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Nutrition and Fitness for the Elderly

Dr Zubeda Tumbi MSc PhD (Clinical Nutrition)

Factors affecting Nutrition of elderly

• Loneliness• Physical Disability• Lack of knowledge about cooking.• Lack of financial resources• Chronic illnesses• Mental Disturbances• Social problems.

• Ageing – Biological process involving cellular & physiological deterioration,↑ risk to diseases, ↓ability to adapt to stress – impaired homeostasis

• In ageing, emphasize on nutrition for health promotion and disease prevention.

• Ageing – Reflects sum total of care, use/misuse and neglection of body in youth or middle age of life.

• Important to seek ways to improve diet –• take help from family, friends, community services.

Physiological changes

• Disease and impaired function are not inevitable parts of aging which results in varying degrees of efficiency and functional decline.

• Factors - genetics, illnesses, socio-economics and lifestyle all determine how aging progresses in each person.

Sensory losses

• Age related alteration to the sense of taste, smell and touch can lead to poor appetite, inappropriate food choices and lower nutrient intake.

• Although some degrees of Dysgeusia(loss of taste) and hyposmia (decreased sense of smell), are attributable to aging, many changes are due to medications.

Other causes- Impairement of health \Quality of Life DiabetesLiver and kidney disease Hyper tensionNeurological conditions – Alzheimer's and

Parkinson's.Zinc or niacin deficiency.Untreated mouth sores, tooth decay, dental or nasal

hygiene, and cigarette smoking.

Gastrointestinal

• GI changes negatively impact a persons nutrient intake starting in the mouth.

• Decreases in taste sensation and saliva production makes eating less pleasurable and more difficult.

• Gastric changes affects a persons ability to eat.• Decrease gastric mucosa leads to an inability to

resist damage such as cancer, ulcers and infections.• Gastritis causes inflammation and pain, delayed

gastric emptying, discomfort.

• Decreased bioavailability of nutrients and increase risk of developing

• Chronic deficiency disease – like Sarcopenia ,osteoporosis. • Achlorhydria – decreased stomach acid

production - ↓ Calcium and Iron absorption. • Decline in acid can be due to age as well as

astrophic gastritis.

Immune System

• Adequate intake of protein, energy, Vitamin A,C,E and nutrients like copper, zinc, iron prevent infections and speed up healing process.

• Poor nutrient intakes impairs immunity, reduces healing capacity and ↑ chances of infection.

Nutritional DeficienciesCommon Indicators Involuntary Weight loss Abnormal BMI - Obesity Undernutrition ↓ Dietary intake Deficiencies of specific micronutrients –Fe ,calcium,

Vit D, Vit B12, protein and essential fatty acids.• Presence of morbidity- ↑ Diabetes and Heart disease• risk of malnutrition -Wt loss –> muscle mass ↓.

Body Composition changes

• Body composition changes with aging• Fat mass and visceral fat ↑, whereas lean muscle

mass & bone density ↓. • Sarcopenia, the age-related loss of muscle mass,

strength, and function, impact quality of life by ↓ mobility, ↑ risk for falls, & altered metabolic rates.

• Sarcopenia – begins in 4th decade of life but rate of muscle > after 75yrs of age.

• Fat : Muscle Ratio ↑

Complications• Reduced recovery from surgery, illness or disease.• Increased susceptibility to illness and infection.• Impaired wound healing.• Increased risk for falls and fractures.• Loss of physical strength and energy.• Reduced ability to walk, climb stairs, rise from a chair.• Loss of independence.• Increased mortality.

Decline in bone density with age

choosing healthy meals as you get older

Making healthy food choices is a smart thing to do—no matter how old you are! Your body changes through your 60s, 70s, 80s, and beyond. Food provides nutrients you need as you age. tips to choose foods for better health at each stage of life.

• By adopting sensible dietary and physical activity habits, you can enjoy the rewards of a longer, healthier life. Take it one step at a time

• Seek out support, build on your successes and enjoy the benefits you’ll receive from doing positive things for your health.

• These two steps alone will help reduce your disease risk. Together they also help you to maintain a healthy weight – perhaps the most important factor in disease prevention.

How many calories do adults over 50 need?

Use the following as a guideline:Not physically active needs about 1600 calories a dayA woman over 50 who is:•Somewhat physically active needs about 1800 calories a day•Very active needs about 2000 calories a dayA man over 50 who is:•Not physically active needs about 2000 calories a day•Somewhat physically active needs about 2200-2400 calories a day•Very active needs about 2400-2800 calories a day

Eating Well Promotes Health

Eating a well-planned, balanced mix of foods every day has many health benefits. For instance, eating well may reduce the risk of heart disease, stroke, type 2 diabetes, bone loss, some kinds of cancer, and anemia. For those with one or more of these chronic diseases, eating well and being physically active may help you better manage them. Healthy eating may also help you reduce high blood pressure, lower high cholesterol, and manage diabetes.Eating well gives you the nutrients needed to keep your muscles, bones, organs, and other parts of your body healthy throughout your life. These nutrients include vitamins, minerals, protein, carbohydrates, fats, and water.

Dietary guidelines • Give Small frequent , nutrient dense meals. Nourishing, easy to chew and swallow foods & beverages

preferred. Eg- shakes, yogurts, pancakes, idlis, • Ensure 4-5 servings of fruits and veggies. • Avoid fried foods Add full cream dairy products- easily digestible, ↑ Energy and calcium content.• Include natural fiber sources- whole grains, fruits, veges-

reduces constipation and control blood sugar levels• Regular & adequate water intake – maintain body temperature

, functioning of digestive system & to avoid dehydration.

Good Food-Quality of LifeLive longer and stronger – Good nutrition keeps muscles, bones, organs, and other body parts strong for the long haul. Eating vitamin-rich food boosts immunity and fights illness-causing toxins. A proper diet reduces the risk of heart disease, stroke, high blood pressure, type-2 diabetes, bone loss, cancer, and anemia. Eating sensibly means consuming fewer calories and more nutrient-dense foods, keeping weight in check.Sharpen the mind – Key nutrients are essential for the brain; eat a selection of brightly colored fruit, leafy veggies, and fish and nuts packed with omega-3 fatty acids to improve focus and decrease risk of Alzheimer’s disease. Regular consumption of antioxidant-rich green tea may also enhance memory and mental alertness as one ages.Feel better – Wholesome meals - more energy make you look better, better self-esteem Feels good ; happier inside and out.

Did you know…? the senses of taste and smell decline with age?

Medications can also affect how food tastes. As the senses get duller, food can start to

lose its flavour and appeal.

To give foods a boost: • Vary the texture and temperature of foods at one meal. Ex : top smooth low-

fat yogurt with crunchy cereal. Enjoy a cool fruit salad following a hot and spicy sauce

• Use colour to maximize eye appeal. Add red and yellow pepper strips to a mixed green salad; sprinkle red cabbage or green mint on white potatoes; create a rainbow fruit salad with red and green grapes, melon chunks, strawberries pomegranate, .

• Intensify the flavour-. Use seasonings, spices and herbs instead of salt and fat . As an added bonus, herbs and spices contain health-protective phytochemicals.

• To start, use 3⁄4 tsp of fresh herbs or 1⁄4 tsp dried per serve

• Choose mostly plant foods, limit red meat and avoid processed meat.

• Prevention Is Possible if You desire to improve your health and reduce your risk for heart disease, type 2 diabetes and osteoporosis.

• If you already suffer from these diseases, or even from cancer,• you can help lessen their hold on your health. • It’s often a matter of the choices you make.

CHOOSE LEAN PROTEINS

Go Easy on Red Meat and Fats limit the amount to 200g per week. Too much red meat ( beef, lamb and pork) and processed meat ( ham, bacon, sausage, salami ) can ↑ risk for colorectal cancer. Saturated fat in animal products - meat, milk, cheese, eggs, butter and lard -being high in calories leads to weight gain, & increases the risk of colorectal, endometrial, postmenopausal breast, pancreatic, kidney and esophageal cancers. Obesity↑ risk heart disease, type2 diabetes & high blood pressure. Eating healthy fat is important for health – as vegetable oils-rice bran ,til ,olive ,groundnut or canola, are best choices being high in monounsaturated fat and low in saturated fat. They contain no cholesterol. Omega-3 fatty acids, in fish flaxseeds, are also healthy fats.

10 Tips To Make Food Enjoyable

• Drink plenty of liquids With age, you may lose some of your sense of thirst. Drink water often. Low fat or fat-free milk or 100% juice also helps you stay hydrated. Limit beverages that have lots of added sugars or salt.

• Meals are more enjoyable when you eat with others. Invite a friend to join you or take part in a potluck at least twice a week. A senior centre or place of worship may offer meals that are shared with others.

• Plan healthy meals .Get advice on what to eat, how much to eat, and which foods to choose, all based on the Dietary Guidelines for Indians.

• Find sensible, flexible ways to choose and prepare tasty meals so you can eat foods you need. know how much to eat ;

• Learn to recognize how much to eat so you can control portion size. • When eating out, pack part of your meal to eat later. One restaurant dish might be enough

for two meals or more.• Vary your vegetables Include a variety of different colored vegetables to brighten your

plate. Most vegetables are a low-calorie source of nutrients and good source of fiber.

•Eat for your teeth and gums, People with dental problems sometimes find it hard to chew fruits, vegetables, or meats. •Eating softer foods can help not to miss out on needed nutrients! . Try cooked or canned foods like unsweetened fruit, low-sodium soups, or canned tuna. •use herbs and spices Foods may seem to lose their flavour as you age. •If favourite dishes taste different, Maybe your sense of smell, sense of taste, or both have changed. Medicines may also change how foods taste. Add flavour to your meals with herbs and spices. •ask your doctor about vitamins or supplements Food is the best way to get nutrients you need.• Should you take vitamins or other pills ,Some can interfere with your medicines or affect your medical conditions.

Avoid Food-Borne Illness: Precautions

• Refrigerate promptly. Keep Temperature below 40°F. •Perishable foods not to sit at room temperature for than 1- 2 hour in hot weather. •Store groceries or leftovers quickly in the refrigerator or freezer. • Thaw frozen foods by a safe method: in the refrigerator, in the microwave or in a cold water in which water is changed every 30 min. • When refrigerating leftovers, it is a good idea to mark the date and use them within one to two days.• Food may look or smell fine yet still not be safe to eat. If in doubt, throw the food out.• Wash cutting board with hot, soapy water \ rinse in tsp chlorine bleach water

Get Active Why exercise?•Physical activity at any age: burns calories • increases your energy level • helps relieve stress and depression • helps you sleep better • improves your strength, flexibility and balance; •regular physical activity helps prevent colon cancer & post-menopausal breast & endometrial cancers.• Physical activity can help to prevent weight gain, overweight or obesity.•Being active also helps prevent heart disease, type 2 diabetes and osteoporosis.•Finding a way to be active is essential• Being physically active for 30 minutes or more a day keeps you at a healthy weight throughout life.

DR KRISHANKANT CHATURVEDI (77 YRS)

Health ProblemsObesityHypertensionHigh cholesterolDiabetesGoutHypo Thyroid

Reduced↓uric acid reduced to 4.7mg/dl↓ Triglycerides reduced to 96.3mg/dl↓ Cholesterol reduced to 274mg/dl

MRS.NEETA VIJAY PATKI ( 57yrs )Health ProblemsObesityHypertensionHigh cholesterolDiabetesGout

Reduce↓Weight loss(119 to 70kgs ) (50kg-1yrs)↓ uric acid reduced to3.4mg/dl↓ Triglycerides reduced to 118mg/dl↓ Cholesterol reduced to 152mg/dl

Use These Tips To Help You Reach A Healthy Weight: • Set yourself up for success. Fill your fridge and cupboards with mostly plant-based foods. Keep nutritious foods such as vegetables, fruits, whole grains and beans where they are easy to find. Keep higher-calorie treats out of sight or, better yet, out of the house. • Pay attention to portion sizes. Eating too much of anything – even low-fat or fat-free foods – can affect your weight. Find serving size information on the Nutrition Facts panel of a food label. Get out your measuring cups and see what one portion looks like on your plate. • Go for no starchy vegetables. Use them to replace some of the meat in mixed dishes like casseroles, stir-fries and soups and in dishes that are mostly pasta or potatoes.• Cut down on fat. Fat is high in calories. Try lower-fat versions of higher-fat foods, such as dressings, spreads, milk and cheese. Be aware, however, that low-fat or fat-free products may contain added sugar for flavour, so calorie levels may still be high. Read the nutrition labels of the foods you choose. If you eat meat, make sure it’s lean. Discard the skin from poultry. Sauté vegetables in minimal oil or use broth, water or cooking spray to cut fat. • Drink up. A glass of reduced-sodium tomato juice or cup of broth-based soup before your meal may help you feel less hungry when your entrée is served. Also, all adults should aim for at least eight glasses of water or other non-alcoholic fluid daily.

• Enjoy what you eat. Eat slowly and savor every bite. Eating healthfully can please not only your palate but also your eye with beautiful colours and your sense of smell with delicious fragrances. • Keep active to help burn calories and stay healthy