Nutrition

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What is pathologic weight loss?

>5% weight loss over 6mths

What are some differentials for wt loss in the elderly

1) malignancy
2) Nutrition issues
3) Psychological issues such as depression and dementia
4) Chronic issues - DM, CHF, renal failure
5) non-malignant gastro disease

Ultraprocessed foods high in saturated fats (e.g., preserved meats) has been associated with significant increases in cardiovascular and all-cause mor ta lit y

True, reducing saturated fat in diet not shown to be significant. Not enoughis known

Dietary calcium is important through varied diet, milk etc

Not enough is shown re supplemented Ca. Does not reduce # risk

All Fiber benefitical (but not equally so)
daily fiber intake of 25 g for adult women and 38 g for adult men

Increased intake of dietary fiber may help prevent cardiovascular disease, diabetes, constipa-tion, and gastrointestinal and breast cancers.

steer patients toward whole foods that are naturally high in dietary fiber (often ultraprocessed foods are injected into ultraprocessed food items to increase their fiber content - these are NOT useful)

Weight loss

maintained deficit of 100 calories per day without any other changes will lead to an eventual weight loss of about 5kg over 1 year.

What is Sarcopenia

Sarcopenia is a geriatric syndrome characterised by progressive and generalised loss of skeletal muscle mass and physical strength or function. It is linked to aging, sedentary lifestyle, poor dietary intake and nutritional status

What are some dietary recommendations for reducing hyperglycaemia?

1) Replacing high-GI foods with low-GI food

2) Dietary fibre may also assist in weight management through eects of satiety and fuel partitioning. In Singapore, the recommended fibre intake is 20g for women and 26g for men
( oats and fruit)

3) Increased dietary consumption of fatty fish and polyunsaturated fatty acid omega 3 from vegetable oil (e.g. canola, corn) and walnut were found to be protective against cardiovascular disease mortality in patients with diabetes

* insuffcient evidence to support the routine use of micronutrients such as chromium, magnesium, vitamin D, Vitamin E and C to improve glycaemic control in people with diabetes

What are some recomendations for the elderly who are at risk of sarcopenia?

1) Adequate calories intake (24-36 kcal/kg body weight/day)
2) Protein intake of 1.0 - 1.5g/kg body weight/day from high-quality protein sources that are evenly distributed throughout the day. Approximately 20% to 30% of their total caloric intake
3) Monitor and supplement if deficient vit D level.

recommended intake for calcium is 1000 mg/day for adults 51 years and above, and for vitamin D, 400 IU/day for adults 70 years and above

What are some key points regarding bresatfeeding mothers nutrition

1) Only reliable indicators of poor supply is inadequate weight gain/indicators of dehydration
2) RIsk factors for low supply
- prev breast op
- smoking
- endocrine disorders such as hypothyroidism/PCOS (lack of glandular tissue)
3) Examination: mother's breast (look for glandular breast), check child's mouth (clefts, tongue tie), check heart and resp system, check latch
4) Treatment
- Medical issues: treat hypothyroid/anemia
- encuorage emptyng of breasts - pump etc
- galactogogues - domperidone 20mg TDS

*Always screen for mothers mood