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Introduction Topics include nutritional aspects of adulthood from ages 20 to 64 Chapter explores nutritional needs & guidance aimed at helping meet those needs.
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Chapter 16 Adult Nutrition Introduction Topics include
nutritional aspects of adulthood from ages 20 to 64 Chapter
exploresnutritional needs & guidance aimed at helping meet
those needs. Definition of Adulthood in the Life Cycle
Early adulthoodages yrs Involve becoming independent & leaving
the parental home In the 20s, planning, buying and preparing food
are newly developing skills In the 30s, renewed interest in
nutrition for the kids sake Definition of Adulthood in the Life
Cycle
Midlifeages 40 to 64 yrs Period of active family responsibilities
Managing schedules and meals becomes a challenge Time of reviewing
lifes accomplishments & recognition of mortality Definition of
Adulthood in the Life Cycle
Sandwich generation the 50s Many are multigenerational caregivers
Juggle roles of caring for children and aging parents, while
maintaining a career Health concerns frequently are added Chronic
disease Managing identified risk factors to prevent diseases
Definition of Adulthood in the Life Cycle
Later adulthoodage 65+ Transition to retirement More leisure time
greater attention to physical activity and nutrition Food choices
and lifestyle factor, especially for those with chronic disease
Importance of Nutrition
The span of years between ages 20 and 64 is a time when the future
course of health & wellness are influenced by: Diet Physical
activity Smoking Body weight Importance of Nutrition
How do food & nutrition enhance life? Nutrition & exercise
are among the main lifestyle factors that reduce risk of the onset
and severity of 5 of the 10 leading causes of death (See Table
16.1) Cancer Heart disease Stroke Diabetes Liver disease Health
Objectives for the Nation
The Health Objectives for the Nation Address multiple goals for
adult health improvement Data on dietary goals for disease
prevention and health promotion for adults are shown on Table 16.3
A priority of national public health goals is overweight/obesity
Health Disparities Among Groups of Adults
Some population groups have a higher prevalence ofchronic diseases
than others Some groups have a genetic disposition for certain
diseases Genetics and environment interact Physiological Changes of
Adulthood
Growing stops by the 20s Bone density continues until 30 Muscular
strength peaks around 25 to 30 years of age Decline in size and
mass of muscle and increase in body fat Dexterity and flexibility
decline Physiological Changes of Adulthood
Hormonal and Climacteric Changes Women Decline of estrogen
menopause Increase in abdominal fat Increase in risk of
cardiovascular disease & accelerated loss of bone mass Men
Gradual decline in testosterone level & muscle mass
Physiological Changes of Adulthood
Body Composition Changes in Adults Bone loss begins around age 40
Positive energy balance resulting in increase in weight and
adiposity; decrease in muscle mass Fat redistribution- gains in the
central & intra-abdominal space, decrease in subcutaneous fat
Physiological Changes of Adulthood
Body Composition Changes in Adults Fat redistribution-associated
with increased risk of chronic disease Hypertension Insulin
resistance Diabetes Stroke Gallbladder disease Coronary artery
disease Continuum of Nutritional Status
Nutritional health can be viewed as a continuum from: Healthy and
resilient state To: Terminal state body system shut down and life
ceases Continuum of Nutritional Status States of Nutritional
Health
Resilient and Healthy Metabolic systems in homeostasis Organs are
functioning at optimal level Nutritional guidance Encourage
adequate intake Not too much, Not too little Mantra: Moderation,
variety, and balance States of Nutritional Health
Altered Substrate Availability Early, subclinical state of
nutritional harm when intake doesnt meet needs Loss of reserves
and/or accumulation of excess-lead to buildup of by-products
Dietary guidelines Inform people of common risks Encourage
healthful diets & lifestyle choices States of Nutritional
Health
Nonspecific Signs and Symptoms Visible changes to insufficient or
excessive intakes Recognized risk factors for chronic disease
Dietary guidance: Target specific risk factors and observable signs
and symptoms Measure and monitor for progress to halt or reverse
risk factors for disease States of Nutritional Health
Clinical condition Definite signs and symptoms of illness
presentmedical diagnosis Examples: atherosclerosis, cancer,
osteoporosis, type 2 diabetes, depression Dietary Guidance Change
is difficult Intensive intervention needed (medical nutrition
therapy or therapeutic behavior-change programs) States of
Nutritional Health
Chronic condition Altered metabolism and structural changes in
tissues become permanent & irreversible Examples: structural
damage to coronary arteries, invasive & metastatic cancer, loss
of kidney function or blindness Dietary guidance: Aimed at managing
the condition Preventing further complication Reduce degree of
disability optimize quality of life States of Nutritional
Health
Terminal Illness and Death Final stage in the continuum
Complications advance Body systems shut down Life ceases Estimating
Energy Needs in Adults
Estimating Energy Needs Based on BMR+TEF+Activity Basil Metabolic
Rate (BMR) Daily BMR expenditure- 60 to 75% for involuntary
processes Thermic Effect of Food (TEF) TEF (metabolism of food)
~10% Activity thermogenesis Activity- most variable component is
which accounts for 20-40% of total energy needs Estimating Energy
Needs in Adults
Doubly labeled water (DLW) Subjects are given a dose of tagged
water Excretion of isotopes in saliva and urine is used to
calculate average energy utilization over several days Used to
determine estimated energy requirements (EER) Estimating Energy
Needs in Adults
Indirect Calorimetry Measurement of heat given off and utilized for
the bodys metabolic processes Indirect calorimetry determines REE
(Resting Energy Expenditure) which is nearly = to BMR The
respiratory quotient (CO2 / O2) is used to estimate 24-hour energy
expenditure Estimating Energy Needs in Adults
Mifflin-St. Jeor Energy Estimation Formula Validated and more
accurate than old Harris-Benedict equation Mifflin-St. Jeor Formula
Males: REE = (10 x wt) + (6.25 x ht) (5 x age) + 5 Females: REE =
(10 x wt) + (6.25 x ht) (5 x age) - 161 Estimating Energy Needs in
Adults
Ballpark caloric levels Simple calculation Weight maintenance = 15
calories per pound Weight loss = 13 calories per pound Weight gain
= 17 calories per pound Energy Adjustments for Weight Change
1 lb of body fat = 3500 calories To lose 1 lb a week, an adult
would need to create a negative balance of 500 calories per day A
combination of decrease intake and increased use (i.e. exercise) is
one approach to use A positive balance of just 100 extra calories
per day will result in a gain of 10 lbs in a year Nutrient
Recommendations
Acceptable Macronutrient Distribution Ranges Fat % of calories
Carbohydrate % of calories Protein % of calories Nutrient
Recommendations
Dietary Reference Intakes (DRIs) Daily Values (DV) used on
nutrition labels Tolerable Upper Intake Levels (ULs) Table 16.5
lists recommended nutrient intakes for adults and shows average
intakes based on NHANES data Risk Nutrients Certain nutrients
exceed or fall short of recommendations Fiber Choline Vitamin A
Calcium Vitamin D Magnesium Vitamin E Potassium Folic acid Sodium
B12 Dietary Recommendations
Dietary guidance systems Sets of dietary and lifestyle
recommendations Based on latest scientific information Developed to
promote health and prevent disease Key components of the U.S.
system are the Dietary Guidelines for Americans and MyPlate Dietary
Recommendations
Dietary guidance systems Voluntary health organizations make
additional science-based dietary recommendations American Cancer
Society Nutrition and Physical Activity Guidelines American Heart
Association Diet and Lifestyle Recommendations Dietary
Recommendations
Dietary guidance systems focus on Consuming greater amounts of
Fruits, vegetables, fiber, and low-fat dairy products Limiting
saturated fat intake, trans fats More nutrient rich foods, less
sugar Keeping sodium low Regular physical activity Energy intake
balanced with energy expenditure healthy weight Dietary
Recommendations
Total Diet Approach: Use 2010 Dietary Guidelines and MyPlate Enjoy
food but choose wisely and eat less Select a variety of foods Get
the most nutrition out of their calories Stay within daily calorie
needs Consider shifting to a plant based diet Classification of
Vegetarians Beverage Intake Recommendations
Recommendations in dietary guidance systems: Consume fewer or
smaller portions of beverages containing fats and added sugar Plan
beverage intake as part of total calorie intake Make beverage
choices that fit into the dairy, vegetable, and fruit groups
Alcohol: Food, Drug and Nutrient
~61% if U.S. adults drink alcohol Highest rate is among those ages
25-44 Nations vary on alcohol consumption guidelines U.S.
guidelines are If you drink, do so in moderation Alcohol Content of
Selected Beverages
A drink contains roughly grams of alcohol or 0.5 oz of ethanol
Water Intake Recommendations
AI (Adequate Intake) level for water based on median total water
intake Upper level for water intake not set but toxicity can occur
Total Water AI for Adults Men liters (125 oz) Women liters (91 oz)
Other Fluids Diuretic effects of caffeine
While caffeine does act as a diuretic, the DRI committee concluded
caffeine-containing beverages contribute to the total daily water
intake Dietary Supplements and Functional Foods
Dietary supplements indicated: Pregnancy Certain illness Low
calorie or nutrient restricted diets Dietary Supplements and
Functional Foods
Survey data indicate that 44% of adult males and 53% of adult
females take vitamin or mineral supplement nearly every day Herbals
and botanicals are grouped with dietary supplements Dietary
Supplements and Functional Foods
See Table Definition and examples of supplements and functional
food categories Functional foods - term used for food products that
have a physiological benefit or reduce the risk of chronic disease
beyond basic nutritional functions Physical Activity
Recommendations
Healthy eating & increased physical activity are the featured
duo for combating obesity Any physical activity is better than none
Physical activity helps to manage weight and reduce disease risk
factors Physical Activity Recommendations
At least 150 minutes/week of moderate-intensity physical activity
Table lists current U.S. recommendations Muscle
strengtheningactivities2 times a week Physical Activity, Body
Composition, and Metabolic Function
Regular physical activity leads to changes in body composition with
reduced fat mass and increased lean mass Even without caloric
restriction, aerobic physical activity results in decrease of
adiposity Promotion of Physical Activity
Healthy People 2020 Objectives Reduce proportion of adults who
engage in no leisure-time physical activity Increase proportion of
adults who meet federal guidelines for aerobic physical activity
and muscle-strengthening activity Physical Activity Reported Diet
and Physical Activity
Physical Activity is supported by a general healthful diet
Competitive sports may have increased nutrient needs Nutritional
ergogenic aids Caffeine Protein powders Sports drinks Energy gels
& bars Few improve performance, may be harmful Nutrition
Intervention for Risk Reduction
Many types of interventions Individual counseling Multi-component
programs Policy and system changes A Model Health-Promotion Program
Sisters Together: Move More, Eat Better Public Food and Nutrition
Programs
SNAP Government extension programs Meals on Wheels Soup kitchens
and shelters for homeless Putting It All Together
Adults need: Variety of healthful foods Knowledge to guide food
choices Positive attitudes about food and eating Balance with
discipline The message is to follow the principles of variety,
moderation, and balance in choosing a diet