Nutritional deficiencies on ageing

Institute of Food Bioresources
Nutritional deficiencies
on ageing
Nastasia Belc, Denisa Duta
Elena Lupeanu
Natalia Cucu
Institute of Food Bioresources
Ana Aslan National Institute of Gerontology and
Geriatrics
University of Bucharest, Faculty of Biology
Galati, 16-17 January 2009
Institute of Food Bioresources
1. Introduction and statistics
2. Changes (psychological, socio-economic
and functionality of the body)
3. Needs (nutritional and others)
4. Conclusions
Galati, 16-17 January 2009
Introduction
Institute of Food Bioresources
Food industry has to address to consumers,
but it has to take into account that,
The categories of the consumers are in the
continuing changing, because:
increasing of the non-transmissible
chronically diseases incidence;
changing on the ratio between young,
adults and elderly;
ethnicity and increasing of migration of
people;
increasing of individuality importance.
Galati, 16-17 January 2009
Introduction
Institute of Food Bioresources
According to the UN, ageing is increasingly becoming one of the
most important social, economic and demographic phenomena of
our times.
The ageing of Europe - greying of Europe, is characterized by:
decreasing of fertility;
increasing of mortality;
higher life expectancy.
The "greying" of Europe specifically refers to the increase in the
percentage of Europe's elderly population relative to its
workforce.
The group of those capable to work aged between 15 and 65 will
fall by approx.50 mil., whereas the number of those aged over 80
will triple
As much as a person will live longer she/he will learn more
about needs that never had before.
Galati, 16-17 January 2009
Introduction
Institute of Food Bioresources
There is a large potential of elderly people, this so-called
“silver economy” - the 60+ generation in Germany has a
purchasing power of 316 billion Euros and thus contributes
nearly one third of the total private consumption. (German
Institute for Economic Research);
2050, this share will increase to 386 billion Euros
solely for demographic reasons and will amount to more
than 41% of the total consumption (Demographic Change is
also a chance for Europe, Federal Ministry for Family
Affaires and EU Commissioner open congress within the
context of the German Council of Presidency,
www.eu2007.de/en/news/press_release).
Galati, 16-17 January 2009
Introduction
30
2015
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2030
2050
25
20
15
10
20
5
18
0
16
Europe
Northen
America
Australia/New
Zealand
14
12
10
8
6
Proportion of the population
aged 65 and over in the total
population, major more
developed regions of the
world, including Turkey and
Caucasus
4
2
0
TR MK IE CY SK IS PO MT HR RO NL LT GR CZ SI LU HU DK FI NO ES LV CH AT PT UK FR DE BG BE SP SE GR IT
European countries
Adapted after data from: Council of
Europe, 2002
Galati, 16-17 January 2009
Proportion of
the eldely in
the total
population
Statistics in Romania
Institute of Food Bioresources
Age structure:
0-14 years: 18%
15-64 years: 68%
65 years and over: 14%
Urban-rural ratio:
55.20% - 44.80%
The population growth rate is:
-1,6 for 2006 and -0,7 for 2007.
Life expectancy: total population - 69.93 years
male: 66.1 years
female: 73.99 years (2000 est.)
Galati, 16-17 January 2009
D IO N A
Core Conce pt
Oute r Env iro nme nt
Evaluatio n
N atural
Social
Eco no mic
Cultura l
D ie tary
Elde r pe rs on’s
bio -me dical pa rtic ula ritie s
Evaluatio n
Oxidative me tabo lo me
C ontrol
Kno wle dge
acquire me nt
•N e w, pe rs ona lize d foo d
de s ign & pro ductio n
M e thylatio n me tabo lo me
Ge no mic /Epige ne tic profile
Action:
PR EV EN TI ON & C UR E
•D ie t mo nito ring
•Acade mic & pe ople
ge riatric e ducatio n
He alth Sta tus
• Pathology
• P re ma ture aging
Pre ve ntio n/I mprove me nt
Outco me s :
•D e cre ase d me dico s ocial cos ts
•Improve d life
quality
DIONA P ro pos al 20 07. A ll rights res erve d
Galati, 16-17 January 2009
Changes
Institute of Food Bioresources
Natural:
medication related eating;
oral and dental problems;
feeling of hunger and thirst
is reduced;
less appetite depending on
changes in taste and smell,
dry mouth problems;
depression, weakness and
fatigue;
weakness immune system;
dramatic endocrine
changes, corresponding
hormonal aging processes in
women.
Environmental and socio-cultural:
meal times
table rules
food environment
loneliness (social isolation and less
social contacts);
lack of cooking skills;
economic concerns;
affordable foods;
socio-cultural aspects of food
preferences for older people;
reduced pleasure and enjoyment of
food;
declining of self-confidence.
Galati, 16-17 January 2009
Changes
Institute of Food Bioresources
Ageing process is a good candidate
model for studying the genome
instability correlated with specific
metabolomic changes as the result of
the above mentioned factors linked
with:
familial aspects (parental nutritional
behavior, prenatal and postnatal
environmental conditions);
individual lifestyle;
lifetime activities;
genomic reprogramming towards
aberrant gene activation (genetic point
of view).
Galati, 16-17 January 2009
NT Chronic Diseases:
CVD;
digestive diseases
obesity;
cancers;
dementia (e.g.
Alzheimer);
osteoporosis;
etc
Changes
Institute of Food Bioresources
After age fifty there are many metabolic and physiological changes
with impact on the nutritional needs of an individual:
- decreasing of lean body mass (as much as 25%);
- decreasing of total body water;
- decrease of bone mass;
less physically
- increase of body fat;
active and
- reducing synthesize of vitamin D;
lower
- reduction of the basal metabolic rate by about 2% energy needs
per decade of age as compared to young adulthood.
The metabolic rate slows - as much as thirty percent over a lifetime
decreasing of caloric needs - changes in an older person's ability to
balance food intake and energy needs;
insufficient calories
immune system.
chronic fatigue, depression and a weakened
Galati, 16-17 January 2009
Changes in eating behavior of Romanian
elderly people
Institute of Food Bioresources
19; 20%
The changes in eating behavior and
nutritional status was evaluated by:
• Mini Nutritional Assessment (MNA)
screening test;
• Risk nutritional test;
• Food behavior evaluation.
• Study groups: 73 persons
questioned by Ana Aslan Institute
and 23 persons questioned by IBA,
over 40 years old and 25 persons
questioned by IBA between 18-39
years old .
Women
Men
77; 80%
28; 29%
Galati, 16-17 January 2009
31; 32%
Normal weight
Overweight
Obeses
37; 39%
Pathology prevalence, social status
and degree of dependency.
Institute of Food Bioresources
Cardiovascular
Rheumatic
Diabetes
Renal
Married
Scents
Widow /Div orced
Neurologic
Digestive
Mental
Breath
Pathology prevalence
Social status
Living arrangements
Galati, 16-17 January 2009
Single
With family
Pathology prevalence, social status
and degree of dependency.
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Physical exercises
No
3 times a week
Daily
Independent
Independent
Assisted
Assisted
Dependent
Dependent
Barthel Index – Basal functionality
Lawton Index – instrumental functionality
Galati, 16-17 January 2009
Factors that affect daily diet
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70
60
50
%
40
Young
30
Old
20
10
0
Incidence of
digestive
diseases
Dental problems
Economic
problems
Loneliness
Drug
consumtion
Galati, 16-17 January 2009
Daily alcohol
consumtion
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Consumption of the main food over 2 portions
100
80
60
%
Young
40
Old
20
0
Cereals
Vegetables
Fruits
Dairy
Been and nutsSweets (over 1
products (over
(over 1
1 portion)
portion)
Galati, 16-17 January 2009
portion)
Fats
Salty foods
Needs
Institute of Food Bioresources
Require and demand, healthpromoting foods more than any other
group;
have special needs, in particular
nutritional dense food products and
an interest in their health and
appearance;
it is of particular importance to adopt
diet and lifestyle practices minimizing risk of morbidity and
maximizing prospects for healthful
aging;
inadequate nutrition in older adults is
a major, often unrecognized, problem.
Healthy ageing is
associated with:
low energy consuming;
low animal origin protein
content;
low fat and cholesterol
content;
high intake of fruits,
vegetables and
dairy products;
higher chance of survival;
delay in the deterioration
of health status.
Galati, 16-17 January 2009
Needs
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A relationship between sensory ability and food preferences
• texture preferences changed with age due to the following
factors:
- decreased sense of smell, taste and vision ;
- decreased saliva production;
- chewing and swallowing problems besides all disease
problems
affect the perception of food items as well as meals
none or little chewing
easy to swallow
attractive sensory attributes
Galati, 16-17 January 2009
Needs and eating behavior
Institute of Food Bioresources
always whole bread
Food products in order to satisfy:
whole and white bread
18%
26%
white bread
only white bread
nutritional needs, e.g. nutrientdense –
- antioxidants (oxidative damage);
21%
- vitamins, fibers;
- high quality protein (to maintain
lean tissue mass), water;
Bakery products
35%
very rare
1 portion
2 portions
3 portions
10%
tasty;
19%
familiar foods (e.g. traditional
food);
22%
available in convenient;
Dairy products
easy-to-open packaging;
49%
reasonably prices
Galati, 16-17 January 2009
Eating behavior
Institute of Food Bioresources
18%
always whole
bre ad
whole and
white bre ad
white bre ad
26%
10%
19%
very rare
1 portion
22%
2 portions
3 portions
21%
only white
bre ad
Bake ry products
35%
10%
3%
25%
very rare
1 portion
2 portions
3 portions
Dairy products
49%
very rare
1 portion
2 portions
3 portions
4%
19%
40%
Vegetables
62%
Sweets
37%
Galati, 16-17 January 2009
Eating behavior
Institute of Food Bioresources
very rare
11%
rare
rare
often
daily
36%
47%
53%
Fatty foods
Meat
53%
rare
11%
25%
10%
14%
very rare
1 portion
1 portion
2 portions
2 portions
3 portions
33%
64%
43%
Be ans and eggs
Galati, 16-17 January 2009
Fruits
Conclusions
Institute of Food Bioresources
ageing is not a disease
thus, the most modifiable lifestyle
factors are diet and physical activity.
the quality of the nutrition is basic
to the quality of the life.
synchronizing the individual biography of eating,
the physiological, emotional, social and
environmental changes to enhance the ageing to feel
self-determinant and self-confident.
poor nutrition has to be identifiable, preventable,
and reversible, and should be handled before
diseases are manifested.
Galati, 16-17 January 2009
Conclusions
22%
Normal nutritional status
Malnutrition risk
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Nutritional programs:
78%
- “prevention by healthy food”;
consumer education to healthy food habits choice;
communication strategies necessary in food
choice refer to the risk/benefits, healthy food, etc.
intervention strategies – changing consumer
behavior in healthy food choice;
existing an appropriate model for a long, active
and independent life.
Galati, 16-17 January 2009
Conclusions
Institute of Food Bioresources
• Consumer priorities identification related to food
benefits: taste, pleasure, convenience, price, so on;
• Promotion traditional, regional food – to reduce shelf
life and preservation
• Functional food promotion;
• Following the message ”it is easier to prevent instead of
cure”.
• Better for our senior, better for us!
Galati, 16-17 January 2009
Institute of Food Bioresources
Nastasia Belc
[email protected]
Denisa Duta
[email protected]
www.bioresurse.ro/RODIONA.html.
Galati, 16-17 January 2009