Transcript Biological Change Nutritional implications

Gerontology –
Elderly
–branch
person
Aged
Geriatrics
– term
–used
branch
to
broader
ofin
the
age
group
65-75
cover
of medicine
both
elderly
and
science
dealing
years
old with
old.
concerned
psychological,
prolonging life,
sociological,
Old
- persons
Senescence
delaying
the- onset
economic,
beyond
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process
ofthe
growing
of degenerative
physiological
and
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or theaspect
period
aspects
of aging
medical
ofof
aging
and treating the
aging.
disease of aged.
Theoretically aging begins at conception and ends in death.
The characteristics of aging however differ at various stages of the
life cycle. During the period of growth, the anabolic or building up
processes exceeds the catabolic or degenerative changes so that
the net result is one of growth and increased functional capabilities
of the organs and tissues of the body. Upon physiologic maturity,
the process is reversed. Anabolism starts to exceed catabolism,
although the rate of reversal is slow. This results to slowing down of
functional capabilities. During senescence, catabolism greatly
exceeds anabolism which results to impaired functioning of many
organs of the body.
Decrease in the efficiency of the organs
caused by loss of cells and decreased
functioning level of the remaining cells
Decrease in the number and functional
capabilities of the cells resulting to decreased
ability of the cells to synthesized needed
enzymes, decreased ability to synthesize and
break down protein and also a decreased ability
to use energy because of the decreased in
number of mitochondria.
There are structural changes
associated with collagen. Collagen is the
non cellular protein substance that binds
the cells together. Among the aged, their
collagen is less elastic and more fibrous.
It is believed that the collagen replaces
some of the active cells lost from
degenerating organs. Also, the muscle
fibers of the muscle tissues maybe
replaced by collagen which gives the
wrinkled appearance of the skin.
The process of aging proceeds
at different rates in different individuals.
It is also affected by several factors
such as biological and environmental
influences. It also depends on exposure
to life stresses. To date, there are no
conclusive evidences yet which could
fully explain the process of aging.
Generally though, the changes are
irreversible.
Since aging starts at conception, the
best preparation for a healthy old age
starts at conception. Observing proper
nutritional habits and also of a healthy
lifestyle should be a decorum at all stages
of the life cycle. The nutritional needs of
the elderly persons are basically the same
as those of a younger individual with only
minor modification.
Energy.
The demand for calories is decreased because of decreased
basal metabolism and decreased physical activities. The
average change in caloric allowance are as follows;
Age group
Change in caloric allowance
(compared to adult RDA 20 to 39 years)
50-59 years
decreased by 10%
60-69 years
decreased by 20 %
>70 years
decreased by 25%
Since calorie requirement is reduced, carbohydrate and fat
sources must be chosen with considerable care. Carbohydrate should be
in the form of starches or complex forms rather than refined
carbohydrate. Fat must be mainly composed of polyunsaturated fatty
acid. Such recommendation is made because of the relationship of the
form of carbohydrate and saturated fatty acid with the occurrence of
coronary heart disease.
Protein
Protein is necessary for the
prevention of progressive tissue
wasting and susceptibility to
disease and infection. The
allowance of 1.1 gram per
kilogram DBW is still applicable
to this age group. However, the
aged who have had poor dietary
habits or is ill, will benefit from an
increased protein intake.
Vitamins and Minerals.
Special emphasis must be placed on the adequacy of
calcium, iron and ascorbic acid. Researches have shown
that an increased calcium intake will relieve the symptoms
of osteoporosis. Vitamin C will facilitate absorption of
calcium and iron.
Water and Fiber.
About 6-8 glasses of fluid should be
consumed to enable the kidneys to efficiently
eliminate waste solids. Also, water stimulates
peristalsis thus preventing constipation. Fiber
also encourages peristalsis but rough fiber is
not recommended. The aged must be given
tender fruits and vegetables.
The aged enter this period with set dietary
habits which have been acquired in their
entire lifetime. If they have had good food
habits, they’ll have less nutritional
problems. However, having undesirable
food habits will pose a big problem.
Furthermore, there are many factors that
affect adequate feeding of the elderly such
physical, physiological, psychological and
economic considerations.
Biological Change
Nutritional implications
Atrophy of salivary gland
May cause of difficulty in
swallowing especially of dry
foods.
Loss of taste buds
May make eating less pleasurable.
Many elderly people use increased
amounts of seasoning because
food is tasteless otherwise
Loss of teeth
Although not inevitable, very
common with aging. Diet need
not suffer if properly fitted
dentures are worn. However, if
the necessary dental treatment
cannot or will not be obtained,
the diet may be limited to soft
foods that do not require
chewing. Such diets are
commonly inadequate unless the
person knows about nutrition
that most people do.
Decreased Secretion
of stomach acid
Decreased Secretion
Of intrinsic factor
Common but far from universal in
old age. Certain minerals are
absorbed less efficiently when
stomach acid secretion declines.
Magnitude of decrease so small to
significantly
impair B12 absorption in most elderly
people.
Decline in Basal
Metabolic Rate
It is common for the elderly to feel
cold at temperatures comfortable to
younger people. Energy needs also
decrease.
Decreased size and
Activity of thyroid
gland
Probably a response to decrease
need for thyroxin to regulate
metabolism of lean body mass.
Increased proportion of Universal in aging as dying cells are
Fat to Lean
progressively replaced with fat cells
rather than with the type of cell that
died.
Decreased Physical
Activity
This results from impaired coordination,
decreased speed and strength
neuromuscular reactions. However, the
basis may also be social and
psychological: retirement from work, lack
of opportunities for previously enjoyed
group activities and loss of companions
with whom activities were formerly
shared can lead to a
sedentary lifestyle.
Loss of Neuromuscular
The ability to maintain fine
Coordination
neuromuscular
Coordination declines with the aging
process. This poses a problem
among the aged because they will
have a harder time in manipulating
eating utensils. Thus, rather that
take the risk of embarrassment, that
would come with spilled food or
inability to cut meat, they will just
avoid eating foods which they find
hard to manage.
Onset of many
Degenerative Diseases
such as Cardiovascular
diseases, diabetes,
osteoporosis
and arthritis
Disease can impair the
digestion, absorption and
metabolism of nutrient. Drugs
necessary to treat the disease
may have further adverse effects
on nutrient utilization. Presence
of degenerative
diseases calls for modification of
diet and change of lifestyle.
Aside from biological changes that
accompany aging which affects his nutrient
intake, certain psychological and economic
factors also pose nutritional problems for
the aged.
Boredom, inactivity and routine of
the aged tend to encourage a monotonous
diet which often leads to deficiency
symptoms. The aged undergoes various
emotional stresses associated with his
increasing insecurity as he advances old
age. Anxiety, depression and suspicion are
commonly felt by the aged which impairs
their ability to properly utilize ingested
nutrients.
Decreased functional capabilities
lead to decreased productive capacity
which will likely affect the aged’s financial
status. Thus, the aged, especially those
coming from poor families, tend to
compensate for decreased income by
decreasing the quantity and quality of
their food choices.
Therefore, the dietary
management of the elderly should not
only keep him physically alive but also
socially and psychologically young.
Difficulty in chewing due to loss of teeth and poor dentures
Meat, fish and vegetables can be sliced or chopped into
small bite-sized pieces for easy chewing.
Lack of appetite
Use of appetizers such as light soups will stimulate
better appetite. Finger foods have been found to be well
liked by the aged because it requires less effort and
easier to handle. It is also better to serve familiar foods
served attractively by varying the color, shape and size
can make meals enjoyable. Light exercise like walking
and gardening can improve appetite and keep body fit.
Poor Digestion leading to constipation, gas
pains or diarrhea
Inclusion of fruits and vegetables in
the daily meals will prevent constipation.
For those with sensitive digestive
system, something hot at each meal will
be beneficial. Frequent but smaller
meals are often more acceptable than
three big meals. The heaviest meal
should be eaten during lunch rather than
supper. Fats may retard digestion so
fatty meat and desserts containing
coconut milk should be avoided.
Poor absorption leading to anemia and
other vitamin deficiencies.
Anemia can be prevented by eating
iron rich foods like liver, lean meat,
egg yolk and other green leafy
vegetables, Vitamin C rich foods will
also help absorb iron. Enough
sunshine and foods like milk,
cheese and other milk products,
dilis, alamang and leafy vegetables
contain calcium needed for strong
bones.
Unwanted weight due to lack of physical
activity and/or overeating.
It is recommended to take only moderate
amount of energy foods. Eat only the lean
part of the fish and meat. The fatty portion
should be avoided.
Anxiety, confusion, insecurity an loneliness
Give the aged something to do. Let him feel
useful. Encourage the aged to have social
life by having a hobby or joining a club.