Older Adult Nutrition Flashcards by Sydney Perry

What defines “old” ?

DRI category
U.S. Census Bureau
Eligibility for Medicare
World Health Organization
Older American Act Nutrition Program

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CDC suggest that longevity depends on:
◦____% lifestyle factors
◦_____% environmental factors (pollution, etc.)
◦____% genetics
◦____% access to high-quality health care

51%
20%
19%
10%

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More Americans are living longer

◦Currently, _____% are >65 yrs
◦ By 2030, it is expected that ~____% will be >65 yrs

Persons ≥____ are the fastest growing population group

16.8%
19%
85

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Average number of years of life remaining for persons in a population cohort or group

life expectancy

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Maximum number of years someone might live;
is projected to range from 110-120 years

life span

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life expectancy is higher in the ______ of the US
lowest in ____ area of US

which gender is living longer?

west and northeast
south

females

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Animal studies show that an energy- restricted diet that meets micronutrient needs can prolong healthy life

▪Caloric restriction defined as: decreasing energy intake by_______% while meeting protein and micronutrient needs
▪Studies of caloric restriction (CR) in primates have shown conflicting results

25-30%

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cardiovascular changes with age:

◦ Reduced stroke volume
◦ Increased arterial stiffening, increased BP

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Endocrine changes with age:

◦ Reduced levels of estrogen & testosterone
◦ Decreased secretion of growth hormone
◦ Increased cortisol
◦ Reduced glucose tolerance
◦ Decreased ability to convert provitamin D to previtamin D in the skin

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GI changes with age:

◦ Reduced secretion of saliva & mucus
◦ Missing or poorly fitting teeth
◦ Dysphagia
◦ Damaged, less-efficient mitochondria produce less ATP, less energy
◦ Reduced secretion of HCl & digestive enzymes
◦ Slower peristalsis
◦ Reduced vitamin B12 absorption

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Renal changes with age:

◦ Reduced number of nephrons
◦ Slowed glomerular filtration rate

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Neurological changes with age:

◦Reduced nerve conduction velocity=>
affecting cognition and sense of smell, taste, & touch

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Respiratory changes with age:

◦ Reduced breathing capacity
◦ Reduced work capacity & endurance

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Musculoskeletal changes with age:

◦ Reduced LBM
◦ Increased fat mass
◦ Decreased RMR
◦ Reduced work capacity & strength

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LBM and Fat decline on average ____% per decade from age _____

this results in lower ____, _____, and ______

2-3%
30-70

lower
- mineral
- muscle
- water reserves

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Loss of skeletal muscle mass & strength associated with aging

sarcopenia

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sarcopenia’s cause is multifactorial including _____________

muscle disuse
nutritional deficiencies
hormone changes
chronic diseases
inflammation

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sarcopenia is a precursor to ______.

Which results in worsening disease burden, nutritional inadequacies, increased disability, increased fall risk, functional dependency, and death.

Older adults with reported decline in function, strength, or with recurrent falls should be assessed for sarcopenia

frailty

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Coexistence of age-related loss of muscle mass & strength and excess body fat

sarcopenia obesity

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Sarcopenia obesity results in _____ outcomes and declines in function than sarcopenia or obesity alone

worse

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protein recommendations for sarcopenia is _________
when during the day?

also, consume _____ HBV protein source at each meal

healthy diet with dietary sources of __________.
Exercise with emphasis on __________.

1.0-1.5 g/kg/day
evenly throughout the day

25-35 g

antioxidants
resistance strength training

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as age increases, body fat increases, especially in the ______ region

lost muscle mass is replaced with fat.

For women, lack of ______ promotes fat accumulation

visceral

estrogen

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Wt & BMI gradually increase with aging, peaking between _______ yrs
◦ Physical activity moderates weight gain, increases LBM, & decreases body fat

Weight then stabilizes and starts to slowly drop around age ____

50-59 yrs

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Taste & smell decline with age
* Declining number of _________ receptors
* Blunted sense of smell decreases sense of taste
* Women retain their sense of smell _____ than men do
* Disease & medications affect taste & smell _____ than aging

olfactory
better
more

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Poor dietary habits can lead to dental caries & tooth loss * Frequent consumption of sugary foods & beverages provide a continuous substrate for bacteria * Oral bacteria ferment _______ producing acids that erode tooth enamel * The acid in _____________ also corrodes enamel *Poor oral hygiene, lack of saliva, loss of teeth, and a diet deficient in vitamin ___ contribute to periodontal disease

sucrose carbonated beverages C

Appetite ◦ Hunger & satiety cues _______ with age ◦ Older adults may need to be more conscious of food intake levels since appetite-regulating mechanisms may be blunted Thirst ◦ Thirst-regulating mechanisms ________ with age

weaken decrease

Methods for identifying risk ◦ Before chronic illness: total saturated fats, fruits, vegetables, whole-grains, and poor habits leading to obesity ◦ Leading to malnutrition: Compare dietary intake to nutrient intake recommendations ◦ Population-based risk screening: Factors that lead to interventions to prevent or delay onset of chronic disease ◦ _____________________: DETERMINE Checklist ◦ ________________________ ◦ __________________________

Nutrition Screening Initiative (NSI) Mini Nutritional Assessment (MNA) Malnutrition Universal Screening Tool (MUST)

DETERMINE Checklist was developed by the _______________________ and is a list of earning sign of _________ in older adults

American academy of family physicians academy of Nutrition and dietetics national council on aging poor nutrition

Mini-Nutritional Assessment (MNA) * The MNA short form uses ____ screening items: ( over period of ____) What are the screening items?

Six 3 months food intake weight loss mobility psychological stress or acute disease neurophysiology problems (dementia or depression) BMI

latrogenic nutrition risk factors include _________

Prolonged NPO status Delays in addressing nutritional needs overly restrictive therapeutic diets

Food-Based Guidance: MyPlate ◦ MyPlate for older adults' adaptations ◦ _______: video, shopping tips, physical activity, recipes ◦ ___________: fortified foods, text to describe food groups, food pattern with range of calories

Tufts University of Florida

modified my plate changes

pictures softer foods canned and packaged foods soup included in drinks shows type of excercises

Considerations for Nutrition Education Materials for Older Adults

* Larger type size * Serif lettering (such as Times Roman) * Bold Type * High contrast (black on white) * Non-glossy paper to decrease glare * Reading level of 5th to 8th grade

Nutrient Recommendations *DRIs for macronutrients, fiber, & water are available for age >___ years *RDA/AI and UL available for micronutrients for age >___ years

50 70

Goal is to maintain a healthy body weight *DRI EER equations; Mifflin-St. Jeor equation *___________ report the lowest intake and are especially at risk for malnutrition

Women age >70

Average intake for adults aged 70 and older Vitamin A: ◦DRI: ______ ◦Average intake:______

900 mcg/d males, 700 mcg/d females 689 mcg/d males, 599 mcg/d females

Vitamin E: ◦DRI: _______ ◦Average intake: _______

15 mg/d 8.9 mg/d males, 7.5 mg/d females

Vitamin D: ◦DRI: _______ ◦Average intake: ________

20 mcg/d 5.4 mcg/d males, 4.2 mcg/d females

Calcium: ◦DRI: ______ Average intake: ______

1200 mg/d 935 mg/d males, 761 mg/d females

Sodium: ◦ UL: ______ ◦ Average intake: __________

2300 mg 3351 mg/d males, 2517 mg/d females

Magnesium ◦ DRI: _____________ ◦ Average intake: _______________

420 mg/d males, 320 mg/d females 294 mg/d males, 238 mg/d females

Potassium ◦DRI: ______ ◦ Average intake: ________________

4700mg/d 2758 mg/d males, 2171 mg/d females

Fiber * Need to increase whole grains & vegetables to meet fiber needs and increase nutrient density ◦ DRI: _______________ ◦Actual intake for age > 70 yrs : _____________

30 g/d males, 21 g/d females 19g/d males, 15g/d females

On average, older adults in the U.S. ________ the RDA for protein Older adults living alone, living in poverty, or who have functional limitations may have low protein intakes ◦ Contributes to sarcopenia, weakened bones, decreased immune status, & poor wound healing Optimal amount of protein needed for older adults is unclear ◦ Some studies have indicated that protein intake of ____may be beneficial to older adults as compared to the RDA of _____

meet or exceed 1- 1.5 g/kg 0.8 g/kg

considerations for Protein Adequacy of Older Adults * Are enough _____ eaten so that protein does not have to be used for energy? * If marginal amounts of protein are eaten, is the protein of high quality? * Are there additional needs (e.g., _________)?

calories wound healing

Keep total fat between _____ of calories Limit saturated fat to <____ of total kcal <___ of kcal if hyperlipidemia, atherosclerosis, CHD, or DM Minimize intake of trans fat

20-35% <10% <7%

The amount of total body _____ decreases with age, resulting in a smaller margin of safety for staying hydrated * ____ glasses of fluid/d will prevent dehydration in most older adults * Symptoms of dehydration=> __________ * To individualize fluid recommendations, ____ of fluid per kcal needed or 25 ml/kg with a minimum of 1500 mL/d

water ≥6 confusion, weakness 1 mL

Vitamin A ◦__________ dietary intake for both older men & women ◦However, plasma levels & liver stores _______ with age ◦ May be linked to _________ clearance from the blood ◦Older adults are more vulnerable to toxicity & possible liver damage than deficiency

Inadequate higher lower

Vitamin D ◦ Factors that put older adults at risk for deficiency: o Four-fold decrease in ability of ________ to synthesize vitamin D o _____=> institutionalization, homebound, sunscreen, more clothing o ______ (Phenobarbital, cholestyramine, Dilantin) o Poor _____ intake

aged skin Limited exposure to sunlight Medications dietary

Vitamin E * Potent _____ * Associated with enhanced immune function and cognitive status * Dietary intake is _________ for older adults * At higher doses, vitamin E is linked to _____ and risk of _____

antioxidant inadequate longer blood-clotting times hemorrhage

Vitamin B12 ◦Serum levels ______ with age even in healthy adults with adequate intake ◦______ levels of HCL, pepsin, & intrinsic factor (from atrophic gastritis) in older persons leads to______ serum B12 ◦Synthetic or purified B12 is _____ and is much _____ absorbed

decrease lower lower not protein-bound better

Folate ◦Some medications used can affect folate ___________ (methotrexate, phenytoin) ◦Deficiency caused by ______ ◦Folate supplementation can mask ____ deficiency, which is a more common problem in elderly

absorption or metabolism alcoholism B12

Iron ◦Iron needs _____ after menopause for women ◦Most older adults consume ______ iron than is needed ◦Excess iron contributes to _______ ◦Reasons that some older adults may have iron deficiency include: ◦ _____ from disease or medications ◦ Poor absorption due to __________ ◦ ______ calorie intake

lower more oxidative stress Blood loss lower acid secretion less calories

Calcium ◦Need adequate intake for ______ health ◦RDA for men & women >70 yrs: _______ ◦UL: ______

bone 1200 mg/d 2000 mg/d

Magnesium ◦Need adequate intake for _______ ◦ Involved in over 300 ______ systems ◦Deficiency can occur due to: ◦ Inadequate intake ◦ Malabsorption due to _________ ◦ Chronic ______ ◦ _______ (Lasix, cyclosporine)

bone health, nerve activity, glucose utilization enzyme GI disorders alcoholism Medications

When to Consider Supplements ◦ Lack _______ resulting from illness, loss of taste or smell, or depression ◦Diseases of _____ ◦Have a _______ due to food insecurity, loss of function, or disinterest ◦Avoids specific ______ ◦Take _________ or other substances (alcohol) that affect absorption or metabolism

appetite GI tract poor-quality diet food groups medication

Nutrient Supplements * Usage_______ with age * The individuals most likely to take supplements are _____ *Among older adults, the most frequently used micronutrient supplements are: ___________________ * Important to assess use in older adults since they are on more medications=> potential DNI

increases non-Hispanic white females MVM, vitamin D, calcium, & vitamin C

Academy Position on Micronutrient Supplements ◦The routine & indiscriminate use of micronutrient supplements for the prevention of chronic disease _______ recommended, given the lack of available scientific evidence

is not

Food Safety Recommendations ▪Older adults with compromised immune systems are vulnerable to foodborne illness ▪Leading hazardous practices: ◦ Improper holding _______ ◦ Poor personal _______ ◦ Contaminated-food preparation ______ ◦ Inadequate ______ time ▪Limited vision, decreased sense of smell, or forgetfulness can contribute to poor food-handling practices

temperatures hygiene equipment cooking

PA for Older Adults ▪PA builds LBM, helps to maintain _______ ▪Brain health: improved _____, reduced _____, reduced risk of _____, and improved _____ ▪Lowers the risk of several chronic diseases ▪Initial screening by physician to identify potential contraindications or problem areas

balance & flexibility cognition anxiety depression sleep

Physical Activity Recommendations The PA guidelines for ______ also apply to older adults * All adults should avoid inactivity. Some PA is better than none. * For substantial health benefits, adults should do at least ______ of moderate-intensity, or _______ of vigorous-intensity aerobic PA, or an equivalent combination of _________ intensity aerobic activity * Adults should also do muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups on _____days a week

adults 150min/wk 75-150 min/wk moderate- and vigorous 2 or more

Additional PA Guidelines for Older Adults * When older adults cannot do 150 minutes of moderate-intensity aerobic activity a week due chronic conditions, they should be as physically active as their _______ * Weekly PA for older adults should include _______ * Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely

abilities and conditions allow balance training

Older Adult Nutrition Flashcards

(62 cards)