Handbook of Clinical Nutrition and Aging PDF
Preview Handbook of Clinical Nutrition and Aging
N U T R I T I O N & H E A L T H Handbook of Clinical Nutrition and Aging Second Edition Edited by Connie Watkins Bales, p d, rd, macn h Christine Seel Ritchie, md, msph H C N A ANDBOOK OF LINICAL UTRITION AND GING N (cid:2) (cid:2) H UTRITION AND EALTH Adrianne Bendich, Series Editor HandbookofClinicalNutritionandAging,SecondEdition,editedbyConnieWatkins BalesandChristineSeelRitchie,2009 HandbookofNutritionandPregnancy,editedbyCarolJ.Lammi-Keefe,Sarah CollinsCouch,andElliotH.Philipson,2008 NutritionandHealthinDevelopingCountries,SecondEdition,editedby RichardD.SembaandMartinW.Bloem,2008 NutritionandRheumaticDisease,editedbyLauraA.Coleman,2008 NutritioninKidneyDisease,editedbyLauraD.Byham-Gray,JerrilynnD. Burrowes,andGlennM.Chertow,2008 HandbookofNutritionandOphthalmology,editedbyRichardD.Semba,2007 AdiposeTissueandAdipokinesinHealthandDisease,editedbyGiamilaFantuzziand TheodoreMazzone,2007 NutritionalHealth:StrategiesforDiseasePrevention,SecondEdition,editedby NormanJ.Temple,TedWilson,andDavidR.Jacobs,Jr.,2006 Nutrients,Stress,andMedicalDisorders,editedbyShlomoYehudaandDavidI. Mostofsky,2006 CalciuminHumanHealth,editedbyConnieM.WeaverandRobertP.Heaney,2006 PreventiveNutrition:TheComprehensiveGuideforHealthProfessionals,Third Edition,editedbyAdrianneBendichandRichardJ.Deckelbaum,2005 TheManagementofEatingDisordersandObesity,SecondEdition,editedbyDavid J.Goldstein,2005 NutritionandOralMedicine,editedbyRivaTouger-Decker,DavidA.Sirois,and ConnieC.Mobley,2005 IGFandNutritioninHealthandDisease,editedbyM.SueHouston,JeffreyM.P. Holly,andEvaL.Feldman,2005 EpilepsyandtheKetogenicDiet,editedbyCarlE.StafstromandJongM.Rho,2004 HandbookofDrugNutrientInteractions,editedbyJosephI.BoullataandVincentT. Armenti,2004 NutritionandBoneHealth,editedbyMichaelF.HolickandBessDawson-Hughes, 2004 DietandHumanImmuneFunction,editedbyDavidA.Hughes,L.GailDarlington, andAdrianneBendich,2004 BeveragesinNutritionandHealth,editedbyTedWilsonandNormanJ.Temple, 2004 H C ANDBOOK OF LINICAL N A UTRITION AND GING Second Edition Edited by C W B , ONNIE ATKINS ALES PhD, RD, FACN Durham VA Medical Center and Duke University Medical Center, Durham, NC and C S R , , HRISTINE EEL ITCHIE MD MSPH Birmingham VA Medical Center, University of Alabama at Birmingham, Birmingham AL Foreword by N S.W , , , ANCY ELLMAN PhD RD FADA Former Director, National Resource Center on Nutrition, Physical Activity and Aging, Florida International University, Miami, FL Past President, The American Dietetic Association Editors ConnieWatkinsBales ChristineSeelRitchie DurhamVAMedicalCenterandDuke BirminghamVAMedicalCenter UniversityMedicalCenter UniversityofAlabamaatBirmingham Durham,NC Birmingham,AL SeriesEditor AdrianneBendich GlaxoSmithKlineConsumerHealthcare Parsippany,NJ ISBN978-1-60327-384-8 e-ISBN978-1-60327-385-5 DOI10.1007/978-1-60327-385-5 LibraryofCongressControlNumber:2009920207 #HumanaPress,apartofSpringerScienceþBusinessMedia,LLC2004,2009 Allrightsreserved.Thisworkmaynotbetranslatedorcopiedinwholeorinpartwithoutthewrittenpermissionof thepublisher(HumanaPress,c/oSpringerScienceþBusinessMedia,LLC,233 SpringStreet,NewYork,NY 10013,USA),exceptforbriefexcerptsinconnectionwithreviewsorscholarlyanalysis.Useinconnectionwithany formofinformationstorageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilar methodologynowknownorhereafterdevelopedisforbidden. Theuseinthispublicationoftradenames,trademarks,servicemarks,andsimilarterms,eveniftheyarenot identifiedassuch,isnottobetakenasanexpressionofopinionastowhetherornottheyaresubjecttoproprietary rights. Printedonacid-freepaper springer.com Dedications ConnieWatkinsBalesdedicatesthisvolumetoherchildren,AudreyAshburnBales BrittonandWilliamBrittainBales,inappreciationofallthewaystheyhaveenriched herlifeandwithenthusiasticanticipationofalltheyarebecoming. ChristineSeelRitchiededicatesthisvolumetothememoryofherfather,DavidJohn Seel,MD,FACS,amanofcompassionwhowasdevotedtolife-longlearning. Acknowledgements CWBwouldliketorecognizeandthankTienThiHowho,asaDukestudentassistant, workedtirelesslyfortwoacademicyearsonthemanagementandcopyeditingofthistext, contributingsubstantiallytoitsquality.ThanksalsotoJustin(Cody)MaxwellandCaroline Friedman for their contributions to this project. CWB and CSR thank our series editor, Dr. Adrianne Bendich, for her encouragement to begin what has become an ongoing and excitingsetofencounterswithcriticalclinicalissuesingeriatricnutritionandthegiftedand dedicated scientists who study them. Without the creative contributions of these scientist- authors,thisbookwouldnothavebeenpossible. vii Series Introduction The Nutrition and Health series of books have, as an overriding mission, to provide health professionals with texts that are considered essential because each includes (1) a synthesisofthestateofthescience,(2)timely,in-depthreviewsbytheleadingresearchersin theirrespectivefields,(3)extensive,up-to-datefullyannotatedreferencelists,(4)adetailed index, (5) relevant tables and figures, (6) identification of paradigm shifts and the con- sequences, (7) virtually no overlap of information between chapters, but targeted, inter- chapter referrals, (8) suggestions of areas for future research and (9) balanced, data-driven answerstopatient/healthprofessionalsquestionsthatarebaseduponthetotalityofevidence ratherthanthefindingsofanysinglestudy. The series volumes are not the outcome of a symposium. Rather, each editor has the potentialtoexamineachosenareawithabroadperspective,bothinsubjectmatteraswellas in the choice of chapter authors. The international perspective, especially with regard to publichealthinitiatives,isemphasizedwhereappropriate.Theeditors,whosetrainingsare bothresearchandpracticeoriented,havetheopportunitytodevelopaprimaryobjectivefor theirbook;definethescopeandfocus;andtheninvitetheleadingauthoritiesfromaround theworldtobepartoftheirinitiative.Theauthorsareencouragedtoprovideanoverviewof the field, discuss their own research and relate the research findings to potential human healthconsequences.Becauseeachbookisdevelopeddenovo,thechaptersarecoordinated so that the resulting volume imparts greater knowledge than the sum of the information containedintheindividualchapters. ‘‘HandbookofClinicalNutritionandAging,SecondEdition’’editedbyConnieWatkins BalesandChristineSeelRitchiefullyexemplifiestheNutritionandHealthSeries’goals.The firstvolumeofthehandbook,publishedin2004,wasacknowledgedbyreviewersasthemost comprehensive volume available concerning the role of clinical nutrition in preserving the healthofolderadults–especiallythosesufferingfromestablishedchronicdisease.Thesecond editionisverytimelyasthefastestgrowingpopulationin theUSaswellasglobally isthose over60yearsofageandespeciallytheoldest-old,thoseover80yearsofage.Thisimportant textprovides practical,data-drivenoptions to enhance this at-risk population’spotentialfor optimalhealthanddiseasepreventionwithspecialemphasisonsecondarydiseaseprevention and therapeutic nutritional interventions. The overarching goal of the editors is to provide fullyreferencedinformationtohealthprofessionals,sothattheymayenhancethenutritional welfareandoverallhealthoftheirolderadultclientsandfamilymembers.Thisexcellent,up- to-date volume will add great value to the practicing health professional as well as those professionalsandstudentswhohaveaninterestinthelatestinformationonthesciencebehind the agingprocess,and thepotentialfor nutrition to modulatetheeffects ofchronic diseases andconditionsthatarewidelyseeninthegeriatricpopulation. ix x SeriesIntroduction Drs.BalesandRitchie,whohaveeditedthefirstandsecondeditions,areinternationally recognized leaders in the field of clinical nutrition and aging. Both editors are excellent communicatorsandtheyhaveworkedtirelesslytodevelopabookthatcontinuestobethe benchmark in the field because of its extensive, in-depth chapters covering the most importantaspectsofthecomplexinteractionsbetweencellularfunctions,dietandnutrient requirementsandtheirimpactonthechronicdiseasesaswellastheacuteconditionsthatcan adverselyaffectthequalityoflifeandhealthofolderindividuals.Theeditorshavechosen40 ofthemostwell-recognizedandrespectedauthors,internationallydistinguishedresearchers, cliniciansandepidemiologists,whoprovideacomprehensivefoundationforunderstanding theroleofnutrientsandotherdietaryfactorsintheclinicalaspectsofnutritionalmanage- mentoftheelderly. Hallmarks of all the 29 chapters include complete explanations of terms, with the abbreviations fully defined for the reader, and consistent use of terminology between chapters. Key features of this comprehensive volume include the informative bulleted summary points and key words that are at the beginning of each chapter and appendices thatincludeadetailedlistofrelevantnutritionresources,includinglistsofbooks,journals andwebsites.Glossariesoftermsandabbreviationsareprovidedasneededandrecommen- dationsforcliniciansareincludedattheendofrelevantchapters.Thevolumecontainsmore than45detailedtablesandinformativefigures,anextensive,detailedindexandmorethan 1100 up-to-date references that provide the reader with excellent sources of worthwhile informationaboutnutritionoptionstohelpmaintainthehealthofseniors. Thefirstsectionofthevolumecontainsthreechaptersthatexamineoverarchingissuesfor nutritionalwell-beinginlaterlife.Thefirstchapterexaminesthecomplexfactorsthataffect foodchoices.Asoneages,thesocialinteractionsatmealtimesgreatlyaffectfoodchoicesand intake.Alsorelevantiswherethemealsareconsumed–inthehome,inahospitalornursing homeor othertypeofinstitution,asexamples. Nationalfeeding programsavailableinthe USaredescribedandrelevantdetailsabouthowtheseaffecttheaccesstofoodfortheelderly arereviewed.Thesecondchapterreviewstheroleofbehaviormodificationinassuringthe benefitsoftherapeuticnutritionalchanges.Twomajordeterminantsofsuccessinadherence todietarycomplianceareenhancementofpatientknowledgeandunderstandingofthevalue of the change for their own health and secondly, enhancement of patient confidence that theycanmakethechangesandmaintainthemoverthelongterm.Sixbehavioraltheoriesare discussed in detail and helpful educational materials are also provided in this informative chapter. The third chapter highlights changes in population demographics in both the developedanddevelopingworld,theso-called‘‘globalgraying’’attributedtothecombina- tionoflowerbirthratesandincreasedlongevity.Adetaileddiscussionofdemographics,diet anddiseasetrendsinChinaservesasanexampleofthepotentialeffectsoftheWesternized diet on causes of death as they shift from infectious to chronic diseases associated with obesity.Asin36otherdevelopingcountries,inChinaoverweightexceedsunderweightasa nutritionalproblem.Althoughpopulationgrowthhasbeencurtailedduetotheonechild/ family policy, lifespan has increased dramatically in the past 40 years. There are currently more than 100 million Chinese who are 65 years or older, and that number is increasing annually (from 8% now to 24% of the population by 2050). At present, China has more people65 andolder than allEuropean countries combined.Family care of elderly parents remainsthenorminChinaandmaybeamajorfactorthatdifferentiateseldercareinChina SeriesIntroduction xi from that seen in the US and other Western cultures. However, urbanization and smaller livingspacesmayleadtochangesinthecareofolderfamilymembersinfuturegenerations. Thesecondsectiondealswiththefundamentalsofnutritionandgeriatricsyndromesin 10chapters.Thefirstchapterinthissectionreviewsthemajorityofnutritionscreeningtools available for dietary intake assessment geared to seniors and examples are included in the ninetables.Toolsforassessmentoffrailtyarealsodiscussed.Themostcriticalinformation forassessmentofoverallnutritionalstatusremainsbodymassindexandrecentweightloss. Sensorysignals,includingtasteandsmell,arekeyfactorsaffectingthenutritionalstatusof seniorsandweareremindedinChapter5thatmanyofthemedicationsthatarecommonly takenasweageaffectthesesensesnegatively.Visualandauditorylossesalsoaffectresponses to food and eating experiences. There are somatosensory changes with aging that result in loweredoral,touchandothertemperature-relatedsensations.Aseparatechapterreviewsthe roleofcertainenvironmentalfactors,suchassmokingandsunlightexposure,inincreasing the risk of vision loss. The latest data on the potential for essential nutrients to prevent cataracts and age-related macular degeneration – the two major causes of blindness in the elderly – are included in detailed tables. Nutrients reviewed include vitamins C and E, carotenoidsincludingluteinandzeaxanthin,zincandomega-3fattyacids.Therecommen- dationistoconsumedietsthatarerichinthesemicronutrients.Tothisend,extensivetables listingfoodsthatcontainthesenutrientsareincluded. Theimportantchangesthatoccurthroughoutthegastrointestinaltract,beginninginthe mouth, are outlined in the seventh comprehensive chapter. Topics such as dysphagia, gastroesophageal reflux disease (GERD), gastritis, ulcers, diarrhea, fecal incontinence, constipation, colitis, inflammatorybowel disease, lactose intolerance,GI bleeding,anemia and hepatitis are all discussed and clinical recommendations are provided. There is an importantchapteronthechangesinthestimulusforthirstandpotentialfordehydrationin theelderly.Deficienciesinsodiumandcertaintracemineralsandelectrolyteimbalancesthat maybedrug,illnessorageinducedarereviewed. Nutritionalfrailty,whichischaracterizedbythelossofbothmuscleandfat,isoftenthe consequenceofunintentionalprogressivedecreasesinfoodintakeintheelderly.Nutritional frailty differs from sarcopenia and cachexia, and, thus, each of these conditions that significantly affect health in the aging population is given its own in-depth chapter. In contrast to the loss of weight in the overweight or obese adult <65years that is associated with reduced mortality risk, even a small loss of weight over age 65 is associated with an increased risk of death. The difference may be due to the change in body composition in olderadultswiththereplacementofmusclewithfatandthelossofbone.Theremayalsobe a loss of appetite and hormonal changes may also increase the potential for unintended weightloss.Informationisgivenabouttheinteractionsbetweenphysiological,psychological and socioeconomic factors that may increase the risk of weight loss. Guidance is also provided on the introduction of nutritional supplements and drugs that may enhance appetite,andenteralandparenteralnutritionoptionsinolderadultswhocontinuetolose weight. Sarcopenia, which is defined as age-related loss of skeletal muscle mass, is most prevalentinindividualswhoconsumelowproteindietsandwhoaresedentary,butoccurs almost universally as adults grow older. Lower body exercises that include resistance activitiesandprotein-richdietsmayhelptoavertthelossofmuscle,functionalimpairments and loss of mobility seen in those with muscle loss. Cachexia includes sarcopenia and, becauseofitsrelevancetoaging,isdiscussedinChapter11.Cachexia,thewastingofskeletal
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