Understanding

Nutrition,
16e
Chapter 17: Life Cycle Nutrition:
Adulthood and the Later Years

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 Learning Objectives (1 of 2)
By the end of this chapter, you should be able to:

17.1 Describe the role nutrition plays in longevity.

17.2 Summarize how nutrition interacts with the physical,

psychological, economic, and social changes involved
in aging.

17.3 Explain why the needs for some nutrients increase

or decrease during aging.

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 Learning Objectives (2 of 2)
By the end of this chapter, you should be able to:

17.4 Identify how nutrition might contribute to, or prevent, the

development of age-related problems associated with vision,
arthritis, the brain, and alcohol use.

17.5 Instruct an adult on how to shop for groceries and prepare

healthy meals for one person on a tight budget.

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Nutrition and Longevity

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 The Aging of the US Population
• Two motivating goals
− Promote health
− Slow aging

• Ratio of old people to young

is increasing
− Fastest­­-growing age group

• Factors influencing life

expectancy
− Modern medicine
− Abundant food supply is working
for and against
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 Observation of Older Adults
• Physiological versus chronological age
− Physiological age refers to a person’s health status, may be
different from their chronological age

• Healthy habits
− Eating well-balanced meals
− Engaging in physical activity daily
− Not smoking
− Not using alcohol, or using it in moderation
− Maintaining a healthy body weight
− Sleeping regularly and adequately
− Relieving stress; focus on a sense of purpose
− Having a community of family and friends (blue zones)
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 Knowledge Check 1
Fill in the missing words or phrases:

1. Aging is an _____ process, programmed into our genes. The process can
be _____ by adopting healthy lifestyle habits.

2. Good nutrition aids in maintaining a healthy body and can improve _____
[3 words] in later years.

3. Life expectancy in the United States is _____ years.

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 Knowledge Check 1: Answer
1. Aging is an inevitable process, programmed into our genes. The process
can be slowed by adopting healthy lifestyle habits.

2. Good nutrition aids in maintaining a healthy body and can improve quality
of life in later years.

3. Life expectancy in the United States is 79 years.

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 Physical Activity
• Benefits of physical activity in older adults
− Weigh less
− Greater strength & flexibility
− Reduced inflammation
− Increased bone density
− More endurance
− Better balance therefore reduced falls
− Cardiovascular and brain health
− Improve sleep
− Better quality of life
− Live longer

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Exercise Guidelines for Older Adults

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 Energy Restriction in Human Beings
• Moderate restriction of 15%
− Body weight decreases
− Metabolism slows
− Oxidative stress declines
− Favorable changes for preventing chronic diseases and
supporting longevity

• Possible benefit from Intermittent Fasting

• Mediterranean Diet
− Nutritional adequacy essential to a long and healthy life

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 The Aging Process

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 Stress
• Psychological and physical stressors elicit the body’s
stress response
− Prolonged or severe stress can lead a body to be vulnerable to
illness

• Difference between men and women

− Fight-or-flight response
− Tend-or-befriend response

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 Physiological Changes
• Body weight
− Lowest mortality correlates with a slightly higher BMI of 23.5-
27.5 for >65 years old
− Older adults who are obese still face serious medical
complications at least until age 85

• Body composition
− Loss of bone and muscle
− Gain of body fat
Sarcopenia – loss of skeletal
muscle mass, strength, and
20-year-old 64-year-old
quality woman’s thigh woman's thigh
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 Immunity and Inflammation
• Immune system loses function with age

• Inflammation— duel effect

− critical in supporting health
− Limit harmful consequences

• Compromised by nutrient deficiencies

• Improving immune system response

− Regular physical activity
− Diet rich in fruits and vegetables

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 GI Tract
Changes contribute to poor appetite, early satiety, malnutrition

• Atrophic gastritis
− Lack of stomach acid and intrinsic factor
− Absorption of nutrients impaired, especially vitamin B12

• Dysphagia
− Difficulty swallowing, texture of diet often requires modification

• Constipation
− Intestinal walls lose strength, motility slowed

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 Tooth Loss
Tooth Loss:
• Difficult and painful chewing
− Limited food selections
− Less dietary variety
− Lower intakes of fiber and vitamins

Sensory losses that can also impact eating:

− Vision, mobility, hearing, taste, smell

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 Other Changes
• Psychological changes
− Depression
▪ Loss of appetite and motivation to
cook
▪ Support and companionship of family
and friends
− Economic changes
▪ Living arrangements and income
− Social changes
▪ Malnutrition most likely to affect those
living alone
• Especially men, those with low
income and/or education
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 Discussion Question 1

Do you know someone who is considered elderly? Which

outward signs of aging do you notice in them? Can you
identify things you can do to help with some of the
changes they experience as they age?

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Energy and Nutrient Needs
of Older Adults

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 Water
Barriers to Adequate Hydration:
• Thirst response and dry mouth
• Mobility issues make getting water and going to the bathroom difficult
• Memory issues may forget to drink

Concerns:
• Dehydration
− Total body water decreases with age – more easily become dehydrated
− Increased risk for: UTI, pneumonia, pressure ulcers, confusion

Prevention:
▪ At least six glasses of water daily
▪ Set reminders/alarms
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 Energy and Energy Nutrients
• Energy needs decline estimated at 5 percent per decade
− Reduced activity
− Loss of muscle mass
− Thyroid hormone diminishes

• Nutrient needs remain high

− Greater need for nutrient dense foods
− Little room for added sugars and fats

• Protein
− Especially important to support immune system, prevent muscle wasting,
and optimize bone mass
− Focus on lean sources or Liquid nutritional formulas
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 Carbohydrates, Fiber, and Fat
• Carbohydrates – spare protein

• Fiber
− 14 grams per 1000 calories
− Along with water, alleviate constipation

• Fats
– Mono & Polyunsaturated provide valuable nutrients
– Saturated fats raise risks of atherosclerosis and
other generative diseases
– Limiting fats too much may lead to nutrient deficiencies and
weight loss
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 Vitamins and Minerals
• Vitamin B12
− People with atrophic gastritis especially vulnerable
• Vitamin D
− Less milk intake and sun exposure
• Folate
− Medications can interfere
• Calcium
− Need are higher, 1200 mg/day
• Iron
− Deficiency & Excess is possible
• Zinc
− Deficiency decreases appetite/taste and worsen poor intake
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 Nutrients of Concern for Older Adults

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 Dietary Supplements
• Over 50 percent of older adults use dietary supplements.
− Recommended by many health care professionals
− Can provide 100 percent of daily values
− Thought to be more beneficial than harmful
− Careful of sources

• Food is the best source of nutrients for everybody.

− Supplements are not a substitute for food.

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Nutrition-Related Concerns
of Older Adults

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 Vision
Common Issues:
• Cataracts
− Age-related clouding of the lenses of the eyes
• Macular degeneration
− Leading cause of vision loss

Prevention:
Age-related
Omega-3’s, Antioxidants (vitamin C & E) may slow progression

Nutrition Concerns:
Reduced food purchase, preparation, and consuming with poor vision.

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 Arthritis
• Osteoarthritis
− Deterioration of cartilage in the joints
• Rheumatoid arthritis
− Immune system destroys bone and cartilage
• Gout
− Deposits of uric acid in joints
− Purines in foods – alcohol, meat, seafood, and sugar sweetened
beverages

Nutrition Concerns:
Pain interferes with appetite and food prep
Pain medications can interfere with digestion
Focus on anti-inflammatory foods
Glucosamine and Chondroitin may be helpful
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 The Aging Brain
• Dementia
− Affects 15 percent of adults over 70
• Characteristic changes with age
− Loss of neurons
− Decreased blood supply
• Obesity & Nutrient deficiency
− May be a factor in loss of memory and cognition
• Alzheimer’s Disease
• Unsure of cause, primary risk is age
• 3rd leading cause of death in older people
• Alcohol use
− Empty calories
− Contributes to 60 percent of falls

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 Nutrition Concerns and Prevention
Concerns:
• Cardiovascular disease, diabetes, and obesity can accelerate
progression
• Remember to eat/healthy foods

Prevention/Slowing of Progression:
• Healthy weight
• Regular Exercise
• DASH Diet
• Mediterranean Diet
• Help with meal planning

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Food Choices and Eating
Habits of Older Adults

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 Malnutrition in Older Adults
One in six are malnourished
− Contributing factors –> chronic illness, medications, depression, social
isolation

Malnutrition limit’s a person’s ability to function in a variety of

ways including:
1. Impairing muscle function
2. Decreasing bone mass
3. Compromising immunity
4. Reducing cognition
5. Poor wound healing/slowed recovery (surgery)
6. Increasing hospitalizations
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Nutrition Screening Initiative – Risk Factors for Malnutrition in Older Adults

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 Food Assistance & Meals Planning
• Familiarity, taste, and health benefits influence older person’s
food choices the most.
• Food assistance programs
− OAA Nutrition Program provides group meals in a social setting
− Meals on Wheels

• Challenges in purchasing, storing, and preparing food

− Limited “fixed” income
− Foodborne illness risk increases
− Being a wise planner and shopper
▪ In season fresh foods, buy bulk and store, many meals based
around one protein, etc.
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 Highlight: Nutrient-Drug Interactions
Nutrient and Drugs can interact in the following
ways:

• Drugs can alter food intake and the absorption,

metabolism, and excretion of nutrients

• Foods and nutrients can alter the absorption,

metabolism, and excretion of drugs

• Interactions can create drug toxicities

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