3506 Final

potential consequences of dehydration

Increased heart rate, palpitations Increased susceptibility to urinary tract infections, pneumonia, and pressure ulcers Confusion, disorientation, dementia

what are the consequences of vitamin B-12 deficiency

Macrocytic (large cell) anemia Numbness in the hands and feet (due to neurological damage) Memory loss Depression

potential causes of xerostomia (dry mouth)

Medications (e.g., diuretics, anti-anxiety drugs, antidepressants, sedatives, antihistamines) Cancer treatment Sjogren's syndrome

Functions of vitamin D

Muscle strength Dental health Immune function Calcium absorption Cancer protection (most adults have low Vitamin D status)

signs and symptoms of dehydration among older adults

Upper body weakness Speech difficulty Confusion Dry mucous membranes in nose and mouth Furrowed tongue Dry tongue Sunken appearance of eyes

why is consistent vitamin K intake is important for people who take anticoagulant medications?

Vitamin K's best known role is as an activator of clotting factors in the clotting cascade Some anticoagulant medications function by altering blood clotting factors Vitamin K should be included in the dietary patterns of people who take anticoagulant medications, but at a consistent level once an effective dose of anticoagulant medication has been established.

Energy needs decline by _____ to _____ kcal per decade

70-100 -decreased BMR -decreased physical activity

routine use of two or more medications.

Polypharmacy

Fish oil supplements have been shown to help lower triglycerides in people with elevated triglycerides. T or F

True

As women reach menopause (around age 50), the iron RDA decreases to ______ mg/d (same as for men)

8

Due to improvements in health care in recent decades, the ________ demographic group is the fastest growing segment of the population

85+

MIND diet

= Mediterranean-DASH Intervention of Neurodegenerative Delay -has 15 components = 10 brain-healthy food groups and 5 unhealthy food groups -research shows that this seems to be a promising strategy to improve cognitive decline in older populations

Name the predictors of longevity

?

owest risk of mortality for older adults is seen around the overweight BMI range

(24.0 - 30.9 kg/m2)

What are the 5 leading causes of death in the US?

-heart disease -cancer -stroke -diabetes -kidney disease

what are the 2 perspectives in the causes of aging

1) programed aging theories 2) wear-and-tear theories of aging

~_______ of all adults have hypertension ~_______ of older adults have hypertension

1/2 2/3

fluid needs for women

11 c/d total water (from foods and beverages) or 9 c/d of fluids (from beverages only)

Calcium RDA increases to _______mg/d for older adults

1200 (after age 50 for women and 70 for men)

The AI for fluid intake (just beverages, not including water content of foods) is _____ c/d for men or ____ c/d for women

13;9

Fiber recommendation is still _______ kcal - most older adults would benefit from increasing fiber intake

14 g/1000

fluid needs for men

15 c/d total water (from foods and beverages) or 13 c/d of fluids (from beverages only)

adults should do at least ______ minutes to _____ minutes per week

150;300

Adults should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on _______ or more days a week, as these activities provide additional health benefits.

2

Calcium UL decreases to _________ mg/d for older adults (after age 50)

2000

~_____% of older adults are edentulous (lacking natural teeth).

25

Bone loss occurs gradually and steadily for both men and women after ~_____ years of age

30

The Joint Commission (which accredits health care organizations and programs in the United States) requires that every patient undergo nutrition screening within _________ of admission to a health care facility.

48 hours

nutritional considerations for older adults who exercise

Adequate fluid intake Adequate protein intake to support muscle synthesis and repair

Prevalence of and rate of death from hypertension are highest among _________

African-American men

why are vitamin D requirements increased among older adults

After age 70, vitamin D RDA increases to 20 mcg/d (800 IU) Decreased skin synthesis of vitamin D Decreased sun exposure Declining kidney and liver function (involved in vitamin D activation) Food/drug interactions

Explain why older adults should consume more food sources of vitamin E.

Although the RDA for vitamin E does not change, many older adults do not meet the RDA Several health concerns could be improved with adequate vitamin E intake Immune function Cognitive status Antioxidant status Excessive vitamin E supplementation may interfere with vitamin K's role in blood clotting (leading to hemorrhage)

List potential causes for unintentional weight loss among older adults.

Anorexia Overly restrictive therapeutic diets (e.g., renal, diabetes)- diff than eating disorder, meds. depression. changes in hormones etc. Gastrointestinal diseases may influence ingestion, digestion, and absorption of nutrients. Tooth loss Lack of economic resources Lack of food storage or cooking facilities Impaired mobility or impaired functional status may limit ability to shop for, prepare, and eat foods.

sense of loss after the death of a loved one

Bereavement

prolonged insufficient blood supply to the brain (i.e., stroke)

Cerebrovascular accident

provides financial aid to institutions that serve nutritious foods to older adults

Child and Adult Care Food Program

nutritional implications of declines in taste and smell sensations (changes in oral health)

Decreased ability to detect spoiled or burnt foods Blunted enjoyment of foods, reduced appetite May compensate for loss of flavor by increasing use of sugar and salt

Explain why older adults are at increased risk of dehydration

Decreased body water stores (dehydration may occur rapidly) Decreased thirst mechanism Inability of kidneys to concentrate urine Decreased effectiveness of antidiuretic hormone Swallowing problems Depression (not motivated to seek nourishment) Dementia (forget to seek nourishment) Intentional fluid restriction to avoid nocturia (having to urinate at night) or due to fear of incontinence (inability to hold urine)

DASH diet

Dietary Approaches to Stop Hypertension, a dietary pattern designed to reduce blood pressure that emphasizes potassium-rich vegetables and fruits and low-fat dairy products; includes whole grains, poultry, fish and nuts and limits sodium, red meat, and added sugars.

what do each of the letters in DETERMINE stand for?

Disease Eating Poorly Tooth loss/mouth pain Economic hardship Reduced social contact Multiple medicines (polypharmacy) Involuntary weight loss/gain Needs assistance in self-care Elder years above 80 what are some additional nutritional risk factors for older adults not covered in this list? minority status, rural areas, depression, dementia

why it is more important for older adults to choose nutrient dense foods?

Even though calorie needs decline with age, the RDAs or AIs for most nutrients stay the same (or, in some cases, increase with age)

Summarize special concerns for weight-loss plans for obese older adults.

First, determine whether or not weight loss is truly necessary for an older adult. As you just read, BMI within the range of 24.0 - 30.9 kg/m2 is associated with lowest risk of mortality for older adults. Also, quality of life is a major consideration when making nutrition recommendations for older adults. If dietary restrictions will decrease enjoyment of foods and social activities and may lead to nutrient deficiencies, is it worthwhile to lose a few pounds to achieve a "healthier" BMI? If other metabolic parameters are within normal limits, weight loss may NOT be in the older patient's best interest. If weight loss IS in the best interest of the patient, keep consider the following: Maintain adequate protein and micronutrient intake to minimize loss of lean mass. Include nutrition therapy for comorbid conditions of obesity (e.g., hypertension, diabetes) in meal planning for weight loss. Physical activity (aerobic + strength) is the best way to ameliorate loss of lean mass during any weight-loss program.

best food sources of magnesium

Green leafy vegetables Whole grains, fortified cereals Nuts

why are older adults at increased risk for foodborne illnesses?

Impaired immune function (immunosenescence) Limited vision Decreased senses of taste and smell Forgetfulness

consequences of magnesium deficiency

Neuromuscular problems Gastrointestinal problems Personality changes May increase risk for metabolic syndrome, hypertension, diabetes, cardiovascular disease, and osteoporosis

administers home-delivered meals (i.e., Meals on Wheels) and congregate meal programs

Older Adults Act Nutrition Program (OAANP)

inflammation and degeneration of cartilage in joints that occurs due to mechanical wear and tear as adults age; most common form of arthritis

Osteoarthritis

significantly low bone mineral density that leads to fractures

Osteoporosis

which older adults are most likely to benefit from dietary supplements?

Poor appetite Malabsorption (e.g., B-12) Calorie restriction Avoidance of entire food groups (e.g., dairy products, meats) Substance abuse Food/medication interactions

functions of vitamin B-12

Red blood cell health (DNA synthesis) Neurological function (myelin synthesis) Homocysteine metabolism

dietary strategies to alleviate GERD

Reduce fat content of meals (fat slows digestion, so food remains in the stomach for a prolonged time) Eat small, frequent meals rather than a few, large meals (decreases pressure in stomach) Limit acid-stimulating foods (high-protein, fermented beverages, caffeine) Avoid peppermint (relaxes LES) Avoid lying down within 2 hours after eating Avoid foods that irritate the esophagus (varies by individual, but spicy foods, caffeinated beverages, chocolate, citrus, and tomato products are common culprits)

nutritional effects of xerostomia

Reduced food intake, which could lead to undernutrition: Decreased taste sensation Reduced nutrient digestion and absorption Increased discomfort (coarse textures) Increased risk for dental caries and tooth loss Dysgeusia (loss of taste sensation) Glossodynia (tongue pain)

inflammation and damage of joints due to autoimmune disease

Rheumatoid arthritis

provides funds for purchase of foods and garden seeds for low-income adults

SNAP

dietary strategies to cope with xerostomia

Sugar-free candies and gum (CAUTION: excessive use of sugar alcohols may induce osmotic diarrhea) Frozen fruit Frequent sips of water

why should older adults consume more food sources of potassium?

The AI remains constant, but many adults do not meet the AI Some diuretic medications may increase urinary excretion of potassium, which puts patients at risk for low potassium levels Adequate potassium intake can help to lower blood pressure; recall that ~50% of adults have hypertension

temporary insufficient blood supply to the brain (i.e, mini-stroke)

Transient ischemic attack

Daily Values on Nutrition Facts panels _________ (are or are not) always consistent with nutrient needs of older adults

are not

in general, this term applies to anyone born during a baby boom (a period of increased birth rate); most commonly, this term refers to a person born during the baby boom that followed the return of U.S. soldiers from World War II (i.e., individuals born between 1946 and 1964)

baby boomer

why is functional status a better indicator of health for older adults than chronological age?

because although functional status does generally decline with age, there is a lot of variability in functional status

relate calorie restriction to longevity

calorie restriction decreases basal metabolic rate. The resulting reductions in metabolic rate may decrease oxidative stress and slow the rate of aging. (shown on animal models)

avoid excessive exposure of teeth to ___________

carbohydrates

Collective term that includes diseases of the heart and blood vessels

cardiovascular disease

four basic consumer food safety principles

cleaning cooking cross contamination chilling

digestion and absorption of vitamin B-12 is a ______ process.

complex

is essentially, optimizing quality of life for as long as possible

compression of morbidity

is the shortening the period of illness and decreased functional capabilities at the end of life

compression of morbidity

dietary strategies used to prevent or treat gout

consume fruits and veggies limit sugar sweetened beverages limit alcohol

kyphosis is the

curvature of the spine

Birth rates have steadily ________ since the 1950s

declined

nutritional status both affects and is affected by the presence of _____

disease

strategies to prevent/treat dehydration

drink water drink nutrient dense beverages (tea, coffee, milk, fruit and veggie juices) stay away from sugar sweetened drinks

~______ of older adults use dietary supplements

half

is the number of years a person can live free of disease

health span

best sources of potassium

fruits and vegetables

ability to accomplish tasks of daily living

functional status

GERD

gastroesophageal reflux disease

nutritional strategies that may reduce risk of stroke

good dietary pattern (DASH) consume fruits and veggies vitamin B intake moderate alcohol intake

is a type of arthritis caused by the accumulation of uric acid crystals in the joints. Uric acid is a product of purine metabolism

gout

emotional response to bereavement

grief

__________ stroke: due to bleeding

hemorrhagic

f body water content is lower than usual due to dehydration, interpretation of bioelectrical impedance analysis of body composition will indicate an artificially_______ % body fat.

high

Even though current evidence does not support supplementation with fish oil to prevent cardiovascular disease or cognitive decline among healthy adults, plenty of evidence shows that dietary patterns that include seafood (e.g., 2 servings per week) are associated with lower risk for heart disease and cognitive decline.

info card

__________ stroke: due to obstruction (e.g., blood clot)

ischemic

average number of years a person born in a certain year and of a certain population group can expect to live

life expectancy

is the maximum number of years humans might live (110 - 120 years)

life span

is the number of years a person can live

life span

is the length of life, measured in years

longevity

Sarcopenic obesity

loss of lean mass accompanied by gains of fat mass Exercise can lessen the impact of aging on body composition Maintain or increase muscle, bone, and water content of body Reduce fat mass Maintain functional status

Women go through a period of rapid bone loss during ______ due to decreased estrogen production

menopause

The synthetic form of vitamin B-12 is _______ (more or less) bioavailable than the natural form because the synthetic form is not bound to food protein

more

why should older adults consume more food sources of magnesium?

older adults are at increased risk for magnesium deficiency low dietary intake Decreased intestinal absorption Increased excretion (reduced kidney function, diuretic medications)

low bone mineral density

osteopenia

excess iron intake may be a concern because it contributes to _________, which is related to many chronic diseases

oxidative stress

Low intakes of vitamin C and zinc may contribute to ________ disease

periodontal

theory that describes the possible mechanisms by which cells lose the ability to replicate after a certain time

programed aging theories

some excess weight may be _____________ for older adults, particularly during episodes of illness.

protective

RDA is _____ g/kg, HOWEVER, recent research indicates that older adults may optimize health with protein intake within the range of 1.0 to 1.5 g/kg (slightly higher than the RDA)

still 0.8

Protein AMDR for older adults is ____% to _____% of total kcal

still 10% to 35%

Fat AMDR is ____% to ____% of total kcal for older adults

still 20% to 35%

Carbohydrate AMDR is _____% to _____% of total kcal - this guideline is usually met by older adults

still 45% to 65%

Sarcopenia

the loss of muscle mass, strength, and function that comes with aging -Lean body mass (LBM; a.k.a. fat-free mass) declines 2% to 3% per decade after age 30 Lower mineral reserves Lower muscle reserves Lower water reserves Contributes to loss of functional ability -Fat mass (especially visceral fat) tends to increase with age. Increased fat reserves are a source of energy, provide cushioning and insulation.Among post-menopausal women, decreases in estrogen tend to promote fat accumulation in the abdominal region.

heavy use of fortified foods and beverages can lead to micronutrient ________.

toxicities

Recognize that older adults are at increased risk for ________ toxicity.

vitamin A Due to changes in liver and kidney function, older adults are at risk for vitamin A toxicity (most likely from overuse of supplements or fortified foods) Plant sources of provitamin A carotenoids do not cause toxicity, but may cause yellowing of the skin (hypercarotenemia)

theory that describes the possible mechanisms (e.g., oxidative stress, glycosylation of proteins) by which cells become damaged and lose their ability to function over time

wear-and-tear theories of aging