Nutrition and Aging


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Determine your personal energy needs by understanding the components of nutrition, learn to make healthier meal choices, and ensure you are getting the proper amounts of nutrients in your diet.

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  • Fat, in the form of fatty acids
  • Trans fat: Snack foods, fast foods MUFA: meats are combo of sat and unsat fats. e.g. beef fat is 50% mufa
  • Certain PUFA cannot be synthesized by the body but are required in small amts in various biological pathways. Essential fatty acids must be obtained from the diet ALA can be converted to EPA and SHA in the body but not efficiently
  • Note that, the narrow yellow band in the graphic represents oils. While oils are needed in the diet as a source of important nutrients (essential fatty acids and vitamin E), they are not considered a food group.
  • Nutrition and Aging

    1. 1. Inova Health System Federal Retiree Association March 16, 2011 Healthy Eating Dr. June Taheri , Inova Internal Medicine – Falls Church
    2. 2. Objectives <ul><li>Determine your personal energy needs </li></ul><ul><li>Understand the components of nutrition </li></ul><ul><li>Gain tools to be able to make healthy meal choices </li></ul><ul><li>Ensuring you are getting the proper amount of each nutrient. </li></ul>
    3. 3. Importance of Healthy Eating <ul><li>Rise in obesity and being overweight in US </li></ul><ul><ul><li>BMI is a proportion of weight to height </li></ul></ul><ul><ul><ul><li>Ideal body weight: BMI 18.5 – 25 </li></ul></ul></ul><ul><ul><ul><li>Overweight: BMI 25-30 </li></ul></ul></ul><ul><ul><ul><li>Obesity: BMI >30 (e.g. 5’2” >164# or 5’10” >209#) </li></ul></ul></ul><ul><ul><li>Waist circumference </li></ul></ul><ul><ul><ul><li>Higher risk for diabetes, HTN, and heart disease if </li></ul></ul></ul><ul><ul><ul><ul><li>> 40 inches in men </li></ul></ul></ul></ul><ul><ul><ul><ul><li>> 35 inches in women </li></ul></ul></ul></ul>
    4. 4. Importance of Healthy Eating <ul><li>Nutrient and Vitamin Deficiencies </li></ul><ul><ul><li>Especially Vitamin D, Calcium, Potassium and Fiber </li></ul></ul><ul><ul><ul><li>Osteoporosis </li></ul></ul></ul><ul><ul><ul><li>High blood pressure </li></ul></ul></ul><ul><ul><ul><li>Potential increased risk for varying cancers including colon and breast cancers </li></ul></ul></ul>
    5. 5. Determining Caloric Needs 2000 1600 2400 2000 > 76 2000 1600 2600 2000 71-75 2000 1600 2600 2000 66-70 2000 1600 2600 2000 61-65 2200 1600 2600 2200 56-60 2200 1600 2800 2200 51-55 2200 1800 2800 2200 46-50 2200 1800 2800 2200 41-45 2200 1800 2800 2400 36-40 2200 1800 3000 2400 31-35 2400 1800 3000 2400 26-30 2400 2000 3000 2400 21-25 2400 2000 3000 2600 19-20 2400 1800 3200 2400 18 Female Active Female Sedentary Male Active Male Sedentary Age
    6. 6. Fat and Cholesterol <ul><li>Fat </li></ul><ul><ul><li>Supply energy </li></ul></ul><ul><ul><li>Transport fat-soluble vitamins </li></ul></ul><ul><ul><li>are precursors to numerous biological pathways that influence inflammation, coagulation, and gene expression </li></ul></ul>
    7. 7. Fat and Cholesterol <ul><li>Saturated Fats </li></ul><ul><ul><li>Associated with increased risk of cardiovascular disease by raising LDL (“bad cholesterol”) </li></ul></ul><ul><ul><li>Due to its molecular makeup, has a high melting point and is solid at room temperature </li></ul></ul><ul><ul><li>Found in: Dairy products, esp. cream and cheese </li></ul></ul><ul><ul><ul><ul><ul><li>Animal fats (fatty meat, lard) </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Plant sources (coconut oil, palm oil, shea nut oil) </li></ul></ul></ul></ul></ul>
    8. 8. Fat and Cholesterol <ul><li>Trans fat </li></ul><ul><ul><li>Associated with increased risk of cardiovascular disease by raising LDL and lowering HDL (“good cholesterol”) </li></ul></ul><ul><ul><li>Produced in small amounts in the rumen of grazing animals </li></ul></ul><ul><ul><li>Majority is produced by hydrogenation </li></ul></ul><ul><ul><li>Found in margarine, shortening </li></ul></ul><ul><li>Mono-unsaturated fatty acids </li></ul><ul><ul><li>Reduces blood cholesterol </li></ul></ul><ul><ul><li>Liquid at room temperature </li></ul></ul><ul><ul><li>Found in olive oil, canola oil, nuts, poultry, avocados, whole milk products </li></ul></ul>
    9. 9. Fat and Cholesterol <ul><li>Polyunsaturated Fatty Acids (PUFA) </li></ul><ul><ul><li>Essential fatty acids </li></ul></ul><ul><ul><ul><li>Linoleic acid (Omega-6) </li></ul></ul></ul><ul><ul><ul><ul><li>Deficiency contributes to dry hair, hair loss, poor wound healing </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Found in vegetable oils (corn, sunflower, safflower, soybean) </li></ul></ul></ul></ul><ul><ul><ul><li>Alpha-linoleic acid (Omega-3) </li></ul></ul></ul><ul><ul><ul><ul><li>Related to a lower risk of cardiovascular disease </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Plant sources (soybean oil, canola oil, flaxseed, walnuts) </li></ul></ul></ul></ul><ul><ul><li>Nonessential Omega-3 fatty acids </li></ul></ul><ul><ul><ul><li>Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA) </li></ul></ul></ul><ul><ul><ul><li>“ Marine oils” - cold water oily fish such as trout and salmon </li></ul></ul></ul>
    10. 10. Fat and Cholesterol <ul><li>Cholesterol </li></ul><ul><ul><li>Important structural component of cell walls in human tissue </li></ul></ul><ul><ul><li>Precursor for many hormones produced by the adrenal glands, ovaries, and testes </li></ul></ul><ul><ul><li>Bile acids used in digestion of dietary fats are synthesized from cholesterol </li></ul></ul><ul><ul><li>Major sources are egg yolks, dairy products and meat </li></ul></ul>
    11. 11. Protein <ul><li>Major structural component of all cells in the body </li></ul><ul><li>Functions as enzymes, hormones, and other important biological molecules </li></ul><ul><li>Made of amino acids </li></ul><ul><ul><li>If amino acids are limited, the body will break down protein to obtain the necessary amino acids </li></ul></ul><ul><ul><li>Essential amino acids cannot be synthesized in the body </li></ul></ul><ul><li>RDA for adults is 0.80 g protein/kg body weight per day </li></ul><ul><ul><li>e.g. 150 lb person would require 54 g of high quality protein/day </li></ul></ul><ul><ul><ul><li>3 oz of lean meat or poultry is approx 25g of protein </li></ul></ul></ul><ul><ul><ul><li>1c milk or yogurt is approx 8 g protein </li></ul></ul></ul><ul><li>Animal sources: meat, fish, milk and egg are highest quality protein </li></ul><ul><li>Plant proteins are more complete if combination of legumes and grains are consumed </li></ul>
    12. 12. Carbohydrates <ul><li>Sugar </li></ul><ul><ul><li>Found intrinsically in fruits, milk, and milk products </li></ul></ul><ul><ul><li>“added sugars” used as sweetener </li></ul></ul><ul><ul><ul><li>Provide calories but insignificant amounts of vitamins, minerals, or other essential nutrients </li></ul></ul></ul><ul><li>Starches </li></ul><ul><ul><li>Most are broken down by digestive enzymes into sugar </li></ul></ul><ul><ul><li>Some are resistant to digestive enzymes (cooked dry beans, peas, pasta) </li></ul></ul><ul><li>RDA = 130 g/day </li></ul>
    13. 13. Carbohydrates <ul><li>Fiber </li></ul><ul><ul><li>Not digestible, passes relatively intact through the bowels </li></ul></ul><ul><ul><li>Helps provide satiety </li></ul></ul><ul><ul><li>Helps regulate bowel movements </li></ul></ul><ul><ul><ul><li>Fermented in the colon to produce gases and bind water </li></ul></ul></ul><ul><ul><ul><li>Short-chain fatty acids are also produced by fermentation and can be absorbed and used as energy for the body </li></ul></ul></ul><ul><ul><li>Present in plants </li></ul></ul><ul><ul><li>High-fiber diets can reduce risk of diabetes, colon cancer, obesity </li></ul></ul><ul><ul><li>RDA = 25g per day </li></ul></ul><ul><ul><li>“good source of fiber” = 10% of the recommend amount </li></ul></ul><ul><ul><li>“excellent source of fiber” = 20% of the recommended amount </li></ul></ul>
    14. 14. 1992 Food Guide Pyramid
    15. 15. 2005 Food Pyramid
    16. 18. Nutrition Facts Label <ul><li>Check serving size </li></ul><ul><li>Values are based on a 2000-calorie/day diet </li></ul><ul><li>Footnote is a reminder of dietary recommendations </li></ul><ul><li>Calcium percentage is based on an average recommendation of 1000mg/day </li></ul><ul><li>Does not distinguish between added sugars and sugars naturally present in foods </li></ul>
    17. 19. Organic Foods <ul><li>Organic label </li></ul><ul><ul><li>A food’s total plant and animal ingredients must be at least 95% organic </li></ul></ul><ul><ul><li>Free of artificial food additives </li></ul></ul><ul><ul><li>Processed with fewer artificial methods such as chemical ripening, food irradiation, and genetically modified ingredients </li></ul></ul><ul><ul><li>The pesticides that are used are not synthetic </li></ul></ul><ul><li>Natural does not = Organic </li></ul>
    18. 20. Organic Foods <ul><li>Noted benefits </li></ul><ul><ul><li>Higher level of nutritionally desirable compounds including vitamins, antioxidants, poly-unsaturated fats </li></ul></ul><ul><ul><li>Lower levels of undesirable compounds such as heavy metals and pesticide residues </li></ul></ul><ul><ul><li>Subjectively, better taste </li></ul></ul><ul><li>Drawbacks </li></ul><ul><ul><li>Higher price </li></ul></ul>
    19. 21. Supplements <ul><li>Vitamin B12 </li></ul><ul><ul><li>Intake is usually adequate but ability to absorb natural Vitamin B12 decreases with age </li></ul></ul><ul><ul><li>Foods fortified with Vitamin B12 (crystalline form) are better absorbed </li></ul></ul><ul><li>Calcium </li></ul><ul><ul><li>Age 51+ should be getting at least 1200mg calcium daily </li></ul></ul><ul><ul><li>Food sources of calcium (Calcium phosphate) are better absorbed </li></ul></ul><ul><li>Vitamin D </li></ul><ul><ul><li>RDA = 600 IU (15mcg) daily for most adults </li></ul></ul><ul><ul><li>800 IU (20mcg) daily for adults 70+ </li></ul></ul>
    20. 22. Medications and foods <ul><li>Statins (e.g. simvastatin, Lipitor, Crestor) </li></ul><ul><ul><li>avoid grapefruit juice which reduces the body’s ability to metabolize the medication </li></ul></ul><ul><li>Ace inhibitors or Angiotensin Receptor Blockers (e.g. lisinopril, enalapril, losartan, Diovan) </li></ul><ul><ul><li>Be careful of too much potassium in the diet </li></ul></ul><ul><li>Diuretics (e.g. furosemide, Lasix, Hydrochlorothiazide (HCTZ)) </li></ul><ul><ul><li>May need more potassium in the diet </li></ul></ul><ul><li>Warfarin or Coumadin </li></ul><ul><ul><li>Be consistent with Vitamin K intake </li></ul></ul><ul><li>Proton Pump Inhibitors (e.g. omeprazole, Prilosec, Prevacid) </li></ul><ul><ul><li>Calcium intake may need to be increased. Calcium citrate is the preferred supplement over Calcium Carbonate. </li></ul></ul>
    21. 23. Key Points <ul><li>No drastic changes </li></ul><ul><li>Moderation is key </li></ul><ul><li>Seek out nutrient-dense foods </li></ul><ul><ul><li>Lean or low in solid fats without added sugars, solid fats, starches, or sodium and retain fiber </li></ul></ul><ul><ul><li>e.g. all vegetables, fruits, whole grains, fish, eggs, and nuts prepared without added solid fats or sugars </li></ul></ul><ul><li>Reduce sodium intake </li></ul>
    22. 24. Locations <ul><li>Inova Family Medicine - Ashburn </li></ul><ul><li>Inova Family Medicine - Chantilly </li></ul><ul><li>Inova Internal Medicine - Falls Church </li></ul><ul><li>Inova Internal Medicine - Mark Center </li></ul><ul><li>Inova Internal Medicine - Old Town </li></ul><ul><li>Inova Family Medicine - Springfield </li></ul><ul><li>Inova Internal Medicine - McLean </li></ul>