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Answer to #1
The most common type of arthritis that disables older people is osteoarthritis, a painful swelling of the joints. During movement, the ends of bones are normally protected from wear by cartilage and by small sacs of fluid that lubricate the joint. With age, the cartilage sometimes disintegrates, and the joints become malformed and painful to move.
Obesity is common among adults with arthritis. Weight loss can help overweight people with osteoarthritis, partly because the joints affected are often weight-bearing joints that are stressed and irritated by having to carry excess pounds. Interestingly, though, weight loss often relieves the worst pain of osteoarthritis in the hands as well, even though they are not weight-bearing joints. Jogging and other weight-bearing activities do not worsen osteoarthritis. In fact, both aerobic activity and weight training offer modest improvements in physical performance and pain relief, especially when accompanied by even modest weight loss.
Two popular supplements for treating osteoarthritisglucosamine and chondroitinmay alleviate pain and improve mobility, but mixed reports from studies emphasize the need for additional research. Drugs and supplements used to relieve arthritis can impose nutrition risks; some affect appetite and alter the body's use of nutrients.
Another type of arthritis, known as rheumatoid arthritis, has a possible link to diet through the immune system. In rheumatoid arthritis, the immune system mistakenly attacks the bone coverings as if they were made of foreign tissue. In some individuals, certain foods, notably a Mediterranean-type diet of fish, vegetables, and olive oil, may moderate the inflammatory responses and provide some relief. The omega-3 fatty acids commonly found in fish oil reduce joint tenderness and improve mobility in some people with rheumatoid arthritis. The same diet recommended for heart healthone low in saturated fat from meats and milk products and high in omega-3 fats from fishhelps prevent or reduce the inflammation in the joints that makes arthritis so painful.
Answer to #2
In their efforts to understand longevity, researchers have not only observed people but have also manipulated influencing factors, such as diet, in animals. This research has produced some interesting and suggestive findings. For example, animals live longer and have fewer age-related diseases when their energy intakes are restricted. These life-prolonging benefits become evident when the diet provides enough food to prevent malnutrition and an energy intake of about 70 percent of normal; benefits decline as the age at which energy restriction begins is delayed.
Exactly how energy restriction prolongs life remains unexplained, although gene activity appears to play a key role. Energy restriction in animals prevents alterations in gene expression that are associated with aging. Food restriction may also extend the life span by preventing damaging lipid oxidation, thereby delaying the onset of age-related diseases such as cancer and atherosclerosis. Other research suggests that energy restriction beneficially alters several aspects of fat cell metabolism, which may play a role in reducing chronic disease risk and extending life. Experiments with food restriction and longevity in animals have not suggested any direct applications to human nutrition.
Moderate energy restriction (80 to 90 percent of usual intake) in human beings may be valuable. When people restrict energy intake moderately, body weight, body fat, and blood pressure drop, and blood lipids and insulin response improvefavorable changes for preventing chronic diseases. The reduction in oxidative damage that occurs with energy restriction in animals also occurs in people whose diets include antioxidant nutrients and phytochemicals. Diets such as the Mediterranean diet that include an abundance of fruits, vegetables, olive oil, whole grains, and legumeswith their array of antioxidants and phytochemicalssupport good health and long life.
Answer to #3
There are a number of ways older adults can stretch their food dollars. These usually involve storing leftovers and having food staples on hand during meal preparation. Also, creative cooking and meal planning can save older adults money. People who have the means to shop and cook for themselves can cut their food bills just by being wise shoppers. Large supermarkets are usually less expensive than convenience stores. A grocery list helps reduce impulse buying, and specials and coupons can save money when the items featured are those that the shopper needs and uses.
Buying the right amount so as not to waste any food is a challenge for people eating alone. Many foods that offer a variety of nutrients for practically pennies have a long shelf life; staples such as rice, pastas, dry powdered milk, and dried legumes can be purchased in bulk and stored for months at room temperature. Other foods that are usually a good buy include whole pieces of cheese rather than sliced or shredded cheese, fresh produce in season, variety meats such as chicken livers, and cereals that require cooking instead of ready-to-serve cereals. A person who has ample freezing space can buy large packages of meat, such as pork chops, ground beef, or chicken, when they are on sale. Then the meat can be immediately wrapped in individual servings for the freezer. All the individual servings can be put in a bag marked appropriately with the contents and the date. Alternatively, grocers will break open a package of wrapped meat and rewrap the portion needed. Similarly, eggs can be purchased by the half-dozen. Eggs do keep for long periods, though, if stored properly in the refrigerator. Frozen vegetables are more economical in large bags than in small boxes. Fresh fruits and vegetables can be purchased individually. A person can buy fresh fruit at various stages of ripeness: a ripe one to eat right away, a semi-ripe one to eat soon after, and a green one to ripen on the windowsill. Finally, breads and cereals usually must be purchased in larger quantities. Again the amount needed for a few days can be taken out and the rest stored in the freezer. Creative chefs think of various ways to use foods when only large amounts are available. A variety of vegetables and meats can be enjoyed stir-fried; inexpensive vegetables such as cabbage, celery, and onion are delicious when crisp cooked in a little oil with herbs or lemon added.
Answer to #4
Iron-deficiency anemia is less common in older adults than in younger people, but it still occurs in some, especially in those with low food energy intakes. Aside from diet, other factors in many older people's lives make iron deficiency likely: chronic blood loss from disease conditions and medicines, and poor iron absorption due to reduced secretion of stomach acid and antacid use. Anyone concerned with older people's nutrition should keep these possibilities in mind.
Answer to #5
Older adults face a greater risk of vitamin D deficiency than younger people do. Vitamin Dfortified milk is the most reliable source of vitamin D, but many older adults drink little or no milk. Further compromising the vitamin D status of many older people, especially those in assisted living facilities or group homes, is their limited exposure to sunlight. Finally, aging reduces the skin's capacity to make vitamin D and the kidneys' ability to convert it to its active form. Not only are older adults not getting enough vitamin D, but they may actually need more to improve both muscle and bone strength. To prevent bone loss and to maintain vitamin D status, especially in those who engage in minimal outdoor activity, adults 51 to 70 years old need 15 micrograms daily and those 71 and older need 20 micrograms. Supplements may be needed to achieve adequate levels of vitamin D.
Answer to #6
Dehydration is a risk for older adults, who may not notice or pay attention to their thirst or who find it difficult and bothersome to get a drink or to get to a bathroom. Older adults who have lost bladder control may be afraid to drink too much water. Despite real fluid needs, older people do not seem to feel as thirsty or notice mouth dryness as readily as younger people. Many employees of health care communities such as assisted living facilities say it is hard to persuade their elderly clients to drink enough water and fruit juices.
Total body water decreases as people age, so even mild stresses such as fever or hot weather can precipitate rapid dehydration in older adults. Dehydrated older adults seem to be more susceptible to urinary tract infections, pneumonia, pressure ulcers, confusion, and disorientation. An intake of 9 cups a day of total beverages, including water, is recommended for women; for men, the recommendation is 13 cups a day of total beverages, including water.
Answer to #7
As a general rule, adult 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. Loss of muscle mass, known as sarcopenia, can be significant in the later years (its prevalence is more than 50 percent among those older than 75), and its consequences, dramatic. As skeletal muscle mass diminishes, people lose their ability to move and to maintain balance, making falls likely. The limitations that accompany the loss of muscle mass and strength play a key role in the diminishing health that often accompanies aging. To some extent, however, declines in lean body mass and energy needs may not be entirely inevitable. Optimal nutrition with sufficient protein and regular physical activity, especially resistance training, can help maintain muscle mass and strength and minimize the changes in body composition associated with aging. Physical activity not only increases energy expenditure but also, along with sound nutrition, enhances bone density and supports many body functions as well.
Answer to #8
In Alzheimer's disease, the most prevalent form of dementia, brain cell death occurs in the areas of the brain that coordinate memory and cognition. Alzheimer's disease afflicts more than 5 million people in the United States, and that number is expected to triple by the year 2050.
Nerve cells in the brains of people with Alzheimer's disease show evidence of free-radical attackdamage to DNA, cell membranes, and proteinsand of the minerals that trigger these attacksiron, copper, zinc, and aluminum. Some research suggests that the antioxidant nutrients can limit free-radical damage and delay or prevent Alzheimer's disease, but more research is needed to confirm this possibility.
Increasing evidence also suggests that overweight and obesity in middle age are associated with dementia in general, and with Alzheimer's disease in particular. The possible relationship between obesity and Alzheimer's disease is disturbing given the current obesity epidemic. Efforts to prevent and treat obesity, however, may also help prevent Alzheimer's disease. Diets designed to support a healthy heart, which include the omega-3 fatty acids of oily fish, may benefit brain health as well. Maintaining appropriate body weight may be the most important nutrition concern for the person with Alzheimer's disease.
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