Chapter 17 adulthood and the later years

Exercise Guidelines for Older Hold onto table or chair with one hand, then with one finger, Hold stretch for 10 seconds; do each stretch 3 times Frequency At least 5 days per week of mo

Life Cycle Nutrition:

Adulthood and the

Later Years

Chapter 17

Introduction

• Promote health

• Slow aging

• Growing “old” happens day by day

• Fastest-growing age group

The Aging of the U.S

Population

Nutrition and Longevity

Healthy Habits

Physical Activity

Exercise Guidelines for Older

Hold onto table or chair with one hand, then with one finger,

Hold stretch for 10 seconds; do each stretch 3 times

Frequency At least 5 days per week of

moderate activity or at least 4 days per week of vigorous activity

At least 2 (nonconsecutive) days per week.

2 to 3 days each week At least 2 days per week, preferably

on all days that aerobic or strength activities are performed

Intensity a Moderate, vigorous, or

combination

Moderate to high; 10 to 15 repetitions per exercise;

gradually increase weights

Duration At least 30 minutes of

moderate activity in bouts of at least 10 minutes each or at least 20 minutes of continuous vigorous activity

8 to 10 exercises involving the major muscle groups

At least 20 to 30 minutes Stretch major muscle groups for

10-30 seconds, repeating each stretch

Breathe out as you contract and in as you relax (do not hold breath), use smooth,

Incorporate balance techniques with strength exercises as you progress

Stretch after strength and endurance exercises for 20 minutes,

3 times a week; use slow, steady

Manipulation of Diet

• Animals live longer and have fewer age-related diseases

• Slows aging process

• Food intake

• Prevent malnutrition

• Increases antioxidant activity and DNA repair

• Age of starting energy restriction

Energy Restriction in Human

Beings

• Nervous and hormonal systems

• Prolonged or severe stress effects

• Fight-or-flight response

• Tend-or-befriend response

Physiological Changes

• Being moderately overweight may not be harmful

• Lowest mortality correlates with a BMI of 23.5 to 27.5

• Obesity complications

• Risks associated with low body weight

Immunity and Inflammation

• Regular physical activity

• Diet rich in fruits and vegetables

Tooth Loss

• Limited food selections

• Less dietary variety

• Lower intakes of fiber and vitamins

• Vision, mobility, hearing, taste, and smell

Psychological Changes

• Lose appetite and motivation to cook

• Support and companionship of family and friends

• Living arrangements and income

• Malnutrition most likely to affect those living alone

education

Energy and Nutrient Needs of

Older Adults

• Two age categories

• 51 to 70 years

• 71 and older

• Individual differences are more pronounced with age

• Different chronic diseases

• Total body water decreases with age

• Risks associated with dehydration

• Prevention

• At least six glasses of water daily

Energy and Energy Nutrients

per decade

• Reasons

• USDA Food Patterns

• Especially important

Carbohydrate, Fiber, and Fat

Vitamins and Minerals

Dietary Supplements

supplements

• When recommended by a physician

Nutrient Concerns of Aging

Nutrient Effect of Aging Comments

Water Lack of thirst and decreased total body water

make dehydration likely.

Mild dehydration is a common cause of confusion

Difficulty obtaining water or getting to the bathroom may compound the problem

Energy Need decreases as muscle mass decreases

(sarcopenia)

Physical activity moderates the decline.

Fiber Likelihood of constipation increases with low

intakes and changes in the Gl tract.

Inadequate water intakes and lack of physical activity, along with some medications, compound the problem.

Protein Needs may stay the same or increase slightly Low-fat, high-fiber legumes and grams meet both protein

and other nutrient needs.

Calcium Intakes may be low; osteoporosis is common Stomach discomfort commonly limits milk intake; calcium

substitutes or supplements may be needed.

deficiencies are linked to chronic blood losses and low stomach acid output.

Adequate stomach acid is required for absorption;

antacid or other medicine use may aggravate iron deficiency; vitamin C and meat increase absorption.

• Age-related clouding of the lenses of the eyes

• Lead to blindness if not surgically removed

Healthy Lens and Cataract

Lens Compared

• Deterioration of cartilage in the joints

• Connection with being overweight

• Benefits of aerobic activity and strength training

The Aging Brain

• Affects 15 percent of adults over 70

Alzheimer’s Disease

• Affects older adults

Alzheimer’s and Healthy

Brains Compared

Food Choices and Eating

Habits of Older Adults

• Quality of life has improved

• Chronic disabilities have declined

eat at home

• Less on foods eaten away from home

Strategies for Growing Old

Healthfully

• Choose nutrient-dense foods.

• Be physically active Walk, run dance, swim, bike, or row for aerobic activity Lift weights, do calisthenics, or pursue some other activity to tone, firm, and strengthen muscles Practice balancing on one foot or doing simple movements with your eyes dosed Modify activities to suit changing abilities and preferences.

• Maintain appropriate body weight.

• Reduce stress—cultivate self-esteem, maintain a positive attitude, manage time wisely, know your limits, practice assertiveness release tension, and take action.

• For women, discuss with a physician the risks and benefits of estrogen replacement therapy.

• For people who smoke, discuss with a physician strategies and programs to help you quit.

• Expect to enjoy sex, and learn new ways of enhancing it.

• Use alcohol only moderately, if at all; use drugs only as prescribed.

• Take care to prevent accidents.

• Expect good vision and hearing throughout life; obtain glasses and hearing aids if necessary.

• Take care of your teeth; obtain dentures if necessary.

• Be alert to confusion as a disease symptom, and seek diagnosis.

• Take medications as prescribed; see a physician before prescribing medicines or herbal remedies and a registered dietitian before

self-prescribing supplements.

• Control depression through activities and friendships; seek professional help if necessary.

• Drink six to eight glasses of water every day.

• Practice mental skills Keep on solving math problems and crossword puzzles, playing cards or other games, reading, writing, imagining, and creating.

• One in six are malnourished

• Contributing factors

• Diminished quality of life

• Nutrition Screening Initiative

• Screening for malnutrition

• Food assistance programs

• OAA Nutrition Program provides group meals in a social setting

• Meals on Wheels

Meals for Singles

• Purchasing, storing, and preparing food

Nutrient-Drug Interactions

Highlight 17

drugs by people over 65

• Average 14-18 prescriptions per year

• Vitamin and mineral supplements

drug metabolism and excretion

The Actions of Drugs

The Interactions between

Drugs and Nutrients

• Lead to nutrient imbalances

• Interfere with drug effectiveness

nutrient-drug interactions

interactions

The Effect of Drugs on Food

Intake

loss

The Effect of Drugs on Nutrient

Absorption

damage the intestinal mucosa

nutrient absorption

transport of nutrients into mucosal cells

The Effect of Diet on Drug

Absorption

intestine

• Stomach acidity and emptying rate

• Direct interactions with dietary components

• Drug formulation

• Whether drug is taken on empty or full stomach

• Binding with nutrients and nonnutrients

The Effect of Drugs on Nutrient

Metabolism

activity needed for nutrient metabolism

• Some foods affect the activities of enzymes that metabolize drugs

• May counteract the drugs’ effects

• Some food and drug interactions can cause

toxicity and exacerbate side effects

Some Grapefruit

Juice-Drug Interactions

Drug Category

Drugs Affected

by Grapefruit Juice

Saxagliptin

Glyburide Metformin Anti-infective drugs Erythromycin

Saquinavir

Clarithromycin Indinivir

Cardiovascular drugs Amiodarone

Felodipine Nicardipine

Amlodipine Digoxin Diltiazem Central nervous

system drugs

Buspirone Carbamazepine Diazepam

Haloperidol Lorazapam Risperidone Cholesterol-lowering

drugs

Atorvastatin Lovastatin Simvastatin

Fluvastatin Pravastatin Rosuvastatin Immunosuppressants Cyclosporine

Tacrolimus

Prednisone

The Effect of Drugs on Nutrient

and Drug Excretion

• Greater urinary losses of nutrients

• Mineral depletion

• May lead to toxicity

• Urine acidity

• Example: lithium

Examples of Foods with a High

Tyramine Content

• Aged cheeses (cheddar, Gruyére)

• Aged or cured meats (sausage, salami)

• Beer

• Fermented vegetables (sauerkraut, kimchi)

• Fish or shrimp sauce

• Prepared soy foods (miso, tempeh, tofu)

• Soy sauce

• Yeast extract (Marmite, Vegemite)

The Inactive Ingredients in