Ch. 20 Nutrition During Adulthood SB

T/F: Aside from achieving and maintaining a healthy body weight, nutrition does not play a major role in the development of osteoarthritis

true

When it comes to quantifying drinking habits, a standard drink of beer equals

12 fl oz

usual and successful aging

Chronic diseases and degenerative processes have long been assumed to be unavoidable consequences of aging. Certainly, some of the declines are inevitable, such as gradual reductions in cellular function, graying hair, and reduced lung capacity. However, many age-related changes can, in fact, be minimized, prevented, and/or reversed by healthy lifestyles (e.g., maintaining a nutritious dietary pattern, engaging in regular physical activity, and getting adequate sleep) and avoiding adverse environmental factors (e.g., excessive exposure to sunlight and tobacco). These discoveries have led researchers to introduce the concepts of usual aging and successful aging. usual aging: All body cells eventually age. However, to a considerable extent, you can control how quickly you age throughout your adult years. Usual aging refers to those changes commonly thought to be a typical or expected part of aging, such as increasing body fatness, decreasing lean body mass, increasing blood pressure, declining bone mass, and progressive poor health. Researchers point out that many of these changes represent an acceleration of the aging process induced by modifiable lifestyle choices, adverse environmental exposures, and/or chronic disease. For instance, blood pressure does not tend to rise with age among people who maintain a healthy body weight, engage in regular physical activity, and consume a primarily plant-based dietary pattern low in sodium. Lean body mass is maintained at much higher rates in older people who regularily engage in physical activity than in those who do not. successful aging: Successful aging, on the other hand, describes physiological declines that occur only because one grows older, not because lifestyle choices, environmental exposures, and chronic disease have accelerated the aging process and assaulted body tissues. Those who are successful agers experience age-related declines at a slower rate and the onset of chronic disease symptoms and disabilities at a later age than usual agers. Disability dramatically reduces quality of life for patients as well as their caregivers. Disability dramatically reduces quality of life for patients as well as their caregivers. Striving to have the greatest number of healthy years and the fewest disabled years is referred to as compression of morbidity. In other words, a person tries to delay the onset of disabilities and discomforts caused by chronic disease as long as possible and to compress, or reduce, age-related illness into the last few years—or months—of life.

What are some physical changes that occur with aging?

Decreased vision Reduced bowel function Weakened sense of thirst *a person's appetite decreases as he/she/they ages

How can fiber help keep an adult healthy?

Fiber helps prevent constipation. Fiber can reduce the risk of colon cancer. Fiber can lower blood cholesterol levels. *Fiber does not have a direct impact on the body's blood circulation.

What are some negative effects that medications and supplements can have on the body?

Iron supplements can interfere with the functioning of zinc and copper. Antibiotics can deplete the body of vitamin K. Diuretics and laxatives can cause excess water loss. Aspirin can increase the likelihood of stomach bleeding. Excessive folic acid supplementation can mask a vitamin B-12 deficiency.

WHO def of healthy aging

The WHO defines healthy aging as the process of developing and maintaining the functional ability that enables well-being in older age. Healthy aging enables individuals to be and do what they value, including a person's ability to: Meet their basic needs Learn, grow, and make decisions Be mobile Build and maintain relationships Contribute to society

Dietary Guidelines for Americans for adult years

The challenge of the adult years is to maintain the body, preserve optimal function, and avoid chronic disease—that is, to age successfully. A healthy dietary pattern can help achieve this goal. One blueprint for a healthy eating pattern comes from the Dietary Guidelines for Americans. The advice from those guidelines includes the following goals: Follow a healthy eating pattern across the lifespan with special attention to potassium, calcium, vitamin D, vitamin B-12, minerals, and dietary fiber. Focus on variety, nutrient density, and amount of foods and beverages. Meet individual calorie needs and strive to achieve a healthy weight. Limit calories from added sugars and saturated fats and reduce sodium intake.

Decreased appetite, reduced kidney function, and lowered immune function are all physical changes that occur in

adulthood (particularly later adulthood)

Match the chronic disease with its most likely effect on nutritional status.

obesity, heart disease, and osteoporosis: Impair physical mobility to the extent that a person cannot shop or prepare food. hypertension: May indicate a need for lower sodium diabetes: alters the body's ability to utilize glucose

Diminished lean body mass, increased fat stores, and decreased body water are all primary changes in body composition that occur in the ______ years.

older adult The primary changes in body composition that occur with aging are diminished lean body mass, increased fat stores, and decreased body water. A focus on physical activity, as detailed below, can attenuate many of these unwanted changes. *sarcopenia=loss of lean body mass

Inadequate intake of calcium and vitamin D, reduced calcium and vitamin D absorption, and the reduced synthesis of vitamin D in the skin are all factors that contribute to the development of

osteoporosis These bone-building nutrients (calcium and vit D) tend to be low in the dietary patterns of all adults. They become particularly problematic after age 50. Inadequate intake of these nutrients, combined with their decreased absorption, the reduced synthesis of vitamin D in the skin, and the kidneys' decreased ability to put vitamin D in its active form, greatly contributes to the development of osteoporosis.

As adulthood progresses, the rate of hormone synthesis and release will:

slow As we age, it takes our bodies longer to return the body to normal. This means that the rate of hormone synthesis and release would slow, rather than increase. As adulthood progresses, the rate of hormone synthesis and release can diminish. Declining thyroid hormone production, for example, can decrease basal metabolic rate, leading to unexpected weight gain. A decrease in insulin release or sensitivity to insulin, for instance, means that it takes longer for blood glucose levels to return to normal after a meal. Maintaining a healthy weight, engaging in regular physical activity adhering to a dietary pattern that is low in saturated fat and high in fiber, and avoiding highly processed foods can enhance the body's ability to use insulin and restore elevated blood glucose levels to normal after a meal.

The potential oldest age a person can reach is referred to as life ____________

span

Yes, the calorie needs of inactive adults over the age of 30 actually decrease throughout adulthood.

the calorie needs of inactive adults over the age of 30 will decrease throughout adulthood. Energy input needs to match energy output. When there is little energy output (exercise/activity), the energy input (food consumption) needs to be reduced.

Many adults fail to consume adequate amounts of _________, a habit that places them at risk of mild dehydration and electrolyte imbalances

water

All adults should engage in moderate intensity aerobic activity for at least ______ minutes per week.

150 to 300

calorie needs of adulthood

After the age of 30, total calorie needs of physically inactive adults tend to steadily decline. There are a variety of explanations for the lower calorie requirements of older adults. Basal metabolic rate declines by about 2% per decade after age 30, such that overall energy needs of a 70-year-old man are reduced by 100 to 150 kcal per day compared to those of a 30-year-old man. Losses of lean body mass and decreases in physical activity also tend to accompany aging. To a considerable extent, adults can exert control over this reduction in calorie need by exercising. Physical activity can halt, slow, and even reverse reductions in lean body mass and subsequent declines in energy needs. Being able to consume more calories makes it much easier to meet micronutrient needs without dietary supplements.

What are some suggestions consistent with the Dietary Guidelines for Americans? (focuses on aspects of diet, not on any suggestions regarding healthcare)

Balance energy input with energy output. Limit intake of foods with added sugars. Consume a variety of nutrient-dense foods.

centenarian lifestyle

Besides having other long-lived family members, centenarians, or people who live to 100 years, generally: Do not use tobacco Drink alcohol in moderation, if at all Maintain a healthy weight Eat many fruits and vegetables Perform daily physical activity Challenge their minds Maintain a positive outlook Have close friendships and social networks Are or were married (especially men)

In which of the following ways can heart disease compromise nutritional status?

Impairs ability to shop for and prepare food Affects the kidneys' ability to reabsorb some nutrients The prevalence of obesity, heart disease, osteoporosis, cancers, hypertension, and diabetes rises with age. More than half of older adults have one of these chronic and potentially debilitating diseases. Six out of 10 older adults have at least two chronic conditions. One small change can trigger a chain of events that results in poor health. Chronic diseases may have a strong impact on dietary patterns. For instance, obesity, heart disease, and osteoporosis may impair physical mobility to the extent that victims are unable to shop for and prepare food. Chronic disease also can influence nutrient and calorie needs. Cancer, for example, boosts these needs. Hypertension may indicate a need to lower sodium intake. Nutrient utilization can be affected by chronic disease, too. For instance, diabetes alters the body's ability to utilize glucose. In addition, the effects of heart disease on the kidneys may impair their ability to reabsorb glucose, amino acids, and vitamin C.

For dinner, Brice goes to a sports bar and orders a dozen chicken wings, a side of nacho cheese fries, and drinks four beers while watching his favorite basketball team on the big screen. Which of the following changes could Brice have made to better comply with the Dietary Guidelines?

Order a grilled chicken sandwich instead of fried chicken wings. Reason: This would help Brice consume fewer calories and limit saturated fat intake. Order a baked sweet potato instead of nacho cheese fries. Reason: This would help Brice limit saturated fat and cholesterol intake and consume more vegetables. NOT: order four glasses of red wine instead of beer. Reason: Moderate alcohol intake is one of the key recommendations in the general category of foods and food components to reduce. Moderate alcohol intake is 2 drinks per day for men.

True or false: Physiological declines that occur during aging cause the effects of medications and nutrient supplements to be exaggerated and last longer in older adults.

True *Many older adults have reduced body water or reduced liver or kidney function, which can make medications and supplements more potent and long lasting. The rate of supplement use increases throughout adulthood such that by the time they reach retirement age, approximately 70% of all adults are using supplements. Physiological declines that occur during aging (e.g., reduced body water and reduced liver and kidney function) may exaggerate and prolong the effects of medications and nutrient supplements in older adults. Medications can eradicate infections and control chronic diseases, but some also adversely affect nutritional status, particularly of those who are older and/or take many different medications. For instance, some medications depress taste and smell acuity or cause anorexia or nausea that can blunt interest in eating and lead to reduced dietary intake. Some medications alter nutrient needs. Aspirin, for example, increases the likelihood of stomach bleeding, so long-term use may elevate the need for iron, as well as other nutrients. Antibiotics kill beneficial bacteria along with pathogens, so they can limit the amount of vitamin K that is synthesized by bacteria in the large intestine. Some medications may impair nutrient utilization; diuretics and laxatives may cause excessive excretion of water and minerals. Even vitamin and mineral supplements may have unanticipated effects on nutritional status. Iron supplements taken in large doses can interfere with the functioning of zinc and copper. Folate supplements can mask vitamin B-12 deficiencies. People who must take medications should eat nutrient-dense foods and avoid any specific food or supplement that interferes with the function of their medications. For example, vitamin K can reduce the action of oral anticoagulants, aged cheese can interfere with certain drugs used to treat hypertension and depression, and grapefruit can interfere with medications such as tranquilizers and those that lower cholesterol levels. A registered dietitian nutritionist can help to plan a dietary pattern that meets nutritional needs while avoiding harmful food/medication interactions.

what are good options for older adults with poor dentition?

cooked vegetables, pureed meats (NOT chewy meat or crunchy fruits and veggies) As you recall from previous chapters, digestion begins in the mouth. Over 25% of older adults have no natural teeth, and many more are missing some teeth. The problem of tooth loss is worse among low-income populations. Even with properly fitting dentures, chewing ability may be limited. Older adults with poor dentition often avoid meats or crunchy fruits and vegetables, thereby missing out on key nutrients such as protein, iron, and zinc (from meat) as well as potassium and fiber (from fruits and vegetables). Ground meats, legumes, and cooked or finely chopped vegetables are easier options for older adults with chewing problems.

What are some things that older adults should do to maintain normal glucose metabolism (i.e., prevent diabetes) as they age?

eat fiber rich foods maintain a healthy weight exercise As adulthood progresses, the rate of hormone synthesis and release can diminish. Declining thyroid hormone production, for example, can decrease basal metabolic rate, leading to unexpected weight gain. A decrease in insulin release or sensitivity to insulin, for instance, means that it takes longer for blood glucose levels to return to normal after a meal. Maintaining a healthy weight, engaging in regular physical activity adhering to a dietary pattern that is low in saturated fat and high in fiber, and avoiding highly processed foods can enhance the body's ability to use insulin and restore elevated blood glucose levels to normal after a meal. white breads: This would not be a good food to eat when trying to help your body restore elevated blood glucose levels. White breads have a high glycemic index - it causes a dramatic blood glucose levels.

All of the following are major contributors of calories to the adult diet EXCEPT:

fruits (Most fruits are relatively low in calories and are not considered to be a major contributor of calories to the adult diet.) donuts, cheese, soft drinks are all major contributors of calories to the adult diet

High fat intake can lead to which of the following?

heart disease obesity certain cancers It is a good idea for almost all adults to reduce their fat intake because of the strong link between high saturated fat and obesity, heart disease, and certain cancers. The Dietary Guidelines describe a healthy eating pattern as one that includes plant-based oils (27 grams or 5 teaspoons per day) and limits saturated fats. A key recommendation is to consume less than 10% of calories per day from saturated fats.

Protein, vitamins A, D, and E, folate, iron, and zinc all help improve and maximize _______ system function, thereby working to prevent sickness and poor wound healing

immune

The "graying" of North America is ______ federal health care expenditures.

increasing

anemia can be caused by

lack of iron, folate, vitamin B-6, or vitamin B-12

What is the term for the potential oldest age a person can reach?

life span *life expectancy refers to the average length of life for a given group of people born in a specific year

lifespan vs life expectancy

lifespan The potential oldest age a person can reach; max # of years a human can live life expectancy: The average length of life for a given group of people born in a specific year.

To preserve bone mass, older adults should

limit alcohol intake to 1 drink per day. consume adequate calcium and vitamin D. avoid smoking. engaging in weight-bearing physical activity helps to preserve bone mass Consuming adequate vitamin D, calcium, and protein; not smoking; avoiding excessive alcohol; and engaging in weight-bearing physical activity can help preserve bone mass. There are over 100 forms of arthritis, a disease that causes the degeneration of the cartilage that covers and cushions the joints.

Oral health is linked to nutritional status. Poor dentition may cause older adults to avoid ______, which are rich sources of iron and zinc.

meat *Poor dentition does cause older adults to avoid crunchy fruits and vegetables, but these foods are not rich sources of iron and zinc. Cooked vegetables are typically preferred over raw vegetables among older adults with poor dentition because cooked vegetables are easier to chew. Poor dentition does not limit consumption of dairy products, which are easy to chew.

Consuming ______ in amounts slightly higher than the RDA may help preserve muscle and bone mass in aging adults.

protein

What are some nutrients that can maximize immune system function?

protein, iron, zinc With age, the immune system often operates less efficiently. Consuming adequate protein, vitamins (especially folate and vitamins A, C, D, and E), iron, and zinc helps maximize immune system function.

Match each beverage with the volume that is equivalent to a "standard drink."

regular beer=12 fl oz malt liquor=8 fl oz wine=5 fl oz distilled spirits=1.5 fl oz A standard drink contains about 14 grams of alcohol. For beer or wine coolers, this equates to a 12-fluid-ounce serving. Most cans of beer are 12 fluid ounces, but some cans or bottles may contain as much as 40 fluid ounces. Malt liquor and most craft beers have a slightly higher alcohol content than regular beer, so the standard drink size is 8 fluid ounces. For wine, a 5-fluid-ounce glass is standard. A standard drink of hard liquor, such as whiskey or rum, is the size of a shot glass—1.5 fluid ounces.

How do the calorie needs of an inactive adult over the age of 30 change through adulthood?

the calorie needs decrease As activity levels and lean mass decrease, the typical aging adult requires fewer calories to maintain body weight. Energy input needs to match energy output if weight is to be maintained. So, an inactive adult's calorie needs would decrease because they do not need to take in as many calories to replace the calories expended.

True or false: Consuming protein in amounts slightly higher than the RDA may help preserve muscle and bone mass in aging adults.

true this is true; a protein intake just above the RDA may help to preserve muscle mass and bone density in older adults. Among older adults, however, several studies indicate that consuming protein in amounts slightly higher than the RDA (in the range of 1.0 to 1.2 grams per kilogram of body weight) may help preserve muscle and bone mass.4,5 As with calorie needs, protein requirements should be determined in relation to routine physical activity.

High ______ intake can lead to obesity, heart disease, and certain cancers.

fat

According to the Physical Activity Guidelines, how much moderate-intensity aerobic exercise should an adult strive to get?

150 to 300 minutes per week The Physical Activity Guidelines recommend 150 to 300 minutes per week of moderate-intensity physical activity or 75 to 150 minutes per week of vigorous-intensity physical activity or any equivalent combination of the two. All adults should engage in either moderate-intensity aerobic physical activity for at least 150 to 300 minutes per week, or vigorous-intensity aerobic activity for 75 to 150 minutes per week, or an equivalent combination of the two.

Although people older than age 65 make up less than 15% of the U.S. population, they account for nearly ______ of the federal health budget.

35% Although great news, the graying of North America poses some unique challenges. People older than age 65 make up less than 15% of the U.S. population, but account for more than 35% of all prescription medications used, 35% of acute hospital stays, and almost 35% of the federal health budget. Hip fractures alone cost the nation about $20 billion per year. Of older persons, 80% or more have chronic conditions, such as cardiovascular diseases, type 2 diabetes, hypertension, cancers, and osteoporosis. Preventing or postponing the onset of these chronic diseases for as long as possible can help control health care costs and improve quality of life. Health and independence contribute quality—not just quantity—to life and lessen the load on an already overburdened health care system. Keep in mind that aging is not a disease. Furthermore, diseases that commonly accompany old age—osteoporosis, cancers, and atherosclerosis, for example—are not an inevitable part of aging. Many can be prevented or managed by adhering to positive lifestyle behaviors

What are some foods that are major contributors of calories to the adult diet?

white bread, beef, potatoes, soft drinks *Water supplies the body with no usable calories and would not be a major contributor of calories to the diet. *Lettuce supplies the body with very few calories and would not be a major contributor of calories to the diet. Other aspects of the average adult eating patterns are still in need of improvement. The latest nutrition survey of eating in the United States shows that the major contributors of calories to the adult dietary pattern are still white bread, beef, doughnuts, cakes and cookies, soft drinks, milk, poultry, cheese, alcoholic beverages, salad dressing, mayonnaise, potatoes, and sugars/syrups/jams. If Americans were truly lowering their intakes of sugar, saturated fat, and sodium while increasing their intakes of fiber, many of these foods would not appear at the top of the list.

causes of aging?

Adulthood, the longest stage of the normal life cycle, begins when an adolescent completes his or her physical growth. Unlike earlier stages of the life cycle, nutrients are used primarily to maintain the body rather than support physical growth. Recall from Chapter 18 that pregnancy is the only time during adulthood when substantial amounts of nutrients are used for growth. As adults get older, nutrient needs change. For example, vitamin D needs increase for older adults. Aging can be defined as the physical and physiological changes in body structure and function that occur throughout adulthood as humans mature and become older. When we are young, aging is not apparent because the major metabolic activities are geared toward growth and maturation. We produce plenty of active cells to meet physiological needs. During late adolescence and adulthood, the body's major task is to maintain cellular function. From the beginning of adulthood until age 30 or so, the body operates at peak performance: stature, stamina, strength, endurance, efficiency, and health. During this time, rates of cell synthesis and breakdown are balanced in most tissues. Inevitably, though, cells begin to age and die. After ages 30 to 40, the rate of cell breakdown slowly begins to exceed the rate of cell renewal, leading to a gradual decline in organ size and efficiency. Eventually, the body cannot adjust to meet all physiological demands, and body functioning begins to decline (Fig. 20-3). Still, body systems and organs usually retain enough reserve capacity to handle normal, everyday demands throughout one's lifespan. Problems caused by diminished capacity typically do not arise unless severe demands are placed on the aging body. For example, alcohol intake can overtax an aging liver. The stress of shoveling a snow-covered sidewalk can exceed the capacity of the heart and lungs. Coping with a serious illness can push an aged body beyond its capacity. The specific mechanisms of aging remain a mystery. Most likely, the physiological changes of aging are the sum total of automatic cellular changes, lifestyle patterns, and environmental exposures, as listed in Table 20-1. Even with the most supportive environment and healthy lifestyle, cell structure and function continue to decline over time. In some scenarios, programmed cell death is advantageous. For example, the eventual death of deteriorating cells can be beneficial in preventing diseases such as cancer. Unfortunately, as more cells in an organ die, organ function declines. For example, the number of kidney nephrons declines as we age. In some people, this loss exhausts the kidneys' reserve capacity and ultimately leads to kidney dysfunction or disease.

True or false: Diminished lean body mass and decreased body water are changes in body composition that frequently occur during young adulthood.

FALSE Diminished lean body mass, decreased body water, and increased fat stores are all changes that occur during older adulthood, rather than young adulthood.

What are some factors that contribute to the development of osteoporosis?

Inadequate intake of vitamin D and calcium Reduced absorption of vitamin D *An increase in the consumption of dairy products would prevent osteoporosis, rather than contribute to its development. *An increased absorption of calcium would actually help prevent the development of osteoporosis since calcium helps to build stronger bones.

Physical activity has been shown to reduce _____ among older adults.

bone loss *Staying active throughout adulthood is linked to lower risk for dementia. *Staying active helps to preserve muscle mass *Performing exercise can help to stimulate appetite

table 20.2 physiological changes of aging and lifestyle recommendations:

decreased appetite: Monitor changes in weight and report unintentional weight loss to your primary care provider. Eat small, frequent, calorie- and nutrient-dense meals throughout the day. Incorporate nutrient-rich drinks or smoothies between meals. decreased bone mass: Meet nutrient needs, especially protein, calcium, and vitamin D (including regular sun exposure). Perform regular physical activity, especially weight-bearing activities. Aim to maintain a healthy body weight (i.e., BMI between 18.5 and 24.9). decreased bowel function: Emphasize a dietary pattern rich in fruits, vegetables, and whole grains. Meet fluid needs and monitor hydration. Increase physical activity. decreased CV function: Achieve and maintain a healthy body weight. Choose a dietary pattern based on fruits, vegetables, whole grains, plant-based protein, and fatty fish. Stay physically active. decreased chewing or swallowing ability: Work with a dentist or trained therapist to maximize chewing and swallowing ability. Modify food consistency as necessary. decreased cognitive function: Choose a dietary pattern rich in fruits, vegetables, whole grains, beans, and legumes. Consume seafood, a source of omega-3 fatty acids, twice per week. Perform regular physical activity. Obtain adequate sleep, rest, and relaxation. increased fat stores: Avoid overconsumption of calorie-dense foods and beverages. Perform regular physical activity. decreased immune function: Meet nutrient needs, especially protein, vitamin E, vitamin B-6, and zinc. Perform regular physical activity. decreased insulin function: Maintain a healthy body weight. Choose whole grains and limit refined grains. Perform regular physical activity. decreased kidney function: Consume adequate fluids. Maintain normal blood pressure and weight. Be cautious about using medications and dietary supplements. decreased lactase production: Reduce serving sizes of milk with meals. Substitute yogurt or cheese for milk. Use reduced-lactose or lactose-free products and seek nondairy calcium sources. decreased liver function: Consume alcohol in moderation, if at all. Avoid consuming dietary supplements that contain more than 100% of the Daily Value of nutrients, especially vitamin A. decreased lung function: Avoid tobacco. Perform regular physical activity. decreased muscle mass: Meet nutrient needs, especially protein. Perform regular physical activity, including strength training. decreased sense of taste and smell: Vary the colors and textures of foods. Experiment with sodium-free herbs and spices. decreased sense of thirst: Monitor fluid intake. Drink water throughout the day. Stay alert for evidence of dehydration (e.g., dark-colored urine). decreased stomach acidity: Include lean meats and iron-fortified foods in the dietary pattern. Limit drinking tea with caffeine, spearmint, or peppermint. Consume vitamin C rich foods to enhance absorption of nonheme iron from foods. Choose foods fortified with vitamin B-12. decreased vision: Choose a dietary pattern rich in fruits, vegetables, and whole grains. Regularly consume fatty fish, a source of omega-3 fatty acids. Wear sunglasses in sunny conditions. Avoid tobacco.

True or false: Older adults typically consume adequate amounts of water.

false many older adults fail to consume adequate amounts of water Many adults, especially as they approach their later years, fail to consume adequate quantities of water. In fact, many are in a constant state of mild dehydration and at risk of electrolyte imbalances. Low fluid intakes in older adults may be caused by blunted thirst mechanisms, chronic diseases, and/or conscious reductions in fluid intake in order to reduce urination.

A diet rich in ______ helps adults reduce their risk of colon cancer and heart disease, lower their blood cholesterol, and avoid constipation.

fiber Less than 10% of Americans follow the advice to make half your grains whole grains. A dietary pattern rich in complex carbohydrates helps us meet our nutrient needs without excess calories. Replacing sweets and refined carbohydrates with fiber-rich whole grains also improves blood glucose control. This is particularly helpful because inactivity and increasing body fatness that often accompany aging are connected to insulin resistance. Carbohydrate metabolism dysfunction is so common that more than 25% of those age 65 years or older have diabetes. A dietary pattern rich in fiber helps adults reduce their risk of cancers and heart disease, lowers blood cholesterol levels, and minimizes constipation. The typical American adult gets slightly more than half the recommended amount of dietary fiber. Most Americans could benefit from incorporating more whole grains into their dietary patterns.

table 20.3 physical activity guidelines for older adults

guidelines for all adults: -Adults should move more and sit less throughout each day. Any physical activity is better than none and results in health benefits. -For substantial health benefits, adults should engage in at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity, aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week. -Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week. -Adults should also complete muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits. guidelines for older adults: -As part of their weekly physical activity, older adults should engage in multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities. -Older adults should determine their level of effort for physical activity relative to their level of fitness. -Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely. -When older adults cannot do 150 minutes of moderate-intensity aerobic activity a week because of chronic conditions, they should be as physically active as their abilities and conditions allow.

T/F: Aside from achieving and maintaining a healthy body weight, nutrition does not play a major role in the development of rheumatoid arthritis.

true