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.
Lifestyle
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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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