Diet for old age

nutrition

1. PRESENTED BY SREYA.K . R ADHAKRISHNAN 17MSVM 21 M.Sc.BIOCHEMISTRY AND MOLECULAR BIOLOGY DIET FOR OLDAGE

2. CONTENTS WHAT IS THE OLD AGE? SIGNIFICANCE OF PROPER NUTRITION IN OLD AGE THE EFFECTS OF AGING NUTRTIONAL REQUIREMENT NUTRITION RELATED PROBLEMS CONCLUSION REFERENCES

3. OLDAGE

4. WHAT IS THE OLD AGE? “ Old age is a privilege, social success and challenge.” Old age is a process which starts from the prenatal period and continues until the end of life Old is not a disease but a biological process that no one can avoid These are the changes of anatomic structure and physiological functions which take place dependent on time World Health Organization (WHO) defines people of age 65 and above as “old age”

5. According to the progress of the old age and changes in body functions; people between the age group are classified as : 65–74 :“young olds” 75–84 :“old 85 and above :“oldest old”. Nutrition for old age is known as Geriatric Nutrition

6. Geriatrics: The branch of the medicine dealing with health problems of the elderly i.e. delaying the onset of severely degenerating aspects of aging and treating the disease of the aged. Gerontology: Broad area of science concerned with all the psychological, social, economic, physiological and medical problem of elderly.

7. SIGNIFICANCE OF PROPER NUTRITION IN OLD AGE Ageing is an inevitable, irreversible and progressive phenomenon Advancing age is accompanied by progressive physiological changes in functions of most organs As people age, there also tends to be a concomitant increase in chronic conditions such as H ypertension Cardiovascular disease Osteoporosis , diabetes and D ementias

8. Nutrition has emerged as a major modifiable determinant of chronic disease and age related decline As we grow old, certain changes occur in our body, some are visible like graying hair, wrinkling skin, loss of hearing and weak eyesight Several other changes occur internally, which we cannot see Some of these changes influence the diet patterns of the elderly

9. The nutritional needs of the elderly, especially those over 80 years of age, are very different Activity levels decrease and the body's metabolism also slows down So we therefore require less energy and correspondingly smaller quantities of food Even though the elderly need less energy, they need the same amount or even more of vi tamins and minerals Some of these like vitamin E and C are known to have anti ageing benefits as well as protect us from diseases like cancer, heart disease and cataract

10. A liberal use of vegetables and fruits will help to provide these nutrients Loss of teeth with advancing age leads to several dental problems Many elderly are partially or totally toothless C hewing becomes extremely difficult Liquids or soft cooked, mashed foods are preferred by them Such foods may not supply sufficient nourishment and supplements may be necessary

11. The power to digest and absorb food gradually decreases Elderly people commonly complain of heaviness, fullness in the stomach, even gas formation and acidity As we grow older, the pleasure of eating diminishes Food preferences also alter with advancing age This occurs because of a decrease in the sensitivity of the taste buds

12. The ability to perceive tastes like sweet and salty diminishes The taste of food appears bland. The diet should therefore be carefully selected Meals should be made more attractive and appealing by including a variety of foods

13. THE EFFECTS OF AGING PHYSIOLOGICAL CHANGES PSYCHOSOCIAL CHANGES ECONOMIC CHANGES

14. The body’s functions slow with age, and the ability of the body to replace worn cells is reduced The metabolic rate slows Bones become less dense Lean muscle mass is reduced E yes do not focus on nearby objects as they once did, and some grow cloudy from cataracts PHYSIOLOGICAL CHANGES

15. Poor dentition is common The heart and kidneys become less efficient and H earing, taste, and smell are less acute If poor nutrition has been chronic, the immune system may be compromised Osteoarthritis and its debilitating effects are of great concern to the elderly Arthritis can limit the ability to perform activities of daily living (ADLs)

16. Excessive weight, certain vitamin deficiencies, and the type of diet being followed may influence some types of arthritis Digestion is affected because the secretion of hydrochloric acid and enzymes is diminished This in turn decreases the intrinsic factor synthesis, which leads to a deficiency of vitamin B12 The tone of the intestines is reduced, and the result may be constipation or, in some cases, diarrhea

17. ANOREXIA LOSS OF TEETH PHYSCAL DISCOMFERT CHANGE IN BODY COMPOSITION CHANGE IN GASTRO INTESTINAL TRACT CHANGE IN RESPIRATORY FUNCTION

18. Feelings do not decrease with age Age does not diminish the desire to feel useful and appreciated and loved by family and friends Retirement years may not be “golden "if one suffers a loss of self-esteem from feelings of uselessness PSYCHOSOCIAL CHANGES

19. Physical disabilities that develop in the senior years and prevent one from going out independently can destroy a social life Becoming a resident of a nursing home can lead to severe depression. Problems such as these can diminish a person’s appetite and ability to shop and cook.

20. Loss of self-esteem Loss of independence Depression

21. Retirement typically results in decreased income Unless one has carefully prepared for it, this can affect one’s quality of life by reducing social activities Adding worry about meeting bills and Causing one to select a less than healthy diet by choosing foods on the basis of cost rather than nutrient content. ECONOMIC CHANGES

22. NUTRTIONAL REQUIREMENT

23. ENERGY Nutritional requirement change after 30 years After the age of 35 the basal metabolic rate decrease due to reduced muscle mass and other metabolically active tissue mass Reduced physical activity which affects the energy needs

24. Resting metabolic rate decreases approximately 15-20% over the life span, primarily due to the changes in body composition and reduction in physical activity The average body fat percentage in males increases from about 15% when young to 25% at the age of 60 years.

25. Requirement reduces Impaired glucose intolerance can lead to hypoglycemia, hyperglycemia, and type II diabetes mellitus Insulin sensitivity can be enhanced by balance energy intake, weight management and regular physical activity 50 percent energy should derive from carbohydrate Whole grain cereals and pulses should be included in the diet Since caloric requirements are reduced, carbohydrates intake is also reduced. CARBOHYDRATE

26. PROTEIN Decreased in skeletal tissue mass Decrease in store of protein provided by is inadequate to meet the need for protein synthesis Intake of 1.0gm/kg is safe during old age Protein rich food with milk and curd should be included Due to decrease appetite and poor digestion, old people are likely to consume less protein which may lead to edema, anemia, and low resistance to infections Of the total caloric intake 11-12 percent should be from protein.

27. LIPID Dementia and Cardiovascular disease may share risk factors like high intake of dietary total fat Emphasis should be placed on reducing the intake of saturated fat and choosing mono saturated or poly saturated fat sources Sufficient intake of ω-3 fatty acids helps in visual acuity, hair loss, tissue inflammation, improper digestion, poor kidney function and mental depression.

28. MINERALS

29. Elderly are at risk of Vitamin D deficiency due to decreased exposure to sunlight or decrease in renal mass Dietary supplements with calcium and vitamin D improves bone density and prevent fractures People with Parkinson disease have low vitamin D levels. VITAMIN

30. Stress, smoking, and medication can increase vitamin c requirement The antioxidant vitamins such as vitamin E, carotinoids and vitamin c enhances health of elderly Vitamin C may be protective against cataract at an intake level of b/w 150-250 mg/day Vitamin E is potent nutrient for reducing decline in cellular immunity that occur in elderly

31. Changes in immune system can be overcome by taking 200 mg of vitamin E Requirement of vitamin B6 increased due to atrophic gastritis, interferes with absorption Alcoholic and liver dysfunction are additional risk factor for deficiency of vitamin B6 Vitamin B6 have significant role in immune system.

32. Alcoholism is a risk factor for folate deficiency Severe deficiency of folic acid may result anemia and elevated serum homo-cystiene level which is a risk for cardiac diseases Consumption of folate rich food is needed Causes for vitamin B12 deficiency are atrophic and bacterial overgrowth, which decreases absorption and leads to pernicious anemia.

33. The kidney can function more adequately when there is a sufficient fluid(1.5litres) to eliminate the waste solids Water stimulates peristalsis and thus aids in combating constipation W ater can be consumed as in the form of butter milk, fruit juices porridge and soups Some elderly individuals may having a fading sense of thirst and may go long periods without fluid Dehydration may result in mental confusion, headache and instability WATER

34. FIBRE Fibre stimulates peristalsis Rough fibre, bran and mature vegetables are not advised for the aged The fibre of tender vegetables, fruits will make easier the passage of the food mass down the intestinal tract Fibres also help to reduce cholesterol which may reduce atherosclerosis Excess of fibre may reduce the absorption of iron and certain trace elements.

35. NUTRITION RELATED PROBLEMS

36. OBESITY It is higher among elderly Because of more consumption of calorie and sedentary life style Obese are susceptible to diabetes ,cardio vascular disease , arthritis OSTEOPOROSIS Loss in bone density and bone mass Its primarily found in middle age Bone demineralization takes place at faster rate than bone mineralization Bone become porous lighter and fragile

37. DIABETES It increases with age in both male and female The elderly are at a risk of poor nutrition due to economic pressure , reduced mobility , depression loneliness , aging tissues, and inadequate food consumption CARDIO VASCULAR DISEASE Hypertension , acute myocardial infection, congestive cardiac failure is high among elderly

38. CONSTIPATION It is infrequent passes of stools which are more often drier or harder than normal The stools becomes harder and drier because move to slowly through colon The natural contraction and rhythm of colon might be disturbed due to loss of tone , stress medication , illness , resisting the urge of defecate .

39. ANEMIA Inadequate intake of iron causes fatigue , anxiety , lack of energy and sleeplessness C aused by low dietary intake lack of iron or vitamin c or blood loss MALNUTRITION Due to various physiological and socio psychological changes , food intake of the elderly may decreases

40. The elderly are becoming an increasingly large, and their nutritional needs are of growing concern It is becoming apparent that many of the chronic diseases of the elderly could be delayed or avoided by maintaining good nutrition throughout life Most nutrient requirements do not decrease with age, but calorie requirements do CONCLUSION

41. When food habits of senior citizens must be changed, adjustments require great tact and patience on the part of the dietitian Older people are easily attracted to food fads that promise good health and prolonged life.

42. REFERENCES B Sreelakshmi,"Dietetics " ,7th edition,New Age International Publishers . Ruth A Roth, "Nutrition and Diet Therapy"10thedition. Old age period and nutrition, Assistant Professor Emine Aksoydan Baflkent University Faculty of Health Sciences Department of Nutrition and Dietetics. Subhangini a. joshiNutrition And Dietetics,4th edition,Tata Mc Graw Hill Education private Limited, New Delhi

43. THANK YOU