Topic 11 - Lifecycle Nutrition Flashcards
The increase in the proportion of older Australians is largely due to . . .
improved health and longevity
however it means there is likely to be an increase in CHRONIC disease in the population
Average life expectancy is increasing in Australia. What is it for men vs women?
Males - 79.9 years
Females - 84.3 years
What are the benefits of regular physical activity in older adults?
- lower weight
- greater flexibility
- increased endurance
- better balance & health
- longer lifespan
How is exercise good for muscles in older adults?
- can delay the decrease in muscle mass & strength that occurs with age
- loss of muscle mass is a major cause of injury (from falls), disability, and even death
- strength training (>85 years) can prevent muscle atrophy and improves body composition & energy metabolism
also increased blood flow to the brain –> improved cognitive functioning
What is the difference b/w physiological age vs chronological age?
- physiological age: reflects health status
- chronological age: the actual person’s age
How can people improve physiological age?
- sleeping regularly & adequately
- eating well-balanced meals, inc. breakfast regularly
- not smoking
- not drinking alcohol, or drinking it in moderation only
- maintaining a healthy body weight
- regular social engagement & using the mind
Animal studies suggest that ________ may increase life and reduce risk of diseases
energy restriction
animals tho exhibit a range of metabolic, physical, and endocrine changes – hard to replicate in humans (how much restriction?)
Biggest problems with age caused by?
shifts to muscular skeletal system
What is sarcopenia?
- age associated decline in skeletal mass + function
- muscle loss –> less able to move = falls are more likely
- lean mass is replaced with fat mass (sarcopenic obesity)
- decreased resting metabolic rate
- can lead to overall reductions in energy expenditure when paired with reductions in physical activity
Immune system changes in old age
- both cellular & passive immunity (i.e. skin barrier to infection) is compromised in old age
- malnutrition also increases vulnerability to infectious diseases
Taste + smell changes in old age
- decline after age 60
- with 75% of those > 80 years having some olfactory impairment
- can reduce food enjoyment and detection of spoiled or burnt foods
Changes in the gastrointestinal system
- appetite & thirst
hunger + satiety cues weaker; blunted thirst regulation can cause dehydration - loss of teeth/periodontal disease
reduced ability to masticate food (avoidance of certain foods too) - dysphagia, or difficulty in swallowing
caused by decreased flow and increased viscosity of saliva –> impairs nutrient absorption & contributes to periodontal disease - reduced stomach acid + digestive enzymes
impacts on bioavailability of several nutrients, i.e. folic acid, vitamin B12, iron - slower peristalsis & gastrointestinal motility
–> functional changes & a reduction in GI secretions increases GI transit time and constipation
Why do older people experience changes in cognitive function?
blood supply and the number of neurons in the brain decreases - can impair memory
Psychological changes in older people
depression & loss of appetite commonly occur together
Social changes in older people
- loneliness is directly related to low energy intakes
- malnutrition is common, especially among those who live alone
Living arranges/economic changes…
can have a significant impact on food choices, eating habits, and nutritional status
On average, how much do adult energy needs decline by?
they decline by 5% per decade after age 50
What are some important energy & nutrient needs of older adults?
- energy: declines due to decrease in basal metabolic rate + thyroid hormones diminish
- protein: increased requirements to maintain positive nitrogen balance, which protects muscle mass, boosts immune system, and optimizes bone mass
- carbohydrate & fibre: CHOs required for energy; needed for protein-sparing - fibre (& water) help alleviate constipation
- fat: needs to be moderate
Vitamin B12 in older adults
- no change in requirements
- however, inadequate HCl & intrinsic factor might influence B12 absorption
Calcium in older adults
- RDI increases to 1300mg/d (>50y) due to increased bone mineral loss >40yrs
- increased urinary calcium loss
- decreased calcium absorption
Iron in older adults
- no change in requirements
- however, iron deficiency anemia increases with age due to chronic conditions/meds
- poor iron absorption due to reduced stomach acid secretion
Vitamin D in older adults
- recommended intakes increases from 10micrograms/d (>50y) to 15 microg/d (>70y)
- due to high prevalence of Vit D deficiency
- due to limited sun exposure
- reduced efficiency of skin to produce Vit D and kidney to convert to active form
Why is water important in old age?
- declines in kidney functions
- changes in oral health
- use of meds (ie. diuretic)
What are the 7 signs and symptoms of dehydration?
- upper-body muscle weakness
- speech difficulty
- confusion
- dry mucous membranes in nose and mouth
- longitudinal tongue furrows
- dry tongue
- sunken appearance of eyes in sockets
How many glasses of water do adults need?
at least 6
Individuals face increased health risks when they lose. . .
lean tissue
underweight is more serious than being overweight in adults
WHO defines levels of underweight according to grades of thinness
- BMI 17 - 18.49 = grade 1 thinness
- BMI 16 - 16.99 = grade 2 thinness
- BMI <16 = grade 3 thinness
Unintentional weight loss is a valid indicator of ______ in old age
malnutrition
DETERMINE - checklist for malnutrition
Disease
Eating poorly
Tooth loss/mouth pain
Economic hardship
Reduced social support
Multiple medicines
Involuntary weight loss/gain
Needs assistance in self-cate
Elder above age 80
Outline how Vitamin B12 is absorbed in the body
1) Vit B12 in food is bound to protein
2) In the stomach, acid & pepsin help release B12 from food proteins
3) cells in the stomach lining release intrinsic factor (IF)
4) In the upper portion of the small intestine (duodenum), intrinsic factor binds to Vitamin B12
5) In the lower part of the small intestine (ileum), the Vitamin B12-intrinsic factor complex binds to receptors on cells, allowing absorption
6) A small amount of B12 not bound to intrinsic factor can be absorbed through passive diffusion
7) In the colon, Vitamin B12 is synthesized by microorganisms but cannot be absorbed
What atrophic gastritis?
- affects 10-30% of older adults
- cells of the stomach are damaged causing diminished release of intrinsic factor & HCl
- impairs vitamin B12 absorption
a chronic inflammation and thinning of your stomach lining accompanied by a change in your stomach lining cells to mimic intestinal cells
What is pernicious anemia?
- occurs when atrophic gastritis causes Vitmain B12
- causes the production of large, immature, haemoglobin-poor red blood cells (megaloblastic anaemia)
- Weakened stomach lining (atrophic gastritis)
What is the treatment for atrophic gastritis + pernicious anaemia?
Vit B12 supplementation
What are cataracts?
- age-related thickening of lenses on the eyes
- obesity + oxidative stress play an important role
Which compounds may decrease the risk or slow the progression of cataracts?
- vitamin C
- vitamin E
- carotenoids
What is the leading cause of vision?
- macular degeneration: a chronic painless eye disease that causes central vision loss
- risk factors include high fat intake + oxidative stress from sunlight
- preventative factors include antioxidants, zinc, carotenoids (lutein, zeaxanthin), and omega-3 fatty acids
What are the 3 types of arthritis?
- osteoarthritis
- rheumatoid arthritis
- gout
What is osteoarthritis?
- deterioration of the cartilage in the joints
- risk factors include age; smoking; high BMI at age 40
What is rheumatoid arthritis?
- autoimmune condition that attacks bone coverings
- omega-3 fatty acids reduce joint tenderness & improve mobility
- Vitamin C, Vitamin E, and carotenoids might help
What is gout?
- deposits of uric acid crystals in the joints
- avoid purine-rich foods such as meat + seafood
- milk products lower uric and risk of gout
Define dementia
serious losses of memory + cognitive function are frequently grouped under the term dementia
progressive cognitive decline
- collection of symptoms (includes Alzheimers, Parkinsons, alcoholism, vascular dementia. . .)
Features of dementia
- impaired memory
- thinking + decision making
- linguistic ability
- physical functioning
NOT a natural part of growing old
What are the causes of Alzheimer’s disease?
- caused because neurons lose ability to communicate - causing them to die so brain shrinks
What are the 2 proteins thought to contribute to development of Alzheimer’s disease?
- beta-amyloid - clumps into senile plaques
- tau - accumulates and forms neurofibrillary tangles
How does vascular system + chronic inflammation affect Alzheimer’s disease?
- vascular system: fails to deliver sufficient blood and nutrients (i.e. glucose) to brain
- chronic inflammation: sets in as cells (microglial cells and astrocytes) fail to clear away debris and keep neurons healthy
Non-modifiable risk factors of Alzheimers
- age
- genetics
- family history
Modifiable risk factors of Alzheimers
- cardiovascular disease
- nutrient deficiencies (B vitamins)
- physical inactivity
- overweight / obesity
- depression
- sleep disturbance
- social isolation
(obesity v important - remember)
Why are older adults more vulnerable to foodborne illness?
- compromised immune tatus
- could relate to impaired food handling practices (poor food hygiene, inadequate cooking time, sensory losses)
- living alone
Living alone can present challenges for meal preparation. How can these be overcome?
- avoiding food waste/spoilage (buy foods with longer shelf life / smaller portions, use frozen veg)
- sharing meal –> better nutritional value + social interaction
What is polypharmacy?
defined as taking 5 or more medications or taking more meds than medicinally necessary - comes with many risk
What are some risks of polypharmacy?
- harmful drug interactions
- side effects relating to how they are taken
- medication errors
- drugs alter food intake
- drugs alter nutrient absorption
- diet alters drug absorption / metabolism
- drugs can cause unintentional weight loss / gain
