Chapter 012

Williams' Basic Nutrition & Diet Therapy

Chapter 12

Nutrition for Adults: The Early, Middle, and Later Years

Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 1

14th Edition

Lesson 12.1:Individual Process of Aging

1. Gradual aging throughout the adult years is an individual process based on genetic heritage and life experience.

2Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Adulthood: Continuing Human Growth and Development (p. 217)

Goals of Healthy People 2020: high-quality, longer lives, free of preventable disease, disability, injury, death

Population and age distribution By year 2050: U.S. population 439 million Number older than age 65 will more than double Median age from 36.9 to 39


Life Expectancy and Quality of Life (p. 218)

Life expectancy projected at 77.1 for men and 81.9 for women by 2020

Varies among population and income groups Americans value health-related quality of life


Impact on Health Care: Career Opportunities (p. 218)

Disease prevention Health promotion Classes in healthy lifestyle and nutrition Weight management, diabetes management Dietitians, nurses, life coaches, personal trainers,

psychologists


Shaping Influences on Adult Growth and Development (p. 218)

Physical Psychosocial Socioeconomic Nutritional


Physical Growth (p. 220)

Levels off in early adult years Focus shifts to replacing old cells Energy requirements decrease Metabolic rate gradually declines


Psychosocial Development(p. 220)

Young adult (20 to 44): Independence, new roles, life choices, long-term health patterns

Middle adult (45 to 64): Opportunity for personal growth, refocus of life direction, early evidence of chronic disease

Older adult (65 and older): Outcome depends on person’s ability to deal with older age


Socioeconomic Status (p. 220)

Pressures on food security, health, finances Pressures and loss of productivity can combine to

produce depression Failure to thrive is risk


Nutrition Needs (p. 221)

Depend on living and working situations DRIs differ in 50- to 70-year-olds compared with 71+


Lesson 12.2:Biologic, Nutritional, Social, Economic,

Psychological, and Spiritual Aspects of Aging

2. Aging is a total life process, with biologic, nutritional, social, economic, psychological, and spiritual aspects.


The Aging Process and Nutrition Needs (p. 221)

Biologic changes Gradual loss of cells results in lower metabolism Decline in insulin often results in diabetes Decrease in growth hormone and sex hormones Menopause changes body composition, risk of

chronic disease


Effect on Food Patterns (p. 222)

GI secretions and motility decrease Reduced senses affect appetite Reduced physical abilities


Individuality of the Aging Process (p. 222)

Senescence: process of growing old Rate varies by individual Rate depends on genetics and health and nutrition of

past years


Nutrition Needs (p. 222)

Macronutrients and fluids BMR declines 1% to 2% per decade A more rapid decline at age 40 years for men and

50 years for women Gradual loss of functioning body cells and reduced

physical activity Mean energy expenditure for women 51 to 70:

2066 kcal/day For men, 2469 kcal/day


Macronutrients and Fluids(p. 222)

Carbohydrate: should be 45% to 65%, mostly complex carbohydrates

Fat: 30% of total, backup energy source, fat-soluble vitamins, essential fatty acids

Protein: 10% to 35%, 0.8 g/kg body weight Fluid: decreased thirst sensation, kidney function

may increase fluid needs


Micronutrients and Health Concerns (p. 223)

Varied diet should be sufficient Some conditions may necessitate special

attention Osteoporosis, osteopenia: vitamin D and

calcium are essential Nutrient supplementation

Over 55, DRI includes B12 supplementation Vitamin D supplementation may not be needed,

risk of toxicity


Case Study

Mrs. Carnegie is a 73-year-old female who resides in a long-term care facility. She has two children who are married and who each come to visit at least once weekly. Mrs. Carnegie is able to feed herself and participate in activities offered at the facility. She is 5 feet 3 inches tall and weighs 120 lbs.


Case Study (cont’d)

What are some physical changes that Mrs. Carnegie has experienced with the aging process?


Case Study (cont’d)

Is Mrs. Carnegie at risk for osteoporosis? Why? List some recommendations for Mrs. Carnegie to

help with the prevention of bone loss.


Clinical Needs (p. 224)

Health promotion and disease prevention Reduction of risk for chronic disease Nutritional status

• Poor food habits: lack of appetite, loneliness, lack of food availability

• Oral problems: missing teeth, poorly fitting dentures• General gastrointestinal problems: decreased salivary

secretions, inadequate hydrochloric acid in stomach, decreased secretions and motility of intestines


Health Promotion and Disease Prevention (p. 224)

Weight management Malnutrition can produce excessive weight gain or

loss Over/undereating Need for regular physical activity Risk of diabetes increases with age


Weight Management (p. 226)

Individual approach required Personal, sensitive approach


Chronic Diseases of Aging(p. 228)

Hypertension Heart disease Stroke Emphysema Diabetes Cancer Arthritis Asthma


Diet Modifications (p. 228)

Diet modifications in chronic disease will be covered in Chapters 17 to 23

Individual food plans are essential to recovery


Medications (p. 228)

Polypharmacy can affect nutritional intake Medications used by elderly can affect fluid balance,

appetite, absorption of nutrients Ask about use of supplements or herbs


Community Resources (p. 229)

Government programs for older Americans Poverty has direct link to chronic diseases Older Americans Act

• Congregate nutrition services• Home-delivered meals


Community Resources (cont’d) (p. 230)

Government programs for older Americans U.S. Department of Agriculture

• Research centers: focus on nutrition in aging• Extension services: in state land grant universities• Supplemental Nutrition Assistance Program (SNAP):

formerly known as food stamps, now use cards similar to debit cards


Community Resources (p. 231)

Government programs for older Americans (cont’d) U.S. Department of Agriculture (cont’d)

• Commodity Supplemental Food Program: food packages for eligible older adults

• Senior Farmers Market Nutrition Program: provides low-income older adults with coupons for fresh produce obtained from markets, roadside stands

Public Health departments• Division of Department of Health and Human Services• Work through local and state public health departments


Professional Organizations and Resources (p. 232)

Professional organizations and resources National groups: societies of health care workers Community groups: medical, nursing, dietetic

associations Volunteer organizations: national associations

offer volunteer opportunities and resources


Alternative Living Arrangements (p. 232)

Independent living facilities: for those not needing medical care

Congregate care arrangements: keep elderly in their homes

Continuing care retirement communities Spectrum of long-term care Independent living to nursing care facilities


Alternative Living Arrangements (cont’d) (p. 232)

Assisted living facilities Known by several names Provide all meals, housekeeping, assistance with

activities of daily living Nursing homes

Provide the most medical, nursing, nutrition support

Assistance with activities of daily living Usually dietitians on staff


Chapter 012

Health & Medicine

Transcript of Chapter 012