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Nutrition in Ageing
The Older Population
The aged population is presently at its peak globally. The percentage of older people (aged 60 years or over) worldwide increased from 9.2 per cent in 1990 to 11.7 per cent in 2013 and will continue to grow as a proportion of the world population, reaching 21.1 per cent by 2050. The number of aged people is expected to double, from 841 million people in 2013 to more than 2 billion in 2050. History is going to be created in 2047 where older people are projected to exceed the number of children[SS1] . The number of people aged 80 and above was 14 percent in 2013 and is projected to reach over 19 percent in 2050.
Classification
The generic definition of ‘old’ as someone with grey hair, wrinkles and retired is outdated now. The youth today plan for early retirement in their 40s and 50s once they settle down monetarily. Just because they retire these people cannot be termed old which would be meaningless. The U.S. Census Bureau defines ages 65 to 74 as the young old, 75 to 84 as old and 85+ as oldest old. The older population is predominantly females. They make up more than half of the young old and 69% of the oldest old.
Ageism
Ageism is any prejudice or discrimination against or in favour of an age-group. Research indicates that a positive attitude towards aging can increase the life span by 7 ½ years. Gender, economy, status, loneliness and functional health can easily be superseded with a positive attitude. Aged people are often depicted as unhealthy, disabled, impotent, isolated and lonely adults definitely bringing down their morale and this scenario should be changed by the people around them.
Nutrition and its Multiple Roles in Prevention
Aging is not only associated with medical nutrition but also nutrition for health and disease prevention. While we complain about the older generation being outdated we do not see the positive note about their readiness to adapt to the present lifestyle. The older generation is willing to change their lifestyle and eating habits to adapt themselves for an independent living. A helping hand is all that is needed to make them aware of safe exercising and healthy eating. Nutrition is composed of three types of prevention as discussed below.
Nutrition as Primary Prevention
Nutrition in older people must be emphasized for healthy living and disease prevention. This is also the apt time to combine healthy eating with physical activity.
Nutrition as Secondary Prevention
This stage deals with slowing the progression of chronic nutrition-related diseases to maintain functionality and quality of life. The elder population is allergic to the term ‘exercise’ and very rarely can we see them actively involved in physical activity. Many dietitians have concluded that many of the diseases in aged people like diabetes, osteoporosis, cancer and heart disease compromise functional fitness. Aged people must be made aware of the fact that functional fitness can be achieved by consuming healthy foods.
Nutrition as Tertiary Prevention
Medical nutrition therapy is the most common way nutrition has been related to health. Dietitians are exploring new areas with case management and diet planning. Though older people have issues in chewing, appetite problems and functional limitations case managers rarely consult dietitians regarding these. Whereas, dietitians give a positive feedback saying that they are comfortable handling cases.
Gerontology + Geriatrics = The Spectrum of Aging
Gerontology and geriatrics are two aging domains of nutrition. Gerontology is the scientific study of biologic, psychological and sociologic phenomena associated with aging. This domain mainly aims at disease prevention, risk reduction and health promotion. Gerontologists have numerous theories on the aging process. The most common theory is the ‘one percent rule’ where there is said to be 1% decline in organ function each year starting at age 30.
Geriatrics is the study of chronic diseases frequently associated with aging. This involves diagnosis and treatment of the disease. As the saying goes, prevention is always better than cure. Instead of spending excess money on health care it is advisable to follow a healthy lifestyle to prevent diseases.
Physiologic Changes
Aging involves deterioration in physiologic function and this rate differs for each individual. Senescence, the process of growing old and displaying effects of increased age, begins around 30 years. Systemic changes occur and factors such as genetics, lifestyle and illnesses determine the aging process for each individual.
Body Composition Changes
Increase in fat mass and decrease in lean muscle mass happens with aging. Sarcopenia, the age-related loss of muscle mass, strength and function interrupts the daily routine of older adults. This can be postponed with light physical activity. Obese individuals are at a higher risk of sarcopenia.
Sedentary Lifestyle
Sedentary lifestyle leads to life-threatening diseases like cardiovascular disease, hypertension, diabetes, obesity and increased rates of death. Inactivity is common among people over 75 years of age, especially women.
Sensory Losses
Decrease in eyesight, hearing capacity and appetite is a common complaint among the aged people. The degree of decrease depends on the individual. Genetics, lifestyle and environment play a role in this decline of sensory organs functioning.
Oral Health
Often we see our grandma or grandpa avoiding crunchy and hard eatables. Artificial denture, missing teeth and loose or rotten teeth are all reasons for this which affects diet and nutrition. Nuts, grains, fruits and vegetables are also avoided in this process. The same mentioned foods can be pureed, chopped or boiled and served for easy consumption and healthy diet.
Other Changes
Bowel movements change and constipation is common due to insufficient liquid intake. Cardiovascular diseases due to unhealthy diets are a common cause for death among the aged. Renal functioning changes resulting in inability to excrete urine properly. Brain functioning deteriorates in the form of lack of steadiness, coordination and slowness in performing tasks. Depression is yet another major occurrence among the aged which can be changed with nutrient rich diets, friendly surrounding and positive feedbacks.
Quality of Life
Health-related quality of life relates to mental and physical well-being of the elderly. Factors like health, monetary status, independence, physical activity, spirituality and community have an impact on the quality of life of adults over 60 years of age.
Functionality
Functionality is one term commonly used in the elderly dictionary. This defines the physical ability of a person, that is, the ability to perform self-care, self-maintenance and physical activity which directly relates to the quality of life of that individual. Nutrient-related illnesses have an impact on the physical functionality (sometimes diabetes patients are amputated due to dietary complications) increasing dependency.
Weight Management
Obesity is a major problem even in the elderly category. Sedentary lifestyle and unhealthy food habits are major causes of obesity which may lead to chronic health diseases. Weight-loss therapy focusing on exercise, nutrient-rich diet and behaviour modification technique is a feasible and successful solution for a healthy weight loss. Though underweight elders are rare, many of them are under- or malnourished. Loss in smell or taste, physical pain, depression and social causes like poor economy, isolation and lack of transportation facilities contribute to malnourished individuals. Diet modifications and high nutrition diet can improve the health status of such individuals.
Nutrition Screening
Elderly population is always advised to go for a complete health checkup at least once a year. The screening can be done for BMI and information obtained on dietary habits, living environment and functional status additional to total physical screening.
Nutrition Needs
As metabolic rates decrease with age, energy requirements also come down gradually. Protein requirements do not change with age but the rate of absorption decreases. But this should not be misinterpreted for needing additional protein intake as too much of it can cause stress to the kidneys. Carbohydrates must provide more than half of the daily calorie requirements through complex sources like nuts, legumes, whole grains, fruits and veggies. Lipids must be consumed in any form as minimum as possible. Vitamins and minerals intake should be met without fail to prevent diseases. Vitamin B12 from fortified cereals, vitamin D to prevent hip fracture, vitamin E to delay cataract, folate against Alzheimer’s and Parkinson’s disease, calcium, potassium, sodium and zinc are all important for proper functioning. Many older adults suffer from dehydration due to impaired sense of thirst and physical disability which prevents movement. Always remember to maintain fluid levels and eat a proper balanced meal to prevent and protect from ailments.
The Older Population
The aged population is presently at its peak globally. The percentage of older people (aged 60 years or over) worldwide increased from 9.2 per cent in 1990 to 11.7 per cent in 2013 and will continue to grow as a proportion of the world population, reaching 21.1 per cent by 2050. The number of aged people is expected to double, from 841 million people in 2013 to more than 2 billion in 2050. History is going to be created in 2047 where older people are projected to exceed the number of children[SS1] . The number of people aged 80 and above was 14 percent in 2013 and is projected to reach over 19 percent in 2050.
Classification
The generic definition of ‘old’ as someone with grey hair, wrinkles and retired is outdated now. The youth today plan for early retirement in their 40s and 50s once they settle down monetarily. Just because they retire these people cannot be termed old which would be meaningless. The U.S. Census Bureau defines ages 65 to 74 as the young old, 75 to 84 as old and 85+ as oldest old. The older population is predominantly females. They make up more than half of the young old and 69% of the oldest old.
Ageism
Ageism is any prejudice or discrimination against or in favour of an age-group. Research indicates that a positive attitude towards aging can increase the life span by 7 ½ years. Gender, economy, status, loneliness and functional health can easily be superseded with a positive attitude. Aged people are often depicted as unhealthy, disabled, impotent, isolated and lonely adults definitely bringing down their morale and this scenario should be changed by the people around them.
Nutrition and its Multiple Roles in Prevention
Aging is not only associated with medical nutrition but also nutrition for health and disease prevention. While we complain about the older generation being outdated we do not see the positive note about their readiness to adapt to the present lifestyle. The older generation is willing to change their lifestyle and eating habits to adapt themselves for an independent living. A helping hand is all that is needed to make them aware of safe exercising and healthy eating. Nutrition is composed of three types of prevention as discussed below.
Nutrition as Primary Prevention
Nutrition in older people must be emphasized for healthy living and disease prevention. This is also the apt time to combine healthy eating with physical activity.
Nutrition as Secondary Prevention
This stage deals with slowing the progression of chronic nutrition-related diseases to maintain functionality and quality of life. The elder population is allergic to the term ‘exercise’ and very rarely can we see them actively involved in physical activity. Many dietitians have concluded that many of the diseases in aged people like diabetes, osteoporosis, cancer and heart disease compromise functional fitness. Aged people must be made aware of the fact that functional fitness can be achieved by consuming healthy foods.
Nutrition as Tertiary Prevention
Medical nutrition therapy is the most common way nutrition has been related to health. Dietitians are exploring new areas with case management and diet planning. Though older people have issues in chewing, appetite problems and functional limitations case managers rarely consult dietitians regarding these. Whereas, dietitians give a positive feedback saying that they are comfortable handling cases.
Gerontology + Geriatrics = The Spectrum of Aging
Gerontology and geriatrics are two aging domains of nutrition. Gerontology is the scientific study of biologic, psychological and sociologic phenomena associated with aging. This domain mainly aims at disease prevention, risk reduction and health promotion. Gerontologists have numerous theories on the aging process. The most common theory is the ‘one percent rule’ where there is said to be 1% decline in organ function each year starting at age 30.
Geriatrics is the study of chronic diseases frequently associated with aging. This involves diagnosis and treatment of the disease. As the saying goes, prevention is always better than cure. Instead of spending excess money on health care it is advisable to follow a healthy lifestyle to prevent diseases.
Physiologic Changes
Aging involves deterioration in physiologic function and this rate differs for each individual. Senescence, the process of growing old and displaying effects of increased age, begins around 30 years. Systemic changes occur and factors such as genetics, lifestyle and illnesses determine the aging process for each individual.
Body Composition Changes
Increase in fat mass and decrease in lean muscle mass happens with aging. Sarcopenia, the age-related loss of muscle mass, strength and function interrupts the daily routine of older adults. This can be postponed with light physical activity. Obese individuals are at a higher risk of sarcopenia.
Sedentary Lifestyle
Sedentary lifestyle leads to life-threatening diseases like cardiovascular disease, hypertension, diabetes, obesity and increased rates of death. Inactivity is common among people over 75 years of age, especially women.
Sensory Losses
Decrease in eyesight, hearing capacity and appetite is a common complaint among the aged people. The degree of decrease depends on the individual. Genetics, lifestyle and environment play a role in this decline of sensory organs functioning.
Oral Health
Often we see our grandma or grandpa avoiding crunchy and hard eatables. Artificial denture, missing teeth and loose or rotten teeth are all reasons for this which affects diet and nutrition. Nuts, grains, fruits and vegetables are also avoided in this process. The same mentioned foods can be pureed, chopped or boiled and served for easy consumption and healthy diet.
Other Changes
Bowel movements change and constipation is common due to insufficient liquid intake. Cardiovascular diseases due to unhealthy diets are a common cause for death among the aged. Renal functioning changes resulting in inability to excrete urine properly. Brain functioning deteriorates in the form of lack of steadiness, coordination and slowness in performing tasks. Depression is yet another major occurrence among the aged which can be changed with nutrient rich diets, friendly surrounding and positive feedbacks.
Quality of Life
Health-related quality of life relates to mental and physical well-being of the elderly. Factors like health, monetary status, independence, physical activity, spirituality and community have an impact on the quality of life of adults over 60 years of age.
Functionality
Functionality is one term commonly used in the elderly dictionary. This defines the physical ability of a person, that is, the ability to perform self-care, self-maintenance and physical activity which directly relates to the quality of life of that individual. Nutrient-related illnesses have an impact on the physical functionality (sometimes diabetes patients are amputated due to dietary complications) increasing dependency.
Weight Management
Obesity is a major problem even in the elderly category. Sedentary lifestyle and unhealthy food habits are major causes of obesity which may lead to chronic health diseases. Weight-loss therapy focusing on exercise, nutrient-rich diet and behaviour modification technique is a feasible and successful solution for a healthy weight loss. Though underweight elders are rare, many of them are under- or malnourished. Loss in smell or taste, physical pain, depression and social causes like poor economy, isolation and lack of transportation facilities contribute to malnourished individuals. Diet modifications and high nutrition diet can improve the health status of such individuals.
Nutrition Screening
Elderly population is always advised to go for a complete health checkup at least once a year. The screening can be done for BMI and information obtained on dietary habits, living environment and functional status additional to total physical screening.
Nutrition Needs
As metabolic rates decrease with age, energy requirements also come down gradually. Protein requirements do not change with age but the rate of absorption decreases. But this should not be misinterpreted for needing additional protein intake as too much of it can cause stress to the kidneys. Carbohydrates must provide more than half of the daily calorie requirements through complex sources like nuts, legumes, whole grains, fruits and veggies. Lipids must be consumed in any form as minimum as possible. Vitamins and minerals intake should be met without fail to prevent diseases. Vitamin B12 from fortified cereals, vitamin D to prevent hip fracture, vitamin E to delay cataract, folate against Alzheimer’s and Parkinson’s disease, calcium, potassium, sodium and zinc are all important for proper functioning. Many older adults suffer from dehydration due to impaired sense of thirst and physical disability which prevents movement. Always remember to maintain fluid levels and eat a proper balanced meal to prevent and protect from ailments.
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Dr. Nafeesa Imteyaz of First Eat Right clinic, is the Best Dietitian Nutritionist in Bangalore. Best Dietitian Nutritionist in Pune. Best Dietitian Nutritionist in Hyderabad. Best Dietitian Nutritionist in Chennai. Best Dietitian Nutritionist in Mumbai. Best Dietitian Nutritionist in Delhi. Best Dietitian Nutritionist in Kolkata.