HSC 4572 – SELECTED PORTIONS OF CHAP 14 – NUTRITION FOR CHILDREN AND OLDER ADULTS Valerie Schulz, MMSc, RD, LD/N, CDE

A few quick items about children  From 12 to 24 months, a child’s diet changes from infant foods consisting of mostly formula or breast milk to mostly modified adult foods.  Children’s fiber intakes should equal their “age plus 5 grams.”  Carbohydrate recommendations are based on glucose use by the brain.  A one-year-old’s brain is large for the size of the body, so the glucose demanded by the one-year-old falls in the adult range.

A little more on children  Children who watch more than four hours of TV a day are least likely to eat fruits and vegetables and more likely to be obese.  The parent must be responsible for what the child is offered to eat, but the child should be allowed to decide how much and even whether to eat.  Don’t bribe or force foods.

The Problem of Lead  More than 300,000 children in the U.S., most under the age of six, have blood lead concentrations high enough to cause mental, behavior, and other health problems.  Older children with high blood lead may be mislabeled as delinquent, aggressive or learning disabled.  Lead poisoning, and children’s average blood lead concentrations have declined dramatically over the past 20 years.  Bans on leaded gasoline, leaded house paint, and lead- soldered food cans have dramatically lowered the amount of lead in the US environment.

Lead exposure decrease  Blood lead in US children

The Later Years  How will you age?  In what ways do you expect your appearance to change as you age?  Will you be independent?

The Later Years  People who reach old age in good health most often: Are nonsmokers Drink alcohol moderately Are highly physically active Maintain a healthy body weight  An estimated 70 to 80 percent of the average person’s life expectancy depends on Lifestyle behaviors  Genes determine the remaining 20 to 30 percent.

Energy and Activity  Cross sections of ??

Energy and Activity  Cross sections of two thighs: On left is an older person who has maintained activity (dark is muscle, light is fat) On right has not kept activity up: less muscle to balance

Protein Needs  Protein needs remain about the same for older people as for young adults.  Choose low-fat, fiber-rich protein foods to help control other health problems.  Beans (both low-fat and fiber rich)  Lean animal tissue (low-fat, choose rest of meal w/ fiber)

Carbohydrates and Fiber  Generous carbohydrate intakes are recommended for older adults.  Those with DM would still have carbs each meal, just more controlled amounts, as we considered  Including fiber in the diet is important to avoid constipation.  Many older people experience constipation for this reason  One they feel constipated, reduces the amount they want to eat, and the cycle continues.

Omega 3 fats & Rheumatoid Arthritis  13 double-blind, placebo-controlled studies involving a total of more than 500 people suggest that omega-3 fatty acids may improve symptoms of rheumatoid arthritis.  One of the ways it appears to work is by decreasing the production of inflammatory chemicals.  Although omega-3 fatty acids reduce symptoms of rheumatoid arthritis, they don’t appear to slow the progression of the disease.

Vitamin Needs  Vitamin A is the only vitamin whose absorption increases with aging.  Vitamin D synthesis declines fourfold, setting the stage for deficiency.  Vitamin B 12 absorption also declines.  Lifelong high intakes of vegetables correlate with less macular degeneration and cataracts.

Water and the Minerals  Dehydration is a major risk for older adults.  Total body water decreases with usual change in body composition (why?) and so dehydration can occur quickly.  What can a person do to stop the “usual” change in body composition?  The thirst mechanism is imprecise and the kidneys are less efficient in recapturing water before it is lost as urine.  In a bedridden person dehydration can lead to pressure ulcers.

Minerals  Zinc deficiencies are also common.  Zinc deficiency can depress the appetite and blunt the sense of taste, leading to low food intakes and worsening zinc status.  When iron deficiency occurs, it is often due to low food intake or other causes.  Calcium absorption declines with age and people fail to consume enough calcium-rich foods.

DETERMINE checklist  Please open the following link  Try to answer two or three of the questions as one of your grandparents, or some person in your life that is >75 years old would answer (you don’t have to write down or turn in)  df df  This checklist is used by many agencies to help determine which older Americans are at nutritional risk