Aged to Perfection Rickelle Richards, PhD, MPH, RD BYU Wellness Seminar July 17, 2008.
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Transcript of Aged to Perfection Rickelle Richards, PhD, MPH, RD BYU Wellness Seminar July 17, 2008.
Aged to Perfection
Rickelle Richards, PhD, MPH, RDBYU 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:
Balance
Variety
Moderation
=
=
=
• Eating enough but not too much• Eating foods in different groups• Promotes wider array of nutrient intake
Balance
• Eating many different kinds of foods in each food group
• Promotes wider array of nutrient intake
Variety
• Moderation ≠ Elimination
• All foods can fit into your diet
• Can even have “too much of a good thing”
Moderation
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 Oatmealo 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) removedo Loss of nutrients (fiber, iron, B-vitamins)o Enriched Grains
Examples:o White flour o White breado White rice
Grains:Why eat them?
Health Benefits (esp. Whole Grains)o Decreased risk of heart diseaseo Prevents constipationo May help with weight mgmt
Grains:How much?
1 oz equivalent =
3 cups popped 5 crackers
½ cup cooked rice 1 slice bread 1 cup cereal
2 ½ oz roll/bun
1- 8" tortilla
Vegetables
Variety is key! Try varying your colors Forms = Fresh, Frozen, Canned, Dried, Juice
o Canned may have higher sodium or sugar content
Health Benefitso 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 =
Fruits &
1 small apple
1 large (8") banana
¼ cup raisins
½ cup strawberries
½ cup juice
1 cup spinach (raw)
½ cup carrots
½ medium baked potato
½ cup tomatoes
½ cup green beans
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) low-fat or fat-free milk
1/3 cup shredded cheese
1 cup (8 fl oz) yogurt
½ cup frozen yogurt 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 Benefitso High in iron, zinc, magnesium, B-vitamins, vit E o Building blocks for bone, cartilage, muscle, skin, & bloodo Energy production o Antioxidant
Meat & Beans:How much?
1 oz equivalent = 1 oz meat, chicken, or fish
(picture = 5 oz steak) (picture = 3 oz chicken) (picture = 8 oz salmon)
½ ounce nuts 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
Calorie “Budget”
“Essentials” = 1600 calories
“Extras” = 200 calories
Water
• 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??
• 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.
Some easy tips…
Physical Activity
• At least 30 minutes moderate or vigorous PA most days.• What counts as moderate PA??
– 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??– 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
– ↓ ability to make vitamin D
– ↓ sun exposure
– Drug-nutrient interactions (barbiturates, cholestyramine, Dilantin, laxatives) -- ↓ vit D
Sunlight
Vitamin D
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
Why should I care about Vitamin D??
Recommendation: Some sun exposure + eat in foods (fortified milk, salmon, shrimp).
– Inadequate dietary intake– Reduced calcium absorption– Recommendations = 1200 mg (1 c. milk = ~ 300 mg)
Calcium
…why should I care about Calcium??
– Calcium needed to prevent bone loss – Can protect against high blood pressure
– Abundantly used in body – Needed for strong bones– Involved in nerve activity
Magnesium
– Inadequate dietary intake– Impaired absorption in body from GI disorders & diabetes
…why should I care about Magnesium??
(cooked)*Caution: Mg-based antacids & laxatives may lead to too much magnesium.
Health Concerns with Aging…
What is osteoporosis?
Vertebral
Hip
Wrist
“Porous bone”
Osteoporosis: Effects of Menopause
Sizer & Whitney, 2008
Accelerated Bone Loss•Inadequate intake•Inadequate Ca absorption•Excess Ca excretion
3-5 yrs > loss
Osteoporosis: Prevalence
• 10 million older adults (80% female)
0
5
10
15
20
White Asian Black Hispanic
Men Women
% of > 50 y.o. individuals
http://www.nof.org/osteoporosis/diseasefacts.htm
Osteoporosis-related Fractures
• 2005: 2 million fractures– 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)…– 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– ↓ 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??