasing natural sunlight exposure
  2. Regular bedtime
  3. Dark room
  4. Avoiding artificial light at night
  5. Avoid stimulants (eg caffeine)
  6. Eating Montmorency cherries and B6-rich foods for melatonin synthesis
87
Q

THREE nutritional tips for elderly clients

A

Issue: diets lower in calories, fat, fibre and nutrients.
1. Nutrient dense diets.
2. Increase protein intake (1g / kg body weight) to raise bone mineral density and preserve muscle mass. NB too high protein can stress kidneys and increase urinary calcium excretion.
• Carbohydrates: 50–70% of calories should come from
vegetables, fruits, whole grains, legumes; these will provide micronutrients as well as fibre to counteract constipation.

88
Q

What happens if too much protein is consumed by the elderly?

A

Stress the kidneys and increase urinary calcium excretion.

89
Q

How would you advise an elderly client about lipid consumption?

A

Lipids for cognitive function, skin and joint health

  1. Include n-3 for neurological cognition and joint health: oily fish, chia, flax and hemp seeds.
  2. Reduce saturated fats (trans-fats lead to atherosclerosis).
  3. Include polyunsaturated and monounsaturated fats.
90
Q

General advice for the elderly on dietary intake?

A
  1. Cooked foods easier to chew and digest. Focus on
    - soups
    - stews
    - well-cooked grains and
    – legumes
    - small amounts of stewed fruits (high in sugar).
  2. Ensure adequate hydration by including liquid foods / herbal teas.
91
Q

Why B12 for elderly?

A
  1. Older adults at risk of deficiency from achlorhydria affecting B12 absorption.
    - HCL vital to aid release of B12 from protein
    - pareital cells release both HCL and IF.
  2. Important for cognition and nerve function.
92
Q

Why Vitamin D levels decline in the elderly?

A

Low levels due to:
1. Poor skin synthesis (Loss of skin integrity due to reduced lipids, leading to desquamation).
2. Reduced kidney conversion
3. Less sun exposure (housebound).

93
Q

Vit E for elderly

A

Antioxidant - ROS protective which linked to:
1. Accelerated ageing
2. Neurodegenerative diseases
3. Atherosclerosis.

94
Q

Folate for elderly

A

Vital for lowering homocysteine levels, risk marker for:
1. Alzheimer’s
2. Atherosclerosis
3. Parkinson’s.

95
Q

Ca for elderly

A

Decreased absorption (due to lower HCL and vit D).

96
Q

Potassium for elderly

A
  1. Positive effect on blood pressure.
  2. Inverse association of potassium and stroke mortality (higher levels of K associated with lower rates of death due to stroke).
97
Q

CoQ10?

A

CoQ10
Antioxidant (protects cells from oxidative damage).
1. Body production declines with age and with statin use (very common in elderly).
2. CoQ10 also supports immune system
3. Facilitates ATP production.
4. Useful for cardiovascular problems such as coronary artery disease, hypertension, angina, atherosclerosis

98
Q

Which FOUR herbs would you recommend for the elderly?

A
  1. Nettle leaf
  2. Dandelion root
  3. Peppermint
  4. Camomile

**Nettle leaf”:
1. Diuretic — relieves fluid retention
2. Blood purifier — flushes out toxins, skin cleanser,
3. Nutritive
4. Assists blood glucose balance
5. Anti-inflammatory (arthritis).

Dandelion root:
1. Enhances digestion (bitterness stimulates
release of digestive juices to improve breakdown
and absorption of nutrients)
2. Supports liver detoxification, a gentle laxative, mild diuretic (assists with fluid retention). Promotes peristalsis.

Peppermint:
1. Soothes digestion — relieves griping pain, flatulence and nausea.
2. Antimicrobial internally and topically.
3. Relieves pain (muscle pains) and itching topically.

Chamomile:
1. Relieves pain, flatulence and spasm in digestive tract. 2. Calming to nervous system, relieving stress
and promotes a restful sleep.
3. Topically helps with wound healing

Nut 1 Semester 2 (11 decks)

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