Life Cycle Nutrition

Adulthood and
the Later Years
A.YasminSyauki
NutritionDepartment
FacultyofMedicine
HasanuddinUniversity
syaukiyasmin@gmail.com

Population trends
Kenya has pyramid shape with many young people rapid growth
United States has column shape slow growth
Italy is slightly top-heavy slow/negative growth

Lesson 2 / ESRM100 / University of Washington

Life expectancy
The expected number of years to be lived from age x (typically
from birth)
Measure of population health
In USA, the average life expectancy were increased dramatically
during the twentieth century.
Average life expectancy :
50 years (1900)
74,8 years for men (2003)
80,1 for women (2003)

Lesson 2 / ESRM100 / University of Washington

Life expectancy at birth:

Selected Asian countries, 1990-2002

LE is increasing over time in Asia and around the world

Result: an increase in Asian populations, particularly at older ages

World Bank Indicators, 2003

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Nutrition in adulthood and later years

Quality of life:
More Americans may be living longer
than before, but many are not living as
healthfully. For example, many suffer
from diet-related chronic disease such as
coronary heart disease, osteoporosis, etc.
Evidence is mounting that dietary
practices, exercise habits and other
lifestyle play a major role in determining
how long a person will live and the number
of years a person will maintain a fully
functioning body and mind.

Lesson 2 / ESRM100 / University of Washington

Physical and Physiological changes

during adulthood

Adulthood, the longest stage of the life cycle, begins when an adolescent
completes his or her physical growth.
Nutrients primarily to maintain the body rather than support physical
growth.
As adult get older, nutrient needs change.
Based on the needs for various nutrients, the Food and Nutrition Board
divided the adult years into 4 stages :
ages 19 to 30 (young adulthood)
31 to 50 (young adulthood)
51 to 70 (middle adulthood)

beyond 70 years of age (older adulthood)

Lesson 2 / ESRM100 / University of Washington

The Aging Process

Aging can be defined as the time-dependent physical and physiological
changes in body structure and function that occur normally and
progressively throughout adulthood as humans mature and become older.
Furthermore, chronologic age alone is not a particularly precise indicator
of biologic
functional age
because of
differences in
genotypes,
individual
characteristics.

Lesson 2 / ESRM100 / University of Washington

Lesson 2 / ESRM100 / University of Washington

Current hypothesis about the causes of aging

Errors occur in copying the genetic blueprint (DNA)
failing in copying DNA, cause a cell can no longer synthesize the
major protein needed to function and it dies.
Free radicals damage cell parts
electron-seeking free radicals can break down cell membranes and
proteins such as DNA in mitochondria.
Neuroendocrine communication and coordination diminish
With the age, communication and coordination between
neurological and endocrine systems are decline.
The immune system loses some efficiency.
It is less able to recognize and counteract foreign substances.

Lesson 2 / ESRM100 / University of Washington

Current hypothesis about the causes of aging

Autoimmunity develops.
Autoimmune reactions occur when white blood cells and other immune
system components begin to attack body tissue. Many diseases, including

some forms of arthritis, involve this autoimmune response.

Cross-linking or glycosylation of protein occurs.
body proteins develop attachments or unnecessary cross-links that
damage proteins or affect their function.
Death is programmed into the cell
each human cell can divide about 50 times. If this happen, the cell dies

Excess energy intake speeds body breakdown.

usual energy intake must be reduced by about 30% to live longer.

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How do they do it?

Some people just stay younger...or do they?
Adequate sleep?
Adequate nutrition?
Motion?
Smoke, drink excessively
Too big? Too small?

Lesson 2 / ESRM100 / University of Washington

Usual and succesful aging

Body cells age, it depends on health practices.

Usual aging refers to the age-related physical and physiological changes

commonly thought to be a typical or expected part of aging, such as
increasing body fatness, decreasing lean body mass, rising blood pressure,
etc. Researchers point out that many of these changes really represent the

aging process accelerated by unhealth y lifestyle choices, adverse

environmental exposure, and/or chronic disease.
Successful aging, on the other hand, describes physical and physiological
function declines that occur only because one grows older, not because
lifestyle choices, etc. Those who are successful agers experience age-related
declines at slower rate and the onset of chronic disease symptoms at a later
age than usual agers.

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Factors affecting the rate of aging

Heredity
If your parents and grandparents lived a long time, you are likely to have
the potential to live to an old age, too.
Gender also influencing longevity (females tend to live longer than males)
Metabolic efficiency can influence longevity (individual with thrifty
metabolism tend to live longest)

Lifestyle
it can have a major impact on health and longevity, as well as on the
expression of genetic potential.
Lifestyle choices (high-fat diet ) can increase susceptibility to diseases that
hasten the rate of aging, ultimately shortening life expectancy, even if a
persons genetic potential is for a very long life.

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Factors affecting the rate of aging

Environment
some aspects that expert a powerful influence on the rate of aging are
income, education level, health care, shelter and psychosocial factors.
income that enable individuals to purchase nutritious foods, quality
health care, and safe housing help decrease the rate of aging.

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Nutrient needs during adulthood

The challenge of the adult years is to maintain the body, preserve its function
and avoid chronic disease, that is to age successfully.

A healthy diet can help achieve this goal.

There are 3 main point for a healthy diet in adulthood :

1. consume a variety of nutrient-dense foods and beverages that result in a diet low
in saturated and trans fat, cholesterol, added sugars, salt and alcohol (if used).
Healthy meal patterns emphasize vegetables, fruits, whole grains, reduced fat
milk or milk products, and lean protein foods.
2. maintain body weight in a healthy range by controlling energy intake, increasing
physical activity, and reducing time spent in sedentary behaviors.
3. build healthy eating patterns that meet nutrient needs and reduce the risk of
food borne illness.

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Defining nutrient needs

The DRIs for adults are divided by gender into 4 age groups to reflect how
nutrient needs change as adults grow older.
Calories

after age 30 or so, total calorie needs of physically inactive adults fall steadily
throughout adulthood. This cause by a gradual decline in basal metabolism. To a
great extent , adults can exert considerable control over this reduction in calorien
need by exercising

Protein

in the US the protein intake of adults of all ages tends to exceed current
recommended levels. However, some recent studies indicate that consuming
protein in amounts slightly higher than the RDA may help preserve muscle and
bone mass.

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Defining nutrient needs

Fat

the fat intake of adults of all ages is often at or above the recommendations.

it is a good idea for almost all adults to reduce their fat intake because of the
strong link between high-fat diets and obesity, heart disease and certain cancers.

Carbohydrates

A diet richer in complex carbohydrates makes it easier to meet nutrient needs

and stay within calorie bounds because many highly sweetened foods are low in
nutrient and high in calories.

Substituting foods rich in complex carbohydrates for sweets also make it easier
for the body to control blood glucose levels-a function that become less efficient
as the increases in body fatness and inactivity associated with usual aging occur.

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Defining nutrient needs

Water

Low fluid intakes in older adults may be caused by a fading sensitivity to thirst
sensations, chronic diseases and/or conscious reductions in fluid intake in
order to reduce the frequency of urination.

Dehydration is very dangerous and among other symptoms, can cause

disorientation and mental confusion, constipation, impacted fecal matter and
death.

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Lesson 2 / ESRM100 / University of Washington

Defining nutrient needs

Mineral and Vitamin
Adequate intake of all vitamins and minerals is important throughout the adult
years.

Calcium and vitamin D

These bone-building nutrients tend to be low in the diets of all adults. They
become particularly problematic after age 50. Inadequate intake of these
nutrients, coupled with their reduced absorption, the reduced synthesis of vitamin
D in the skin, and the kidneys decreased ability to put vitamin D in its active form.
greatly contributes to the development of osteoporosis.

Iron

Iron deficiency anemia, the most common type of malnutrition during the adult
years, is found most frequently in women in their reproductive ages

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Defining nutrient needs

Zinc

In addition to less than optimal dietary zinc intake during adulthood, zinc
absorption declines as stomach acid production diminishes with age. Poor zinc
status may contribute to the taste sensation losses, mental lethargy, and
delayed wound healing elderly adults experience.

Magnesium

This mineral tends to be low in adults diets.

Inadequate magnesium intakes may contribute to the loss of bone strength,

muscular weakness, and mental confusion seen in some elderly adults.

It also can lead to sudden death from poor heart rhytm and is linked to
cardiovascular disease, osteoporosis and diabetes.

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Defining nutrient needs

Folate and vitamin B-6 and B-12

Folate, vitamin B-6 and B-12 are especially important because they are required to
clear homocysteine from the bloodstream, elevated blood concentrations of
homocysteine are associated with increased risk of cardiovascular disease, stroke,
bone fracture and neurological decline seen in some elderly people.

Vitamin E

Low vitamin E intake means the body has a reduced supply of antioxidants which
may increase the degree of cell damage caused by free radicals, promote the
progression of chronic disease and cataracts and speed aging.

Carotenoids

Dietary this nutrient especially lutein and zeaxanthin have been linked with the
prevention of cataracts and age-related macular degenerations.

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Lesson 2 / ESRM100 / University of Washington

Table. 1 Nutritional Implications of Physical and Physiological

Changes that Occur after about age 30
Usual Changes

Nutritional implications of the

changes

Ways to minimize the

changes and promote
successful aging

Body composition
Gradual
steady decline in lean body
mass (sarcopenia) and body
water,
slow increase in fatty tissue
and redistribution of body fat
from the limbs to the torso

Loss of lean body mass decreases

metabolic rate, causing calorie needs
to drop.
Adequate fluid intake is important
Raise the risk of developing
conditions (high blood pressure,
high blood glucose levels, etc) from
excessive increase in fatty tissue.

Eating a nutritious diets that

meet the need
Reguler exercise (include
strength training) to helps
minimize increase in body fat
and maintain lean body mass

Skeletal system
Slow,
Steady loss of bone minerals
(women), loses rises greatly in
the first 5 to 10 years after
menopause

Adequate calcium and vitamin D

during young adulthood
If osteoporosis causes adults limit
physical exercise

Eating a diet rich in calcium

and vitamin D, combined
with participations in weightbearing exercises
Keeping weight at a healthy
level (preserve bone mass)
Avoiding smoking and
chronic alcohol
Lesson 2 / ESRM100 / University of Washington

Table. 1 Nutritional Implications of Physical and Physiological

Changes that Occur after about age 30
Usual Changes

Nutritional implications of
the changes

Ways to minimize the

changes and promote
successful aging

Cardiovascular and respiratory

system
Gradual
Decrease in the ability of the heart
and lungs to deliver oxygen and
nutrient rich blood to body cells
Decrease in the ability to remove
metabolic waste
Rise in blood pressure

Decrease the function of other

organs (e.g kidney, brain) thus
lowering calorie needs
Limit physical exercise, calorie
needs will drop further

Eating a low-fat diet rich in

antioxidant nutrients,
avoiding cigarette
Exercise regularly
Lowering sodium intake,
eating less minimal protein
and maintaining a healthy
weight
Monitoring and treating high
blood lipids and hypertension
Eating an antioxidant rich
diet and avoiding polluted air
and cigarette smoking

Lesson 2 / ESRM100 / University of Washington

Table. 1 Nutritional Implications of Physical and Physiological

Changes that Occur after about age 30
Usual Changes

Nutritional implications of
the changes

Ways to minimize the

changes and promote
successful aging

Digestive system
Diminished chewing ability if
gum disease occurs
Decline in efficiency of
digestion and nutrient
absorption due to reduced
secretions of HCl and gastric,
pancreatic and intestinal
digestive enzymes
Decline vitamin B-12
absorption due to decreased
secretion of intrinsic factor
Decline in the livers ability to
metabolize alcohol and drugs
Slowdown in the movement
of chyme through the
intestines

Reduced intake of crisp or

chew foods, such as fruits and
vegetables, whole grains, and
meats.
Impair absorption of iron,
calcium, folate, vitamin B-6 and
protein.
Impair fat and fat-soluble
vitamin absorption compete for
B-vitamins and leads to weight
loss and vitamin deficiencies.
Halt vitamin B-12 absorption.
Impair digestion and
absorption of macronutrients

consuming a diet rich in vitamin

C ( to maintain gums), calcium
and vitamin D (to maintain bone
surrounding teeth) and practicing
good dental health habits
Eating several smaller meals each
day instead of a few larger ones
Making dietary modifications
and/or getting treatment to
improve malabsorption problems
Avoiding megadoses of vitamin
and minerals
Eating fiber rich diet, drinking
plenty of fluids and exercising
regularly help prevent
constipation
Lesson 2 / ESRM100 / University of Washington

Table. 1 Nutritional Implications of Physical and Physiological

Changes that Occur after about age 30
Usual Changes

Nutritional implications of
the changes

Ways to minimize the

changes and promote
successful aging

Urinary system
Decreased efficiency of
kidneys in filtering out
metabolic wastes,
concentrating urine and
putting vitamin D synthesized
in the skin in its active form
Progressive weakening of the
muscles that control
urination.

Diminished kidney function

may impair reabsorption of
glucose, amino acids and
vitamin C and impair vitamin D
status
Avoid excessive intake of
protein, electrolytes, watersoluble vitamins, and other
substances that must be filtered
out by the kidneys.
Vitamin D rich foods need to
be emphasized or supplements
may be needed
Reductions in the ability to
concentrate urine increase the
need for fluid.

Avoid excessive intake of protein,

electrolytes, water-soluble
vitamins, and other substances
that must be filtered out by the
kidneys.
engaging in practices that
maintain cardiovasculer health (so
that the blood supply to the
kidneys is sufficient) and prevent
hypertension (which can damage
the kidney)
Limiting protein and electrolyte
intake may restore some kidney
function
Doing muscular exercises and
using behaviour modification and
medications
Lesson 2 / ESRM100 / University of Washington

Table. 1 Nutritional Implications of Physical and Physiological

Changes that Occur after about age 30
Usual Changes

Nutritional implications of
the changes

Ways to minimize the

changes and promote
successful aging

Nervous system
Gradual
Decline in number of cells
that transmit nerve signals,
which may result in decreased
sensory perceptions, slowed
reaction times, and impaired
neuromuscular coordination,
reasoning, and memory.

Loss in taste and smell may

reduce desire to eat, leading to
weight loss
Diminished sensory perception
may decrease secretions from
the salivary glands, stomach
and pancreas and result in
impaired digestion and blood
glucose regulation.
Neuromuscular coordination
losses may make it
Reduced reasoning abilities
can result in an ability to
choose a nutritious diet .

Engaging in practices that

promote a healthy cardiovascular
system
Expertimenting with herbs,
spices, and flavoring
Drinking enough fluids
Keeping blood pressure under
control

Lesson 2 / ESRM100 / University of Washington

Table. 1 Nutritional Implications of Physical and Physiological

Changes that Occur after about age 30
Usual Changes

Nutritional implications of
the changes

Ways to minimize the

changes and promote
successful aging

Immune system
Progressive decline in
efficiency that increases
susceptibility to infection and
disease

Calorie and nutrient dense rise

during infection and disease

eating a diet that meets nutrient

needs and prevents obesity
Exercising regularly
Avoiding prolonged emotional
stress

Endocrine system
Gradual decrease in hormone
synthesis, hormone release or
sensitivity to hormones

Decrease in sensitivity to
insulin
Reduction in thyroid hormone
slows metabolic rate
Decline in growth hormone
leads to loss of lean body mass
and thinning of skin

Maintaining a healthy weight,

getting physical exercise, and
eating a low fat, high fiber diet
Maintaining lean body mass
Getting injections of growth
hormone

Lesson 2 / ESRM100 / University of Washington

Table. 1 Nutritional Implications of Physical and Physiological

Changes that Occur after about age 30
Usual Changes

Nutritional implications of
the changes

Ways to minimize the

changes and promote
successful aging

Reproductive system
Females : few changes untill
menopause

In females, iron needs drop

when menopause occurs.
Healthy diets and exercise are
important

Age-related changes in the

reproductive system currently
appear to be unalterable

Lesson 2 / ESRM100 / University of Washington

Energy And Nutrient Needs

of Older Adults

Lesson 2 / ESRM100 / University of Washington

Nutrition-Related Concerns Of
Older Adults

Cataracts and macular degeneration

Preventative nutrition includes

antioxidants, zinc and lutein,
zeaxanthin (vitamin A)
DHA might also help prevent
degeneration!

Lesson 2 / ESRM100 / University of Washington

Nutrition-Related Concerns Of
Older Adults

Arthritis

Osteoarthritis
Rheumatoid arthritis
Treatment

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The Aging
Brain

Lesson 2 / ESRM100 / University of Washington

The Aging Brain

Senile dementia

Alzheimers disease
senile plaques
neurofibrillary tangles

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Choices

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Choices

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Risk

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Food Assistance
Programs
Congregate meals

Elderly Nutrition Program

Meals on Wheels

Lesson 2 / ESRM100 / University of Washington

Lesson 2 / ESRM100 / University of Washington

Lesson 2 / ESRM100 / University of Washington