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PUBHLTH 310 > PUBHLTH 310 Exam #3 > Flashcards

PUBHLTH 310 Exam #3 Flashcards

1
Q

Adolescent

A

Ages 11-21
Physical and biological changes: puberty
Psychological development: cognitive maturity
*personal identity, increasing sense of indepdendence

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2
Q

Puberty

A

A hormonally-driven process
*increasing levels of gonadoptropin releasing hormone (GnRH) trigger onset (LH and FSH release)

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3
Q

First physical signs of GnRH increase

A

Thelarche: breast buds present (females)
Gonadarche: enlargement of testes (males)
Growth factors: growth hormone and insulin like growth factor

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4
Q

Puberty Cont.

A

Age of onset varies due to:
*amount of body fat, chronic conditions

Biological (maturation) versus chronological age

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5
Q

Puberty Cont.

A

Physical changes measured by Tanner Stages
*sexual maturity rating, measures biological age

5 stages for makes and females, stage 5 signifies end of puberty
*development of external physical features

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6
Q

Adolescent Growth Spurt

A

Females: 10.5-13 years
Males: 12-15 years

Peak velocity in linear growth
*females: 3.4 inches/year, Tanner stage 2/3
*males: 4 inches/year, Tanner stage 4

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7
Q

Differences in Male and Female Body Composition

A

Females
*lean body mass: 74-80% of body weight
*body fat: 20-60% body weight

Males
*lean body mass: 85-90% of body weight
*body fat: 10-15% of body weight

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8
Q

Differences in Male and Female Body Composition & Weight

A

Males lean body mass greater than females

Females greater body mass than males

Males grow faster rate - eventually gain more height
* male bone mass greater than female

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9
Q

Total Weight Gain Throughout Puberty

A

Females: 53 lbs
Males: 70 lbs

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10
Q

Bone Mass Development

A

40% of total development occurs in adolescent years
*females: by 18 years, 92% of bone mass development occurs
*males: by 20.5 years, 90% of bone mass development occurs

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11
Q

Factors affect bone mass accumulation

A

Nutrients - calcium, vitamin D, phosphorus, energy status
Height attainment - accrual ceases dramatically after reaching final height
Hormonal changes - testosterone, androgen, estrogen
*bone growth has sex differences in response to hormones

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12
Q

Three Stages of Psychosocial Development

A

Early Adolescence (11-14)
*cannot think conceptually (focus on present)
*influenced by peers
*self-conscious develops

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13
Q

Three Stages of Psychosocial Development Cont.

A

Middle Adolescence (15-17)
*increasingly able to think conceptually and rationally
*not widely applied, self-conscious

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14
Q

Three Stages of Psychosocial Development Cont.

A

Late Adolescence (18-21)
*conceptual thinking still developing
*self-identification
*morals and beliefs shaped (ability to question/think for self)

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15
Q

Nutrient Needs

A

Total nutrient needs will support physical and biological changes
*needs based off Tanner Stage

DRI for adolescents
*based off chronological age, ages 9-13, 14-18
*sex-specific

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16
Q

Energy Needs

A

Total calories per day
Males: 2200-3150
Females: 2100-2400

Clear increase in appetite - need to balance intake and nutrient needs

Caloric range due to - physical activity, timing of maturation and growth spurt

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17
Q

Carbohydrate Needs

A

130 g/day (45-65% of total Caloric intake)

Adolescents tend to take in high amounts of added sugars
*contributes up to 18-20% of total caloric intake

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18
Q

Protein Needs

A

Highest needs at peak of adolescent growth spurt
*maintain existing tissue, support development of lean body mass

Females: 34-46 g/day
Males: 34-56 g/day

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19
Q

Fat Needs

A

25-35% of total caloric intake

Females v. Males
*higher recommendation for essential fatty acids

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20
Q

Micronutrient Needs

A

Micronutrient deficiencies are common
*females more deficient than males
*bone related nutrients: calcium, vitaminD; iron, folate

Contributing factors
*less than 18% of adolescents meet recommended fruit/vegetable intake
*low intake of fiber, dairy, high intake of added sugar

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21
Q

Bone Related Nutrients: Calcium and Vitamin D

A

Critical for bone mass accrual

Calcium intake correlated to energy intake
*requirements highest for all life stages: 1300 mg/day

Vitamin D increases dietary calcium absorption

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22
Q

Micronutrient Needs

A

Iron
*increase in blood volume, lean body mass development
*onset of menarche - higher requirement in females

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23
Q

Micronutrient Needs Cont.

A

Folate
*red blood cell synthesis, key cofactor for metabolism
*females now considered of child-bearing age

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24
Q

Obesity in Adolescence

A

Affects physical and mental health
*type 2 diabetes, hypertension, orthopedic problems, low self esteem

Risk factors
* race, socioeconomic status, physical activity levels, one parent is overweight

90& of overweight adolescences -> overweight adulthood

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25
Q

Obesity and Puberty: Females

A

Observed decreased in the age of puberty onset
*decrease in age coincided with increase in obesity

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26
Q

Critical Weight Hypothesis

A

Observed weight for onset of menarche - around 105 lbs and 22% body far

Children reaching thresholds sooner in life: breast bud, height gain, menarche

Fat is considered to be an endocrine tissue
*sufficient amount needed to trigger GnRH release, obesity alters many hormonal systems

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27
Q

Obesity and Puberty: Females Cont.

A

Age range of thelarche onset for females of overweight and obese BMI: 8-9.6 years of age

Earliest cases around 6 years of age
*due to abnormal estrogen production from increased fat tissue
*aromatase converts androgens to estrogen (alternate mechanism of estrogen production)

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28
Q

Obesity and Puberty: Females Cont.

A

Insulin resistance - increasing circulating insulin results in
*increase growth factors: insulin-like growth factor (stimulate linear growth)
*stimulate production of androgens

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29
Q

Early Onset Puberty: Females

A

Other risk factors - endocrine disruptor exposure
*Polybrominated biphenyls (PBB): crosses placenta and breast milk

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30
Q

Early Onset Puberty: Females Cont.

A

1973 Livestock Exposure: livestock ate PBB-contaminated feed, exposed to humans

High-exposed population: daughters in farmer families
*menarche occurred significantly earlier
*more likely to experience miscarriage

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31
Q

Early Onset Puberty: Females Cont.

A

Endocrine disruptors
*Bisphenol A - estrogen mimicking chemical (targets early activation of GnRH production, release)

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32
Q

Early Onset Puberty: Females Cont.

A

Livestock treated with hormones
*excess estrogen found in liver and kidney, metabolized before consumption
*further concerns about treatment with antibiotics

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32
Q

Early Onset Puberty: Females Cont.

A

Livestock treated with hormones
*excess estrogen found in liver and kidney, metabolized before consumption
*further concerns about treatment with antibiotics

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33
Q

Outcomes of Early Puberty

A

Short stature - bone mass development peaks earlier
Increased risk of breast cancer
Psychological effects
*increased eating disorders, lower self-esteem, increased depression, risky behavior, effects persist into adulthood

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34
Q

Obesity and Puberty: Males

A

Childhood BMI trajectory has a positive association with age of pubertal onset in males
*as BMI increase, age of puberty onset increases

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35
Q

Obesity and Puberty: Males Cont.

A

Mechanism remains unknown
*limited data in low GnRH release and testosterone production
*testosterone produced in converted to estrogen

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36
Q

Outcomes of Late-onset Puberty

A

Psychological effects - not long term
*lower self-esteem
*increased depression

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37
Q

Increased Fat Mass Relation to Puberty Onset: Females vs Males

A

Females:
Early puberty
*variety of mechanisms explored
Long lasting psychological effects

Males:
Later puberty
Shorter term psychological effects

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38
Q

Physical Activity and Puberty

A

Generally, physical activity has positive impacts on growth and development
*promote bone development, maintain healthy weight

Intense physical activity alters
*nutritional status, maturation (puberty)

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39
Q

Nutritional Status

A

Additional lean body mass development
*protein needs, increased mineral requirements

Males need more calories per day

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40
Q

Excessive exercise affects sexual maturation

A

Increased cortisol through exercise suppresses GnRH production

Female athlete triad
*failure of LH, FSH, and estrogen production -> delayed menarche, amenorrhea, osteoporosis

Relative energy deficiency in sports (RED-S)
*failure of LH, FSH and testosterone production -> delayed lean tissue deposition, linear growth

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41
Q

Consumption Patterns: Food Consumed Outside of Home

A

Increasing independence from parents
Dietary intake coming from outside sources
*restaurants, workplace, etc.

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42
Q

Consumption Patterns: Food Consumed Outside of Home Cont.

A

Low dietary quality of food consumed outside home

Factors contributing to meals/snacks outside of home
*low economic status, employment, athletics

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43
Q

Consumption Pattern: Skipping Meals

A

Busy life style limits nutrient intake
*leads to increased snacking

Breakfast - most frequently missed meal
*due to sleeping in, lack of hunger cues
*causes limitation of nutrients

“Grazing Patterns” - correlated to TV, studying, video games

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44
Q

Dieting and Weight Control

A

20-50% of adolescents will try to lose weight
*response to bodily change, females more likely

Restrictive practices
*skipping meals, diet pills, smoking, fasting, food substitutes, intense physical activity

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45
Q

Dieting and Weight Control Cont.

A

Strategies to change body shape differ among sexes
*females: restrict food intake; males: increase muscle mass

Different types of dieters: “overweight”, “depressed”, “feeling fat”

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46
Q

Vegetarianism

A

11% have experimented, 3-4% are established vegetarians
Adolescent vegetarians:
*increased intake of fruits and vegetables, decreased added sugar intake
*need particular supplementation

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47
Q

Eating Disorder Symptoms

A

Behavioral
*dietary restriction, compensatory behavior, binge eating

Physical
*low body weight

Cognitive
*body image issues

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48
Q

Dietary Restriction

A

Behavioral attempts to restrict food intake for wight control

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49
Q

Compensatory Behavior

A

Inappropriate behaviors to compensate for food consumed

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50
Q

Binge Eating

A

Consumption of a large amount food in a short period of time and a sense of lack of control over eating during the eating episode

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51
Q

Low Body Weight

A

Low body weight considering one’s age, gender, development, physical status

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52
Q

Body Image Issues

A

Severe body dissatisfaction or concern with body size/shape or weight; undue influence of body shape and weight on one’s self-evaluation

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53
Q

Eating Disorders vs Disordered Eating

A

Full syndrome cases are relatively rare and represent only a fraction of those who struggle
*eating disorder symptoms/behaviors exist on a continuum

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54
Q

Disordered Eating

A

Term used to describe behavioral symptoms of eating disorders that do not meet diagnostic criteria

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55
Q

Eating Disorder Prevention

A

Primary Prevention
*prevent occurrence of eating disorders before they begin (promote healthy development)

Secondary Prevention
*programs or efforts that are designed to promote the early identification of an eating disorder

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56
Q

Why prevention?

A

Prevalent: 3-5% with eating disorders, 15-20% with disordered eating

Serious: high mortality, psychiatric morbidity, organs

Modifiable: media exposure, thin ideal internalization, food insecurity, abuse history

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57
Q

Disordered Eating on College Campuses

A

Traditional undergraduate college years directly coincide with median age of onset for eating disorders and disordered eating

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58
Q

The Healthy Bodies Study

A

Population-level
Administered to a randomly selected sample of undergraduates and graduates
Two academic years, 12 colleges

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59
Q

The Healthy Bodies Study Cont.

A

Examined:
Elevated dietary restrain and concerns about eating, weight and shape
Binge eating
Compensatory behaviors

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60
Q

The Healthy Bodies Study Cont.

A

Examined:
Elevated dietary restrain and concerns about eating, weight and shape
Binge eating
Compensatory behaviors

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61
Q

The Healthy Bodies Study Cont.

A

Undergrads and younger students were at highest risk of all disordered eating symptoms
Few differences according to race/ethnicity
Elevated dietary restraint and concerns among sexual minority men
Compensatory behaviors were common in female athletes
Weight was consistent predictor of disorder eating

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62
Q

Eating Disorder Treatment

A

The majority of individuals never get diagnosed or treated
*if left untreated, associated with physical, psychological, social and academic consequences

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63
Q

Prevention and Treatment

A

Disordered eating is prevalent on college campuses, yet under-diagnosed and under-treated
*assumptions drive disparities, may continue to disadvantage those who already feel excluded

Additional attention must be paid to improving detection, identification and referral

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64
Q

Emerging Adulthood

A

18-25 years
New focus as a distinct period of life:
*delay of marriage, child bearing
*decline in teen pregnancies, increasing higher education

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65
Q

Developmental Milestones

A

New independence and responsibilities
Time of new and/or solidified identity
Perry’s Intellectual Model: Relativism -> Commitment
*relativism: role models; commitment: own beliefs
Changing social relationships
Shape food and health-behavior choices

66
Q

Physiological Changes

A

Majority of height reached by 16 for girls and 18 for boys

Continued changes in body composition
*bone density increases until age 30, and then begins to decline around age 40 ~ if there is calcium, Vitamin D intake + adequate levels of high/ow impact exercise

67
Q

Physiological Changes Cont.

A

Muscle strength peaks from 25-30

Adiposity (fat) increases through adulthood
*fat tends to redistribute to intra-abdominal space

68
Q

Energy Needs

A

DRI: ages 19-30

Caloric recommendations: less for women than men

69
Q

Energy Needs Cont.

A

Fat: 20-35% of calories
Carbohydrates: 45-65% of calories
Protein: 10-35% of calories

70
Q

Energy Expenditure

A

Energy expenditure begins to decline starting in early adulthood
*2-3% per decade
*corresponds to decreases in physical activity
*decline accelerated due to chronic conditions
*compensatory trend with caloric intake

71
Q

Dietary Behaviors

A

Fast food/ready made food is common
*52% of 20-40 report eating fast food recently

Dietary quality declines
*fruit/vegetable intake decline following high school
*red meat intake increases

Dietary quality predicts cardiovascular health in mid-adulthood

72
Q

Caffeine

A

No nutritional value
Moderate intake has not demonstrated adverse outcomes
*benefits to cognition

800+ is considered dangerous
*dependence, bone health, acid reflux, heart problems, sleep

73
Q

Alcohol Use

A

Normative during early adulthood
*63% report drinking in the last month

Underage drinking - public health problem
*20% of 12-20 year olds report drinking in last month
*unnecessary deaths, costly, alcohol dependence, etc.

74
Q

Alcohol Use and Compensatory Behaviors

A

39% of college freshman report eating less on days they drink
*women more likely to eat less before drinking
*for weight control, drunk faster

75
Q

Weight Gain in Emerging Adulthood

A

Rate of weight gain is highest during young adulthood than other adult period

Higher rate of weight gain in emerging adulthood associated with:
*steeper trajectory of weight gain, diagnoses of diabetes, hypertension and inflammation

76
Q

Freshman 15: Myth or True

A

15 lbs on average for college freshmen (myth)
Weight gain is expected

True: gain between 4-8 lbs during freshman year

77
Q

Social Facilitation of Eating

A

Children and adults tend to eat more with others than alone

Time extension Hypothesis: socializing extends time of meals
Arousal Hypothesis: sight and sound of eating makes people eat more extending time of meal
Weight status influences intake

78
Q

Interventions among Early Adults

A

Traditional not well represented in weight control trials

Many obesity interventions have begun in past 5 years

79
Q

Adolescents: Vulnerable Population

A

60% of middle schoolers have insufficient sleep
*70% of US high schoolers

80
Q

Adolescents: Vulnerable Population

A

80% of Michigan high schoolers sleep-deprived

81
Q

Why is sleep deprivation so bad?

A

Academic performance
Mental health
Motor vehicle accidents
Risky behavior
Lower immunity
Poor diet quality
Higher body size
Adverse cardiometabolic health

82
Q

Cause of short sleep

A

Lack of time
Distraction & growing independence
Sleep difficulties

83
Q

Delayed Sleep Syndrome

A

When a person’s sleep is delayed by 2 hours or more beyond a conventional bedtime
*7-16% of teens/young adults

Sleep that is out of sync with underlying body rhythms may lead to metabolic dysfunction

84
Q

Delayed Sleep Syndrome Cont.

A

Highly correlated with duration, thus difficult to disentangle analytically

85
Q

Later bedtimes related to

A

Older age
Screen time
Higher maternal education
Alcohol consumption
Male sex

86
Q

Elevated BP and Bed time

A

Those with later bedtimes had higher risk of developing elevated blood pressure
*early bedtimes also had higher risk

Sex differences

87
Q

Early Life Exposure to Environmental Toxin Cohort and Outcomes (Insulin Resistance)

A

Evidence beginning to accumulate that delayed sleep timing has an effect on metabolic health, independent of sleep duration

Potential mechanisms - alterations in metabolism through circadian misalignment, diet quality, eating patterns, body size

88
Q

Food and Sleep

A

Diet can affect sleep in adolescents
Fatty fish consumption (DHA -> higher sleep quality)

Findings in pediatric populations are mixed
Confounders: age, sex, SES, BMI

89
Q

Statistical Analysis

A

Linear regression
Continuous sleep or midpoint as outcome
Quartiles of DHA levels
Adjustment for potential confounders

90
Q

Conclusions (DHA)

A

Higher DHA levels related to healthier sleep in adolescents
Non-linear association explained by toxicants?
RCTs are needed to evaluate causality

91
Q

Conclusions (Beverages)

A

Sex-specific associations; girls affected by caffeine
Benefits of milk and 100% fruit juice?
*through melatonin
Micro-longitudinal studies are need

92
Q

How can we get better sleep?

A

Aim for 7-9 hours
Same time for bed and wake up everyday
Natural light
Avoid caffeine, alcohol, large meals

93
Q

Stages of Adulthood

A

Emerging Adulthood: 18-25
Young Adulthood: 25-40
Midlife: 40
Sandwich Generation: 50-60
Later Adulthood/Senior: 60 and above

94
Q

Stages of Adulthood Cont.

A

Young Adulthood
*career, community, single -> married, parenthood

Midlife
*midlife crisis, empty nester

Sandwich Generation
*multigenerational caretakers (especially females)

95
Q

Physiological Changes

A

Bone mass increases until age 30 and then begins to decline around age 40
*precent loss: calcium and weight-bearing exercise
*risk of osteoporosis dependent on peak bone mass achieved

Adiposity increases through adulthood

96
Q

Energy and Macronutrients

A

Energy expenditure generally includes
*65-70% is basal metabolic rate
*10% energy expended by thermic effect of food
*20-40% from activity thermogenesis

97
Q

Physical Activity

A

Bodily movement produced by skeletal muscles that substantially increases energy expenditure

98
Q

Exercise

A

Planned physical activity with purpose of improving physical fitness or leisure-time physical activity

99
Q

NEAT

A

Energy expenditure related to daily activities including posture and movement

PA energy expenditure = exercise + NEAT

100
Q

NEAT Cont.

A

Lean adults expend more NEAT per day

If individuals having obesity adopted the NEAT behaviors of lean, they could expend addition 350 cal/day
*promote 7lb weight loss over a year

101
Q

Energy Needs

A

Energy expenditure begin to decline starting in early adulthood
*corresponds to decrease in PA/loss of muscle
*corresponds to development of chronic conditions

20-35% fat
45-65% carbohydrate
10-35% protein

102
Q

Micronutrient Needs

A

Calcium and Vitamin D
*vitamin D increases bioavailability of Ca, preventing loss of calcium from bones

Vitamin A and E - strong antioxidant functions
Folic acid, Choline, Vitamin B12 - involved in genotype expression, nucleotide synthesis
Potassium and Sodium - complementary roles in blood pressure
Magenesium - chronic inflammation

103
Q

Adult Health

A

Factors early in this life-stage impact health through adulthood

Modifiable factors: physical activity, food choice, weight
*associated with high caloric intake, physical inactivity, saturated fatty acids

104
Q

Adult Health Cont.

A

Education, economic stability, neighborhood, community

Health disparity: differences in the incidence and prevalence of disease among specific populations

105
Q

Adult Health Cont.

A

Almost all adult Americans have one or more chronic disease
*greater than 50% of deaths from cardiovascular events
*target modifiable risk factors to prevent chronic disease

106
Q

Whole Diet Approach

A

Choose nutrient-dense foods
Limit portion sizes
Minimize refined grains/processed foods
Eat culturally-appealing foods
Exercise
Minimize caloric beverages
Drink water

107
Q

Rethink Your Drink

A

Whole milk -> skim
Non-diet soda -> diet soda
Sports drinks -> water

108
Q

Factors contributing to Obesity

A

Genetic predisposition
Psychological
Social determinants
Obesogenic environment (sedentary jobs, advertising, etc.)

109
Q

Type 2 Diabetes

A

High levels of blood glucose
*insulin resistance and defective production of insulin by the pancreas
*high circulating insulin

Chronic disease
*multitude of risk factors, associated with central adiposity

110
Q

Type 2 Risk Factors

A

Physical inactivity
History of GDM
Family history
Genetic history
Age
Obesity
Race

111
Q

Public Health Issue

A

Prevalence is increasing
Health effects and costly
Preventative and intervention

112
Q

Type 2 Screening and Diagnosis

A

45 or older
Before 45 if overweight and have risk factor:
*family history, GDM, race, inactive, high cholesterol, hypertension

113
Q

Pre-diabetes: Screening and Diagnosis

A

Blood glucose levels are higher than normal
*not high enough to be classified as type 2 diabetes, reversible

Pre-diabetes: 5x to 20x higher risk of Type 2 diabetes

114
Q

Type 2 Diabetes: Diagnosis

A

HbA1c = glycated hemoglobin
*develops when hemoglobin joins with glucose in blood, becoming glycated
*long term measurement

115
Q

Type 2 Diabetes: Health Outcomes

A

Short-term, untreated
*frequent urination, increased thirst, fatigue

Long-term, untreated
*kidney failure, loss of limbs, neurological problems, loss of eyesight, heart disease, hypertension

116
Q

Type 2 Diabetes: Interventions

A

Lifestyle changes
*weight loss, physical activity, diet

Medication

117
Q

Diabetes Prevention Program

A

Nationwide randomized trial

3,200 overweight/obese adults with pre-diabetes
Compared 3 preventative interventions
*brief education + placebo, brief education + pill, intensive lifestyle program

118
Q

Intensive Lifestyle Intervention Group

A

Goal: weight loss of at least 7% of initial body weight
*150 mins of moderate physical activity
*education, training, strong support

119
Q

Medication and Placebo groups

A

Medication
*metformin, recommendations for lifestyle change

Placebo
*fake, recommendations for lifestyle change

120
Q

Type 2 Intervention

A

Physical Activity - controls blood glucose levels
*stimulates glucose uptake without an insulin response
*calcium release upon contraction triggers an AMPKinase response -> GLUT4 translocation

121
Q

Dietary Recommendations

A

Carbohydrates do not cause diabetes
*underlying etiology that insulin signal is disrupted

No specific diet
*spacing of meals, portion sizes, high fiber

122
Q

Co-Morbidity

A

Treatment of chronic conditions in older adults is complicated
*each condition can affect another

123
Q

Chronic Conditions to Consider…

A

Oral Health
Hypertension
Osteoporosis
Cognitive Health (depression, Parkinson’s, Dementia)

124
Q

Hypertension

A

High blood pressure = greater than 130/80 Hg
*new guidelines

Non-modifiable and modifiable risk factors
*age, family history, race, excess weight
*diet: high fat, high salt, low potassium, low magnesium, low calcium

125
Q

Dietary Approach to Stop Hypertension (DASH)

A

Study AIM: reduce hypertension by diet
Control: typical westernized diet
Intervention 1: high in fruit and vegetables
Intervention 2: high in fruit and vegetable + low fat, dairy, etc

126
Q

DASH Results and Further Studies

A

DASH diet made most improvements to blood pressure (intervention 1)
Diet rich in fruits and vegetables also reduced BP but to a lesser extent (intervention 1)

DASH-sodium trial
*different levels of sodium, better results from lower sodium than DASH diet

127
Q

Osteoporosis

A

Prevalence is much higher in women than men

Non-modifiable: female, race, history of restrictive diet
Modifiable: phosphorus, calcium, vitamin D deficiency, inactivity

128
Q

Osteoporosis Cont.

A

Maintaining bone health
*calcium and vitamin D rich, exercise, limit caffeine intake, medication option

Effects
*shrinking height (kyphosis), falls and fractures (don’t heal as well, more time in hospital)

129
Q

Depression

A

Late-life depression
Prevalence: 15% in community, 50% in assisted living

Diagnosis: Geriatric Depression Scale + Cog. functioning tools
Treatment: anti-depressants, EPA and DHA

130
Q

Dementia

A

Overarching term for progressive loss of memory and cognitive function
*loss of independence, impaired judgement, impaired linguistic ability

Symptom of alcoholism, Vascular disease, Alzheimer’s, Parkinson’s

131
Q

Parkinson’s Disease

A

Neurodegenerative disease
*affects dopamine production, altered motor function
Prevalence: 1% of older adults
Cause: genetics and environmental exposures
Early signs: tremors on one side, slouched/shuffled gain, word loss

132
Q

Parkinson’s Disease Cont.

A

Prevention: dopamine too far disrupted by the time symptoms are present to prevent

Interventions: medicine (in absence of protein), Deep Brain Stimulation therapy, exercise, nutrition, monitor mental health

133
Q

Supporting the Geriatric Population

A

Awareness of the aging and diverse population
Understand complex, multiple diagnoses
Support cognitive functioning

134
Q

Food System

A

Entire range of factors and interlinked activities involved in production, aggregation, processing, distribution, consumption and disposal of food products that originate from originate from agriculture, etc. and parts of the broader environments in which they are embedded

135
Q

Food System

A

Production -> Processing -> Distribution -> Consumption -> Disposal

136
Q

Climate Change

A

Key drivers: economic and population factors broadly, any sector that requires energy
When: half of cumulative emissions between 1750-2011 have been in last 40 years
Where: Cumulative rise in all regions of the world, including oceans
Affects: water supply, biodiversity, crop yields, disease and extreme weather events

137
Q

Hurricane Maria Impacts

A

Destroyed 80% of Puerto Rico’s agriculture

Climate change outlier: sea surface temperature increases hurricane intensity
*climate change increases total rainfall, Maria had 30% more than the next most severe hurricane

138
Q

Hurricane Maria Impacts Cont.

A

200$ million worth of produce lost
*only 24% of vendors had reliable electricity

No fresh fruit, unhealthy food widely available

High prevalence of chronic disease risk factors after Hurricane Maria

139
Q

Inadequate Food Distribution

A

FEMA food distribution not appropriate for pregnant persons or infants

Emergency foods must follow the DGA per 1990 National nutrition Monitoring Related Research Act

140
Q

Nutrition Implications via DOHaD

A

Pregnant persons had 200% higher exposure to phthalates (in bottled water, packaged foods)

Higher exposure of certain phthalates linked to preterm birth (compound with maternal stress)

141
Q

GHGE Diets

A

Those who adhere to diet tend to consume
*more fruits and vegetables, less whole and refined grain, more red meat and less poultry/seafood, less added sugars

142
Q

Age

A

Age is arbitrary

DRIs - 70
US census bureau - 65
WHO - 60
Elderly Nutrition Program - 60

143
Q

Lifespan v. Healthspan

A

Lifespan: length of life of any one individual
Healthspan: length of time a person can perform activities of daily living

Compression of Morbidity - shortening period of illness
*increasing healthspan, target lifestyle factors
Postponing change sin health is an important goal

144
Q

Why do we age?

A

All organisms lose cell function and number of cells over time
*loss physiological function, increase disease, malnutrition risk

Effects of aging go unnoticed for a long time
*reserve capacity

145
Q

Hayflick’s Theory of Limited Cell Replication

A

Cells have pre-programmed limited number of divisions
*as cells replicate, it increases the chances of being mutated, leading to cell death

Cells death rate
*too fast = loss of organ functioning
*too slow = damage cells proliferate resulting in disease

146
Q

Calorie Restriction to increase Logetivity

A

20-40% reduction: expands life spans in animal models by 50%
*less oxidative damage to cells

147
Q

Do people age differently?

A

Rate of aging
*influenced by exposures

Different amount and length of exposures through lifetime (weathering hypothesis)
*food, exercise, environment, stress, social

148
Q

Baby Boomer Generation

A

Born into lives with more opportunity and growing prosperity
*more likely to experience chronic illness longer than previous elderly population

149
Q

US Geriatrics

A

Current Life Expectancy: 76.6 years

85 and older: fastest growing of the population

150
Q

Body Composition in Aging Population

A

Increase in fat mass percentage

Decrease in lead body mass percentage
*mineral loss, water loss

151
Q

Physiological Changes with Aging

A

Weight increases until about 70
*decline in all energy expended

Weight loss 70 and older
*lower food intake, hormonal changes, loss of muscle mass

152
Q

Physical Activity and Aging

A

Build and maintain lean body mass
Improves balance and flexibility
Increases caloric need, chances of adequate nutrient intake
Improves cognitive performance

153
Q

Effects of Exercise on Cognitive Function

A

65-75 years of age, less than 60 min per week

Significant better outcomes on emory, verbal fluency, speed of information processing in exercise program

154
Q

Physical Activity Recommendations for Older Adults

A

Muscle strengthening of all major muscle groups 2 or more times/week
Moderate intensity aerobic activity at least 150min/week
Drink water when exercising
Intake of adequate protein throughout dah

155
Q

Carbohydrates

A

45-65% of daily calories are carbohydrates
*focus on whole grains/fiber in the diet: decrease cholesterol, constipation, healthy weight, reduces sugar intake, increases micronutrient intake

156
Q

Fats and Cholesterol

A

High saturated fat and trans fat intake are risk factors for chronic disease
*keep fat intake between 20-35% of calories

High intake of essential fatty acids associated with:
*memory, cognitive functioning, slower development of neurodegenerative disease

157
Q

Protein

A

Inadequate protein intake most abundant in older adults
Elderly at risk: poverty, obese, functional limitations, living alone

Risk of low protein: sarcopenia, weakened immune system, delayed wound healing

35% from calories is recommended

158
Q

Fluid

A

Recommendation is same as younger adults
Reasons underlying dehydration:
*thirst mechanisms decline, kidney function declines, swallowing difficulties

Dehydration: confusion, weakness, body temperature

159
Q

Micronutrient of Concern: Vitamin D

A

Affects bone health

Possible deficit due to:
*decreased ability of skin to synthesize vitamin D, more clothing worn, overall less food eaten

160
Q

Micronutrients of Concern: Vitamin K

A

Blood coagulation

Important to consider if taking blood thinners
*target Vitamin K1, decreasing clotting factors, manage Vitamin K intake

161
Q

What Affects Geriatric Food Intake?

A

Ability to cook
Finances
Ability to shop
Habits
Cognitive functioning
Disease
Senses

162
Q

Oral Health

A

75+ years of age
*fluoride treatment started in late 1940s

Dentures, periodontal disease, cavities, can all lead to changes in nutritional intake
*difficulties chewing, pain, enjoyment decreases

To promote eating and enjoyment
*cut foods down, stimulate saliva, cultural foods

163
Q

Food Safety

A

Food borne illness as a concern in this population
*compromised senses and immune system

Factors contributing to food borne illness
*contaminated food prep, hygiene, cooking, old food, improper temperatures

PUBHLTH 310 (1 decks)

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