1. Nutrition and the Aging Adult
Jamie Pope, Steve Nizielski, Alison McCook
NUTRITION
for a Changing World
FIRST EDITION
Chapter 21
Nutrition and the Aging Adult
Live Long and Prosper
© 2016 by W. H. Freeman and Company and Scientific American

2. Chapter 21
Objectives
Discuss at least four age-related physiological changes
Describe changes in the age structure of the population in the United States in the next 25 years
Explain how skeletal muscle is needed to heal from illness and injury, the benefits of maintaining adequate muscle mass, and the benefits of exercise
Discuss how physical, psychological , economic, and social factors may influence the ability of the aging adult to achieve the recommended nutrient intake
Describe three nutrition-related conditions that are common in older adults, their precipitating factors, and potential consequences
Identify at least five nutrients of concern in the aging adult and describe ways to obtain adequate intake of these nutrients
Identify lifestyle dietary characteristics that may delay the onset of age-related disease

3. Live Long and Prosper Longevity
Leonard Nimoy lived seven years beyond the average life expectancy for a man in the United States
Research for secrets to a longer life
Leonard Nimoy, known for his role as Mr. Spock on Star Trek, died in February 2015 at age 83. Mr. Spock as part Vulcan in the movie ate vegetarian diets and lived to be 200 hundred years old; hence the traditional salute “Live long and prosper.” Though science fiction, the secrets for longer life are a real focus of research.

4. What happens when we age?
Aging
Changes in cells and tissues
Increased risk of disease and death
Physiological changes
Cardiovascular system
Renal system
Musculoskeletal system
Nervous system
Respiratory system
Gastrointestinal system

6. Theories of Aging Programmed theories Damage or error theories
Programmed longevity
Endocrine theory
Immunological theory
Damage or error theories
Free radicals
Protein cross-linking
DNA damage
Epigenetic changes to DNA
Programmed theories: contend that aging follows a biological timetable
Programmed longevity: the switching on and off of specific genes that leads to aging
Endocrine theory: age-related alterations in the regulation of the endocrine system control the rate of aging
Immunological theory: suggests that the immune system is programmed to decline over time which causes increased vulnerability to disease
Damage or error theories: suggest that aging is caused by an accumulation of molecular and cellular damage
Free radicals: cause oxidative damage to proteins, lipids, and DNA
Protein cross-linking: impairs protein function
DNA damage: results in mutations that cause cells to malfunction
Epigenetic changes to DNA: alters patterns of gene expression

7. Life Expectancy and Lifespan
Average number of years individuals in a specific population are expected to live
Increased dramatically over the twentieth century
Lifespan
Span of time between birth and death for an individual
Modest gains in lifespan over the last century
Life expectancy: number of years a person can be expected to live based on the statistical average; for men in the United States it is 76.4 years and for women it is 81.2 years.
In 1900 life expectancy for a man was 46 years. The greatest difference between then and now is the change in the frequency of infant mortality with less children dying as a result of infectious and communicable diseases.
Lifespan: number of years that any particular individual lives. The maximum number of years that any known person has lived is 122 years. Her name was Jeanne Calment; she lived in France and died in Since the 1900s, lifespan has increased about nine years for women and five years for men.

8. The Aging U.S. Population
During the next 25 years, the population of Americans 65+ years old will double
Longer lifespans
Aging baby boomers

9. Factors that Influence Lifespan
Disease
Heart disease
Cancer
Diabetes
Subtle influences
Education
Race
Socioeconomic status

10. Blue Zones Areas with increased longevity
Have a higher number of individuals who live to be at least 100 years old
Also include Seventh-day Adventist communities

11. Seventh-day Adventist Community
Live longer on average
Men, seven additional years
Women, four-and-a-half additional years
Several key behaviors and lifestyle choices
They don’t smoke
They rarely drink alcohol
Many are vegetarians or vegans
Research on this group shows it is not genetics and that nutrition plays a big role.

12. Energy Needs and Physical Activity
Energy needs decrease
Less physically active
Reduced activity leads to sarcopenia
Physical activity can offset losses in muscle mass
Other nutrient needs remain similar to younger adults
Need more nutrient-dense foods

13. Active Aging

14. Special Nutritional Concerns
Challenges making older adults vulnerable to malnutrition
Olfaction: decline in sense of smell
Gustation: decline in sense of taste
Loss of teeth
Periodontal disease
Effect of medications on appetite and nutrient absorption
Drug/nutrient interactions
Age-related gastrointestinal changes
Socioeconomic factors
Psychological factors

15. Common Nutrition-Related Conditions in Older Adults

16. Nutrient Recommendations for Seniors

17. Nutrient Recommendations for Seniors

18. Nutrient Recommendations for Seniors
Decreased absorption in the intestine
Can lead to cognitive impairment

19. Nutrient Recommendations for Seniors
Decreased absorption in the intestine
Can lead to cognitive impairment

20. Nutrient Recommendations for Seniors
Protein
With resistance exercise, higher protein intake may improve functionality
Consumption of plant proteins emphasized

21. Nutrient Recommendations for Seniors
Fluids
Added emphasis on getting enough
Many older adults experience:
reduced thirst sensation
increased fluid loss
difficulty meeting requirements
Recommendations the same as for adults, but risk of dehydration adds emphasis on getting sufficient amounts

22. Nutrient Recommendations for Seniors
Beneficial nutrients in some cases
Zinc
Supportive role in immunity
Omega-3 fatty acids
May reduce symptoms of rheumatoid arthritis
May slow the progression of age-related macular degeneration
May reduce the risk of Alzheimer disease

23. Best Diet to Delay Age-Related Disease
Sufficient but not excessive calories
Low in saturated fat
High in whole grain cereals, legumes, fruits, and vegetables

25. Clues for Longevity from Studying Adventist Lifestyle
Associated with clear benefits to longevity
Being physically active
Eating lots of nuts
Being vegetarian
Having a healthy BMI

26. Clues for Longevity from Studying Adventist Lifestyle

27. Maintaining Physical Strength
Staying active and maintaining adequate skeletal muscle mass crucial for health

28. Other Blue Zone Secrets
Nutrition
Legumes and nuts
Activity
Psychosocial factors
Social connectedness
Having a plan or purpose

29. Summary
Nutrition and physical activity play key roles in maintaining health and preventing chronic disease, as well as in potential longevity and quality of life, in the aging adult.
There are physical, psychological, social, and economic factors that can influence and potentially compromise the dietary intake and nutritional status of the older adult.
Energy needs in older adults generally decline because of decreased physical activity and metabolic rate; however, nutrient needs do not decrease (they may even increase), making it especially important to consume nutrient-dense foods.
Age-related changes in body composition and body fat distribution occur to varying degrees, but physical activity helps offset losses in skeletal muscle mass (sarcopenia).
Age-related gastrointestinal changes may occur, including the bacterial composition of the gut, diminished gastric acid secretion, and slower motility in the small intestine.

30. Summary (cont.)
Nutrients of concern in older adults due to diminished intake or possible changes in absorption and utilization include protein, calcium, vitamin D, vitamin B6, vitamin B12, folate, iron, zinc, fiber, and omega-3 fatty acids.
Although fluid requirements are the same for older adults, the risk of dehydration is higher than in younger adults due to diminished thirst sensation, increased fluid losses, and side effects of certain medications.
Poor nutrition and physiological changes with advanced age, along with possible depressed immunity and a decreased ability to fight and recover from illness, surgery, or infection, can lead to suboptimal nutritional status or even malnutrition.
Nutrient inadequacies may contribute to cognitive decline with age. In addition, some studies show that certain dietary nutrients, like omega-3 fatty acids and some phytochemicals, may reduce the risk of dementia.
Based on current research, the best diet to delay age-related disease onset avoids excess calorie intake and is low in saturated fat and high in whole grains, legumes, nuts, fruits, and vegetables.