Download Chapter 1 – Title of Chapter

Chapter 17-1
Chapter 17 – Life Cycle Nutrition: Adulthood and the Later Years
Learning Objectives
After completing Chapter 17, the student will be able to:
17.1
17.2
17.3
17.4
17.5
H17
Describe the role nutrition plays in longevity.
a. List the lifestyle behaviors that have an impact on health and aging.
b. Discuss the research on energy restriction and aging.
Summarize how nutrition interacts with the physical, psychological, economic, and social changes involved
in aging.
a. Describe physiological aging and lifestyle factors which can modify the process.
Explain why the needs for some nutrients increase or decrease during aging.
a. Describe the energy and nutritional needs of older adults.
Identify how nutrition might contribute to, or prevent, the development of age-related problems associated
with vision, arthritis, the brain, and alcohol use.
Instruct an adult on how to shop for groceries and prepare healthy meals for one person on a tight budget.
a. Identify food assistance programs available for older adults.
Explain why certain nutrients and medications interact.
a. Name some medications that increase excretion of, alter requirements of, or interact with nutrients and
the dietary changes recommended.
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license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-2
Glossary
Chapter Key Terms
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Alzheimer’s (AHLZ-high-merz) disease: a degenerative disease of the brain involving memory loss and
major structural changes in neuron networks; also known as senile dementia of the Alzheimer’s type
(SDAT), primary degenerative dementia of senile onset, or chronic brain syndrome.
arthritis: inflammation of a joint, usually accompanied by pain, swelling, and structural changes.
atrophic (a-TRO-fik) gastritis (gas-TRY-tis): chronic inflammation of the stomach accompanied by a
diminished size and functioning of the mucous membrane and glands. This condition is also characterized
by inadequate hydrochloric acid and intrinsic factor— two substances needed for vitamin B12 absorption.
cataracts (KAT-ah-rakts): clouding of the eye lenses that impairs vision and can lead to blindness.
chronological age: a person’s age in years from his or her date of birth.
congregate meals: nutrition programs that provide food for the elderly in conveniently located settings
such as community centers.
dysphagia (dis-FAY-jah): difficulty swallowing.
gout (GOWT): a common form of arthritis characterized by deposits of uric acid crystals in the joints.
life expectancy: the average number of years lived by people in a given society.
life span: the maximum number of years of life attainable by a member of a species.
macular (MACK-you-lar) degeneration: deterioration of the macular area of the eye that can lead to loss
of central vision and eventual blindness. The macula is a small, oval, yellowish region in the center of the
retina that provides the sharp, straight-ahead vision so critical to reading and driving.
Meals on Wheels: a nutrition program that delivers food for the elderly to their homes.
neurofibrillary tangles: snarls of the threadlike strands that extend from the nerve cells, commonly found
in the brains of people with Alzheimer’s dementia.
neurons: nerve cells; the structural and functional units of the nervous system. Neurons initiate and
conduct nerve impulse transmissions.
osteoarthritis: a painful, degenerative disease of the joints that occurs when the cartilage in a joint
deteriorates; joint structure is damaged, with loss of function; also called degenerative arthritis.
physiological age: a person’s age as estimated from her or his body’s health and probable life expectancy.
pressure ulcers: damage to the skin and underlying tissues as a result of compression and poor circulation;
commonly seen in people who are bedridden or chair-bound.
purines: compounds of nitrogen-containing bases such as adenine, guanine, and caffeine. Purines that
originate from the body are endogenous and those that derive from foods are exogenous.
quality of life: a person’s perceived physical and mental well-being.
rheumatoid (ROO-ma-toyd) arthritis: a disease of the immune system involving painful inflammation of
the joints and related structures.
sarcopenia (SAR-koh-PEE-nee-ah): loss of skeletal muscle mass, strength, and quality.
o sarco = flesh
o penia = loss or lack
senile dementia: the loss of brain function beyond the normal loss of physical adeptness and memory that
occurs with aging.
senile plaques: clumps of the protein fragment beta-amyloid on the nerve cells, commonly found in the
brains of people with Alzheimer’s dementia.
stress: any threat to a person’s well-being; a demand placed on the body to adapt.
stress response: the body’s response to stress, mediated by both nerves and hormones.
stressors: environmental elements, physical or psychological, that cause stress.
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-3
Lecture Presentation Outline
Key to instructor resource annotations (shown to the right of or below outline topics):
Website
= Available for download from book companion website: HN = student handout
IM
= Included in this instructor’s manual: CS = case study, WS = worksheet, CA = classroom activity
Introductory/whole chapter resources: PL figure JPEGs; Test Bank; IM WS 17-2
I.
Nutrition and Longevity (Figure 17-1)
A. Observation of Older Adults
1. Healthy Habits
a. Eating well-balanced meals
b. Engaging in physical activity regularly
c. Not smoking
d. Not using alcohol, or using it in moderation
e. Maintaining a healthy body weight
f. Sleeping regularly and adequately
g. Having a sense of purpose
h. Relieving stress
i. Belonging to a community of loving family and friends
2. Physical Activity (Table 17-1)
a. Lower weight, greater flexibility, increased endurance, better balance and health, and a longer life
span
b. Prevent or delay the decreases in muscle mass and strength that occur with age
c. Higher energy and nutrient intakes
d. Those who have not been active should start easy and build slowly
e. Check with physician first
B. Manipulation of Diet
1. Energy Restriction in Animals
a. Shown to prolong life
b. Shown to delay onset of or prevent disease – reduces oxidative stress
2. Energy Restriction in Human Beings
a. Applying results in animal studies to human beings is problematic
b. Extreme starvation is not worth the price
c. Moderation of energy intake may be valuable
II. The Aging Process
A. Physiological Changes
IM CA 17
1. Body Weight
a. Two thirds of the older adults in the U.S. are overweight or obese
b. Older adults with low body weight may be unprepared to fight illness and disease
2. Body Composition
a. Sarcopenia (Figure 17-2)
b. Nutrition and exercise play a role in maintaining muscle mass
3. Immunity and Inflammation
a. Compromised immune systems can occur with age
b. Chronic inflammation can occur along with frailty, illness, and death
c. An underlying inflammatory process is responsible for many diseases that affect older adults
d. Incidences of infectious diseases increase
4. GI Tract
a. Slower motility resulting in constipation
b. Atrophic gastritis
c. Dysphagia
5. Tooth Loss
a. Tooth loss and gum disease can interfere with food intake
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-4
b.
c.
Edentulous
Conditions that require dental care
1. Dry mouth
2. Eating difficulty
3. No dental care in 2 years
4. Tooth or mouth pain
5. Altered food selections
6. Lesions, sores, or lumps in mouth
d. Ill-fitting dentures
6. Sensory Losses and Other Physical Problems
a. Vision problems can make driving and shopping difficult
b. Taste and smell sensitivities may diminish
B. Other Changes
1. Psychological Changes
a. Depression and loss of appetite
b. Support and companionship of family and friends are helpful
2. Economic Changes
a. Older adults have lower incomes and are at risk for poverty
b. Only 1/3 receive aid from federal assistance programs
3. Social Changes
a. Loneliness is directly related to low energy intakes
b. Malnutrition is most likely among those who live alone
III. Energy and Nutrient Needs of Older Adults
IM WS 17-1
A. Water
1. Dehydration
2. Fluid needs are not recognized
3. Mobility and bladder problems
4. Water recommendations:
a. Men – 13 cups per day
b. Women – 9 cups per day
B. Energy and Energy Nutrients
1. Energy needs decrease by around 5% per decade
2. Protein – To protect muscle mass, boost the immune system, and optimize bone mass
3. Carbohydrate and Fiber
a. Carbohydrate for energy
b. Fiber and water to reduce constipation
4. Fat – To enhance flavors of foods and provide valuable nutrients
C. Vitamins and Minerals (Table 17-2)
1. Vitamin B12
2. Vitamin D
3. Folate
4. Calcium
5. Iron
6. Zinc
D. Nutrient Supplements
1. Vitamin D and calcium for osteoporosis
2. Vitamin B12 for pernicious anemia
3. A multivitamin-multimineral supplement may be recommended
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-5
IV. Nutrition-Related Concerns of Older Adults
A. Vision
1. Cataracts (Figure 17-3)
a. Vitamin C, vitamin E, and carotenoids may decrease the risk or slow progression of cataracts
b. Some association with obesity
2. Macular Degeneration
a. Supplements of the omega-3 fatty acid DHA, folate, vitamin B6, vitamin B12, leutein, zeaxanthin
are preventative factors
b. Oxidative stress from sunlight is a risk factor
B. Arthritis
1. Osteoarthritis
a. Risk factors include age, smoking, high BMI at age 40, and lack of hormone therapy in women
b. Painful deterioration of the cartilage in the joints
c. Associated with overweight
2. Rheumatoid Arthritis
a. Immune system attacks bone coverings
b. Omega-3 fatty acids may reduce joint tenderness and improve mobility
c. Vitamin C, vitamin E, and carotenoids as antioxidants may help
3. Gout
a. Uric acid deposits in the joints
b. Purines are converted to uric acid
c. Limit meat, seafood, sugar-sweetened beverages, and alcohol to lower uric acid levels
4. Treatment
a. Relief from discomfort and improve mobility
b. No cure
c. Alternative therapies such as glucosamine and chondroitin may help
d. Drugs and supplements may affect nutritional status
C. The Aging Brain
IM HN 17-1
1. Nutrient Deficiencies and Brain Function
a. Neurotransmitters need precursor nutrients
b. Senile dementia
c. Neurons diminish as people age
2. Alzheimer’s Disease (Table 17-3)
a. Abnormal deterioration of the brain
b. Free radicals and oxidative stress
c. Senile plaques (beta-amyloid clumps) and neurofibrillary tangles develop in the brain
d. Acetycholine production/breakdown may affect memory
e. Drugs are useful, but are not a cure
f. Maintaining body weight is important; Alzheimer’s patients may forget to consume foods
D. Alcohol
1. Impairs memory and cognition
2. Ask about drinking behaviors
V. Food Choices and Eating Habits of Older Adults
A. Malnutrition (Table 17-5)
1. Limits ability to function
2. Diminishes quality of life
3. Nutritional interventions
4. Screening check list
B. Food Assistance Programs
1. Congregate meals
2. Meals on Wheels
3. The Senior Farmers Market Nutrition Program
IM CS 17-1
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-6
C. Meals for Singles
1. Foodborne Illness
a. Greater risk in older adults
b. If severe, can cause paralysis, meningitis, or death
2. Spend Wisely
a. Buying proper quantities
b. Buy foods with longer shelf life
3. Be Creative
a. Use fresh foods for different recipes
b. Dine with others
c. Freezing meals
VI. Highlight: Nutrient-Drug Interactions
IM CS 17-2
A. The Actions of Drugs
1. Modifies one or more of the body’s functions
2. Desirable and undesirable effects
B. The Interactions between Drugs and Nutrients (Table H17-1)
Website HN 17-2
1. Drugs Alter Food Intake
a. Altering appetite
b. Interfering with taste and smell
c. Inducing nausea or vomiting
d. Interfering with oral functioning
e. Causing sores or inflammation of the mouth
2. Drugs Alter Nutrient Absorption
a. Changing acidity of the digestive tract
b. Damaging mucosal cells
c. Binding nutrients
3. Diets Alter Drug Absorption
a. Stimulating secretion of gastric acid
b. Altering rate of gastric emptying
c. Binding to drugs
d. Competing for absorption sites
4. Drugs Alter Nutrient Metabolism (Figure H17-1)
a. Acting as structural analogs
b. Competing with each other for metabolic enzyme systems
c. Compete for transport proteins
5. Diet Alters Drug Metabolism (Figure H17-2)
a. May increase the side effects of drugs
b. May increase drug action to excessive levels
5. Drugs Alter Nutrient Excretion
a. Altering reabsorption in the kidneys
b. May result in diarrhea or vomiting
6. Diets Alter Drug Excretion – May cause the liver to release enzymes that metabolize drugs and
influence excretion
7. Diet-Drug Toxicities – May cause toxicity or exacerbate drug side effects
C. The Inactive Ingredients in Drugs
1. Sugar, Sorbitol, and Lactose
a. Sugar may be a problem for diabetics
b. Sorbitol may cause diarrhea
c. Lactose can be a problem for those with lactose intolerance
2. Sodium – Can be found in antibiotics and antacids
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-7
Case Studies
Case Study 17-1: Malnutrition in an Elderly Male
Roy is an 89-year-old retired pastor who was married for 60 years before the death of his wife 6 months ago. He
now lives alone, close to his daughter and her family, in a high rise for low-income elderly individuals. He recently
stopped driving on the advice of his physician and depends on his daughter and grandchildren to help him with
groceries and transport him to doctor’s appointments. Although in reasonably good health, he has lost weight over
the past year and complains of feeling more tired than usual, and seems to have had repeated colds recently. Since
his wife’s death, he has stopped going to his exercise class and prefers to eat his meals in his apartment rather than
the community dining facility. He prepares his own meals, which usually include toast and coffee for breakfast, a
meat or cheese sandwich with potato chips and milk for lunch, and canned soup or chili beans for dinner. He rarely
eats between meals. Although usually at a healthy weight for his height, Roy’s family is concerned because he has
lost 12 pounds since his wife’s death. After noticing he has terrible bruises from a recent fall, they decide to take
action.
1.
In the U.S., what percentage of persons 65 and older live in poverty?
a. 3
b. 6
c. 9
d. 12
e. 15
2.
Age-associated loss of muscle mass, called ____, may have contributed to Roy’s recent fall.
a. Glycopenia
b. Thyropenia
c. Lipopenia
d. Sarcopenia
e. Osteopenia
3.
One of Roy’s daughters recalls the large meals her mother prepared for the family and how enthusiastically Roy
ate. She offers to take Roy to her home so she can prepare similar dinners and Roy can enjoy family meals
again. Roy counters by saying that, as people age, their energy needs decrease. On average, energy needs
decline an estimated ____ percent per decade.
a. 1
b. 3
c. 5
d. 7
e. 9
4.
Given Roy’s age and the fact that he spends virtually all of his time indoors, what should his daily vitamin D
intake be?
a. 5 micrograms
b. 10 micrograms
c. 15 micrograms
d. 20 micrograms
e. 25 micrograms
5.
Which of the following is true of vitamin B12 and the elderly?
a. About 15% of the elderly have atrophic gastritis that interferes with their B12 levels.
b. Even when it is extreme, B12 deficiencies rarely have an important impact on the elderly.
c. It is recommended that all individuals aged 50 and older take a daily B12 supplement.
d. Elderly individuals typically get enough B12 from naturally-occurring food sources.
e. Because of its greater bioavailability, it is recommended that elderly individuals get their B12 from B12–
fortified foods.
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-8
6.
Given his diet and his recent fall, Roy’s family is concerned about his calcium intake. What is the daily
recommendation of calcium intake for men Roy’s age?
a. 600 milligrams
b. 800 milligrams
c. 1000 milligrams
d. 1200 milligrams
e. 1400 milligrams
7.
For which nutrient may dietary intake and absorption be poor, while needs increase, resulting in depressed
appetite and sense of taste?
a. Iron
b. Zinc
c. Calcium
d. Vitamin D
e. Vitamin B12
Answer Key
1. c
2.
d
3.
c
4.
d
5.
e
6.
d
7.
b
Case Study 17-2: Avoiding Food-Drug Interactions1
Betsy A. is a 72-year-old woman who was recently hospitalized after having a mild stroke. She has been discharged
from the hospital on warfarin—a blood thinning medication—and has been advised to continue her usual diet at
home. Betsy’s doctor also wants her to continue her other medications, which include a diuretic medication, a lowdose daily aspirin, and pravastatin—her cholesterol medication.
Betsy and her husband consume a varied diet. Betsy’s husband often barbecues fish, poultry, and meat on their
outdoor grill. They eat fresh oranges or grapefruit most mornings and have a mixed green salad with dinner several
nights a week. Betsy begins to wonder if her new medication will require her to make any changes in her diet.
1.
2.
3.
4.
5.
6.
7.
1
Based on information in Highlight 17, what are some potential drug-drug or drug-nutrient interactions Betsy
may encounter with the addition of warfarin to her medication regimen?
Which foods in Betsy’s usual diet have the greatest potential to interfere with the therapeutic effect of her new
medication? Explain why this is important for Betsy to understand.
Why is it important for Betsy to adhere to her doctor’s advice to maintain her current diet in regards to taking
warfarin?
What information about cooking meat and its effect on warfarin activity would be helpful for Betsy and her
husband to understand? How might this change their cooking methods?
How might Betsy’s nutritional status be affected by her diuretic medication? Explain how she can use this
information to make daily food choices.
Based on her current medication regimen, should Betsy stop eating grapefruit? Why or why not?
What is a good course of action for Betsy to follow if she has any questions about the potential interactions of
her medications?
Contributed by Barbara Quinn.
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-9
Answer Key
1. Answers may include anti-clotting effect of aspirin that may enhance the effect of warfarin; and the effect of
vitamin K on warfarin activity (high vitamin K can weaken the effect of warfarin).
2.
Betsy’s diet is high in dark-green leafy vegetables, which are the highest sources of vitamin K, a nutrient that is
structurally similar to warfarin. Warfarin acts by blocking the enzyme that activates vitamin K, thereby
preventing the synthesis of blood-clotting factors. The amount of warfarin prescribed is dependent, in part, on
how much vitamin K is provided by the diet.
3.
If vitamin K consumption from foods or supplements changes substantially, it can interfere with the action of
the drug. (Increased vitamin K can weaken the effect of warfarin and decreased vitamin K can enhance its
effect.) Individuals using warfarin are advised to consume similar amounts of vitamin K daily to keep warfarin
activity stable.
4.
Components of charcoal-broiled meats increase metabolism of warfarin. Answers will vary but it may be
helpful for Betsy’s husband to charcoal-broil meats less often.
5.
Drugs that enhance urine excretion may accelerate the excretion of potassium, calcium, and magnesium. Betsy
should therefore include foods that contain these nutrients, such as fruits, vegetables, dairy foods, and whole
grains, in her daily diet.
6.
Betsy does not have to stop eating grapefruit. Neither warfarin nor her cholesterol medication (pravastatin) is
affected by grapefruit juice.
7.
Betsy can ask her physician about potential interactions and check with her pharmacist for instructions on
taking drugs with foods. If she has any problems with the medications, she should seek professional care
without delay.
Suggested Classroom Activities
This chapter provides information on aging and the nutrition needs of the elderly. Instructors may want to emphasize
particular sections of the chapter and elaborate on them in response to students’ interest.
Classroom Activity 17: Simulation of Aging Processes
Key concept: Physiological changes during aging
Class size: Small to medium
Materials needed: Knee wraps, needles, thread, fabric (several small pieces), scissors (2 pairs), reading glasses (2
pairs), petroleum jelly, plastic/rubber gloves (2 pairs), newspaper, cotton balls
Instructions: Prior to class, collect several items and set up stations in the classroom:
 Station 1—knee wraps;
 Station 2—sewing needles, thread, fabric, scissors, reading glasses with Vaseline on lenses, plastic or rubber
gloves;
 Station 3—newspaper, scissors, plastic or rubber gloves, reading glasses with Vaseline on lenses, cotton balls.
Assign the following tasks to each student:
 Wrap the knee wraps around one knee to simulate joint stiffness and walk around for 3 to 5 minutes; walk up
and down stairs if available.
 Wearing the reading glasses and plastic or rubber gloves, thread a needle and sew a row of stitches.
 Wearing the reading glasses and plastic or rubber gloves, with cotton balls placed in the ears, cut an article out
of the paper and talk about it to another student.
After the activity is complete, discuss the challenges of the aging process.
Study Card 17 Answer Key
1.
c
2.
d
3.
c
4.
d
5.
b
6.
Dehydration is a risk for older adults. Total body water decreases as people age, so even mild stresses such as
fever or hot weather can precipitate rapid dehydration in older adults. Many older people do not seem to feel
thirsty or notice mouth dryness. Older adults may find it difficult and bothersome to get a drink or to get to a
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-10
bathroom. Those who have lost bladder control may be afraid to drink too much water. Dehydrated older adults
seem to be more susceptible to urinary tract infections, pneumonia, pressure ulcers, and confusion and
disorientation.
7.
On average, energy needs decline an estimated 5 percent per decade. One reason is that people usually reduce
their physical activity as they age, although they need not do so. Another reason is that basal metabolic rate
declines 1 to 2 percent per decade in part because lean body mass and thyroid hormones diminish.
8.
Setting standards for older people is difficult because individual differences become more pronounced as people
grow older. People start out with different genetic predispositions and ways of handling nutrients, and the
effects of these differences become magnified with years of unique dietary habits. Also, as people age, they
suffer different chronic diseases and take various medicines—both of which will affect nutrient needs. For all of
these reasons, researchers have difficulty even defining “healthy aging,” a prerequisite to developing
recommendations to meet the “needs of practically all healthy persons.”
9.
b
10. c
11. d
12. Chronic illnesses, medications, depression, and social isolation can all contribute to malnutrition. The
DETERMINE checklist, developed as a screening tool to detect potential malnutrition in the elderly, identifies
the following characteristics associated with malnutrition in this population: disease, poor eating habits, tooth
loss or mouth pain, low economic status, reduced social contact, use of multiple medications (polypharmacy),
involuntary weight loss or gain, inability to acquire and prepare food independently, and age >80.
13. c
14. b
15. On average, people over the age of 65 receive 14 to 18 prescriptions a year. They tend to have an increase in
prescriptions resulting in polypharmacy in which a person can be taking up to 6 different medications at one
time. Polypharmacy in combination with physiological changes associated with the elderly, may cause a
decrease in the efficacy of drugs as well as an increase in the risk of potential toxicities.
Critical Thinking Questions2
1.
What nutritional factors contribute to longevity?
2.
Describe how differences in body weight and body composition affect older adults in terms of health outcomes.
3.
Explain how dentition factors affect nutrition for the older adult.
4.
Describe how decreased fluid intake for the older adult leads to poor health outcomes.
5.
What dietary measures will help to alleviate clinical symptoms of gout?
6.
Compare and contrast the nutritional benefits of congregate meals versus Meals on Wheels for the older adult.
Answer Key
1. Eating a well-balanced diet that is low in unhealthy fats and rich in fruits, whole grains, and vegetables is
associated with increased longevity. Limited alcohol intake and/or avoidance of alcohol is also associated with
living longer. Ingestion of fresh food products and limited use of processed foods are viewed as being healthier
choices that contribute to living longer. Maintaining a healthy weight pattern based on one’s individual body
frame structure is recommended. The integration of physical activity as part of a healthy lifestyle also favors the
likelihood of a longer life.
2.
2
With aging, older adults tend to lose bone and muscle mass but at the same time are prone to gain body fat. This
is considered to be a normal part of the aging process due to hormonal effects. In the older adult, it is better to
be normal weight or slightly overweight as compared to being underweight or obese. If underweight, the older
adult may not be able to fight off a potential infection or survive a wasting illness as he/she has insufficient
nutrient stores. If the older adult is clinically obese, he/she is at risk of developing diseases such as
hypertension, CVD, or diabetes, which can further affect nutritional status and function. BMI classifications
Contributed by Daryle Wane.
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-11
differ in their clinical correlation with disease progression in the older adult. A BMI of 27 is associated with
disease progression for adults 65 and older but this relationship disappears at age 75.
3.
Due to the effects of aging, older adults are likely to experience a dry mouth. Dryness in the mouth can lead to
the occurrence of dental disease that can affect both teeth and gums. Gum or periodontal disease can lead to
significant impairments such as pain, inability to chew foods, and alterations in taste. If there are any lesions or
sores in the mouth, this can also contribute to mouth pain, inability to chew foods, and alterations in taste.
Alterations in swallowing may not only affect dietary choices but may also place the individual at risk for
aspiration. If the individual has bridges and/or dentures that are not fitted correctly, this can further exacerbate
dental health problems. Older adults who have any of these conditions may restrict and/or limit their food
intake, resulting in nutritional deficiencies. It is important to ascertain the dental status of the older adult for its
relative contribution to nutritional health.
4.
Older adults experience a larger proportional fluid loss than younger adults as their total body water decreases
with age. Older adults are therefore at a greater risk to suffer from the effects of dehydration. Older adults also
have a decreased thirst response mechanism along with decreased sensory responses that affect taste perception.
The effects of clinical dehydration in the older adult can manifest in a variety of clinical symptoms ranging
from urinary tract symptoms to mental confusion.
5.
Since gout is associated with an increase in uric acid levels, avoidance and/or limitation of foods that are
considered to be high in uric acid should be practiced. Purine-based foods are associated with high uric acid
levels. Foods that should be avoided are organ meats, seafood, and sugar-sweetened beverages. Alcohol should
be avoided and an increase in water intake is recommended. Low-fat and/or dairy-free products are also
recommended. Clinical evidence supports a strong relationship between certain identified foods (increased
purine content) and occurrence of gout.
6.
Congregate meals are meals that are served in a group setting. Meals on Wheels are those that are served to an
individual person in her/his own home. In terms of nutritional benefits, both of these methods offer similar
nutritional value because they are based on daily food group nutritional standards. Each of these meal options
provides nutritional benefits based on meeting established economic guidelines for distribution. They differ in
their approach to encouraging food intake based on the effect of the group process in facilitating intake.
Congregate meals allow for a group of individuals to come together, whereby communication and interaction
are favored; this interaction can help improve intakes. Meals on Wheels are served at the individual unit level
and as such are provided within the home of the client. If the individual has a spouse, then the spouse also can
receive a meal. Thus, communication and/or interaction during the meal time period is not guaranteed. The
communication and/or interaction is limited to the delivery of the meal for single individuals receiving Meals on
Wheels.
IM Worksheet Answer Key
Worksheet 17-1: Eating for Healthy Aging Review (Internet Exercise)
1. a
2. b
3. a
4. b
Worksheet 17-2: Chapter 17 Crossword Puzzle
1. osteoarthritis
4. Alzheimer’s disease
2. antioxidants
5. folate
3. Depression
6. vitamin K
7.
8.
9.
5.
sarcopenia
physiological age
zinc
a
6.
b
10. vitamin D
11. Energy
12. Congregate meals
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-12
Worksheet 17-1: Eating for Healthy Aging Review (Internet Exercise)
Instructions: Go to this website to answer questions 1-6:
http://nihseniorhealth.gov/eatingwellasyougetolder/benefitsofeatingwell/01.html. Proceed through all of
the information provided on the Benefits of Eating Well, and then click on Choose Nutrient-Dense
Foods and Know How Much To Eat and read these pages as well. Click on Quiz Yourself and take the
quizzes on these three content areas to make sure that you understand the presented information. Do not
close the window until you have answered all of the questions.
1. Eating well can reduce the risk of developing type 2 diabetes.
a. True
b. False
2. The number of calories you need each day is determined by one factor, your age.
a. True
b. False
3. Including nutrient-dense foods in your diet can provide you with needed nutrients while limiting
caloric intake.
a. True
b. False
4. Refined grain food sources are equivalent in nutritional content to whole-grain food sources.
a. True
b. False
5. Walnuts are an example of a food that contains polyunsaturated fat.
a. True
b. False
6. Women over age 50 should consume 2,000 calories (kcal) per day if they are moderately active in
terms of physical activity.
a. True
b. False
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-13
Worksheet 17-2: Chapter 17 Crossword Puzzle
1
2
3
4
5
6
7
8
9
10
11
12
Across:
Regular physical activity and achieving a healthy
weight may help alleviate the pain associated with
_____.
4. Minimize disruptions at meal times to maximize
nutritional intake in individuals with _____.
8. Influenced by regular physical activity and good
nutritional intake
10. Older adults may need supplemental _____ due to
decreased sun exposure and milk consumption.
12. _____ are an important option for socialization at
meal times among older adults.
1.
Down:
Dietary intake of _____ is essential for minimizing
oxidative stress and preventing cataracts.
3. _____ can impact appetite and nutrition status in the
elderly.
5. The anticancer medication methotrexate interferes
with the metabolism of _____.
6. Intake of _____ needs to be carefully maintained
while one is on warfarin.
7. Adequate protein intake and regular exercise lessen
this process
9. Deficiency of _____ can lead to a decreased sense
of taste, impacting appetite also.
11. _____ restriction of 10-20% may be associated with
increased longevity in humans.
2.
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 17-14
Handout 17-1: More about the Brain
Summary of Nutrient-Brain Relationships
Brain Function
Adequate Intake of
Short-term memory
Vitamin B12, vitamin C, vitamin E
Performance in problem-solving tests
Riboflavin, folate, vitamin B12, vitamin C
Mental health
Thiamin, niacin, zinc, folate
Cognition
Folate, vitamin B6, vitamin B12, iron, vitamin E, iodine
Vision
Essential fatty acids, vitamin A
Neurotransmitter synthesis
Tyrosine, tryptophan, choline
Common Signs of Dementia








Agitated behavior
Becoming lost in familiar surroundings or circumstances
Confusion
Delusions
Loss of interest in daily activities
Loss of memory
Loss of problem-solving skills
Unclear thinking
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.