ALIMENTACION EN LA VEJEZ

Ana Paola

José Antonio Torres Aguillon

Older adults are living longer…

• Older adults now a days are living longer, for example in developed countries, life expectancy increased by 30 years in the twentieth century. Those born today can xpect to live 77.6 years. Women who reach age 65 can expect to live an additional 19.8 years and men, 16.8.

• In “normal” aging, inevitable and irresversible physical changes occur over time, and some diseases are more prevalent. The leading causes of death are heart disease, cancer, and stroke; these are linked with nutrition in complex ways.

• Older adults feel that good nutrition and exercise are the most important healt habits they can maintain in order to avoid losing autonomy and independence.

Just exactly what is good nutrition for older adults?

• They can meet their decreasing energy requirements by choosing more nutrient-dense foods. They can drink more water to stay hydrated, even when not thirsty. By eating adequate vegetables, fruits, and whole grains, keeping fats in balance, and drink alcohol only in moderation.

• Diet quality is linked to the longevity of older man and women.

• Older adults can live longer and better with good health habits.

What counts as old?

• Many chronological ages have been used as cut-points to mark the beginning of “old age.” while no biological benchmarck signals a person´s becoming old, there are societal and governmental definitions for old. Turning 50 makes you eligible to join the American Association for Retired Persons (AARP). Views on “normal” retirement ages are changing, however. At age 60, many cafeterias, movie theaters, and shops give senior discounts. What counts as “old” depends on who is counting.

• Governmental definitions of old ages include the following categories suggested by the U.S. Census Bureau:

• 64 to 74 years is “young old”

• 75 to 84 years is “aged”

• 85 and older is “oldest old”

Effect of aging in nutritional health

• The decrease of the weight of the people the are older than 65 years old is really common because of the disminution of nutrients intake and having no appetite, this changes could come as a fact.

• Some social aspects of the lie of older adults may contribute to the loss of weight that they have, some of them live alone and this could contribute to the fact of not having meals or not cooking for their own, just for a simple fact, they don´t want to eat alone.

• A huge loss of weight in older people may be a cause of death.

Eating occasions

Eating out• Older aldults eat away from home at a lower rate

than younger persons. Whereas 62-72% of individuals in their twenties consume more than one-third of their calories away from home. For example,the population aged 70 years and older obtains the following percentages of the day´s calories with foods eaten away from home:

• 13-14% of protein• 14-15% of fat• 11-12% of carbohydrate

snacking

• For older adults, snacking is less common than in other age groups. Snack foods do not appear to be nitrien dense. Two-thirds of people aged 70 and older (65% of women, 67% of men) eat snacks that supply 12% of their food energy but only 6-10% of vitamins, minerals, and potassium consumed. Here are the energy nutrien contributions of snacks for this group:

• 7% of protein consumed• 10-11% of fat consumed• 13-14% of carbohydrate consumed

Nutrition and its multiple roles in prevention

• Nutrition as primary prevention: the timing is right to emphasize nutrition in health promotion and disease prevention. Is necessary to pair healthy eating with physical activity.

• Nutrition as secondary prevention: reduces risks and slows the progression of chronic nutrition -related diseases to maintain functionality and quality of life.

• Nutrition ad tertiary prevention: medical nutrition therapy.

In this period we can find some physiologic changes or losses.

• Body composition changes.

• Sedentary lifestyle • Sensory losses: age-

related alterations of smell, taste and touch.

• Oral health: nutrition can be compromised by poor oral health. xerostomia

• Gastrointestinal: dysphagia, aclorhydria.

• Cardiovascular diseases.• Renal diseases.• Neurologic functions• Depression• Pressure ulcers

• Hearing and eyesight: cataract, diabetic retinopahy.

nutrition needs

energy

• Energy requirements generally decrease with age because of changes in body composition, a decrease in the basal metabolic rate, and reduction physical activity.

• Doing an older adult diet could be difficult due to the decrease of need of energy, but the protein, vitamin and mineral requirements remain the same.

• Average caloric intake should be 2000 cal /day for older men.

• 1600 Cal/ day for older women.

• Health problems arise if the diet is only restricted to 1500 Cal/ day, this person should need supplements.

protein

• The protein intake has not changed, some studies have demonstrated that the intake of 1 g/Kg is needed to maintain positive nitrogen balance (Campbell, 1996)

• A protein intake for older adult of 1 to 1.25 is safe (Merck manual of Geriatrics, 2001)

As people age, experience a loss of skeletal tissue mass, stores of protein in skeletal muscle may be inadequate to meet the needs for protein synthesis, making dietary protein intake more important.

carbohydrates

• Abundant carbohydrates are needed to protect protein from being used as a source of energy. Current guidelines recommend 45 % to 60% of the daily calories should come from CHO’s.

• Emphasis should be placed on increasing the intake of complex CHO’s sources such as legumes, vegetables, whole grains, and fruits to provide fiber , phytochemicals, and essential vitamins and minerals.

Lipids• Emphasis should be

paced of reducing the intake of saturated fat and choosing monosaturated or polysaturated fat sources.

Current daily recommendations for lipids say that it should be no more than 25 % to 35%of he total intake of calories.