Lecture Notes on Nutrition Through the Lifespan - Flashcards

Flashcards about Adolescence, Adulthood, Older Adults, Obesity, and Alcohol

Adolescence

The range of when puberty hits and peaks, involving growth, autonomy, and independence.

Vitamin D

Linked to a lower risk of COVID-19 and low intakes are linked to depression, cognitive impairments, cardiovascular disease, and cancer.

Folate

Cell division and blood maturation.

Iron

Needed for linear growth, protein stabilization, and goes up in females after menarche, and in males after the growth spurt.

Anemia

Lack of sufficient blood cells

Overweight and obesity

Continue to increase, with obesity affecting ⅕ of teens. 90% of overweight teens remain so, and >85% are twice as likely to continue to gain weight.

Anorexia nervosa

Poor body image with irrational fears of weight gain, extreme weight loss, and can lead to a weakened immune system, gastric ruptures, cardiac arrhythmia, heart failure, and suicide.

Bulimia nervosa

Recurrent, uncontrolled eating of large amounts of food followed by purging; it can lead to heart failure, and other less serious conditions compared to anorexia.

Binge-eating

Periodic episodes of binge eating without purging.

Adulthood

21-64 years.

Bone density

Increases until about 30, and declines around 40.

Muscle mass

Peaks around 25-30.

Visceral fat

Related to inflammation and metabolic disturbances → chronic disease.

Metabolic syndrome

A spectrum of metabolic abnormalities that increases the risk of CVD and type 2 diabetes. It is associated with fatty liver, kidney disease, sleep apnea, and cognitive decline.

Atherosclerosis

Is due to plaque buildup in artery walls, thickening them, the formation of foam cells, and expanding the artery walls.

DASH

High in fruits and vegetables, low in sodium.

Type 1 Diabetes Mellitus

An autoimmune attack on the pancreas with no or little production of insulin, which must be managed through self-administered insulin, diet, and physical activity.

Type 2 Diabetes Mellitus

Insulin resistance and is much more common, specifically in those over age 40, but younger onset is increasing; it must be managed through weight sustain or loss (if obese) and diet and physical activity.

Prediabetes

Is where blood glucose levels are elevated.

Cancer

A group of diseases in which abnormal cellular growth affects organs, high incidence, and is related to nutrition; risk factors include smoking, nutrition, and genetics.

Gastrointestinal diseases

Can result from a weakened lower esophageal sphincter. Associated factors include excess alcohol, obesity, smoking, and coffee. Remedies include omitting foods that cause discomfort.

Life Expectancy and Nutrition

Life expectancy is increasing, necessitating adequate nutrition for older adults.

Musculoskeletal System

Reduced lean body mass (bone mass, muscle, water), increased fat mass leading to a decreased resting metabolic rate, and reduced work capacity (strength).

Nervous System

Blunted appetite and thirst regulation, decline in olfactory receptors, reduced nerve conduction velocity, and changed sleep patterns.

Nutrition Assessment Checklists

A checklist that integrates a list of warning signs of poor nutritional health in older adults to prevent malnutrition before it begins.

MyPlate for Older Adults Recommendations

Choose fiber-rich foods often, drink water and beverages low in added sugars, and use fortified foods or supplements for vitamin D and B12 needs.

Nutrient Recommendations

Decrease in physical activity & BMR from early to late adulthood results in lower caloric requirements, often without a decrease (or even an increase) in nutrient needs.

Vitamin D

Needed for calcium absorption and bone maintenance; factors that put older adults at risk for deficiency include insufficient dietary intake, limited sunlight exposure, and decreased ability to use UV rays.

Vitamin B12

Needed for DNA and RNA synthesis and a healthy nervous system; deficiency can lead to cognitive and motor decline and can be mistaken for “normal” ageing process.

Iron

Needed for transport of oxygen; most older adults consume more iron than needed, which can contribute to oxidative stress, but some may have iron deficiency due to disease or medications.

Calcium

Muscle and nerve activity and bone maintenance; adults and older adults need 1000-1200 mg/d.

Older adults

With compromised immune status are more vulnerable to foodborne illness; leading hazardous practices include improper holding temperatures and poor personal hygiene.

Osteoporosis

Generalized skeletal fragility resulting from decreased bone mass and disruption of bone architecture, leading to increased fracture risk.

Inflammatory Diseases

Osteoarthritis, rheumatoid arthritis, atrophic gastritis, celiac disease, irritable bowel disease (IBS), diverticulitis, asthma.

Dementia

A progressive cognitive decline characterized by impaired thinking, memory, decision-making, and linguistic ability, often associated with neurological conditions like Alzheimer’s and Parkinson’s disease.

Polypharmacy

Taking multiple medications daily.

Dehydration

Less sensitivity to detecting thirst, illness, kidney issues, medications, swallowing problems, mental health issues, decreased mobility, and fear of incontinence.

Obesity Trends Among U.S. Adults

Based on BRFSS data; highlights the percentage of adults with obesity across different states.

Lifestyle Factors Linked to Obesity

High energy density diets, excessive sugar and fat intake, too many calories, sedentary behavior, and insufficient physical activity.

Microbiota

Break down undigested food components into short-chain fatty acids (SCFAs).

Sleep Deprivation

Disrupts appetite hormones by increasing ghrelin and decreasing leptin, causes preference and cravings for high-fat foods, prolongs eating time, results in no increase in energy expenditure, and leads to reduced physical activity.

Association of All-Cause Mortality With Overweight and Obesity

Overweight was associated with significantly lower all-cause mortality; both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality.

Why Do People Become Obese?

Results from a chronic energy imbalance where energy consumed exceeds energy expended.

Set-Point Theory

Bodies have a preset weight baseline.

Weight Loss Strategies: National Weight Control Registry

Gradual change in energy intake, regular exercise, and application of behavior modification techniques.

Volatile higher alcohols

Produced by plants (flowers and fruits) and contribute to aroma.

Low molecular weight alcohols

Produced by microbes and act as defense mechanisms.

Moderate Alcohol Intake

Up to one drink per day for women, up to two drinks per day for men.

Alcohol Metabolism

It is converted to Acetylaldehyde, then to Acetate, and finally to Acetyl-CoA, which enters the TCA Cycle to produce ATP and FAT.

Moderate Drinking and the Heart

Reduction of plaque deposits in arteries, protection against blood clot formation, and promotion of blood clot dissolution.

Heavy Drinking and the Heart

Increased risk for heart muscle disease, disturbed heart rhythm, high blood pressure, and hemorrhagic stroke.

Concerns About Alcohol Intake

Strong evidence that alcohol causes cancer at 7 sites in the body and has a relatively high calorie content.

Alcohol-Induced Malnutrition

Direct toxicity and provides "empty calories," leading to maldigestion and malabsorption of nutrients and impaired nutrient utilization.

Consequences of Liver Cirrhosis

Jaundice, edema, ascites, confusion, and muscle wasting as consequences.

Adolescence and Nutritional Habits

According to NHANES, adolescence is the life stage with the worst nutritional habits.

Prevalence of Obesity in Teens

Obesity continues to increase, now affecting approximately ⅕ of teens. A significant majority of overweight teens remain so, with an increased likelihood of further weight gain.

Body Composition Changes During Puberty

During puberty, males typically experience an increase in lean body mass, while females see an increase in body fat.

Nutrient Requirements for Adolescents

Nutrient requirements for adolescents depend on their stage of development; for example, iron requirements differ based on the onset of menstruation in females.

Caloric and Protein Requirements in Adolescence

Caloric requirements during adolescence are higher per kg of body weight compared to childhood. Protein requirements are also higher than in childhood but similar to adulthood. Males generally require more calories and protein than females.

High Protein Diets for Adolescent Athletes

High protein diets are generally not encouraged for adolescent athletes unless under specific guidance due to potential risks.

Calcium and Vitamin D in Adolescence

Calcium absorption is high during adolescence, crucial for bone mass development. Dairy is a superior source of calcium per cup compared to leafy green vegetables. Adolescents often do not consume sufficient calcium.

Nutrients of Concern for Vegetarian Teens

Concerns include vitamin B12, vitamin D, iron, calcium, and omega-3 fatty acids.

BMI Percentiles for Overweight and Obesity in Teens

A BMI in the 85th to 95th percentile is considered overweight, while above the 95th percentile is considered obese.

Acceptable Candidates for Bariatric Surgery

Candidate must have completed most of their growth.

Disordered Eating vs. Eating Disorders

Disordered eating involves irregular eating behaviors that do not meet the full criteria for an eating disorder. Eating disorders, like anorexia and bulimia, have specific diagnostic criteria based on psychological and physical symptoms.

Bodily Functions Affected by Anorexia Nervosa

Multiple bodily functions are affected, potentially leading to issues such as a weakened immune system, gastric ruptures, cardiac arrhythmia, heart failure, and increased risk of suicide.

Prognosis of Eating Disorders

Anorexia nervosa has the worst prognosis in terms of death rate compared to other eating disorders.

Metabolic Syndrome

Metabolic syndrome is a cluster of conditions including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels. Diagnostic criteria include specific measurements for these factors. It increases the risk of CVD and type 2 diabetes, fatty liver, kidney disease, sleep apnea, and cognitive decline

Peak Muscle Mass in Males

Peak muscle mass occurs around ages 25-30 in males, after which it typically decreases with reduced physical activity and decreased testosterone levels.

Physical Activity Recommendations for Adults

Adults should aim for 150 minutes of moderate-intensity physical activity each week. Moderate intensity is defined as activity that noticeably increases heart rate and breathing.

Optimal Weight Loss Strategies

Slow, gradual weight loss is the most effective for long-term maintenance. Frequent dieting can disrupt the body's set point and is generally not successful for sustained weight loss.

Bone Mass and Density

Bone mass can continue to increase until about age 30. Adequate calcium and vitamin D intake, along with weight-bearing exercise, are crucial for ensuring adequate bone mineral density.

Nutritional Prevention of GERD

Nutritional changes include avoiding foods that cause discomfort, reducing alcohol consumption, maintaining a healthy weight, and avoiding smoking and coffee.

Body Composition Changes Post-Menopause

Hormonal changes, decreased muscle mass, and increased fat deposition, particularly around the abdomen.

Iron Requirements After Menopause

The requirement for dietary iron decreases after menopause, becoming similar to that of men both before and after menopause.

Caloric Requirements for the Elderly

Caloric requirements generally decrease in elderly compared to younger adults due to reduced physical activity and BMR.

Nutrient Recommendations for Elderly

Recommended intake often increases for vitamin D and B12 after age 70. Not all elderly adults require a vitamin & mineral supplement, but it may be beneficial for those with poor dietary intake or specific deficiencies.

Vitamin B12 Absorption in Elderly

B12 absorption can be impaired due to decreased stomach acid and reduced intrinsic factor, making it a nutrient of concern for the elderly.

Causes of Weight Loss Among Elderly

Common causes include decreased appetite, social isolation, medical conditions, medications, and reduced ability to taste and smell.

Are all adults caught by checklist

No - Checklists do not catch all elderly adults at risk of undernutrition

Total Body Water Changes in Elderly

Total body water decreases in elderly years due to reduced muscle mass and increased fat mass, increasing the risk of dehydration and poor outcomes related to diarrheal illnesses.

Nutrients to Decrease Osteoporosis Risk

Calcium, vitamin D, vitamin K, magnesium, and phosphorus contribute to decreasing the risk of osteoporosis.

Treatment for Osteoarthritis

Weight management, low-impact exercise, and physical therapy.

Nutrition-Related Reasons for Confusion in Elderly

Vitamin B12 deficiency, dehydration, and electrolyte imbalances can lead to confusion and disorientation in elderly individuals.

Nutrition and Alzheimer’s Disease

Evidence suggests that nutrition, particularly a diet rich in antioxidants and omega-3 fatty acids, may play a role in the development and progression of Alzheimer’s disease.

Diet for Positive Cognition

The MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) has been shown to positively impact cognition.

Moderate Alcohol Consumption

Up to one drink per day for women and up to two drinks per day for men.

Definition of One Drink

The CDC defines one drink as containing 0.6 ounces (14 grams) of pure ethanol.

Initial Site of Alcohol Metabolism

Alcohol begins to be metabolized in the stomach. Men have more alcohol dehydrogenase in their stomach, therefore they metabolize more.

Primary Site of Alcohol Metabolism

Most alcohol is metabolized in the liver.

Macronutrient Produced in Alcohol Metabolism

Alcohol is metabolized into Acetyl-CoA.

Calories per Gram in Alcohol

Alcohol contains 7 calories per gram, compared to 4 calories per gram for carbs and protein, and 9 calories per gram for fat.

Alcohol Consumption and Mortality

Moderate alcohol consumption may decrease mortality due to cardiovascular benefits.

Alcoholism and Malnutrition

Alcoholism can lead to both over-nutrition (from empty calories) and under-nutrition (due to impaired nutrient absorption and utilization), as well as micronutrient deficiencies.

Toxic Intermediate in Alcohol Metabolism

Acetaldehyde is the toxin that builds up during alcohol metabolism and contributes to hangover symptoms.

Reasons for Increase in BMI

Reasons include high energy density diets, excessive sugar and fat intake, too many calories, sedentary behavior, and insufficient physical activity.

Accuracy of CDC Obesity Statistics

Due to the surveys involving self-reporting of height and weight, which can lead to underestimation.

Intestinal Microbes and Diet

A high-fat, high-sugar diet is associated with a high proportion of Firmicutes in the intestines, which is linked to overweight/obesity.

Least Healthy Type of Fat

Visceral fat, which is associated with increased risk of chronic diseases and inflammation.

Diabetes Prevention

Appropriate diet and physical activity can prevent or slow the onset of type 2 diabetes. Type 1 diabetes is an autoimmune attack on insulin secreting cells of the pancreas and can’t be prevented.