Chapter 16 Adult Nutrition Introduction Topics include nutritional aspects of adulthood from ages 20 to 64 Chapter exploresnutritional needs & guidance aimed at helping meet those needs. Definition of Adulthood in the Life Cycle
Early adulthoodages yrs Involve becoming independent & leaving the parental home In the 20s, planning, buying and preparing food are newly developing skills In the 30s, renewed interest in nutrition for the kids sake Definition of Adulthood in the Life Cycle
Midlifeages 40 to 64 yrs Period of active family responsibilities Managing schedules and meals becomes a challenge Time of reviewing lifes accomplishments & recognition of mortality Definition of Adulthood in the Life Cycle
Sandwich generation the 50s Many are multigenerational caregivers Juggle roles of caring for children and aging parents, while maintaining a career Health concerns frequently are added Chronic disease Managing identified risk factors to prevent diseases Definition of Adulthood in the Life Cycle
Later adulthoodage 65+ Transition to retirement More leisure time greater attention to physical activity and nutrition Food choices and lifestyle factor, especially for those with chronic disease Importance of Nutrition
The span of years between ages 20 and 64 is a time when the future course of health & wellness are influenced by: Diet Physical activity Smoking Body weight Importance of Nutrition
How do food & nutrition enhance life? Nutrition & exercise are among the main lifestyle factors that reduce risk of the onset and severity of 5 of the 10 leading causes of death (See Table 16.1) Cancer Heart disease Stroke Diabetes Liver disease Health Objectives for the Nation
The Health Objectives for the Nation Address multiple goals for adult health improvement Data on dietary goals for disease prevention and health promotion for adults are shown on Table 16.3 A priority of national public health goals is overweight/obesity Health Disparities Among Groups of Adults
Some population groups have a higher prevalence ofchronic diseases than others Some groups have a genetic disposition for certain diseases Genetics and environment interact Physiological Changes of Adulthood
Growing stops by the 20s Bone density continues until 30 Muscular strength peaks around 25 to 30 years of age Decline in size and mass of muscle and increase in body fat Dexterity and flexibility decline Physiological Changes of Adulthood
Hormonal and Climacteric Changes Women Decline of estrogen menopause Increase in abdominal fat Increase in risk of cardiovascular disease & accelerated loss of bone mass Men Gradual decline in testosterone level & muscle mass Physiological Changes of Adulthood
Body Composition Changes in Adults Bone loss begins around age 40 Positive energy balance resulting in increase in weight and adiposity; decrease in muscle mass Fat redistribution- gains in the central & intra-abdominal space, decrease in subcutaneous fat Physiological Changes of Adulthood
Body Composition Changes in Adults Fat redistribution-associated with increased risk of chronic disease Hypertension Insulin resistance Diabetes Stroke Gallbladder disease Coronary artery disease Continuum of Nutritional Status
Nutritional health can be viewed as a continuum from: Healthy and resilient state To: Terminal state body system shut down and life ceases Continuum of Nutritional Status States of Nutritional Health
Resilient and Healthy Metabolic systems in homeostasis Organs are functioning at optimal level Nutritional guidance Encourage adequate intake Not too much, Not too little Mantra: Moderation, variety, and balance States of Nutritional Health
Altered Substrate Availability Early, subclinical state of nutritional harm when intake doesnt meet needs Loss of reserves and/or accumulation of excess-lead to buildup of by-products Dietary guidelines Inform people of common risks Encourage healthful diets & lifestyle choices States of Nutritional Health
Nonspecific Signs and Symptoms Visible changes to insufficient or excessive intakes Recognized risk factors for chronic disease Dietary guidance: Target specific risk factors and observable signs and symptoms Measure and monitor for progress to halt or reverse risk factors for disease States of Nutritional Health
Clinical condition Definite signs and symptoms of illness presentmedical diagnosis Examples: atherosclerosis, cancer, osteoporosis, type 2 diabetes, depression Dietary Guidance Change is difficult Intensive intervention needed (medical nutrition therapy or therapeutic behavior-change programs) States of Nutritional Health
Chronic condition Altered metabolism and structural changes in tissues become permanent & irreversible Examples: structural damage to coronary arteries, invasive & metastatic cancer, loss of kidney function or blindness Dietary guidance: Aimed at managing the condition Preventing further complication Reduce degree of disability optimize quality of life States of Nutritional Health
Terminal Illness and Death Final stage in the continuum Complications advance Body systems shut down Life ceases Estimating Energy Needs in Adults
Estimating Energy Needs Based on BMR+TEF+Activity Basil Metabolic Rate (BMR) Daily BMR expenditure- 60 to 75% for involuntary processes Thermic Effect of Food (TEF) TEF (metabolism of food) ~10% Activity thermogenesis Activity- most variable component is which accounts for 20-40% of total energy needs Estimating Energy Needs in Adults
Doubly labeled water (DLW) Subjects are given a dose of tagged water Excretion of isotopes in saliva and urine is used to calculate average energy utilization over several days Used to determine estimated energy requirements (EER) Estimating Energy Needs in Adults
Indirect Calorimetry Measurement of heat given off and utilized for the bodys metabolic processes Indirect calorimetry determines REE (Resting Energy Expenditure) which is nearly = to BMR The respiratory quotient (CO2 / O2) is used to estimate 24-hour energy expenditure Estimating Energy Needs in Adults
Mifflin-St. Jeor Energy Estimation Formula Validated and more accurate than old Harris-Benedict equation Mifflin-St. Jeor Formula Males: REE = (10 x wt) + (6.25 x ht) (5 x age) + 5 Females: REE = (10 x wt) + (6.25 x ht) (5 x age) - 161 Estimating Energy Needs in Adults
Ballpark caloric levels Simple calculation Weight maintenance = 15 calories per pound Weight loss = 13 calories per pound Weight gain = 17 calories per pound Energy Adjustments for Weight Change
1 lb of body fat = 3500 calories To lose 1 lb a week, an adult would need to create a negative balance of 500 calories per day A combination of decrease intake and increased use (i.e. exercise) is one approach to use A positive balance of just 100 extra calories per day will result in a gain of 10 lbs in a year Nutrient Recommendations
Acceptable Macronutrient Distribution Ranges Fat % of calories Carbohydrate % of calories Protein % of calories Nutrient Recommendations
Dietary Reference Intakes (DRIs) Daily Values (DV) used on nutrition labels Tolerable Upper Intake Levels (ULs) Table 16.5 lists recommended nutrient intakes for adults and shows average intakes based on NHANES data Risk Nutrients Certain nutrients exceed or fall short of recommendations Fiber Choline Vitamin A Calcium Vitamin D Magnesium Vitamin E Potassium Folic acid Sodium B12 Dietary Recommendations
Dietary guidance systems Sets of dietary and lifestyle recommendations Based on latest scientific information Developed to promote health and prevent disease Key components of the U.S. system are the Dietary Guidelines for Americans and MyPlate Dietary Recommendations
Dietary guidance systems Voluntary health organizations make additional science-based dietary recommendations American Cancer Society Nutrition and Physical Activity Guidelines American Heart Association Diet and Lifestyle Recommendations Dietary Recommendations
Dietary guidance systems focus on Consuming greater amounts of Fruits, vegetables, fiber, and low-fat dairy products Limiting saturated fat intake, trans fats More nutrient rich foods, less sugar Keeping sodium low Regular physical activity Energy intake balanced with energy expenditure healthy weight Dietary Recommendations
Total Diet Approach: Use 2010 Dietary Guidelines and MyPlate Enjoy food but choose wisely and eat less Select a variety of foods Get the most nutrition out of their calories Stay within daily calorie needs Consider shifting to a plant based diet Classification of Vegetarians Beverage Intake Recommendations
Recommendations in dietary guidance systems: Consume fewer or smaller portions of beverages containing fats and added sugar Plan beverage intake as part of total calorie intake Make beverage choices that fit into the dairy, vegetable, and fruit groups Alcohol: Food, Drug and Nutrient
~61% if U.S. adults drink alcohol Highest rate is among those ages 25-44 Nations vary on alcohol consumption guidelines U.S. guidelines are If you drink, do so in moderation Alcohol Content of Selected Beverages
A drink contains roughly grams of alcohol or 0.5 oz of ethanol Water Intake Recommendations
AI (Adequate Intake) level for water based on median total water intake Upper level for water intake not set but toxicity can occur Total Water AI for Adults Men liters (125 oz) Women liters (91 oz) Other Fluids Diuretic effects of caffeine
While caffeine does act as a diuretic, the DRI committee concluded caffeine-containing beverages contribute to the total daily water intake Dietary Supplements and Functional Foods
Dietary supplements indicated: Pregnancy Certain illness Low calorie or nutrient restricted diets Dietary Supplements and Functional Foods
Survey data indicate that 44% of adult males and 53% of adult females take vitamin or mineral supplement nearly every day Herbals and botanicals are grouped with dietary supplements Dietary Supplements and Functional Foods
See Table Definition and examples of supplements and functional food categories Functional foods - term used for food products that have a physiological benefit or reduce the risk of chronic disease beyond basic nutritional functions Physical Activity Recommendations
Healthy eating & increased physical activity are the featured duo for combating obesity Any physical activity is better than none Physical activity helps to manage weight and reduce disease risk factors Physical Activity Recommendations
At least 150 minutes/week of moderate-intensity physical activity Table lists current U.S. recommendations Muscle strengtheningactivities2 times a week Physical Activity, Body Composition, and Metabolic Function
Regular physical activity leads to changes in body composition with reduced fat mass and increased lean mass Even without caloric restriction, aerobic physical activity results in decrease of adiposity Promotion of Physical Activity
Healthy People 2020 Objectives Reduce proportion of adults who engage in no leisure-time physical activity Increase proportion of adults who meet federal guidelines for aerobic physical activity and muscle-strengthening activity Physical Activity Reported Diet and Physical Activity
Physical Activity is supported by a general healthful diet Competitive sports may have increased nutrient needs Nutritional ergogenic aids Caffeine Protein powders Sports drinks Energy gels & bars Few improve performance, may be harmful Nutrition Intervention for Risk Reduction
Many types of interventions Individual counseling Multi-component programs Policy and system changes A Model Health-Promotion Program Sisters Together: Move More, Eat Better Public Food and Nutrition Programs
SNAP Government extension programs Meals on Wheels Soup kitchens and shelters for homeless Putting It All Together
Adults need: Variety of healthful foods Knowledge to guide food choices Positive attitudes about food and eating Balance with discipline The message is to follow the principles of variety, moderation, and balance in choosing a diet