1ST CITY CLINICAL HOSPITAL

Among the factors maintaining normal physiological state and performance in old age, nutrition plays an important role. Nutrition that is balanced according to age has a significant impact on the development of the aging processes of the body and on the nature of the changes that occur in its various systems.

Aging is a complex of changes that occur in the body as a result of time factors. The accumulation and summation of these changes throughout life lead to irreversible changes in life-supporting systems and the body as a whole. Thus, aging is a slow process of accumulation of age-related changes manifested at all levels - molecular, cellular, tissue, organ and at the level of the entire organism.

The most important factor of aging is a decrease in the activity of the renewable elements of living matter, when the law of constant renewal of the body, characteristic of life, is violated.

Undoubtedly, aging occurs under the influence of a complex of factors and causes that act in the direction and ultimately lead to changes characteristic of old age.

Aging is a general biological pattern, which is based on the development of atrophic and degenerative processes. One of the most important factors causing aging is a decrease in the intensity of self-renewal of protoplasm. During the aging process, generative proteins (nucleoproteins) capable of reproduction, synthesis and restoration are increasingly replaced by proteins that do not have reproductive ability. With age, the body's synthetic capabilities weaken and the regulation of this synthesis deteriorates. During the aging process, protoplasm loses nucleoproteins, nucleic acids and other components characterized by high self-renewal.

Aging is characterized by a weakening of the functional capacity of all body systems.

Significant changes occur in the digestive system. As a result of atrophic processes, the gastric mucosa becomes thinner, and its cells, including glandular cells, become less differentiated, which leads to a decrease and limitation of the secretory and motor functions of the stomach. The most important disorder of digestive functions during aging is a decrease in the acidity of gastric juice, the concentration of enzymes and their activity.

A decrease in the secretion of gastric juice, a weakening of the secretion of hydrochloric acid up to its complete cessation, and a decrease in the enzymatic activity of pepsin affect the functional ability of gastric digestion, as well as the state and nature of the intestinal microflora, in which putrefactive microorganisms begin to predominate sharply. These changes in the intestinal microbial landscape lead to increased formation of putrefactive products in the intestine and their absorption.

In the pancreas, atrophy of its active elements is noted, which causes a decrease in the functional ability of the pancreas, a decrease in the number and decrease in the activity of the enzymes produced by it. The proteolytic (protein-digesting) activity of pancreatic juice is especially significantly reduced, and to a somewhat lesser extent the amylolytic (carbohydrate-digesting) and lipolytic (fat-digesting) activity. Thus, the digestive system undergoes changes during the aging process that negatively affect its functional ability.

The development of aging processes is significantly influenced by hypokinesia and associated excess body weight. The negative consequences of obesity and muscle wasting, which accelerate the aging process, represent an important geriatric problem.

Principles of nutrition for older people

When organizing nutrition for older people, it is necessary to take into account, first of all, the reduced capabilities of the digestive system. In this regard, the first requirement for the nutrition of older people is moderation, i.e. some restriction of nutrition in quantitative terms. Taking into account the decrease in the intensity of metabolic processes during aging, the second requirement should be considered to ensure high biological nutritional value by including sufficient amounts of vitamins, biomicroelements, phospholipids, polyunsaturated fatty acids, essential amino acids, etc. The third requirement for the nutrition of the elderly is its enrichment with natural anti-sclerotic substances contained in significant quantities in some foods.

Nutrient requirements

Protein requirement. In old age, the processes of growth and formation of body tissues are completed, and therefore the need for plastic materials, including protein, is much less. A decrease in overall performance in old age and often the cessation of intense physical work is also the basis for reducing the protein norm. However, in older people there remains a need for the regeneration of worn-out, aging cells, which requires protein (the more, the higher the wear and tear of the tissues). It has been established that in elderly and old people the regenerative need for protein is quite high.

Along with this, there are recommendations regarding protein restriction in old age due to the fact that its excess can contribute to the development of atherosclerosis. According to American authors, protein restriction in old age and old age, like sugar restriction, leads to a persistent decrease in blood cholesterol.

Animal proteins should make up approximately 55% of the total protein in the diet.

Requirement for fats. Fats in the diet of older people should be limited. A connection has been established between abundant fat consumption and the development of the atherosclerotic process. In addition, the intake of large amounts of fat may be too much for the weakened secretory apparatus to digest and for the entire digestive system of older people.

When studying the issue of the fat component in the diet of older people, many researchers obtained data on the predominant negative effect of saturated, saturated fatty acids of animal fats on fat and cholesterol metabolism. In this regard, animal fats are limited primarily.

Along with butter, you must also use vegetable oil. It in the amount of 20-25 g per day provides a sufficient supply of those substances that are necessary in old age (polyunsaturated fatty acids, etc.). Systematic intake of large amounts of vegetable oil is undesirable due to the fact that it may contain a significant amount of oxidation products that are easily formed in vegetable oils due to the high content of unsaturated fatty acids. In addition, a large proportion of vegetable oil in food negatively affects digestion and absorption of fat.

The total fat requirement of elderly people is approximately assumed to be 10% more than the amount of protein in the diet (see table).

Need for carbohydrates. In the generally accepted formula for a balanced diet, the amount of carbohydrates is on average 4 times greater than the amount of protein. This ratio of protein and carbohydrates is acceptable for older people only with an active, active lifestyle. With little physical activity, the amount of carbohydrates should be reduced.

The basis for reducing the level of carbohydrates in the diet of older people is the manifestation of the hypercholesterolemic effect of low molecular weight carbohydrates. In addition, excess sugar adversely affects the activity of beneficial intestinal microflora.

Thus, in old age, against the background of a general decrease in the amount of carbohydrates in food, a slightly greater limitation of easily digestible carbohydrates - sugar and sweet foods - is required.

In old age, whole grain products (rye and wheat bread made from wallpaper flour, etc.), as well as potatoes and other vegetables, are desirable as sources of carbohydrates. You should also use products that contain a lot of fiber and pectin. The positive role of fiber in normalizing the vital activity of beneficial intestinal microflora has been established. Fiber helps remove cholesterol from the body.

Of particular value are raw vegetables and fruits, which have the most active biological effect. Recommended carbohydrate intake is given below.

Recommended daily intake of protein, fat, carbohydrates and energy for older adults.

Need for vitamins. Vitamins, due to their catalytic properties, are able to slow down the aging process to a certain extent. A sufficient level of vitamin supply makes it possible to maintain the metabolic rate at a normal level, preventing the accumulation of acidic sulfated mucopolysaccharides in the connective tissue, and thus prevent the development of sclerotic changes in the connective tissue. In old age, phenomena of endogenous multivitamin deficiency caused by wear and disadaptation of enzyme systems are observed. In this regard, older people need a balanced, complete vitamin supply. Most researchers are of the opinion that in old age it is necessary to create diets rich in vitamins. For elderly people, vitamins that have a normalizing effect on the state of the vascular and nervous systems, as well as vitamins involved in reactions associated with inhibition of the development of the sclerotic process, are of particular importance.

The important role of certain vitamin complexes has been confirmed, affecting the course and development of aging processes in the tissues and systems of the body, as well as the life expectancy of animals. Depending on the vitamin supply, the level of cholesterol in the blood changes. In this regard, particular importance is attached to vitamins and P-active substances.

UL S is considered as one of the substances necessary in old age. Including a sufficient amount of VIIC in the diet of elderly people allows you to create better conditions for the course of oxidative processes and normalize metabolism. The above observations revealed an increased need for VIIC among older people and confirmed the need for regular, sufficiently high C-vitamin provision.

Under the influence of ascorbic acid, the physiological balance between the biosynthesis of cholesterol and its utilization in tissues is stabilized. Ascorbic acid increases the body's reactivity and strengthens defense mechanisms.

Providing the body with VII C should be done from its natural sources. C-vitamin preparations can be used as additional sources vii C. There is evidence of the adverse effects of excess intake of ascorbic acid on some body systems, in particular on the pancreas (pancreatic islets, or islets of Langerhans).

Due to the fact that vii C and P are synergists, in old age the intake of P-reactive substances is rational. The value of VII P for elderly people also increases because it has the ability to lower blood pressure in cases of increased hypertension.

Vitamins that have lipotropic properties that inhibit the development of the atherosclerotic process and are important for the elderly and in old age include choline, inositol, VII B12 and folic acid, and also, according to some data, VII B15. VII Wb (pyridoxine) and pantothenic acid, as well as VII P (polyunsaturated fatty acids) also have pronounced lipotropic properties. According to some reports, VIIE (a-tocopherol) is characterized by lipotropic properties.

Recommended daily intake of vitamins for older adults

Prophylactic agents have been proposed that inhibit, to some extent, the development of premature aging. These products also include various vitamin complexes, which include a number of vitamins taken in certain quantitative ratios, containing the body’s daily need for essential vitamins and minerals. Elderly people can be recommended to use such vitamin complexes as “Complevit”, “Alphabet”, “Centrum”, “Adaptovit”, “Longevit”.

Requirement for minerals. The balance of minerals in the diet of older people is less necessary than in adulthood and middle age. At the same time, it is known that in old age there is an accumulation of minerals in the body, especially calcium salts. Salt deposits are known in the walls of blood vessels, in joints, cartilage and other tissues. These and other manifestations of salt excess in old age make us extremely cautious about the rationing of minerals in the diets of older people.

Along with this, there are known cases of senile osteoporosis associated with salt deficiency. Thus, in old age there are phenomena of both oversaturation with salts and insufficiency of certain minerals. In an aging body, increased mineralization of some tissues is often observed against the background of a decrease in the content of mineral substances and the intensity of their metabolism in others.

Calcium is of particular importance in the mineral metabolism of older people. Currently, the generally accepted calcium norm for older people is the norm adopted for adults, i.e. 800 mg. per day. Another important mineral element in old age is magnesium. It has an antispastic and vasodilating effect, stimulates intestinal motility and increases bile secretion. The effect of magnesium on lowering cholesterol in the blood has been established. With a lack of magnesium, the calcium content in the walls of blood vessels increases. The main sources of magnesium in human nutrition are cereals and legumes. The daily requirement for magnesium is 400 mg.

The third mineral element that plays an important role in old age and old age is potassium. The main importance of potassium is its ability to increase the excretion of water and sodium chloride from the body. In addition, potassium increases heart contractions. All foods in the diet are involved in the daily supply of potassium. However, in old age, the most beneficial sources of potassium are raisins, apricots, and potatoes.

For older people, it is desirable to strengthen the alkaline orientation of nutrition through increased consumption of milk and dairy products, potatoes, vegetables and fruits.

In the Omsk region, the necessary supply of iodine to the body also plays an important role. Iodine is a component of the thyroid hormone - thyroxine. Participates in the processes of phosphorus-calcium metabolism, which is very important in old age. It is necessary to prevent iodine deficiency by using iodized salt or consuming a daily dose of potassium iodide - 150 mcg.

The above does not exhaust the importance for older people of all other macro- and microelements that are necessary in old age.

Diet in old age

In old age, diet is of particular importance for the prevention of weakening of the secretory and enzymatic functions of the digestive glands associated with aging of the body. When establishing a diet, it is necessary to take into account the reduced functionality of the altered and weakened digestive system, for which the greatest load becomes unbearable. The basic principles of the diet for older people are eating strictly at the same time, limiting the intake of large quantities of food and eliminating long intervals between meals.

Four meals a day are recommended. A diet regimen of eating five times a day may be established. This regimen is most rational in old age, when food should be taken in smaller portions and more often than usual. With 4 meals a day, the food ration is distributed as follows: for the first breakfast - 25%, for the second breakfast - 15%, for lunch - 35% and for dinner - 25% of the energy value of the daily ration.