Dietary Guidelines for Americans

1
Dietary Guidelines for Americans 2005 Focus
on Older Adults

• Sheldon Gordon, MS, RD, LD
• NCSFPA Workshop
• March 1, 2007

2
Dietary Guidelines for Americans -The Process

• Direction for all federal nutrition programs
• Mandated every five years
• In 2005 contained stage of life, age-specific key
  recommendations

3
Dietary Guidelines for Americans The Purpose

• Health Promotion
• Disease Prevention

4
Reasons for Specifying Recommendations for Older
Adults

• Differences in requirements for specific
  nutrients
• Physiological changes that affect nutrient
  absorption, utilization, or excretion
• Lifestyle factors that affect nutrient intake or
  synthesis
• Higher risk for certain conditions/diseases
• Functional decline

5
Focus Areas with Key Recommendations for Older
Adults
6
Adequate Nutrients Within Calorie Needs

• Consume variety of nutrient-dense foods and
  beverages.
• Choose foods that limit intake of saturated and
  trans fats, cholesterol, added sugars, salt, and
  alcohol.
• Adopt balanced eating pattern such as USDA Food
  Guide or DASH Eating Plan.
• Nutrients of concern for adults
  calcium, potassium, fiber,
  magnesium, and
  vitamins A
  (as carotenoids), C, and E.

7
Adequate Nutrients Within Calorie Needs People
over Age 50
Consume vitamin B12 in its crystalline form
(i.e., fortified foods or supplements).

• Increased risk for B12 deficiency
• Dietary intake adequate, but decreased
  ability to absorb vitamin B12
• Decreased gastric acid
• Interference by bacteria
• Reduction in intrinsic factor

8
Adequate Nutrients Within Calorie Needs Older
Adults

• Consume extra vitamin D from vitamin D-fortified
  foods and/or supplements.

• Limited sun exposure among frail older persons
• Less conversion to vitamin D in skin
• High risk for low serum 25(OH)D3
• Low intake of dairy foods
• High risk of osteoporosis
• May need up to 25 µg per day

AJCN 200480(suppl)1763S-1766S.
9
Vitamin D in Your Diet
Its possible to get to 25 µg in your diet by
consuming. . .

• 3 cups fortified low-fat milk 7.5 µg
• 2 cups fortified orange juice 2.5 µg
• Supplemental vitamin D 15.0 µg

Dietary Guidelines for Americans 2005 AJCN
200480(suppl)1763S-1766S Family Econ Nutr Rev.
200315(1) 85-91
10
Physical Activity

• Engage in regular physical activity and reduce
  sedentary activities to promote health,
  psychological well-being, and maintain a healthy
  body weight.
• To achieve physical fitness include
  cardiovascular conditioning, stretching exercises
  
• for flexibility, and resistance
• exercises or calisthenics for
• muscle strength and endurance.

11
Physical Activity Older Adults
Participate in regular physical activity to help
reduce decline mobility associated with aging and
to achieve the other health benefits of physical
activity identified for all adults.

• Functional decline related to aging include
• Decreased muscle mass
• Decreased strength
• Increase in joint dysfunction
  and arthritis

AJCN 200582923-34
12
Sodium and Potassium

• Consume less than 2,300 mg of sodium per day
  (approximately 1 teaspoon).
• Choose and prepare foods with little salt.
• Reducing blood pressure reduces
• risk of stroke, heart disease,
• heart failure, and kidney disease.

13
Sodium and PotassiumOlder Adults

• Aim to consume no more than 1,500 mg of
• sodium per day, and meet the potassium
• recommendation (4,700 mg/day) with food.

• Higher risk for hypertension.
• Tend to be more salt sensitive.
• Check with health care provider
  before using salt substitute.

14
Food Safety

• CLEAN Wash hands and surfaces often
• SEPARATE Don't cross-contaminate
• COOK food to proper temperatures
• CHILL Refrigerate Promptly

15
Food Safety Older Adults

• Do not eat or drink unpasteurized milk or any
  products made from raw milk milk or partially
  cooked eggs
• Higher risk for foodborne illnesses
• Medication use
• Chronic illnesses
• Smell and taste deficits
• Cognitive impairment
• More likely to get very sick
• when contracting foodborne illness.

16
Weight Management

• To maintain body weight in a healthy range,
  balance calories from foods and beverages with
  calories expended.
• To prevent gradual weight
• gain over time, make small
• decreases in food and
  beverage calories and
• increase physical activity.

17
(No Transcript)
18
Older Americans Update 2006 Key Indicators of
Well-Being. http//www.agingstats.gov/update2006/
pressroom.html
19
Weight ManagementOverweight Adults with
Chronic Diseases and/or on Medication
Consult a health care provider before starting a
weight-reduction or exercise program.

• Older adults more likely to have
  one or more chronic diseases
• Older adults more likely to take
  medication, particularly multiple
  medications.
• Weight management a concern
  among older adults.

20
Medical Complications Associated with Obesity in
Older Adults

• Metabolic syndrome
• Osteoarthritis (knee)
• Obstructive sleep apnea
• Urinary incontinence
• Cataracts
• Cancer
• Decline in physical function

AJCN 200582923-34
21
Weight Loss in Older Adults

• Improves physical function and health-related
  quality of life.
• Can decrease muscle and bone mass.
• Include aerobic and resistance exercise.
• Encourage adequate calcium and vitamin D intake.
• Older adults may be more compliant in a targeted
  lifestyle intervention (e.g., DPP).

AJCN 200582923-34
22
So What Do We Do Next?
23
(No Transcript)
24
MyPyramid

• Activity
• Moderation
• Personalization
• Proportionality
• Variety
• Gradual Improvement

25
MyPyramid Food Intake Pattern Calorie Levels
MEN Activity level Sedentary Mod. active
Active AGE 51-55 2200
2400 2800 56-60
2200 2400
2600 61-65 2000
2400 2600 66-70
2000 2200
2600 71-75 2000
2200 2600 76
2000 2200
2400
26
MyPyramid Food Intake Pattern Calorie Levels
WOMEN Activity level Sedentary Mod. active
Active AGE 51-55 1600 1800 2200 56-60
1600 1800 2200 61-65 1600 1800
2000 66-70 1600 1800 2000 71-75 1600
1800 2000 76 1600 1800 2000
27
Daily Amount of Food from Each Group
28
Whole Grains

• whole-wheat flour
• bulgur (cracked wheat)
• oatmeal
• whole cornmeal
• brown rice

29
Refined Grains

• white flour
• degermed cornmeal
• white bread
• white rice

30
Grains How much?

• Women   51 years old
• 5 ounce equivalents
• 3 ounce equivalents of whole grains
• Men 51 years old
• 6 ounce equivalents
• 3 ounce equivalents of whole grains

31
Whole Wheat Cereal Flakes 1 Cup
Grains Group counts as 1 ounce equivalent whole
grains
32
Vegetables

• Women, 51
• 2 cups
• Men, 51
• 2 ½ cups

33
Fruits

• Women, 51
• 1 ½ cups
• Men, 51
• 2 cups

34
Meat and Beans

• Women, 51
• 5 ounce-equivalents
• Men, 51,
• 5 ½ ounce-equivalents

35
Milk

• Women, 51
• 3 cups
• Men, 51
• 3 cups

36
Oils

• Women, 51
• 5 teaspoons
• Men, 51
• 6 teaspoons

37
Fats and their bonds

• Unsaturated fatty acid

• Saturated fatty acid/hydrogenated fats

• Carbon-Carbon Double Bond

Carbon-Carbon Single Bond
38
Trans Fats
Trans Fat (i.e., trans fatty acids)

• Cis fatty acids

39
Trans fats in food supply
40
Discretionary Calories

• Women, 51
• Calorie levels from 1600-2200
• Extras can equal 132-290 calories
• Men, 51
• Calorie levels from 2000-2600
• Extras can equal 267-410 calories

41
Commodities That Can Help
42
Commodities That Can Help
43
Resources and References

• DG Advisory Committee Report www.health.gov/dieta
  ryguidelines/dga2005/report
• DG for Americans http//healthierus.gov/dietarygu
  idelines
• Facts about the DASH Eating Plan
  www.nhlbi.nih.gov/health/public/heart/hbp/dash
• Behavioral Risk Factor Surveillance System
  www.cdc.gov/brfss
• Food safety information www.foodsafety.gov
• Kennedy ET. Evidence for nutritional benefits in
  prolonging wellness. AJCN 200683(suppl)
  410S-414S.
• Villareal DT et al. Obesity in older adults
  technical review and position statement of the
  American Society for Nutrition and NAASO, The
  Obesity Society. AJCN 200582923034.
• Dawson-Hughes B. Racial/ethnic considerations in
  making recommendations for vitamin D for adult
  and elderly men and women. AJCN
  200480(suppl)1763S-1766S.