Transcript aged to perfection

Aged to Perfection
Rickelle Richards, PhD, MPH, RD
BYU Wellness Seminar
July 17, 2008
Seminar Overview
• Healthy nutrition habits with aging, including specific
nutrients of concern.
• Exercise recommendations with aging.
• Specific health concerns: osteoporosis, arthritis, and
maintaining healthy quality of life.
3 Guiding Principles for Healthy Eating:
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Balance
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Variety
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Moderation
Balance
• Eating enough but not too much
• Eating foods in different groups
• Promotes wider array of nutrient intake
Variety
• Eating many different kinds of foods in
each food group
• Promotes wider array of nutrient intake
Moderation
• Moderation ≠ Elimination
• All foods can fit into your diet
• Can even have “too much of a good thing”
How much should I eat?
• Individualized plan
• Based on:
– Age
– Gender
– Physical activity level
– Optional: Height/weight
Grains:
Make ½ Whole Grains
 What are whole grains?
o Include entire grain
kernel (bran, germ,
endosperm)
 Examples:
o Whole-wheat flour
o Bulgur (cracked wheat)
o Oatmeal
o Whole cornmeal
o Brown rice
Grains:
Whole Grains & Food Labels
 How can I know if it’s whole grain?
Be sure to check the “Ingredients” list –
Look for the words “whole grain” or “whole wheat”
Example: 100-Calorie Snack Mix vs. Woven Wheats Crackers
What about “refined grains”?
 Milled = Outer layer (bran & germ) removed
o Loss of nutrients (fiber, iron, B-vitamins)
o Enriched Grains
 Examples:
o White flour
o White bread
o White rice
Grains:
Why eat them?
 Health Benefits (esp. Whole Grains)
o Decreased risk of heart disease
o Prevents constipation
o May help with weight mgmt
Grains:
How much?
 1 oz equivalent =
2 ½ oz roll/bun
½ cup cooked rice
1 slice bread
1 cup cereal
1- 8" tortilla
3 cups popped
5 crackers
Fruits &
Vegetables
 Variety is key! Try varying your colors
 Forms = Fresh, Frozen, Canned, Dried, Juice
o Canned may have higher sodium or sugar content
 Health Benefits
o Reduce risk of heart disease, stroke, diabetes, &
certain cancers
o May help to lower calorie intake (wt loss)
Fruits &
Vegetables: How much?
 ½ cup equivalent =
½ cup strawberries
½ cup juice
½ cup green beans
½ cup carrots
1 large (8") banana
½ cup tomatoes
½ medium
baked potato
1 cup spinach (raw)
¼ cup raisins
1 small apple
Milk:
Get Your Calcium-Rich Foods
 Fluid milk & milk products (e.g., cheese, yogurt)
o Note: cream cheese, cream, butter not in milk
group (lacking calcium)
 Try using fat-free or low-fat options
 Health Benefits
 Builds & maintains bone
 Helps prevent osteoporosis
Milk: How much?
 1 cup equivalent =
1 cup (8 fl oz) yogurt
1 cup (8 fl oz) low-fat
or fat-free milk
½ cup frozen yogurt
1/3 cup shredded cheese
2 cups cottage cheese
Meat & Beans:
Go Lean with Protein
 Meat, poultry, fish, dry beans or peas, eggs, nuts, and
seeds
 Try lean or low-fat options
 Health Benefits
o High in iron, zinc, magnesium, B-vitamins, vit E
o Building blocks for bone, cartilage, muscle, skin, &
blood
o Energy production
o Antioxidant
Meat & Beans:
How much?
 1 oz equivalent =
1 oz meat, chicken, or fish
(picture = 5 oz steak)
½ ounce nuts
(picture = 3 oz chicken) (picture = 8 oz salmon)
¼ cup cooked beans
Oils—Know Your Fats:
Liquids vs. Solids
LIQUIDS
 Liquid at room temperature
 Examples: canola oil, corn oil, olive oil, soybean oil, sunflower oil
SOLIDS
 Solid at room temperature
 Found in meat products
 Examples: Butter, chicken/beef/pork fat, stick margarine*, shortening*
*Made from hydrogenated oils
Discretionary Calories
• Allowance for “extras” after “essentials” met
• What counts as “extras”?
– Added sugars
– Solid Fats (e.g., butter, margarine)
– Additional foods
“Extras” =
200 calories
“Essentials” =
1600 calories
Calorie “Budget”
Water
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Majority (50-70%) of body weight
↓ability to sense thirst with aging
Drink even when not thirsty
Water (Rec. = ~8 cups) + Foods
How can I increase my water intake??
Some easy tips…
• Drink glass of water with every meal.
• Carry filled water bottle with you & drink it!
• Put a cup next to bathroom & kitchen sinks – drink when
take meds or brush teeth.
• To limit frequency of urination at night, drink most fluids
during day & less at night.
• Add freshly squeezed lemon or lime in water.
• Start small… make goal today to increase by 1 cup &
gradually increase over time.
Physical Activity
• At least 30 minutes moderate or vigorous PA most days.
• What counts as moderate PA??
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Walking briskly (about 3 ½ miles per hour)
Hiking
Gardening/yard work
Dancing
Golf (walking and carrying clubs)
Bicycling (less than 10 miles per hour)
Weight training (general light workout)
Note: Before starting new exercise program, be sure to talk to
your health care provider.
Physical Activity
• What counts as vigorous PA??
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Running/jogging (5 miles per hour)
Bicycling (more than 10 miles per hour)
Swimming (freestyle laps)
Aerobics
Walking very fast (4 ½ miles per hour)
Heavy yard work, such as chopping wood
Weight lifting (vigorous effort)
– Basketball (competitive)
Note: Before starting new exercise program, be sure to talk to
your health care provider.
Nutrients of Concern with Aging
Vitamin D
– ↓ ability to make vitamin D
– ↓ sun exposure
– Drug-nutrient interactions
(barbiturates,
cholestyramine, Dilantin,
laxatives) -- ↓ vit D
Sunlight
Vitamin D
Why should I care about
Vitamin D??
• Main role – helps keep calcium at the right levels in our
blood & for strong bones
• Too little vitamin D -- > “Soft Bones” (osteomalacia)
– Helps prevent osteoporosis
– Helps prevent painful joints & muscles
Recommendation: Some sun exposure + eat in foods (fortified milk, salmon, shrimp).
Calcium
– Inadequate dietary intake
– Reduced calcium absorption
– Recommendations = 1200 mg (1 c. milk = ~ 300 mg)
…why should I care about Calcium??
– Calcium needed to prevent bone loss
– Can protect against high blood pressure
Magnesium
– Inadequate dietary intake
– Impaired absorption in body from GI disorders & diabetes
…why should I care about Magnesium??
– Abundantly used in body
– Needed for strong bones
– Involved in nerve activity
(cooked)
*Caution: Mg-based antacids & laxatives
may lead to too much magnesium.
Health Concerns with Aging…
What is osteoporosis?
“Porous bone”
Vertebral
Wrist
Hip
Osteoporosis: Effects of Menopause
Accelerated Bone Loss
•Inadequate intake
•Inadequate Ca absorption
•Excess Ca excretion
3-5 yrs > loss
Sizer & Whitney, 2008
Osteoporosis: Prevalence
• 10 million older adults (80% female)
% of > 50 y.o. individuals
20
15
10
5
0
White
Asian
Men
Black
Hispanic
Women
http://www.nof.org/osteoporosis/diseasefacts.htm
Osteoporosis-related Fractures
• 2005: 2 million fractures
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297,000 = hip fractures
547,000 = vertebral fractures
397,000 = wrist fractures
675,000 = fractures at other sites
• Projection for 2025 = 3 million fractures
“A woman’s risk of hip fracture is equal to her combined risk of breast,
uterine and ovarian cancer.”
--National Osteoporosis Foundation
(http://www.nof.org/osteoporosis/diseasefacts.htm)
http://www.nof.org/osteoporosis/Risk_Factor_Card.pdf
Osteoporosis: Cost
• Economics
– 2005 = $19 billion (osteoporosis-related fractures)
– 2025 projection = $23.5 billion
• Quality of Life
– Limited mobility (6 m, only 15% can walk across room w/o
assistance) + impaired activities of daily living
– 1 in 5 ambulatory before require long-term care afterward
– ~ 24% die 1 yr post-fracture
Osteoporosis: Prevention
• Adequate Ca (1200 mg/d)
– To improve Ca intake + absorption
• Drink milk + supplements at meal
• Ca & antacids taken at different times
• Adequate Vitamins C, D, B6, & K
• Physical activity
What is Arthritis?
• Pain, aching, stiffness, & swelling in or around the joints
• Osteoarthritis (“wear and tear”) is most common
• Most common cause of disability (in U.S.)
Risk Factors (Osteoarthritis)…
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Increasing age
Obesity
Injury or overuse
Genetics/Family History
Muscle weakness
Other conditions/types of arthritis
How can I manage osteoarthritis
besides using meds?
• Moderate physical activity
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↓ pain & stiffness
↓ fatigue
Strengthen muscles + bones
↑ flexibility + stamina
↑ sense of well-being
• Weight control
– ↓ stress on joints (esp. hips, knees, back, & feet)
• Reduce daily stresses – balance between work &
leisure activities/rest
• Use good body mechanics
Today’s take-home message…
Balance
Variety
Moderation
Questions/Comments??