week 11- nutrition in older adults Flashcards
(44 cards)
1
Q
changes with aging
A
physical, financial, lifestyle, health, mobility, social schedule
2
Q
physiological changes with aging
A
- changes in taste and smell
- xerostomia (dec saliva) and dentures
- reduced energy expenditure and metabolic rate
3
Q
social changes with aging
A
- may lose significant other or friends
- potential for chronic illness, reduced mobility, depression or dementia
- often consume a tea and toast type of diet
4
Q
challenges with maintaining good nutrition
A
- 34% of canadians 65+ are at nutritional risk
- 22% had weight change >10lbs in previous 6 months
- 15% skipped meals every day
- 18% ate <2 servings of F&V daily
- 23% never or rarely ate with someone
- 18% found cooking a chore
5
Q
healthy adult BMI
A
18.5-25
6
Q
healthy older adult BMI
A
25-32, more reserves if they got sick
7
Q
protein requirements older adults
A
- needs are similar to younger adulthood
- adequate daily intake needed to support losses, be mindful of renal function
- consider sources that are appropriate for older adult
8
Q
fat requirements older adults
A
increase in FA and dec saturated fats
9
Q
carb requirements older adults
A
- necessary for optimal brain function
- fibre is important in preventing constipation
- excess carbs are stored as fat
10
Q
GI system of older adults
A
- reduced gastric acid leads to a dec in B12 and iron absorption
- slowed gastric motility, so water and fibre become increasingly important
11
Q
consequences of decreased gastric acid secretion
A
low B12 = pernicious anemia (change in RBC shape), iron deficiency anemia
12
Q
changes to musculoskeletal system OA
A
- need to support bone density through weight bearing exercises
- vitamin D synthesis decreases with age, 400IU supplement recommended for 50+
- calcium supplements maybe required if intake is inadequate
13
Q
calcium supplements
A
- older adults RDA is 1200mg/d
- several studies have linked calcium supplements to CVD risk
- recommendation that calcium come from dietary sources where possible
14
Q
CVD
A
- second leading cause of death in canada
- includes ischemic HD, cerebrovascular disease, peripheral vascular disease, heart failure, congenital HD, rheumatic HD
- death rate of CVD has decreased by 21% in the last 20 years
15
Q
heart disease progression
A
- people with HT, diabetes, obesity, smoking and high cholesterol are at risk of developing CVD
- we see atherosclerosis (build up of plaque, narrowing of vessels)
- leads to structural heart disease (ischemic HD, MI, arrhythmia)
- eventually they develop symptoms of heart failure (SOB, fatigue, decreased exercise tolerance)
16
Q
non-modifiable CVD risk factors
A
age, sex (men have higher risk until postmenopausal age), family history
17
Q
modifiable CVD risk factors
A
HT, cholesterol, diabetes, overweight, diet, alcohol, physical inactivity, smoking, stress
18
Q
LDL
A
- carries cholesterol to cells, increases risk of atherosclerosis (bad cholesterol)
- LDL should be <3.5mmol/L
- LDL level <2.6mmol/L is optimal
19
Q
HDL
A
- retrieves cholesterol and returns it to the liver, decreases risk of heart disease
- HDL >1mmol/L for men, >1.3mmol/L for women
20
Q
oxidized LDL (VLDL)
A
transports cholesterol into arterial lining
21
Q
foam cells
A
hold oxidized LDL within the arterial wall, contribute to plaque formation and inflammation
22
Q
development of atherosclerosis
A
- inflammatory changes to endothelium attract monocytes
- they migrate through endothelial layer, leading to inflammatory changes and becoming macrophages
- macrophages engulf oxidized LDLs, becoming foam cells
- SM cells mix with foam cells and mineralize with calcium, leading to a hardened plaque
- inflammation weakens the fibrous cap of plaque, increasing the risk of a thrombus
23
Q
atherosclerosis
A
plaque build-up on arterial wall
24
Q
formation of a blood clot
A
- plaque ruptures and forms a thrombus (partial occlusion)
- may turn into a thrombosis (total occlusion)
- if a part of the thrombosis breaks off, it’s called an embolism
- blockage of a BV leads to oxygen deprivation and necrosis of surrounding tissues
25
measuring CVD risk
- c-reactive protein and homocysteine are inflammatory markers, meaning increased levels = increased risk of MI
- total cholesterol should be <5.2mmol/L
- triglycerides should be <1.7mmol/L
- BP should be <130/90
- BMI should be <25
26
normal BP
<130/85 (optimally <120/80)
27
hypertension
- >140/90
- damages BV by decreasing elasticity and decreasing tissue perfusion
- contributes to MI and stroke
28
prevalence of HT
25% of males and 21% of females aged 20-79, 51% of all adults 60-79
29
sodium recommendations
- UL: 2300mg
- canadian average intake is 3400mg
- 77% of sodium comes from processed foods
- can contribute to HT
30
DASH diet
- includes whole grains, F&V, low-fat dairy products, some fish, poultry, legumes, small amount of nuts and seeds
- low in sodium, high in K/Ca/Mg/fibre
- decreased amounts of red meats and sweets
31
metabolic syndrome
- collection of 3 or more symptoms, accompanied by low grade inflammation
- BP>130/85
- TG>1.7mmol/L
- HDL<1/1.3mmol/L
- fasting blood glucose>5.6mmol/L
- waist circumference>102cm in men, 88cm in women
32
treatment of metabolic syndrome
- decrease body weight by 5-10% (moderate exercise for 30-50 min/d, healthy eating)
- stop smoking
- reduce alcohol use
- use medications to lower BP/prevent diabetes
33
sources of saturated fats
animal sources
34
sources of trans fats
manufactured through partial hydrogenation
ie. margarines
35
sources of monounsaturated fats
olive oil, canola oil, avocado, nuts
36
sources of polyunsaturated fats
a) omega 3: fish, walnuts, flaxseeds, canola oils (want more omega 3 in our diet)
b) omega 6: vegetable oils
37
dietary fats and CVD
- saturated and trans fats lead to increased LDL and decreased HDL levels
- unsaturated fats lead to increased HDL levels, decreased inflammation and prevent blood clots
- high blood cholesterol increases CVD risk, but high dietary cholesterol doesn't necessarily inc risk
38
foods high in cholesterol
eggs, shellfish, liver, beef, poultry, dairy (limit to <300mg/d)
39
sugar and CVD
- simple sugars increase TG and reduce HDL
- excess sugar increases chronic inflammation, BP, weight, diabetes risk
- sugar should be <10% of total energy intake (ideally <5%)
40
antioxidants and CVD
1. they scavenge free radicals, preventing oxidative damage from LDL
2. reduce low grade inflammation
3. reduce blood coagulation and clot formation (vitamin E)
41
nutritional recommendations to reduce CVD risk
- increase F&V intake (antioxidants, fibre, vitamins)
- include sources of soluble fibre (binds cholesterol)
- include soy products (antioxidants and lower LDL)
- reduce refined starches and simple sugars
- choose fats wisely
- reduce alcohol
42
mediterranean diet
- emphasizes eating primarily plant-based foods, F&V, whole grains, legumes and nuts
- replacing butter with olive oil and canola oil
- reduced salt
- red meat no more than a few times a month
- fish and poultry twice a week
- red wine in moderation
43
vegetarian diets and CVD
- reduced risk of death from ischemic heart disease
- lower mean blood cholesterol
- lower in saturated fat, higher in fibre, higher consumption of soy and antioxidants
44
supplements and CVD
no supplements can dec CVD risk, Ca/vitamin E supplements can increase risk
