Download Fighting Age-related Chronic Diseases with Nutritional Interventions

By Suraj Chawla Gero 820
Guide :Dr Irving Rootman
Director Health promotion centre
Prof. Gerontology SFU
What is a Chronic disease ?
 Chronic disease simply means persistent or recurring
disease, usually affecting a person for three months or
longer.
 Is the result of factors such as poor diet and living
conditions, using tobacco or other harmful substances,
or a sedentary lifestyle.
 The term chronic disease commonly applies to
conditions that can be treated but not necessarily
cured.
The Rising Tide ……..!
CD –Risk factors & Types
Nutrition & CD-In Ageing
CVD in Seniors
 CVD is the leading cause of disability and death
resulting in premature deaths .(CDCP,2004 )
 Encompasses disorders of heart and Blood vessels .
 Age-related changes in the vasculature leads to
increased susceptibility to CVD.
Nutrition as a Tool
Strong clinical evidence :
 Lowering Cholesterol .
 Modification of High BP with reduced Na intake,
Alcohol consumption & excess Body weight .
 DASH Diet and Mediterranean Diet .
 Low Fat dairy foods.
 High Fiber diet .(Whelton et al .,1998)
Limitations in the (CVD –Nutrition
Studies )
 Absence of senior specific study ,sample size and type
of strong evidence .
 Most of studies has observational evidence rather than
other stronger experimental or statistical evidences .
 Is the DASH Diet and other recommendations same
for the seniors ?.
 Absence of quantitative recommendations for salts .
Cancer in Seniors
 Cancer : Uncontrolled cell growth .
 76% of cancers are diagnosed in adults age 55 and
older (American cancer society ,2004 ) .
 Older adults with cancer suffer from nutritional
deficits as a result of disease or its treatment .(Eldridge
,Mc Callum ,2001 ) .
 Nutritional problems : Anorexia ,weight loss , muscle
wasting and loss of immune function .
Nutrition as a Tool
 High intake of vegetables and fruits associated with
reduced risk of cancers . (American cancer society
,2002 )
 Consumption of whole grains instead of processed
grains and sugars .
 Limiting consumption of meat ,high fat and processed
meat .
 Healthy diet to prevent Obesity .
Limitations in the (Cancer –
Nutrition studies )
Lack of evidence :
 How nutrition increases tolerance to cancer ?
 Quantifying a nutritionally adequate diet .?
 Difficult to maintain optimal nutrition and enhanced
metabolism in cases of metastasized oral cancers
.alternative nutrition sources ?
 How to cope with nutrition related side –effects .
Diabetes in seniors
 Diabetes is a disease with elevated blood glucose levels
due to impaired insulin secretion or action .
 Risk factors for DM : Older age , Family history of DM
, Overweight ,Inactive lifestyle ,Genetics .
 Diabetes have multiple complications .
Diabetes and Complications
Nutrition Therapy for DM
 Maintain blood glucose levels .
 Carbohydrate intake :consistent to maintain control of
blood sugar .
 Whole grains and low fat milk .
 Prevention of weight loss and optimal nutrition status
in older adults . (Stetson ,2004)
Limitations in the DM Studies
 Senior specific complications unaddressed ?
 What are optimal blood sugar levels to be maintained
in hypoglycemic seniors ?
 Alternative optimal dietary regimens in seniors with
compromised metabolic machinery to maintain blood
sugar levels ?
 Lack of studies and evidence on individualized dietary
regimens addressing senior specific needs.
Osteoporosis & Seniors
 Characterized by low bone mass and deterioration of
bone structure .
 Loss of bone mass begins slowly after the age of 30 and
more after menopause .
 Risk factors : Low bone mass , Advanced age ,
Inactivity , Smoking and alcohol consumption
 Medications : Corticosteroids and Anticonvulsants .
Nutrition therapy for Osteoporotic
Seniors
 High intake of Calcium and Vitamin D prevents loss
of bone mass in post menopausal and older adults .(
Dawson –Hughes ,2001).
 Senior adults over 51 should consume 1200 mg of
calcium per day .
 Green leafy vegetables , Soy products and cereals .
 High intake of fruits and vegetables .
Limitations in the Bone studies
 Effectiveness of vitamin –D and calcium as nutritional
supplements in prevention of osteoporosis ?
 Most of the studies have observational evidence and
without any statistical or experimental data for
effectiveness of dietary supplements in the form of
medications.
 Weak evidence for supporting the use of fruits and
vegetables for bone health promotion.
CRF (Kidney diseases )
 CRF results from the progressive loss of the ability of
kidneys to function .
 Causes : Polycystic disease , High BP ,Kidney stones
and Diabetes .
 CRF can range from mild to severe kidney dysfunction
and progressing to ESRD .
 Renal disorders are more common in older adults
more than half beginning dialysis over 65 years of age .
Nutrition Therapy for CRF in
Seniors
 Nutritional management of High BP or Diabetes could
prevent the progression of renal damage .
 Adequate levels of Protein fluid and electrolyte levels.
 Fluid intake restricted to equal amount of volume of
urine produced .
 Restriction of salt , potassium ,phosphorus and
electrolytes .
Limitations in the CRF studies
 Lack of substantial evidence for the effectiveness of
nutritional therapy in different stages of CRF.
 Stage specific CRF nutritional therapies for seniors
with other complications like compromised
metabolism .?
 Statistical evidence supporting the effectiveness of
nutrition therapy for seniors. ?
COPD
Nutrition and COPD
Poor nutrition can make
COPD symptoms worse
and increase the
likelihood of getting an
infection. Eat a well
balanced diet. If chewing
and swallowing interfere
with breathing, take
small, frequent meals.
Limitations : Studies in COPD
 Generalized studies involving the populations below
50 years with less evidence on nutritional benefits in
treatment of COPD and reversibility.
 Less support for mechanism and use of nutritional
therapy in reversibility of COPD and complications .
 More need for Senior-centered nutritional therapy
studies and their effectiveness in treatment of COPD.
Osteoarthritis and Seniors
 OA also called as degenerative joint disease called as
the “wear and tear ‘’ arthritis .
 Progressive breakdown and loss of articular cartilage .
 OA is with features of progressive breakdown and loss
of the articular cartilage .
 OA occurs in more than 10 % of people older than 65
and 75.
Risk factors and OA
 Older than 50 .
 Being a Female (After Menopause ) and Obesity .
 Being overweight due to increased loads on the joints .
 Metabolic factors and osteoarthritis .
Nutrition Therapy and OA
 Beneficial intervention is Weight loss for overweight .
 Antioxidant nutrients as Vitamin C preventing the OA
progression .
 Weight management with less caloric and balanced
diet .
 Foods with Vitamin D sources.
Limitations of study in OA
 Specific impact and the mechanisms involved in the
dietary interventions still unknown .
 Lack of any study with strong evidence in the
effectiveness of nutrition therapy for OA prevention
and treatment .
 Lack of evidence and unknown mechanisms in the
role of Glucocorticoids as anti –OA dietary
supplements .
Future Prospects
 What are the future prospects for medical nutrition
therapies ?
 Delaying the onset and reducing the severity of
Chronic diseases in seniors without use of medications
is a worthy objective .
 Need for more exploring individualized nutritional
therapies with senior centric approaches .
Growing Older Eating Better