Lecture 24Nutrition for Grandparents  Benefits of good nutrition into adult years: Keeps you active and improves quality of life, prevents malnutrition, and delays onset of chronic diseases.  In U.S., life expectancy is in the 80’s. Remaining healthy (healthy life expectancy) is only 70 years. Definition of Aging: Accumulation of changes associated with and responsible for an ever-increasing susceptibility to disease and death  Process include: Loss of cells and cell fxn occurs  Effects are not felt for many years because organisms start with more cells and cell function than needed  Reduced ability to repair damage and resist infection DRIs include four adult age groups Young adulthood (ages 19–30) Middle age (ages 31–50) Adulthood (ages 51–70) NUTR 202 1nd Edition Older adulthood (over age 70)ENERGY WILL DECREASE, btw adulthood and older adulthood = increased vitamins & minerals. As you age E requirements will be less but not less nutrition! Energy needs in elderly: Decrease with decreasing LBM; decreasing BMR. Need for other nutrients: Stays the same or increases To meet these changes: Consume nutrient-dense foods & phytochemicals-dense.Body Composition & Energy Needs in Older Adults èAt same weight have less muscle mass & fatter.*BOLD IS BEST: BIG COLOR AND BIG FLAVOR: 5-9 servings a day; fiber to prevent constipation, hemorrhoids, and diverticulosis. Older adults need to get enough fiber and water to help reduce the risk of constipation and diverticulosis As we age, there is a reduction in sense of: Thirst Physiological effects of aging reduces ability to conserve water in the: Kidneys Risk of dehydration increases The DRI for vitamin D and Calcium increase for the older adult to reduce risk of osteoporosis and bone fractures Accelerated bone loss after menopause: Needs increase after the age of 50 for women After 70 for men As we age, the ability of skin to make Vitamin D (less activation  less Ca transport to bones) from sunlight declines; also, reduced sun exposure.Vitamin D RDA: 600 IU  600  800 for those 71 and older.  Due to reduced stomach acid production as we get older, people over 50 may have decreased absorption of B12 from foods. Need to consume B12 fortified foods and supplements. B12 is onevitamin that is found in only animal sources. In elderly, might be taking antacids  less HCl  less IF  less B12 absorption!  This reduced stomach acid secretion, atrophic gastritis, results in: Reduced ability to release protein in foods May also lead to reduces absorption of: Iron, calcium, folate, vitamin KThe 3 B Vitamins that collectively could be heart healthy:Folic Acid,Vit B-12,Vit B-6.Elderly: negative nitrogen balance therefore need B6 and folic acid (role in DNA synthesis) therefore help produce body proteins. Also helps in reducing homocysteine!!! Risk of deficiency for: iron. May be due to: Increased intestinal blood losses Poor absorption due to low stomach acid  Decreased intake from diet May develop anemia Microcytic vs. macrocytic Physiological changes with aging: Decreased muscle size and strength Lack of exercise may contribute May result in impaired mobility and balance Increased risk of falls and fracturesDecline of immune system: Increased risk of infection, cancers Increased need for medications may result that affect: Appetite, nutrient absorption or metabolismAcute or chronic illnesses: MORE than 75% Can result in change in nutrient requirements and: Impair ability to obtain and prepare food Organ dysfunction: kidney failure and BP  alter phosphate intake/impacts nutritionPhysical disabilities: Arthritis most common physical disability in older adultsOsteoarthritis – less mobile, greater risk falling and injury/breaking bonesDecreased Mental Status:  Impaired memory, thinking, or judgment severe enough to cause personality changes and affect daily activities and relationships with others:  Dementia Can be caused multiple strokes, alcoholism, dehydration, medication side effects, vitamin B12 deficiency Also, Alzheimer’s disease Depression Arthritis - cartilage is reduced -> pain will limit elderly in how they purchase and prepare foodMeeting nutrient needs: Foods must be nutrient dense, not energy dense: Plant based foods contain phytochemicals, antioxidants  Supplements may be necessary in some older adults (vitamin D, Ca, and B12)  Benefits of physical activity for older adult: Extend number of active, independent years Improve quality of life Reduce risk of disabilityEconomic and emotional conditions can affect nutritional health: Depression, lonesomenessFood insecurity- May struggle to cover medical costs, prescription costs, and living expenses and have limited income left for food. Other reasons: inability to shop for self, prepares food, or consumes food. Assistance includes congregate meals and nutrition education, home deliveryModerate alcohol consumption: In moderation: Alcohol is safe to consume and may be beneficial Definition of moderation: One drink daily or less for adult women Two drinks daily or less for men A serving size includes: Beer: 12 oz.  Liquor: 1.5 oz (or 1 ½ oz.) Glass of wine: 5 oz. Alcohol intake in excess: Can lead to chronic health problemsStandard Drink Size = 14 g Alcohol; 7 Cals/gramEMPTY CALORIES!Absorption and Metabolism of alcohol: Small amount alcohol absorbed alcohol stomach: Most alcohol is absorbed from the: Small intestine Enters bloodstream: Peak blood alcohol level ~1 hour after ingestion To be detoxified, must go to the: LiverAlcoholic liver disease The fatty liver or alcoholic hepatitis stage: Reversible if alcohol consumption stopped At cirrhotic stage: Irreversible and often fatalNutritional impact of alcohol intake: 7 kcal/g – energy dense/ Excess calories alcoholic drinks Alters nutrient absorption and/or metabolism Inflammation of stomach, pancreas, intestine What B-vitamin is at risk of being low in those who consume alcohol in excess?Thiamin- Deficiency disease Cancers associated with excess alcohol intake include: Mouth, esophagus, stomach, colon, liver, breast Excess alcohol intake also associated with: Increased risk of hypertension, heart disease & stroke This increased risk may be related to: Increased