Nutrition and the Aging Adult
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Transcript of Nutrition and the Aging Adult
The “graying of America” Physiological changes
» nutritional implications Nutrients and aging
» macronutrients, water» vitamins, minerals
Nutrition and chronic disease Drug-nutrient interactions Lifestyle habits!!
Nutrition and the Aging Adult
Trends in Aging
Demographics/characteristics» age distribution in America» life expectancy
» classification of the elderly– young-old =– old-old =– oldest-old =
Societal implications
Causes of death
Ten Leading Causes of Death in the U.S.
(2000)
Rank Cause of death1
2
3
4
5
6
7
8
9
10
Heart disease
Cancer
Stroke
Lung diseases
Accidents
Diabetes
Pneumonia/influenza
Alzheimer’s disease
Kidney disease
Septicemia Causes in which diet plays a part
Causes in which alcohol plays a part
Aging cells… Decreased cell
division
fewer parietel cells in stomach lining» absorption of Fe, Ca, Zn,
vitamins B6, B12, folate
efficiency of hormonal, enzymatic, neural communication
CNS» brain» blood flow to brain» synthesis
– psychomotor skills and cognitive function
Cardiovascular system»
– peripheral resistance– heart efficiency
» »
Aging systems…
senses of loss of sense of saliva, so ___________
can be difficult
digestion of ______________ is generally normal
nausea, diarrhea, constipation
» anxiety» use of
…GI tract
loss of (lowered cardiac output) glomerular filtration rate sensitivity to hormonal
regulation (ADH)
SO…» clearance of
» ability to» risk of» glucose, plasma proteins,
water-soluble vitamins less efficiently reabsorbed
Aging organs…kidneys
Lungs» decreased gas exchange
Decreased ______________adjustments» stress» temperature changes» glucose tolerance is slower
Decreased
Aging…miscellaneous
Nutrients and Aging:
Macronutrients Kcals: -7 to 10 kc/day per
year over 18-19» BMR, LBM (?)
Protein» need ~1.0 g/kg BW to maintain
_______________» need adequate kcals to
__________________ ___________
» 14 g/1000 kcal» for disease prevention
________: 1 ml/kcal» Increased risk of dehydration
Vit A: Vit D: ability to ____________
» osteomalacia Vit C: elderly men need more to
maintain body pool Vit B6: RDA is increased to
maintain ____________ Vit B12: ____% of elderly have
decreased absorption» pernicious anemia
Folacin: decreased _________» UL set to prevent masking of
vitamin ______ deficiency
Nutrients and Aging: Vitamins
Folic acid = term for synthetic form used in supplements and in food fortification
Folate = term for naturally occurring form found in foods; generic term
Folacin = generic term
Tetrahydrofolate (THF) = active form
Terminology forpteroylglutamic
acid
Folate and B12: Functions
cell growth and division» DNA
synthesis formation of
heme formation of
choline» involves
homocysteine to methionine conversion
homocysteine to methionine conversion» regenerates
active THF
synthesis of myelin sheath of nerves
Folate Vitamin B12
Conversion of homocysteine to methionine converts inactive THF
to active THF, which is then converted to a form needed in
DNA synthesis.
inactive THF
active THF nucleic acids
DNA, RNA
vitamins B12, B6
homocysteine
methionine
Folate and B12: homocysteine to
met
Folate and B12: Deficiency
megaloblastic anemia
megaloblastic anemia
+ neurological damage
= pernicious anemia
Folate Vitamin B12
SO…
Why does megaloblastic anemia occur in a vitamin B12 deficiency?
How can a vitamin B12 deficiency cause a folate deficiency?
Which is a more serious deficiency--B12 or folate?
Can you have a vitamin B12 deficiency without megaloblastic anemia?(The answer is “yes”; can you figure out why?)
Would you want to have a vitamin B12 deficiency without megaloblastic anemia?(The answer is “no”; can you figure out why?)
Why are the elderly at risk for B12
deficiency?
absorption requires:» stomach acidity» Intrinsic Factor» special proteins from
the stomach poor diet
Sources of Folacin in U.S. Food Supply
Grains
Meat, poultry, fish
Vegetables
Legumes, nuts, soy
Other
1970
1994
Dairy
Fruit
2%18%
13%
20%
28%
9%
10%
3%12%
22%
20%
24%
7%
12%
1994: 331 mcg per capita availableFolic acid fortification began January 1, 1998
Sources of Vitamin B12 in U.S. Food
Supply
Meat, poultry, fish
Dairy
Dietary Folate Equivalents (DFEs)
Folic acid and B12 are the two supplements better absorbed in their synthetic forms
1 DFE = 1 mcg food folate =
0.6 mcg synthetic folic acidin combination with food =
0.5 mcg synthetic folic acidtaken on empty stomach
Folate and B12: Supplements
DRIs for Vitamin B12
Adults 2.4#
Life stage group RDA (mcg/day)
#Since 10-30% of older people may malabsorb food-bound B12, it is advisable for those older than 50 years to meet their RDA mainly by taking foods fortified with B12 or a B12-containing supplement.
______: absorption decreased» after ________, women’s
need also decreases Calcium
» decreased ________
_________ deficiency» impaired _______ sensitivity
_____ deficiency» taste acuity» wound healing» immune function
Nutrients and Aging: Minerals
Nutrients and Aging: Chronic
Disease
Osteoporosis» impaired __________ status» loss of __________ protection for
bones so now bone is _________ faster than it is replaced
Glucose tolerance» chromium status» overweight» low ___________
Heart disease
Drug-Nutrient Interactions
Drugs can interfere with nutrient intake, absorption, metabolism, excretion
Nutrients can interfere with drug absorption, distribution, metabolism, excretion
loss or stimulation of ________ digestion/absorption via:
» HCl» chelation» competition for binding sites» damage to GI tract
prevent ________ to active form
antagonists _______ affect ____ via metabolism
and/or __________
Drugs can interfere with
nutrients
influence _________ of absorption» chelation
alter ________ via availability of plasma proteins» protein
influence rate of _________
influence rate of _________
Nutrients can interfere with
drugs
Drug-Nutrient Interactions
Antagonism» vitamin __ vs. Coumadin» caffeine vs. tranquilizers
Absorption problems» _______ and minerals
» Al-antacids + _____ = absorption of Al
» tetracycline and calcium» _________ and vitamin K
Drug-Nutrient Interactions
Nutrient losses» aspirin _______» diuretics, laxatives
Trigger ______» MAO inhibitors + tyramine
=
Drug-Nutrient Interactions
Side effects» digoxin, chemotherapy
drugs» anticonvulsants increase
need for __________
Nutrients as drugs» megadoses
Drug-Nutrient Interactions
Systemic effects of alcohol
» tolerance decreases with age
» depletion of __________
» poor nutrient intake
» risk of _________ in diabetes