Nutrition In Older Adults - How Nutritional Needs Change With Aging

Knowledge of the patterns of aging development makes it possible to predict the occurrence of such diseases as atherosclerosis, arterial hypertension, coronary heart disease a,nd brain disease, diabetes mellitus, and cancer.

 

Since the time of Hippocrates, man has been interested in why old age comes and how to preserve youth. But until now, scientists have not come to a consensus about the causes and essence of aging. Until now, disputes have not stopped about when the aging of the body occurs - along with its inception, the cessation of growth, the onset of menopause, etc. The dispute is of general biological significance not only for understanding the essence of aging but also for constructing tactics and strategies for finding means of increasing life expectancy. Knowledge of the patterns of aging development makes it possible to predict the occurrence of such diseases as atherosclerosis, arterial hypertension, coronary heart disease and brain disease, diabetes mellitus, and cancer. These diseases develop at an older age, and most scientists believe that this is due to the aging process.

What is Aging

Aging is a destructive process that inevitably develops with age as a result of the damaging effect of exogenous factors and leads to a lack of physiological functions of the body. Aging leads to a decrease in the adaptive capabilities of the body, a decrease in its reliability, the development of age-related pathology and an increase in the probability of death.

Viaduct process

Along with aging, the viaduct process operates in the body. Viatukt - a process that stabilizes the vital activity of the organism, increases its reliability, aimed at preventing damage to living systems with age and increasing life expectancy. The processes of aging and viaduct are influenced not only by endogenous factors, but also by the environment. This justifies the search for an optimal lifestyle, environmental conditions that slow down the rate of aging.

Aging is a multi-causal process. Factors such as stress, diseases, activation of free radical oxidation and accumulation of peroxide metabolic products, exposure to xenobotics, changes in the concentration of hydrogen ions, insufficient excretion of protein breakdown products, hypoxia, etc., accelerate the aging process and reduce life expectancy.

Aging is a multifocal process occurring in different cell structures; in different types of cells (nerve, secretory, immune, hepatic, connective tissue, etc.) The classics of Russian biology - I.I. Mechnikov, I.P. Pavlov, A.A. Bogomolets, F.V. contribution to the formation of ideas about the essence of aging. IP Pavlov associated the leading mechanisms of aging with changes in nervous activity. A.A. Bogomolets believed that aging is determined by age-related changes in connective tissue. I.I. Mechnikov put forward the theory of autointoxication (self-poisoning), according to which aging was explained by the poisoning of the body with toxins formed in the intestines. To preserve youth and prolong life, Mechnikov suggested leading a reasonable lifestyle and eating right, while the scientist made another extremely important conclusion:we must prolong life, not old age. In other words, he formulated the concept of active longevity, that period of life when a person retains both physical and mental strength - when he is capable of creativity.

Biological lifespan

Biological lifespan is defined as the age to which most people can live. Many scientists believe that our body is programmed for 100-120 years. American scientists argue that 180 years is not the limit.

According to the modern classification, 50-60 years old is a mature age, persons 61-74 years old are elderly, 75-90 years old are old, over 90 years old are centenarians.

According to statistics, about 75% of older people have certain eating disorders: about 20% overeat, and 60% eat irrationally (more often men), which is expressed in the predominance of meat and flour products with a high content in their diet. animal fat, sweets, muffins and insufficient consumption of dairy products, fish, vegetables, fruits. The nutrition of the elderly should be not only complete, but also balanced, taking into account, first of all, the age characteristics of the body.

The science of gerodietetics deals with the nutrition of elderly and senile people . The nutritional status of elderly and old people depends on many factors, such as frequent chronic diseases, lifestyle, environment, financial situation, age-related changes, including the digestive system. The table shows the most characteristic changes in the digestive system during aging.

Changes in the digestive system during human aging

organ of the digestive system	Age-related changes with aging
Oral cavity	The volume of the oral cavity decreases Atrophy of the upper jaw, ahead of the atrophy of the lower jaw There is a violation of the bite, difficulty chewing food. Mimic and chewing muscles atrophy. Decreased volume of salivary glands Severe dry mouth occurs Cracks in the tongue and lips Preserved teeth have a yellowish tint and varying degree of wear.
Esophagus	Esophagus lengthens and curves Decreased number of secretory cells Muscle fibers are replaced by connective tissue (may cause some disturbance in the passage of food) The tone of the muscles of the lower esophageal sphincter decreases (the risk of reflux esophagitis increases)
Pancreas	The death of acinar cells occurs: • proliferation of connective tissue instead • increase in the volume of adipose tissue. In the remaining acinar cells, the number of secretory granules decreases (the secretion of bicarbonates, the activity of trypsin, amylase, and lipase decrease) The number of beta cells of the islet apparatus of the pancreas decreases Functioning beta cells have increased activity The number of insulin receptors decreases.
Liver	Decreased liver mass The functionality of hepatocytes decreases: • increases the likelihood of violations of protein, lipid, carbohydrate and pigment metabolism; • the antitoxic function of the liver decreases.
gallbladder	Increases in volume (due to lengthening it in the anteroposterior dimension and reducing the tone of the muscle wall) The risk of developing biliary dyskinesia, cholelithiasis increases.
Intestines	The total length increases (most often due to the lengthening of individual sections of the colon). In the wall of the small intestine, atrophic changes are revealed (disturbances in membrane digestion, absorption of proteins, fats and carbohydrates occur). Changes in the intestinal microflora: • the number of lactic acid bacteria decreases • the number of putrefactive bacteria increases • increasing production of endotoxins • the functional state of the intestine is disturbed.

 

When constructing diets for the elderly, it is necessary to adapt the chemical composition and physicochemical properties of food substances to the physiological characteristics of the body of people in this age group.

All types of metabolism (protein, carbohydrate, fat and mineral) decrease with age. The decrease in metabolism is due to the deterioration in the delivery of oxygen and nutrients to tissues, which leads to a decrease in energy exchange and a drop in performance. In old age, basal metabolism and physical activity decrease, so the energy value of the diet should be reduced. The most diverse diet (providing sufficient intake of proteins, fats, carbohydrates, vitamins and minerals) of the elderly should be combined with an energy balance, i.e. the calorie content of the diet should correspond to the energy expenditure of the body. A balanced intake of essential macro- and micronutrients is very important. The carbohydrate content should be 55-60% of the total energy value of the food, while easily digestible carbohydrates are reduced to 30-35 g/day. Fiber (cellulose, lignin, pectin) must be supplied with food, which is an effective anti-aging agent, improves digestion, relieves the burden on the liver, and also reduces the risk of developing colon cancer, atherosclerosis, and diabetes. The content of cholesterol in food should be reduced to 200-300 mg / day. The need for animal proteins should be covered by dairy products and fish.

PREMIUM CHAPTERS ▼

 

Recommended intake of energy, proteins, fats and carbohydrates for the elderly (per day) (PREMIUM)

Age, groups	Energy (kcal)		Protein (g)			Fat (g)	Carbs (g)
Total			including meat
Men 60-74 years old	2300		69			38				77		333
Men 75 years and older	2000		60			33				67		290
Women 60-74 years old		2100		63	35					70	305
Women 75 years and older		1900		57	31			63	275

 

Vitamins and mineral elements	Men		Women
	60-74 years old	75 years and older	60-74 years old	75 years and older
Thiamine, mg	1.4	1.2	1.3	1.1
Riboflavin, mg	1.6	1.4	1.5	1.3
Vitamin B6, mg	1.6	1.4	1.5	1.3
Vitamin B 12, mcg	3	3	3	3
Folacin, mcg	200	200	200	200
Niacin, mg	fifteen	13	fourteen	fourteen
Vitamin C, mg	58	fifty	52	48
Vitamin A (retinol equivalent)	1000	1000	1000	1000
Vitamin E, IU	fifteen	fifteen	12	12
Vitamin B, IU	100	100	100	100
Calcium, mg	800	800	800	800
Phosphorus, mg	1200	1200	1200	1200
Magnesium, mg	400	400	400	400
Iron, mg	eighteen	eighteen	eighteen	eighteen

The need for vitamins and minerals in old age remains quite high. (PREMIUM)

Diet.

The main principle of the diet of the elderly should be: a uniform 4-5 meals a day, and the exclusion of taking a large amount of food at the same time. The distribution of food throughout the day should be strictly regulated. The most rational is 4 meals a day, in which breakfast should be 25% of the total daily energy value, second breakfast 15%, lunch 35%, dinner 25%. The last meal should be no later than 2 hours before bedtime.

Another very important principle in the nutrition of the elderly is the use of foods and dishes that are easy to digest and assimilate. These requirements are due to a decrease in the activity of digestive enzymes with age. Therefore, older people are not recommended to use smoked meats, mushrooms, legumes often and in large quantities, which complicate the work of the digestive tract. Preference should be given to fish, dairy and especially fermented milk products (kefir, curdled milk, acidophilus, yogurt). Even I.I. Mechnikov attributed simply sour milk to substances capable of delaying old age. In his opinion, lactobacillus prevents the development of putrefactive microbes in the large intestine, prevents poisoning of the body with putrefactive decay products, which are the cause of human aging. Lactic acid products well regulate the work of the intestines, prevent the development of constipation. In order to normalize the microflora of the large intestine, specialized fermented milk products are useful for the elderly - kefir and cottage cheese, enriched with eubiotics (bifido- and lactobacilli).

Vitamins are among those biologically active substances, the deficiency of which in the body can be accompanied by a violation of the functions of many physiological systems of the body and the development of metabolic disorders. As we age, putrefactive microflora begins to predominate in the intestines. The synthesis of vitamins B2, B6, B12, H, pantothenic, cholic acid is disturbed. The presence of normal microflora contributes to the excretion of cholesterol, improves immunity. Normalize the intestinal microflora fermented milk products and dietary fiber.

Alimentary life-prolonging factors are food antioxidants - amino acids: methionine, cysteine, glutamic acid; mineral elements: magnesium, manganese, copper, zinc, selenium; vitamins: B, P, K, A, E, C; various substances of plant origin: flavonoids, pilifen, aromatic herbs, etc. The greatest antioxidant protection of the body can be achieved when using a dairy-vegetarian diet.

For proper nutrition and disease prevention, it is necessary to use more often biologically active food supplements containing vitamins, microelements, antimutagenic, anticarcinogenic and immunomodulatory substances in a balanced form, as well as foods rich in these substances.

The main source of calcium in food is milk and dairy products (cottage cheese, cheeses, etc.), phosphorus - dairy products, meat, fish, legumes. Magnesium is rich in vegetable products - cereals, legumes, vegetables, carrots, cabbage, nuts, etc. Potassium is found in potatoes, black plums, apricots, pumpkins, zucchini, cabbage, cereals, berries, fruits. Due to the fact that sodium retains water in the body, salt intake should be reduced to 5 g per day while limiting salinities (herring, pickled cucumbers, mushrooms), the abuse of which increases blood pressure and makes the heart difficult.

Wateris the most important substance for sustaining life, yet despite the need for a constant supply of fresh water, older people do not consume enough water to maintain a long and healthy life. In the elderly, the most common biological sign of aging is dehydration, and perhaps one factor in its development is the loss of sensitivity to thirst with age. It is necessary to drink at least 8 glasses of water per day (on average 1.5 liters), but it must be remembered that water cannot be replaced by juices, tea, coffee, alcoholic and non-alcoholic drinks. It is necessary to use only tap or boiled spring water purified with household filters, as well as melted and bottled environmentally friendly water for drinking and cooking. Water hygiene for health is also important, as well as food hygiene. It is necessary to limit the use of artificial carbonated canned drinks (lemonade, Pepsi-Cola, Coca-Cola, Fanta, etc.), as they have a very negative effect on the mucous membranes of the esophagus and stomach.

Products of animal origin. The diet of the elderly should include meat and fish (especially sea) low-fat varieties, preferably boiled. It is not recommended to use strong rich broths, it is preferable to use dairy and fish products, as they are easier to digest, better absorbed and have a high nutritional value. Milkcontains almost all the substances necessary for a person, it is a product balanced by nature itself. Whole milk is not always well tolerated by the elderly, so it can be added to tea, coffee or replaced with fermented milk products that prevent the development of putrefactive microbes in the colon, regulate intestinal motility, and prevent the development of constipation. In addition, milk and lactic acid products have a diuretic effect. In the diet of an elderly person, it is useful to introduce such a source of protein as cottage cheese, which contains a relatively large amount of methionine, which has a lipotropic effect. Cheese, which has a lot of protein and calcium, for the elderly is recommended only non-sharp and low-fat varieties. Eggshave the best, close to optimal, amino acid composition of the protein, so 1-2 times a week it is useful to include them in the diet of an elderly person in the form of an omelette or soft drink.

Animal fats, taken in food in increased quantities, contribute to the progression of the atherosclerotic process and aggravate the digestion of food. From the diet it is necessary to exclude refractory fats (lamb and lard, beef fat). It is advisable to replace part of the butter with sour cream.

In the diet of the elderly, there should also be a sufficient amount of vegetable protein (half of the total amount of protein). The ratio of animal and vegetable proteins in food, equal to 1:1, contributes to their better digestion, absorption and assimilation.

Vegetable products. Sources of carbohydrates and vegetable protein are bread, bakery products, cereals, legumes (soybeans, peas, beans, lentils). An excess of carbohydrates in the diet leads to an increase in body weight, which adversely affects the state of both the cardiovascular system and metabolic processes in the body. In this regard, with age, it is recommended to limit the use of sweets, confectionery, bakery, pasta. At the same time, it is necessary to use as widely as possible in the diet products that are sources of complex carbohydrates and contain vegetable protein, vitamins, microelements, fiber - wholemeal bread, bran bread, cereals from oatmeal and buckwheat, legumes, various vegetables. , berries and fruits.The use of legumes, however, should be somewhat limited due to the increase under their influence of fermentation processes that cause bloating, abundant gas formation, which adversely affects the state of the cardiovascular system. Carbohydrates should mainly be used at the expense of a complex, slowly absorbed polysaccharide - starch, found in cereals, potatoes, etc. For older people, fiber is especially important. The consumption of vegetables and fruits promotes the separation of bile, enhances the contraction of the gallbladder, and prevents constipation.

The attractive appearance and smell of food dishes is very important, as older people often suffer from reduced appetite. Therefore, when cooking, you can make more use of herbs, vegetable and fruit juices, horseradish, onions, garlic, which not only improve the taste of dishes, but also contain mineral salts, vitamins, phytoncides, etc. Onions and garlic enhance the motor and secretory function intestines, reduce putrefactive processes in it.

The role of nutrition in the prevention of atherosclerosis. (PREMIUM)

As is known, the main cause of morbidity and mortality in the elderly is currently cardiovascular diseases caused by atherosclerotic vascular lesions. At the same time, nutrition is an important factor in both the progression of this disease and its prevention and treatment. The antiatherogenic orientation of the diet is not only a reduction in the calorie content of food, but also a restriction of foods containing cholesterol (liver, kidneys, brains, fatty meats, fish caviar, egg yolks), and animal fats rich in saturated fatty acids (beef, pork, mutton, duck, goose, chicken and other fats), replacing them with vegetable oils (sunflower, olive, corn, cottonseed, soybean, linseed, rapeseed, etc.) - sources of mono- and polyunsaturated fatty acids (PUFAs) of the omega 6 families and omega 3 providing hypolipidemic, antiplatelet, antiatherogenic and hypotensive effects in the amount of 20-30 g per day. The risk of developing diseases such as coronary artery disease, stroke, diabetes is associated with the consumption of large amounts of saturated fats and trans-fatty acids. Fats and oils are found in foods in the form of triglycerides (TG). TG contains fatty acids. They can be saturated (in hard margarines, butter), polyunsaturated (in vegetable oils, fish), monounsaturated (in olive, rapeseed, peanut oils). Particular attention is paid to oils rich in monounsaturated fatty acids, especially olive oil, because they have antioxidant properties. Limiting the consumption of meat, poultry and fish (fatty varieties) - 180 g per day, substitution with low-fat meat and dairy products,

In connection with the functional features of the digestive system in the elderly, it is necessary to additionally introduce specialized enteral nutrition products with easy digestibility and assimilation into the diet. An example of this is standard and special diets, which are available in liquid and dry form. The basis of these diets is milk protein, oligo- and polysaccharides, medium chain triglycerides, poly-, monounsaturated and saturated fatty acids in a ratio of 1:1:1. The use of enteral nutrition helps to prevent mucosal atrophy and restore the functions of the gastrointestinal tract, correct nutritional status disorders, eliminate metabolic disorders, prevent dysbacteriosis, and has an immunomodulatory effect.

Fasting and fasting days. (PREMIUM)

It is recommended to regularly spend fasting days (on the recommendation of the attending physician, usually 1 time per week): fish, meat, vegetable, dairy, fruit.

Due to the fact that fasting has a number of contraindications for various diseases (malignant tumors, tuberculosis, diabetes, etc.), it is possible only under the supervision and on the recommendation of the attending physician. Fasting is recommended for no more than a day, with the obligatory consumption of water.

 

In conclusion, I would like to say that age-related changes are an inevitable process that awaits all living people, and this must be treated with understanding and patience. However, it should be remembered that an active life position of a person, systematic mental and physical labor, as well as proper nutrition will help slow down the rate of aging and active longevity.