Human Life Stages and Aging

Classification of Life Stages

• Human life is divided into 13 stages based on age.
• Newborn child: From birth to 3 months.
• Infant: Months to 1 year.
• Toddler: 1 to 3 years old.
• Pre-school: 4 to 5 years.
• Primary school stage: 6 to 8 years.
• Pre-adolescence: 9 to 12 years.
• Beginning of adolescence: 12 to 15 years.
• Adolescence: 16 to 19 years.
• Youth stage: 20 to 29 years old.
• Maturity stage: 30 to 39 years.
• Middle age: 40 to 59 years.
• Elderly: 60 to 74 years old.
• Old age: 74 years and more.

Aging and Physical Changes

• Aging occurs due to the accumulation of products from molecular and cellular reactions
• Aging leads to a gradual decline in physical and psychological capabilities
• Aging increases the possibility of disease and eventual death
• Aging changes are not inevitable

Definition of Elderly People

• Aging is a biological process beyond human control
• Definition of aging varies across societies
• Aging is determined by age and factors determining retirement age
• Aging begins when a person can't participate effectively in society

Factors affecting the health of the elderly:

• Individual factors include age-related changes, habits and behaviors, genetic factors and having diseases.
• Environmental factors include- home environment, social facilities, transportation and assistive technologies.

Factors Affecting Eating Ability in the Elderly

• Oral and dental pain
• Tooth loss
• Living alone
• Infections

Common Health Problems in the Elderly

• Chronic diseases: diabetes, high blood pressure, enuresis, osteoporosis, impaired vision/hearing, cancer
• Heart disease
• Falls and fractures
• Musculoskeletal diseases: arthritis, loss of balance, gait disturbance, difficulty moving
• Malnutrition: wasting or obesity
• Respiratory diseases: influenza, pneumonia
• Nervous system diseases: stroke, tremor (Parkinson’s)
• Digestive problems: poor taste, reduced digestion, constipation
• Drought
• Oral and dental problems: teeth falling out

Mental and Psychological Problems in the Elderly

• Mental and psychological diseases: dementia, Alzheimer's, depression, delirium
• Sleep disturbance.

Social Problems in the Elderly

• Social isolation
• Decreased level of functionality

Nutrition for the Elderly

• Nutrients and supplements contribute to health and reduce disease risk in the elderly
• Healthy diet and maintaining body weight is essential for a healthy life
• Maintaining health becomes more important as metabolism slows down with age

Importance of Proper Nutrition

• Protects from some diseases and complications
• Decreases energy decline, improves performance in daily activities
• Provides essential nutrients for physical and psychological health

Nutrition Assessment for Elderly People

• Science helps to determine the nutritional status of elderly people
• Involves social history
• Involves dietary history
• Includes medical analysis
• And nutrient and drug interaction
• Clinical data
• Biochemical data
• Anthropometry data

Healthy Weight for Elderly

• Muscle mass lost with age
• Elderly may need fewer calories
• Maintaining a healthy weight is critical
• Overweight/obesity increases risk of heart disease, high blood pressure, type 2 diabetes, bone problems
• Body Mass Index (BMI) scales that determine a healthy body weight
• A BMI score of 18.5 to 24.9 usually indicates a healthy weight for adults.
• Waist circumference above 35 inches (0.8 m) for women or 40 inches (1 m) for men increases health problem risks

Healthy Foods

• Body needs fewer calories and more nutrients with age
• Fruits and vegetables of various vibrant colors
• Whole grains: oatmeal, whole wheat bread, brown rice
• Milk, fat-free or low-fat cheese, soy milk, or rice fortified with vitamin D and calcium
• Seafood, poultry, eggs
• Beans, nuts

Foods to Eat in Smaller Quantities

• Sugar-sweetened beverages and sweets
• Foods with butter or other fats

Proper Nutrition for Elderly

• Proper nutrition maintains health, reduces chronic diseases, and contributes to vitality and independence
• Older people, 65+, are more likely to be undernourished
• Food consumption should align with the food pyramid, with less consumption as you go up

Malnutrition in the Elderly

• Malnutrition is a lack of food/improper food
• 462 million people worldwide suffer from malnutrition, as per WHO
• The elderly are vulnerable to malnutrition because of nutrition process issues not meeting all body requirements

Symptoms of Malnutrition

• Lack of appetite/interest in food/drink
• Fatigue and irritability
• Inability to concentrate
• Feeling cold
• Increased disease risk/slow healing
• Depression
• Low libido and fertility problems

Why Nutrition Matters in the Elderly

• Maintains health as people age
• Good nutrition protects against age-related diseases
• Eating foods rich in nutrients reduces the risk of infection.
• Nutritional needs affected by aging changes
• Changes in body components/functions affect nutrition needs, determined by lifestyle, marital status, economic status, health status

Healthy Food Specifications for the Elderly

• Balanced in all nutrients: includes all food groups like milk, meat/legumes, grains, vegetables, fruits, fat
• Clean and safe
• Available in sufficient quantities

Modified Food Pyramid for Elderly

• Emphasizes foods rich in nutrients, fiber, and water
• Nutrient-specific supplements may be appropriate

Elderly Food Pyramid: Water

• Main component of our body
• It is important to drink water between and at mealtime
• Provides important minerals like calcium, magnesium and fluorine

Elderly Food Pyramid: Cereals group

• The first group where you should eat a relatively large amount from
• They contain mainly starch (carbohydrates) and a certain amount of protein
• Consists of bread, pasta, potatoes, oats, corn, wheat, bulgur, buckwheat, rice, and morning cereals.

Elderly Food Pyramid: Fruits and Vegetables

• Contain carbohydrates (sugars), water, fiber, vitamins, and minerals
• Rich in vitamin C: cabbage, tomatoes, peppers, lettuce, citrus fruits, kiwis, cantaloupe, strawberries
• The ratio of 2/3 of vegetables and - 1/3 of fruits.

Elderly Food Pyramid: Food rich in protein

• Contains meat products, dairy products, eggs and legumes
• Zinc, vitamin B-12, fiber (legumes), omega-3 (in fish)
• consume foods with a low amount of fat: cheeses up to 5%, milk and yoghurt 1%-3%, lean meat products, without the skin.

Elderly Food Pyramid: Food rich in fat

• Contains foods such as oils, avocado, mayonnaise, nuts, almonds, olives, ghee, butter
• These foods are important to health, but only when the body needs them
• It is recommended to consume foods rich in unsaturated fats

Elderly Food Pyramid: Sweets, snacks and sweet drinks

• This group contains foods rich in fat, sugar and sometimes salt
• These foods are not essential to physical and nutritional health

Defining Nutritional Needs of Older Persons

• Aging impacts other nutrient needs, energy needs may decrease
• Review current recommended daily nutrient allowances
• Increasing demand worldwide for WHO guidelines

Calories

• Calorie needs change due to more body fat and less lean muscle
• Activity decreases calorie needs
• The challenge for older adults is to meet the same nutrient needs as when they were younger, yet consume fewer calories
• Choosing nutrient-dense foods will help reduce calories
• Low-fat milk is more nutrient dense than regular milk

Macronutrients

• Macronutrients include carbohydrates and fiber
• Macronutrients include protein
• Macronutrients include fat

Carbohydrates and Fiber

• About 60% of calories should come from complex carbohydrates
• Glucose tolerance decreases with age
• Complex carbohydrates are better than refined ones
• This also enhances dietary fiber intake
• Adequate fiber, with fluid, maintains bowel function
• Vegetables, fruits, grain products, cereals, seeds, legumes, and nuts are all dietary fiber sources

Protein

• Protein needs usually do not change for the elderly, although research studies are not definitive
• Protein requirements vary because of chronic disease
• Excess protein could unnecessarily stress kidneys

Fat

• Reducing overall fat content in the diet is reasonable to cut calories and reduce weight
• Lower fat intake is necessary because of chronic disease

Micronutrients

• Fat and water-soluble vitamins are micronutrients
• Minerals are micronutrients

Vitamins

• Vitamin deficiencies may not be obvious
• Illness stresses the body and may use up the vitamin stores
• Medications also interfere with many vitamins
• Eating nutrient-dense foods becomes increasingly important when calorie needs decline but vitamin and mineral needs remain high
• (Fat-Soluble Vitamins: A, D, E, and K. Water-Soluble Vitamins: B-Complex and Vitamin C)

Vitamin A

• Deficiency causes night-blindness
• Necessary for keeping the skin and mucous membrane intact
• Severe symptom of vitamin A deficiency is blindness, which occurs later on
• A reduced immune activity sets in
• White blood cell count decreases in its absence
• Carrot, rhubarb, and spinach are rich inβ-carotene

Vitamin D

• Older adults at lower risk of fat-soluble vitamin deficiencies
• Vitamin D-fortified milk is recommended for the housebound, nursing home residents, and for those without sunlight exposure.
• Helps with calcium absorption

Vitamin E

• May have a potential role in the prevention of Alzheimer's disease
• Eating foods with vitamin E, reduces the risk
• The same benefits did not hold true for vitamin E from supplements

Vitamin K

• Deficiency leads to severe hemophilia appearing first of all in the gastrointestinal tract
• The bleeding wounds do not heal up and coagulation does not take place because the liver cannot synthesize inadequate amount of prothrombin
• Human intestinal flora synthesizes a sufficient amount of vitamin K.

Vitamin B12

• Low levels of vitamin B12 have been associated with memory loss and linked to age-related hearing loss in older adults.
• To avoid deficiency, older adults are advised to eat foods rich in vitamin B12 regularly, including meat, poultry, fish, eggs and dairy foods
• Consult your doctor to see if a vitamin B12 supplement may also be necessary

Vitamin C

• An essential nutrient
• Supports normal growth and development and helps your body absorb iron
• Your body doesn't produce or store vitamin C
• A large orange or a cup of strawberries, chopped red peppers, or broccoli will provide enough vitamin C

Iron and Calcium

• Iron and calcium intake appears to be low in many older adults
• To improve absorption of iron, include vitamin C-rich fruits and vegetables with these foods
• Have juice or sliced fruit with cereal, a baked potato with roast beef, vegetables with fish, or fruit with chicken.

Zinc

• Can be related to specific diseases in the elderly
• It can also be a factor with vitamin K in wound healing
• Zinc improves taste acuity in people where stores are low
• The best way to obtain these nutrients is to consume at least five servings of fruits and vegetables, especially dark green, orange and yellow ones. Good choices include kale, spinach, broccoli, peas, oranges and cantaloupes.

Phosphorous

• Helps in the formation of teeth and bones
• It is possible to obtain it by eating all types of protein in general such as fish, meat, nuts, dairy, grains, and legumes.

Potassium

• Potassium thus contributes as an essential element in the formation of fluids in the body
• There are many sources of obtaining it
• It is found in legumes, potato skins, broccoli, bananas, tomatoes, and citrus fruits and green leafy vegetables

Water

• Is the most important, serving many essential functions
• Adequate fluid intake also eases constipation
• Drink plenty of water, juice, milk, and coffee or tea to stay properly hydrated
• The equivalent to nine (for women) or 13 (for men) glasses of fluid should be consumed every day.