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Nutrition, Weight, and CAM for Aging
- 1. CHAPTER 5 Nutrition, Weight Management, and Aging POWERPOINTS TO ACCOMPANY 1 2 Food guide pyramid to MyPlate No distinctions within food categories Nutrition bull’s-eye Includes distinctions within food categories Can be personalized Food Guide Pyramid 3 Nutritionism versus eating whole food Basic categories of nutrients Carbohydrates Fats Proteins Fiber Water
- 2. Vitamins Minerals Good Nutritional Habits 4 Trans fat banned Increased risk of heart disease and diabetes Mediterranean diet—high fat, yet healthy Unsaturated fats Monounsaturated fats Polyunsaturated fats Polyunsaturated fats: omega-3 versus omega-6 Saturated fats converted into low-density lipoproteins Fat 5 Complex carbohydrates and fibers Refined carbohydrates and simple sugars Unrefined whole grain kernels contain germ and protective bran coating Vegetables and fruits Carbohydrates
- 3. 6 Fructose, glucose, dextrose, maltose, etc. Added sugars versus natural sugars Hidden sugars Sugar consumption Americans consume more than double the recommendation Low-fat food trend correlated with increased sugar intake Sugar 7 Forms antibodies Contain eight essential amino acids Vegetables as a healthy source Recommended consumption 12% to 20% of total calories Older, ill adults most likely to experience deficiency Protein 8 Reduced thirst perception with aging can lead to inadequate hydration Effects of dehydration Symptoms Development of diseases Additional hospital days
- 4. Water 9 Meeting hydration needs Water, juice, and milk Foods 80% of many fruits and vegetables 50% of meat One-third of bread More modestly hydrating fluids: coffee, carbonated beverages, but not alcohol Water—cont’d 10 Vitamins Growth, digestion, alertness, and infection resistance Minerals Regulate cell function; provide cell structure Recommended Dietary Allowance (RDA) Difficult to establish Changing requirements with age Age-related classifications still too few and too broad Vitamins and Minerals
- 5. 11 Keeps muscles and nerves working properly Attracts water to retain body fluid Consumption Average: 3,400 mg/d Recommended: 2,300 mg/d Sodium sensitivity increases with age Debate over target for some at-risk individuals Sodium 12 Challenges meeting recommendations Processed foods Restaurant foods Benefits of sodium reduction National Salt Reduction Initiative Sodium—cont’d 13 1993 Nutritional Labeling and Education Act Proposed label changes in near future Serving size changes, note added sugars, and other recommendations Food rating systems Affordable Care Act Restaurants with 20+ locations post calorie counts 83% of restaurant diners want information posted Nutrition Labels
- 6. 14 Serious problem among those age 75+ Undernourished Malnourishment Risks for malnourishment for older adults Consume fewer fruits and vegetables Greater propensity to select easily prepared foods Loneliness, bereavement, and social isolation Difficulty preparing meals Loss of appetite due to disease and medication Malnutrition 15 Organic food movement Pesticides and chemical fertilizers Hormones, antibiotics, and artificial preservatives Bioengineering and synthetic ingredients Humane treatment of animals Up to six cups of coffee a day o.k. for fluid intake Spices (not salt or sugar) added to compensate for decline in taste (enhances smell) Nutrition 16 Fast food restaurants U.S. Preventive Services Task Force (USPSTF)
- 7. Screen all adults for obesity Offer behavior counseling to obese adults Obesity most prevalent among low-income minority women Metabolism slows with age Trends in Weight Gain 17 Standard gauge of weight status: body mass index (BMI) Method Weight (lb) x 700 ÷ height (in.) ÷ height (in.) Shortcomings associated with age Underestimates excess body fat What to do about 2‒3 inches in age-related height loss BMI versus waist-to-hip ratio Measuring Overweight and Obesity 18 Morbidity and mortality Overweight: longevity versus quality of life Obesity shortens life expectancy Medical costs for excess weight far exceed costs due to smoking Measuring Overweight and Obesity—cont’d 19 Genetics: family history increases risk of becoming obese by
- 8. 25% to 30% Environment Lifestyle Focus on what you can eat, not what you cannot Do not deny yourself favorite foods Avoid high-risk and emotional eating Incorporate weekly exercise Seek outside help Genetics and Lifestyle 19 20 Overweight in midlife Increases morbidity and physical/mental decline later Obesity and morbidity/mortality Sarcopenia Body composition Hydrodensitometry Skinfold caliper Bioelectrical impedance Bod Pod Weight Gain and Body Composition 20 21 Diets Low-carbohydrate, high-protein, high-fat Weight Watchers, behavior modification
- 9. Religion-based and other odd diets Bariatric surgery Modifies GI tract “10 Tips” model for weight loss Diet drugs Diets, Drugs, and Surgery 21 22 Plan meals and snacks Put needed food on plate without seconds Select foods that satisfy Rehearse response to stimulating food offers Recognize emotions Remove image of trigger food Six Steps to End Overeating 22 CHAPTER 6 Complementary and Alternative Medicine and Aging 1 POWERPOINTS TO ACCOMPANY
- 10. 1 2 Allopathic medicine Alternative medicine Complementary medicine Integrative medicine National Center for Complementary and Integrative Medicine (NCCIM) 2 3 Visits to CAM providers exceed primary care physician visits Highest amount of CAM usage is by boomers Ages 56 to 74 (in 2020) Half of patients neglect to communicate CAM usage to physicians Danger of dietary supplements interacting with prescribed or over-the-counter medications Prevalence and Barriers 3 4 National Institutes of Health’s definition focuses on what CAM is not Three categories
- 11. Mind–body medicine Manipulative and body-based therapies Energy therapies Nutrition and exercise no longer CAM But inadequate guidance and motivation Types of CAM 4 5 Diaphragmatic breathing Progressive muscle relaxation Visualization Relaxation response, meditation, and mindfulness Acupuncture Therapeutic massage Popular CAM Techniques 5 6 Chiropractic Hypnosis Biofeedback Magnet therapy Aroma therapy Laughter Popular CAM Techniques—cont’d 6
- 12. 7 Naturopathy Naturopaths complete 4 years in a medical college and take national licensing examinations More inclined to try alternative treatments Not recognized by Committee on Medical Education Drs. Weil, Chopra, and Oz Two-thirds of HMOs cover one form of CAM Chiropractic (65%) Acupuncture treatments (19%) CAM Practitioners and Insurance 7 8 Use caution Phytochemicals versus supplements Interactions with medications 1994 Dietary Supplement Health Education Act (DSHEA) Eliminated premarket safety evaluations Allowed advertisers to make unproven claims Lack of purity regulation No check on discrepancies between label and actual content Dietary Supplements 8 9
- 13. Multivitamins Discredited research No evidence to support routine use Calcium and vitamin D No longer routinely recommended Concern with kidney stones Vitamin D fad Vitamin E Does not reduce risk of cancer or heart disease Vitamin and Mineral Supplements 9 10 Antioxidants Vitamin E, vitamin C, and beta-carotene Mostly ineffective May stall cataract growth and macular degeneration Vitamin B12 deficiency Lack of absorption with aging Vitamin and Mineral Supplements—cont’d 10 11 Basis for aspirin, morphine, digitalis, and other medicines Over-the-counter access Ginkgo biloba’s memory improvement claims Ginseng, garlic, and ginger
- 14. Anticoagulants (increased risk of bleeding) Herbs 11 12 St. John’s wort Most popular antidepressant in Germany Interacts with a wide range of medications Saw palmetto and echinacea: Placebos? Black cohosh Not effective at alleviating menopausal symptoms Except as a placebo for some women Herbs—cont’d 12 13 Muscle mass begins declining by age 30 Hormone supplements may contribute to Carpal tunnel syndrome Edema Joint and muscle pain High blood pressure Congestive heart failure Tumor growth Worsen effects of arthritis and diabetes Human Growth Hormone (HGH) 13
- 15. 14 Testosterone and HGH Popular with some men for gaining muscle strength Only beneficial to those with a deficit Increased risk of heart attacks and stroke Melatonin and the sleep cycle Limited empirical support for improving sleep Or for jet lag No empirical support for Valerian Hormone Supplements 14 15 Glucosamine and chondroitin Omega 3 fatty acids versus EPA Coenzyme Q-10 CBD Nutritional drinks Other Dietary Supplements 15 16 ConsumerLab.com Subjects supplements to laboratory analysis and posts results for subscribers
- 16. Not uncommon for product labels to be inaccurate Does not evaluate benefits Nutraceuticals Exploit nutritionally weak foods ConsumerLab.com and Nutraceuticals 16 16