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The Ageing Process

 

Practitioner of The Compounding Pharmacy Australia, Cassandra Hilton shares with us a recent article written on anti-aging.


Australian and New Zealand populations are ageing; influenced by declining fertility rates and increases in life expectancy. With a rapidly ageing population; in 2061 22% of the population will be 65 years or older and an increased prevalence of noncommunicable disease; the health-care system is overburdened (Croxford et al 2015). The physiological changes to metabolism and changes in the nutritional requirements that occur as the ageing process interacts with both genetic and non-genetic theories of ageing resulting in challenges for the promotion of health.

Early detection, prevention and treatment of age-related dysfunction and disease to compress morbidity and enhance the quality of life and increase the human lifespan may then begin to slow the ageing population.


Ageing is fundamentally a metabolic process with a decrease in anabolic metabolism; this is influenced by internal forces of free radicals and oxidative stress, glycosylation,methylation, apoptosis, immune dysregulation, DNA damage and the regulation of gene expression (Brown, 2011). The bodies ability when required to mobilise a margin of defense greater than the normal functioning ability against both internal and external forces of ageing and then to return this function back to normal physiology through organ reserve, will enable resilience (Brown, 2011; Whitney, 2011). As individuals age, we lose our organ reserve, therefore the maintenance of organ reserve is a critical factor in the prevention of age related diseases. The nervous,endocrine, and immune systems play a key role in their ubiquitous actions in coordinating all other systems and in their interactive and defensive responsiveness to external and internal stimuli (Whitney et al, 2011).


Atrophic gastritis affects one-third of individuals over 60 years of age with a reduced secretion of hydrochloric acid and intrinsic factor affecting increased bacterial growth and stomach inflammation that impairs the digestion and absorption of key nutrients. Vitamin B12 is insufficient in these individuals and adequate intake, often requiring supplementation can prevent anemia, declining cognition and the neurological effects of deficiency. Atrophic gastritis also impairs the absorption of folate, calcium, iron and zinc (Whitney et al, 2011).


Age-related metabolic changes affect Vitamin D status due to a lack of ability of aged skin to synthesise Vitamin D and for the kidney's ability to convert it to its active form. This is also affected by the use of medications that interfere with Vitamin D absorption. Vitamin D is particularly crucial in older female populations for bone remodelling and the prevention of osteoporosis (Brown, 2011; Whitney et al, 2011). Osteoporosis commonly affects menopausal and postmenopausal women and occurs when bone loss is greater than bone remodelling resulting in low bone density and fractures. This affects loss of functioning and independence and can cause premature mortality (Croxford et al, 2015). Increased physical activities, cessation of smoking and alcohol consumption, adequate Vitamin D, K and calcium intake are modifiable risk factors for osteoporosis (Croxford et al, 2015). While there is a well established role of dietary calcium to reduce the risk of osteoporosis, the recommended dietary intake of 1300mg/day, the calcium intakes are often below these recommendations (Whitney et al, 2011). Elevated iron stores are more likely in the elderly population than iron deficiency;however, iron deficiency can result from a lack of caloric intake, malabsorption conditions, chronic blood loss and from a lack of gastric functioning affecting the absorption of iron (Whitney et al, 2011).


The physiological changes that occur as a result of the aging process impact on the ability of older adults to meet nutrient requirements. The dietary recommendations for older adults and nutrient reference values have a primary focus to meet physiological needs (Croxford et al, 2015).


The reduction in thirst mechanisms in the elderly,impaired renal function and the use of diuretics make water crucial for aging health as dehydration increases the susceptibility to urinary tract infections, pneumonia, pressure ulcers and functional decline. An adequate intake from all foods and fluids has been set at 3.4L males and 2.8L females (Whitney et al, 2011; Croxford et al, 2015).


With the incidence of constipation higher in the aging population, recommendations for dietary fibre are established at adequate intake levels of 30gms for males and 25gms for females with levels lower than current recommendations (Whitney et al, 2011;Croxford et al, 2015). The longevity response to caloric restriction involves molecular, cellular, and systemic changes such as increased tissue sensitivity to insulin; neuroendocrine and immune responses to stress, infections and cancers are significantly enhanced during caloric restriction. Recent published studies by Mattison et al, (2012) suggest the role metabolic pathways and healthy diets as more crucial to caloric restriction (Coxford et al, 2015).


Recommendations for high quality dietary protein sources increase by 25% for adults over 70 years and contribute to 15-25% of total energy to prevent muscle wasting, optimize bone mass and support immune functioning (Croxford et al, 2015).


The use of nutritional supplementation to prevent nutritional insufficiency or deficiency as we age provides cellular support for the aging process.




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