HN Ch. 16
What counts as a serving of alcohol?
- 12 fl oz of regular beer (or wine cooler) - 8-9 fl oz of malt liquor - 5 fl oz of table wine - 1.5 fl oz shot of 80-proof spirits ("hard liquor") - 3 oz sherry or liqueur
What are the physiological changes of aging?
- Appetite (decreased) - Sense of taste and smell (decreased) - Chewing or swallowing ability (decreased) - Sense of thirst (decreased) - Stomach acidity (decreased) - Bowel function (decreased) - Lactase production (decreased) - Liver function (decreased) - Insulin function (decreased) - Kidney function (decreased) - Immune function (decreased) - Lung function (decreased) - Vision (decreased) - Lean tissue (decreased) - Cardiovascular function (decreased) - Bone mass (decreased) - Mental function (decreased) - Fat stores (increased)
What are some benefits of moderate drinking?
1. Coronary Heart Disease: decreased risk of death 2. Hypertension and stroke: mild decrease in blood pressure 3. Peripheral Vascular Disease: decreased risk due to blood clotting 4. Blood Glucose Regulation & Type 2 Diabetes: decreased risk of developing type 2 diabetes and cardiovascular disease 5. Bone and joint health: Increase in bone mineral content in women 6. Brain function: enhanced brain function, decreased risk of dementia (increased blood circulation in the brain) 7. GI Tract Disease: decreased risk of bacterial infections in the stomach 8. Sleep disturbances: some relaxation 9. Nutrient intake: May supply some B vitamins and iron 10. Socialization and relaxation: benefit to socialization and leads to relaxation (increases brain neurotransmitter activity)
What are some risks of heavy drinking?
1. Coronary Heart Disease: heart rhythm disturbances, heart muscle damage, increased blood triglycerides, increased blood clotting 2. Hypertension and stroke: increased blood pressure 3. Blood glucose regulation and type 2 diabetes: hypoglycemia; reduced insulin sensitivity; damage to pancreas 4. Bone and joint health: loss of active bone-forming cells and eventual osteoporosis 5. Brain function: brain tissue damage, decreased memory 6. Skeletal muscle health: skeletal muscle damage 7. Cancer: increased risk of cancer (stomach, liver, lung, oral, breast) 8. Liver function: fatty infiltration and liver cirrhosis 9. GI Tract Disease: inflammation of stomach 10. Immune system function: reduced function and increased infections 11. Nervous system function: loss of nerve sensation 12. Sleep disturbances: fragmented sleep patterns, sleep apnea 13. Impotence and decreased libido: contributes to the problem in both men and women 14. Drug overdose: contributes to the problem 15. Obesity: increased abdominal fat disposition, contributes to weight gain 16. Nutrient intake: leads to numerous nutrient deficiencies 17. Fetal health: variety of toxic effects on the fetus 18. Socialization and relaxation: contributes to violent behavior and agitation 19. Traffic deaths and violent deaths: contributes to both traffic deaths and violent deaths
What are the physical activity recommendations for adults? What are the consequences of following them?
2008 Physical Activity Guidelines for Older Adults - Engage in moderate-intensity aerobic exercise for at least 150 minutes per week - OR vigorous-intensity aerobic exercise for 75 minutes per week, - OR an equivalent combination of the above recommendations - GOAL: Weight management, preservation of bone mass, and prevention of chronic diseases 2008 Physical Activity Guidelines for Older Adults - Perform strength training exercises 2-3 times per week: focus on large muscle groups and enhancing grip strength - GOAL: Maintain lean tissue and basal metabolic rate 2008 Physical Activity Guidelines for Older Adults - Include exercises that improve balance if there is a risk of falling. - Incorporate stretching exercises into strength or aerobic exercises 2 days/week - GOAL: Improve balance and daily functioning
Name three nutrients that are commonly lacking in the diets of adults.
Adults often deficient in calcium, vitamin D, iron, zinc, magnesium, folate, and vitamins B-6, B-12, and E
What are the ways to combat the changes in aging?
Appetite - 1. Monitor weight and strive to eat enough to maintain healthy weight 2. Use meal replacement products 3. Choose energy-dense foods (plant sources of fat) Sense of taste and smell - 1. Vary the diet 2. Experiment with salt-free herbs and spices Chewing or swallowing ability - 1. Work with a dentist to maximize chewing ability 2. Modify food consistency as necessary Sense of thirst - 1. Monitor fluid intake 2. Stay alert for evidence of dehydration Stomach acidity - 1. Include some lean meat and iron-fortified foods in the diet 2. Ask physician to monitor blood iron status 3. Consume iron-rich foods with a source of vitamin C 4. Choose foods fortified with vitamin B-12 or use a supplement source of vitamin B-12 Bowel function - 1. Consume enough fiber daily, choosing primarily fruits, vegetables, and whole-grain breads and cereals 2. Meet fluid needs Lactase production - 1. Limit milk serving size at each use 2. Substitue yogurt or cheese for milk 3. Use reduced-lactose or lactose-free products 4. Seek nondairy calcium sources Liver function - 1. Consume alcohol in moderation, if at all 2. Avoid consuming dietary supplements that contain more than 100% of the Daily Value of nutrients, especially Vitamin A Insulin function - 1. Maintain healthy body weight 2. Choose carbohydrates with low glycemic index 3. Perform regular physical activity Kidney function - 1. If necessary, work with physicians and registered dietitians to modify protein and other nutrients in the diet Immune function - 1. Meet nutrient needs, especially protein, vitamin E, vitamin B-6, and zinc 2. Perform regular physical activity Lung function - 1. Avoid tobacco products 2. Perform regular physical activity Vision - 1. Regularly consume sources of carotenoids, vitamin C, vitamin E, zinc 2. Moderate total fat intake 3. Wear sunglasses in sunny conditions 4. Avoid tobacco products 5. Perform regular physical activity 6. In the case of diagnosed moderate macular degeneration, talk with a physician about following a protocol of zinc, copper, vitamin E, vitamin C, and beta-carotene supplementation Lean tissue - 1. Meat nutrient needs, especially protein and vitamin D 2. Perform regular physical activity (strength training) Cardiovascular function - 1. Use diet modifications or physician-prescribed medications to keep blood lipids and blood pressure within desirable ranges 2. Stay physically active 3. Achieve and maintain a healthy body weight Bone mass - 1. Meet nutrient needs, especially protein, calcium, and vitamin D 2. Perform regular physical activity (weight-bearing exercise) 3. Women should consider use of approved osteoporosis medications at menopause 4. Remain at a healthy weight Mental function - 1. Meet nutrient needs and consume seafood twice a week 2. Strive for lifelong learning 3. Perform regular physical activity 4. Obtain adequate sleep Fat stores - 1. Avoid overeating 2. Perform regular physical activity
List three possibly nutrition resources for an older adult with limited financial means. How can community nutrition programs have a positive impact on emotional, physical, and nutritional health of older adults?
Community Nutrition Services for Older People • Older Americans Act Nutrition Program - serves about 242 million meals/yr to adults 60+ - Provides 1/3 energy and nutrient requirements - Congregate meal programs provide lunch at a central location - Meals-on-wheels deliver to home-bound adults • Federal commodity distribution - Low-income elderly - Food stamps (SNAP) • Food cooperatives and religious organizations also provide assistance
What is the compression of morbidity?
Compression of morbidity- strive for greatest number of healthy years, and fewest years of illness - compressing sickness to last few years of life
Which nutrients should be limited in the diets of most American adults?
Consume fewer foods with sodium, saturated fats, trans fats, cholesterol, added sugars, refined grains
How does depression influence nutritional status?
Depression • Consequences - Poor appetite - Poor food choices - Misuse of medication - Disability (weakness)) - Mental confusion - Poor nutrition - Obesity for some • Prevention - Positive outlook on life - Social support - Eating with others - Maintaining health as best as possible
What are the digestive system concerns of adulthood? How can an adult prevent or address constipation?
Digestive System Concerns in Adulthood • Constipation is main intestinal problem - Increase fiber, fluid - Exercise - Fiber supplements may be needed - Some medications cause constipation • Gallbladder and pancreas function declines - Gallstones and gall bladder disease can impair fat absorption - High blood glucose signals pancreatic dysfunction
What are the consequences of decreased HCI production and intrinsic factor in the stomach?
Digestive System: GI tract • Decline in acid production (HCl) and intrinsic factor in stomach - Impaired absorption of iron, calcium, zinc, and B12 • Decreased production of some digestive enzymes (ex: lactase)
What are the changes in dentition that occur with aging? How can you address these concerns?
Digestive System: Mouth • Digestion begins in the mouth • About 25% of older adults have no natural teeth, many more missing some teeth - Worse in low-income populations - Avoid harder-to-chew foods - Miss out on protein, iron, zinc, potassium, and fiber - Pureed foods sometimes necessary
How can limited financial resources affect nutritional status?
Economic Factors • Money impacts types/amounts of food one eats - Do not eat enough food or enough nutrients to meet nutrient needs - Nutritional and health status declines • Commodity Supplemental Food Program and Supplemental Nutrition Assistance Program (SNAP), help low income individuals of all ages
What are the changes in insulin sensitivity? What is the effect these changes can have on health?
Endocrine System • Rate of hormone synthesis and release can slow • Decreases in insulin production and/or in insulin sensitivity results in high blood glucose that takes longer to return to normal after a meal
What advice would you give an older, single man about eating well?
Guidelines for Healthful Eating in Later Years - 1. Eat regularly; small frequent meals may be best 2. Use labor-saving devices and convenience foods while also incorporating some fresh foods 3. Try new foods, new seasonings, and new ways of preparing foods 4. Keep easy-to-prepare foods on hand 5. Have a treat occasionally 6. Eat in a well-lit or sunny area 7. Arrange kitchen so that preparation and clean-up are easier 8. Eat with friends, relatives, or at a senior center 9. Share cooking responsibilities with a neighbor 10. Use community resources for help in shopping 11. Stay physically active 12. Take a walk before eating to stimulate appetite 13. Chop, blend, or grind hard-to-chew foods 14. Cut the food ahead of time
What happens to immunity as we age?
Immune System • Immune system operates less efficiently • Require protein, folate and vitamins A, D, and E, iron, zinc to maximize immune system function • Overnutrition harmful to immune system
What is the difference between life span and life expectancy?
Life Span • Maximum number of years a human can live • Record - 122 years (woman) - 116 years (man) • Dependent on genes and environment Life Expectancy • Number of years an average person, born in a specific year, is expected to live • In North America: - 75 yrs for men - 81 yrs for women - Only 64 "healthy years" • Those who make 80, expect 7 to 10 more years
How can medication and supplement use affect health?
Medications and Supplements • 90% of older adults take at least one prescription medication daily • Half those 65+ take several medications daily • Half of adults age 50+ use supplements daily • May interact with nutrients • May affect appetite, sense of taste and smell • Some alter nutrient needs, utilization
What are the vitamins and minerals addressed in section 16.2?
Minerals and Vitamins • Dietary requirements change throughout adulthood • Adults often deficient in calcium, vitamin D, iron, zinc, magnesium, folate, and vitamins B-6, B-12, and E • As adults age, acid production in stomach declines and absorption of nutrients that require acid is impaired (B12, iron, zinc, calcium) • Calcium and Vitamin D - Decreased intake and decreased absorption - When low, increased risk of osteoporosis • Iron - Blood loss, ulcers, hemorrhoids, decreased absorption • Zinc - Decreased absorption - Deficiency leads to decreased taste sensation, impaired immunity and wound healing, mental lethargy • Magnesium - Limited intake - Deficiency leads to bone loss, weakness, mental confusion • Sodium - Intake usually in excess - Intakes in excess lead to hypertension, osteoporosis, tax on kidneys (sodium filtered by kidneys) • Folate, B-6 and B-12 - Required to clear homocysteine from blood to reduce risk of cardiovascular disease, stroke, bone fracture, and neurological decline - B-12 absorption declines as acid production declines with aging (acidic requirement needed for absorption) - Some may require supplements • Vitamin E - Intake usually short of recommendation - Inadequate intake decreases antioxidants in body and increases risk of cell damage • Carotenoids - Lutein, zeaxanthin link to prevention of cataracts, macular degeneration - Fruit, vegetables: major sources of carotenoids and other beneficial phytochemicals, are shown to be protective against wide variety of age-related conditions
What happens to perception of taste and smell as we age? How can that affect nutritional status? What are the consequences of other nervous system changes?
Nervous System • Gradual loss of nerve cells - Decreased sense of taste and smell - Impaired neuromuscular coordination, reasoning, memory • Hearing and vision decline - Curtails social, physical activity • 9.1 million with macular degeneration - Diet rich in carotenoids decreases risk • Neuromuscular coordination losses, ability to prepare meals declines - Opening packages becomes challenging
What are the unique nutrient needs of adults?
Nutrient Needs During Adulthood - 2010 Dietary Guidelines for Americans: • Balance calories with physical activity to manage weight • Consume more fruits, vegetables, whole grains, fat- free and low-fat dairy products, seafood • Consume fewer foods with sodium, saturated fats, trans fats, cholesterol, added sugars, refined grains • Older adults (65+) at risk for nutrient deficiencies Calories • After age 30, total calorie needs of physically inactive adults falls steadily - BMR declines 2% per decade after 30 - Decreases in lean mass and physical activity • Exercise can halt, slow, or reverse reductions in lean body mass - Increases calorie need - Easier to meet nutrient needs with higher calorie requirement Protein • Adult intake usually exceeds RDA (0.8 g/kg/day) • Studies indicate slightly higher protein intake per day (1.0-1.3 g/kg/day) may preserve muscle and bone mass in adults • Excessive protein may accelerate decline in kidney function - Excess protein used for energy or stored as fat - Products of protein metabolism filtered out by kidney Fat • Older adults usually consume at or above the recommended 20% to 35% kcal from fat • Good idea for almost all adults to reduce fat intake - strong link to obesity, heart disease, and certain cancers Carbohydrates • Intake often lower than recommended • Need to consume more fiber and less simple sugar - Improves glucose management - Reduces risk of colon cancer, heart disease, lowers cholesterol, prevents constipation Water • Many older adults fail to consume adequate quantities of water • Many in constant state of dehydration, electrolyte imbalance - Dehydration very dangerous, can cause disorientation WHY? • Fading sensation to thirst sensation • May be intentional to reduce frequency of urination • Medications can increase fluid output
Hypotheses about the causes of aging
There are many hypotheses about the causes of aging. They are just hypotheses (best guesses based on data and observation). You do not need to understand each hypothesis.
What is the difference between usual and successful aging?
Usual aging - typical, expected part of aging... increasing fatness, decrease lean body mass and bone mass - affected by lifestyle choices and environment Successful aging - declines that occur only because we grow older and not because of lifestyle choices, environment, and chronic disease
What are the warning signs for undernutrition in adults?
Warning Signs of Undernutrition: DETERMINE D isease E ating poorly T ooth loss or mouth pain E conomic hardship R educed social contact and interaction Multiple medications I nvoluntary weight loss or gain N eed for assistance with self-care E lder at an advanced age
What causes aging?
• "Process of slow cell death" - Cells age and die - After age 30 cell renewal occurs less than cell breakdown - Aging body can no longer meet physiological demands and function declines
What are Dietary Guidelines for drinking alcohol?
• 2010 Dietary Guidelines for Americans Regarding Alcohol - Moderation • 1 drink/day - women, • 2 drinks/day - men - None for those who cannot restrict, pregnant, become pregnant, children/adolescents, those taking medications, medical conditions - None for those engaging activities requiring attention - Monitor calorie intake, for weight management
What is binge drinking?
• Binge drinking - men, 5 or more drinks in a row - Women, 4 or more drinks in a row
What changes in body composition occur with aging?
• Changes with aging - Diminished lean body mass - Increased fat stores - Decreased body water (lean mass holds water)
What can an adult do to prevent insulin resistance?
• Improve insulin sensitivity and high blood glucose - Maintain healthy weight - Exercise regularly - Eat diet low in fat, high in fiber, and avoid foods with a high glycemic index
How does the environment influence aging?
• Income, education level, health care, shelter, and psychosocial factors • Being able to purchase nutritious foods, quality health care, safe housing helps decrease rate of aging • Education helps with decision making • Autonomy and psychosocial support promote successful aging
How does heredity influence aging?
• Living to old age tends to run in families • Twin studies indicate 20% to 30% of longevity attributed to genes • Gender: females live longer than males • Thrifty metabolism: metabolic efficiency - Not as beneficial in sedentary society - Require less calories - store fat
How does lifestyle influence aging?
• One's pattern of living: food choices, exercise patterns, substance use • Improving lifestyle can slow progression of familial diseases in some cases (ex: premature heart disease) • Worsening lifestyle can offset the benefit of longevity genes • Okinawa Japan has highest average life expectancy: 86 yr. women, 78 yr. men - Diet (plant based): rice, fish, vegetable protein, fruits, vegetables, tea, herbs, low meat • Following Mediterranean diet linked to lowest rates of chronic disease
What is reserve capacity?
• Organs retain reserve capacity - Maintain normal function with decreased cell number or activity for a while - Sever demands on the body can exhaust reserve capacity --> function decreases
How is alcohol absorbed and metabolized? What factors affect the rate of metabolism? What organs are involved?
• Requires no digestion • Absorbed rapidly via simple diffusion in intestines • Depends on rate of stomach emptying • Rate of absorption - Wine --> distilled spirits --> beer (slowest) • Alcohol is found wherever water is found in the body • Easily moves through the cell membrane (damaging it) Alcohol Metabolism • Depends on - Gender, race, size, food, physical condition, alcohol content • 90% to 98% is metabolized , mostly in liver • Enzymes alcohol dehydrogenase and acetaldehyde dehydrogenase • Alcohol cannot be stored
Define sarcopenia.
• Sarcopenia - Loss of muscle mass - Muscles shrink and can be lost - Muscles lose elasticity with added fat and collagen
Define sarcopenic obesity.
• Sarcopenic obesity - Loss of muscle mass accompanied by gains in fat mass
