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Markham Family Health Team

Registered

Nurse

Clinical

Pharmacist

Nurse

Practitioner Social Worker

Registered

Dietitian

PhysicianOccupational

Therapist

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Presented by: MFHT Registered Dietitian

� Supports a positive aging experience

� Supplies us with our daily vitamin and mineral needs

� Increase our energy levels

� Lowers our risk of some chronic diseases

� Can help us achieve or maintain a healthy body weight

� May help with improved mood

It’s never too late to start! Let’s learn how….

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� Heart Health

� Cancer—Breast, Ovarian, Colorectal, Prostate

� Osteoporosis

� Weight management

� Chronic diseases—e.g. Diabetes

To reduce the risk of developing these diseases, focus

on:

� Calcium and Vitamin D

� Healthy Fats

� Fibre—fruits, vegetables and whole grains

� Protein

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� Increased weight from

fat tends to deposit

around abdomen

� Body shape matters:

o Apple (visceral)

o Pear

� Weight gain is natural

part of aging process;

but it is not inevitable!

o Body Mass Index

o Waist Circumference

• Muscle mass naturally

declines with age

• By 50+ yrs people tend to

lose 12% muscle strength

and 6% muscle mass every

decade

• Can you prevent this loss?

*2-3 months muscle

strengthening exercise 3x/wk

can increase muscle &

strength mass by 30%

Making up for 3 decades of loss!

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Meat &

Alternatives

Starch

(½ Cup)

One Item Per Meal

Vegetables

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Keep your bones

strong

�Check in with your diet…

Our needs…

Females > 51 yrs: 1200 mg

Males > 51-70 yrs: 1000mg

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325 mg 330 mg 400 mg

95 mg

130 mg

Total =

1280mg

1000 IU supplement

105 IU in milk

60 IU in 2 eggs 500 IU in salmon

= 1665 IU Vitamin D total

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CHOOSE…

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Trans Fat

Saturated Fat

LIMIT…

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Are you eating 7 servings every

day?

Aim for 4g fibre per serving

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Legumes can provide 6-12 g fibre

per ¾ cup serving!

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� Dietitians of Canada. (2011). Eating Guidelines for Menopause. British Columbia:

PEN – The Global Resource for Nutrition Practice.

� Dietitians of Canada. (2011). Food Sources of Calcium. British Columbia: PEN – The

Global Resource for Nutrition Practice.

� Dietitians of Canada. (2011). Food Sources of Vitamin D. British Columbia: PEN –

The Global Resource for Nutrition Practice.

� Dietitians of Canada. (2010). Food Sources of Omega-3 Fats. British Columbia: PEN

– The Global Resource for Nutrition Practice.

� Osteoporosis Canada. (2011). Facts and Statistics: About Osteoporosis. Retrieved

April 01 2012, from

http://www.osteoporosis.ca/index.php/ci_id/8867/la_id/1.htm

� Health Canada. (2007). Vitamin D for people over 50: Background. Retrieved April

01 2012, from http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/context/vita_d-

eng.php

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Presented by: MFHT Clinical Pharmacist

� Natural Health Products

� Buyer Beware

� Skin Care

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� Calcium◦ Calcium carbonate –most bang for your buck◦ 1200mg/d from all sources

� Vitamin D ◦ D3-(cholecalciferol) preferred

� Magnesium◦ Dietary intake sufficient◦ Laxative effect to reduce constipation from calcium

� Iron/B12◦ Consult with your provider

� Saw Palmetto

◦ Best known for decreasing symptoms of an enlarged

prostate

◦ Little or no benefit for reducing symptoms

� Vitamin E

◦ Not recommended for preventing cancer or heart disease

◦ May actually increase risk of prostate cancer and stroke

� Antioxidants◦ No proven heart/cancer benefit

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� Safety

◦ Not guaranteed and unproven claims

◦ Purity, potency and quality

◦ Drug interactions, side effects possible

� Source

◦ 25% of all modern drugs have a

natural/botanical origin

� Buyer beware

◦ Talk to a professional

◦ Look for “Natural Product Number” NPN

◦ www.camline.ca

� Prevent premature skin aging and skin cancer

� Minimum SPF 30, broad spectrum (UVA/UVB)

� Pay attention to face, ears, neck and hands and lips

SLIP, SLOP, SLAP, SEEK and SLIDE!

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Presented by: MFHT Nurse Practitioner

� Diabetes

� Osteoporosis

� Breast Cancer

� Colorectal Cancer

� Prostate Cancer

� Cervical Cancer

� Abdominal Aortic

Aneurysm (AAA)

� Cardiovascular

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� Risk factors for developing

type 2 diabetes include:

◦ Older age

◦ Obesity

◦ Physical inactivity

◦ History of gestational diabetes

◦ Coronary artery disease

◦ Impaired glucose tolerance

(pre-diabetes)

1. Blood sugar test

should be done every

3 years after the age

of 40

2. Cholesterol test

should be done

every 3-5 years in

men over 40 and

women over 50

� Everyone over the age of 65 should have a Bone Mineral Density (BMD) test done.

� Over the age of 50 years individuals should be assessed for risk factors that may lead to testing before age 65.

� Frequency of testing is based on tests results.

� Woman are 4 times more likely than men to have osteoporosis

� Key factors for osteoporosis related fractures include:◦ Low BMD

◦ Fragility fracture after age 40

◦ Advanced age

◦ Family history of osteoporosis

◦ High alcohol intake

◦ Smoking

◦ Low body weight or major weight loss

◦ Corticosteroid use

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� For women aged 50-74, mammograms are recommended every 2 years

� Risk factors include:◦ Family history of breast cancer or

ovarian cancer

◦ Above average exposure to estrogen

◦ Dense breast tissue on mammogram

◦ Atypical cells on biopsy

◦ Radiation to the chest

� Other factors that may slightly increase risk include:◦ obesity, alcohol intake

and birth control pills

� Starting at age 50, screening for colorectal cancer is recommended.

� Tests available include:

◦ Fecal Occult Blood Test (FOBT)

◦ Colonoscopy or sigmoidoscopy

� Risk Factors include:

◦ First degree relatives with

colorectal cancer

◦ Personal history of

colorectal cancer

◦ Inflammatory bowel

disease

◦ Some inherited syndromes

◦ Benign polyps of the colon

or rectum

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� A Pap test should be

done every 3 years until

age 70 (with 3 normal Paps in last 10

years)

� Pap tests should be

performed even if you

are no longer having

sex

� You may or may not

require a Pap test after

having a hysterectomy

� Risk factors

Risk factors include:

� African American men

� Older than 60

� Family history- father or brother

� Also- high alcohol intake, high fat

diet, farmers, tire plant workers,

painters

Screening:

DRE (digital rectal exam)

Other test

PSA

The research is unclear about the

risks and benefits of these tests.

It is recommended that you speak

with your primary care provider

for an individual

recommendation

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� AAA is when the large blood

vessel that supplies blood to the

abdomen, pelvis and legs

become abnormally large or

balloons outwards. There are no

symptoms. The larger it is the

more likely it is to rupture or

break open.

� All men age 65-75 should be

screening once with an

abdominal ultrasound

� Women are at lower risk for

developing AAA

Risk Factors:

� Smoking

� High blood pressure

� High cholesterol

� Male

� Emphysema

� Family history of AAA

� Obesity

Presented by: MFHT Registered Nurse

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� Social Alcohol

� Smoking

� Physical Activity

� Immunizations

� If you drink alcohol, try to limit intake to 1-2 drinks per day to a maximum of

9 per week for women

12 per week for men

� Drinking too much of any type of alcohol can increase your blood pressure

� If you already have high blood pressure, limit your use of alcohol

The Heart and Stroke Foundation of Ontariowww.heartandstroke.ca

American Institute for Cancer Researchwww.aicr.org

Drinkawarewww.drinkaware.co.uk

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“New facts you may not have

heard…”

Women:

Younger at the onset of menopause

Lower bone densities post menopause

Men:

Erectile dysfunction is twice as likely to

occur

Smoking cessation is possible

for everyone – your primary care

provider can help you.

The Canadian Cancer Society

The American Heart Association

The Centers for Disease Control and Prevention

(CDC)

Markham FHT Program Alert!!

Smoking Cessation Program

�Why?

�What kind?

�How much?

150 minutes of moderate-to-vigorous aerobic physical activity per week.

Canada’s Physical Activity Guide to

Healthy Active Living

Health Canada

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� Tetanus/Adacel

� Pneumonia

� Influenza

� Travel Vaccines

� ShinglesNational Advisory Committee on Immunizations (NACI)

Markham FHT Program Alert!!

Immunization Program

Influenza Program

Presented by: MFHT Occupational Therapist

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Anything you DO in your daily life

Self-care Productivity

Leisure

Occupation

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Everyday activities have an important impact on health

and well-being.

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We need a range of experiences that contribute to health

and well-being.

• Activate body, mind, senses

• Connect with others

• Contribute to community

• Take care of self

• Develop and express identity

• Develop capability / potential

• Experience pleasure, joy

• Build prosperity / security

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The nature of the experience matters.

• Meaningful

• Engaging

• Reflect balance

• Relevance to culture / stage of life

• Provide control / choice

• Routine

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Activity patterns can be influenced by many

forces.

“A joyful life is an individual creation that cannot be

copied from a recipe.”

Mihaly Csikszentmihalyi

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Consult your MFHT – Occupational Therapist

Do – Live – Well Framework: Moll, S.E., Gewurtz, R.E., Krupa, T.M., Law, M.C., Lariviere, N. &

Levassesur, M. (2014). “Do – Live – Well”: A Canadian framework for promoting occupation,

health, and well-being. Canadian Journal of Occupational Therapy, 1-15.

Canadian Association of Occupational Therapy: http://caot.ca/

What is Occupational Therapy? - https://www.youtube.com/watch?v=Ud5Fp279g4Y

Aging & Seniors: Public Health Agency of Canada - http://www.phac-aspc.gc.ca/seniors-

aines/index-eng.php

World Health Organization – Aging: http://www.who.int/topics/ageing/en/

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Presented by: MFHT Social Worker

�Changes in Life

�How to navigate

through life in your 50’s

and 60’s

�Coping Strategies

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1. Can you name one

personal change in

your life that has

come about since you

turned 50?

2. Which of the new

coping strategies

could you plan to use

in your daily life?

� Physical changes related to age

� Change of status in the workplace

� The sandwich generation – elderly parents

� Children leaving home/still at home/returning home

� Divorce/Remarriage /blended families

� Older man/younger woman or older

woman/younger man – making it work

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1) Maintain a healthy lifestyle

2) Take control of the stress in your life

3) Make time for meaningful relationships with family and

friends

4) Set realistic goals for yourself so that your life is interesting

and meaningful to you

5) Address practical issues such as Power of Attorney for

Health and Finance

�Airplane Scenario

�Defining/Maintaining

Boundaries

�Protected Time

�Building Blocks to

Maintaining Resilience

“When something is not working …change it.

When something is working…do more of it”

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�Work, family, friends,

leisure, exercise, R & R

�Mental and Physical

Health

�Resources and

Demands

�Finding the “Optimum

Zone”

Support

System

Balance

Resources and

Demands

Healthy

Lifestyle

Hope and

Optimistic

Outlook

Resilience

Strategies

Reaching our Optimum Zone

“We’re not getting older, we’re getting better!!!”

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� Positive self-talk

� Being “mindful”

� Healthy communication

� Use humour

� Check-in with yourself

� Implement and

re-evaluate your goals

Life can seem ungrateful, and not always kind

Life can pull at your heartstrings, and play with your mind

Life can be blissful, and happy and free

Life can put beauty, in the things that you see

Life can place challenges, right at your feet

Life can make good, of the hardships that we meet

Life can overwhelm you, and make your head spin

Life can reward those, determined to win

Life can be hurtful, and not always fair

Life can surround you, with people who care

Life clearly does offer, its ups and its downs

Life’s days can bring you, both smiles and frowns

Life teaches us to take the good with the bad

Life is a mixture, of happy and sad

Life’s Tug of War

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Take the life that you have, and give it your best

Think positive, be happy, let fate do the rest

Take the challenges that life has laid at your feet

Take pride and be thankful, for each one you meet

To yourself give forgiveness, if you stumble and fall

Take each day that is dealt you, and give it your all

Take the love that you’re given, and return it with care

Have faith that when needed, it will always be there

Take time to find the beauty, in the things that you see

Take life’s simple pleasures, let them set your heart free

The idea here is simply to even the score

As you face and are met with, Life’s Tug of War

So…

� Wells, A Read N, Uvnas-Moberg K, et al: influences of fat and carbohydrate on postprandial

slieepiness, mood, and hormones. Physl Behav 1997;61:679-686.

� Wurtman R, Wurtman J: Barin serotonin, carbohydrate-craving, obesity, and depression.

Obes Res 1995:3 (suppl 4):477S-480S

� Campfield, L: Metabolic and hormonal controls of food intake: Highlights of the last 25 years-

1972-1997. Appetite 1997;29:135-152

� Osteoporosis Canada

� Hahn N: the flavour of food?It’s all in your head! J Am Diet A 1996;96:655-656

� Dekker T: Nutrition and Recovery. A Professional Resource for Healthy Eating during Recovery

from Substance Abuse. 2000 Centre for Addiction and Mental Health.

� References: Heaney R. Dason-Hughes B, Gallagher, J, et al: The role of calcium in peri- and

post-menopausal women. Menopause 2001;8:84-95

� Ebbeling C, Leidig M et al: Effects of a Low-Glycemic Load vs Low-Fat Diet in Obese Young

Adults. Jama May 16, 2007 297:19 p. 2092-2102

� Nguyen T, Center J, Eisman J: osteoporosis in elderly men and women: Effects of dietary

calcium physical activity and body-mass index. J Bone Min 2000;15:322-331

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� OHIPl http://www.healthyontario.com/ConditionDetails.aspx?disease_id=188

� Major GC et al Recent developments in calcium related obesity research. Obesity Reviews

2008;9:428-445

� J Am Geriatr Soc 2010;58(7):1299-1310

� http://www.dermatology.ca/photoaging/index.html

� Canadian Cancer Society (www.cancer.ca)

� Canadian Journal of Diabetes, 2008, 32(1)

� Canadian Clinical Practice Guidelines, 2007

� The Heart and Stroke Foundation of Ontario www.heartandstroke.ca

� Health Canada www.hc-sc.gc.ca

� The Centers for Disease Control and Prevention www.cdc.gov

� The Public Health Agency of Canada National Advisory Committee on Immunizations

www.publichealth.gc.ca

� Canadian Society for Vascular Surgery www.canadianvascular.ca

� http://www.mayoclinic.com/health/abdominal-aortic-aneurysm/DS01194

www.markhamfht.com

Markham Family Health Team

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