Wednesday, June 29, 2016

Phlippines - Aging can lead to malnutrition

MANILA, Philippines – Malnutrition can be found not only among patients in hospitals but also even in our homes,” Dr. Marianna Ramona C. Sy-Quia Sioson, Section of Nutrition head, Department of Internal Medicine at The Medical City, said at a recent event hosted by celebrity Miriam Quiambao-Roberto for nestle Health Science, “a health science-based company which is focused on advancing nutritional therapy.”

There are certain signs you can watch out for that can help you identify the risks for malnutrition among your family members, particularly among the older adults. Are they losing weight unintentionally? Are they able to finish only 50 percent of the food on their plate when before, they could finish 100 percent? Are they experiencing difficulty in chewing, swallowing, drinking, or lifting their spoon and fork?

“Look at their oral cavity. What do you see? Changes that happen in the mouth can affect the way they eat,” Sioson noted. “Are they wearing dentures or are they experiencing dryness that can lead to mouth sores? When you get older, you are not always aware that you are thirsty. A lot of aging patients are brought to the ER and the only reason is because they lack water. They are dehydrated.”

Aging can be a factor in malnutrition due to certain changes which the older adult experiences such as a decrease in the sense of taste and smell or loss of vision. They are depressed. They experience loss of appetite. They eat less because they are not able to digest their food properly. They have slower digestion and what happens next is gas formation.

Gut disorders, such as constipation and diarrhea, are common among older adults.

“25.6 percent of individuals aged 65 and above report troubles with their stomach,” said Dr. Jimmy M. Bautista, a specialist in gastroenterology, neuro-gastroenterology, motility, and clinical research. He is the medical and scientific affairs lead of Nestle Health Science.

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“It is important to maintain a healthy digestive tract,” stressed Bautista. “Do you know that the gut is considered a second brain? That’s how the term ‘gut feel’ was coined. There is what we call brain-gut interaction. Some symptoms are recognized by the brain and are manifested as digestive disorders. One way to improve or correct the changed environment in the gut would be the intake of probiotics or good bacteria, and prebiotics or soluble fibers from fruits and vegetables.”

The so-called “plate method,” an alternative to counting calories, is an easy way  to know if one is eating healthy.  This is how your 9” plate should look: 1/2  should contain non-starchy vegetables, cooked or raw; 1/4 should contain 3-4 oz. of lean meat, fish or chicken; and the remaining 1/4 should contain complex carbs high in fiber such as brown rice, whole wheat bread or pasta.

“There is also a tendency for older people to have a highly restrictive diet. If they are hypertensive or diabetic, they are not allowed to have sugar, salt or cholesterol. So, what is left for them to eat?” remarked Sioson. “They can add an oral  nutritional supplement to their diet, which is different from a dietary or vitamin  supplement. Oral nutritional supplements are drinks in powder form that’s a complete  meal, with a good balance of micro and macro nutrients. While it is often mistaken  for milk, it is not milk so it can be taken  even by those who are lactose intolerant.”

Nestle’s Nutren Optimum, an oral nutritional supplement, contains  vitamin E, a powerful antioxidant; Prebio, a proprietary prebiotic blend that promotes the growth  of beneficial gut bacteria; lactobacillus paracasei, a natural probiotic that helps maintain a healthy microbial gut  environment  that’s essential for a strong immune system; and 50-percent whey protein, a high-quality protein that’s readily absorbed to promote muscle  strength as well as strengthen immune response.

Studies show that as you get older, you actually need more protein than the  younger adult. “If you eat less or consume an inadequate amount of protein, your muscle  mass tends to break down,” said Bautista. “As you grow older, your muscle mass becomes smaller and is replaced with fat cells. Sarcopenia is the gradual loss of muscle mass that affects people starting at age 30. After 50, the average individual loses 10 percent of his muscle mass per decade.”           

“Changes in strength and physical activity can be due to a physiological loss of muscle mass. There is an altered level of energy,” Bautista observes. “Among chronic conditions, the most frequent ailment is a state of impaired mobility, which is prevalent in nearly 40 percent of adults, 50 years old and above.”

Physical activity is advised, at least 30 minutes per day. “Opt to be active,” Sioson prescribed. “It’s not only the number of calories and protein intake that’s important, you also need to exercise to maintain muscle strength.”

Head coach Julio Manuel Veloso shared some tips. “The best advice I can give is stay active,” he says. “Find something that is sustainable, that you can do on a fairly regular basis at least five times a week.”  Walking is a good example. If you had been  sedentary for some time, you can start leisurely at first, then pick up the pace gradually. Climbing up and down the stairs is also a form of exercise. Strength training is effective for maintaining muscle and bone mass. Start with some body weight exercises such as squats and lunges. You can hold on to a chair if you need assistance. Eventually, you  can carry some weight such as a bottle of water.

“Physical activity and nutrient intake are two modifiable factors controlling the  rate of decline in bodily functions that naturally occurs with age,” Bautista observed “Age is just a number. An individual who exercises regularly may have a biological age  10 years younger than his chronological age.”

“But you can never work out a bad diet. Exercise has benefits such as strength and endurance, but nutrition still accounts for 80 percent” Veloso says. “Nutrition is the  one thing everybody needs,” Sioson remarks. “Nobody can live without nutrition.

People need to know how, when, and what to eat.”

Julie Cabatit-Alegre

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