Young, Middle Age and Elderly

Height is often chosen as an indicator of nutritional status, though why is not clear, since diet is not the only environmental factor that influences height. Other factors include genetic make-up, childhood illnesses, and sleep patterns.

A better measure is height velocity, rather than height as a single measurement. The short child in the 25th percentile or growing less than 4 cm per year should always be considered for investigation. However, some children grow slowly before achieving their final height. Height is an indicator of past growth rather than present health.

Growth is dependent upon a series of factors including the inherited genetic potential, available nutrition to enable genetic potential to find expression and good health.

Normal growth takes place in distinct spurts in a cyclical manner with a periodicity of about 2 years. This cyclical pattern is maintained even during growth lags.

Food which satisfies the energy gap, micronutrient and nitrogen needs is essential for growth and high activity. However, access to effective primary health care is also essential for good growth. The progress of growth can be assessed by regular weight and height measurements and compared with tables for the population. During adolescence there are increased nutritional requirements of adequate protein, vitamins and minerals and calorie intake.

1. Development in growing children is usually measured as height or preferably, rate of increase in height over a defined period of time. Height is determined both by genetic background and nutrition.

2. There is a prepubertal growth spurt in which height, body shape and composition change. The characteristic body shapes of males and females are formed at this time. The prepubertal growth pattern varies in different racial and economic groups. Young people on defined diets should ensure that specific nutrient requirements are met, e.g. vitamin B12.

3. The correct dietary intake is critical during childhood and growth.

Middle Age

Middle age might be defined as the age group between 35-59 years. Middle age is the established group at the peak of social and professional achievement. A healthy middle age is dependent upon good nutrition in the formative years. Middle age is the time when excess nutrition especially fat and alcohol occurs with adverse consequences for weight and disease.

The concerns of middle age are

• the empty nest (children leaving home)

• the middle life crisis

• change of life, the menopause, etc.

• the period of transition and change before retirement

• the period when ‘health and illness’ problems begin to become more frequent

Growth that is of functional value has stopped. During middle age, fat stores usually increase and there is a decline in organ function — especially of pulmonary and renal capacity, which reduce by half between the ages of 30 and 90. The decline in organs and systems is gradual except for the abrupt cessation of ovarian function at the menopause. At the menopause the female is released from the constant threat of iron deficiency through menstruation and pregnancy. The obverse side of this is to lose the protection afforded by oestrogens against coronary heart disease. This is a period of life when if there is a sufficiency of food available, food intake, storage and metabolism should be balanced.

In middle age there are increasing numbers of deaths, from diseases believed to be associated with excess of inappropriate foods, too much alcohol, and smoking, or all three. Those middle aged who die or who suffer from these conditions are disadvantaged by their genetic make-up and consequently by a vulnerability to dietary constituents, alcohol and tobacco. The killers are the six most common conditions, coronary hear disease, stroke, lung cancer, diabetes and chronic pulmonary disease. The individual’s weight, especially if male, and the amount of exercise taken are of importance. An individual should be of acceptable weight (BMI 20–25) and take 70 or more minutes of exercise a week which results in tachycardia.

A broadly based diet is to be commended. It is not yet clear if it is too late to alter life expectation by improved diet in the middle aged. The early years are certainly more important in establishing the individual’s constitution. Perhaps the next generation will benefit from improved social and nutritional influences. The health problems which develop in this age group are dependent upon a number of factors, only some of which are avoidable:

• vulnerabilities dependent upon genetic make-up

maternal health and nutritional status during uterine life
nutrition during the first year of life
• exposure to factors including culture, smoking, employment hazards, war or accidents.

• exposure to dangerous infections

• excess food challenging the genetic make-up

• overall or individual factors, including amount of food, alcohol, exercise and body weight.

1. Middle age is a period of equilibrium in nutrition. There is no further growth except the laying down of undesirable fat.

2. The decline of body organs begins, and tissue repair becomes increasingly important.

3. Premature death is in part dictated by genetic make-up and early nutritional patterns but may be reduced by attention to weight, exercise, smoking habits and an adequate diet.

Old age —

Ageing may be defined as regression of physiological functions accompanied by advancing age. Ageing means increased years, but often also means deterioration. Malnourished populations do not have a long expectation of life. In developed countries, for many an expectation of life of 85 years or more is being achieved. There is an, as yet undefined upper limit of life expectation and perhaps quality of the overall life should be the objective rather than the extension of life in the frail and disabled.

. 1. The ageing process is a generalised decline in physiological function and stamina, which is a feature of the number of years lived, rather than of a disease process.

2. Longevity is more likely with a good diet and regular exercise, though there is a genetic contribution.

3. There is a slow reduction in body mass, mineral and water with age. Fat may accumulate in the centre of the body. BMR and other measures of metabolism are reduced with age.

4. Alzheimer’s disease is a progressive dementia with characteristic clinical and pathological lesions in the brain.

5. In old age the general debility may alter nutritional intake for physical and/ or intellectual reasons. However, once old age has been achieved, changes in diet have little effect on longevity, unless the diet is deficient.

Further Reading

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