老年人的营养和膳食

老年人的营养与膳食,演讲人：XXX,老年人的定义：,2016版中国居民膳食指南中将65岁以上的成年人定义为老年人，80岁以上的成年人定义为高龄老人。,老,人,目录,老年人的生理代谢特点,老年人的营养需要,保健品的滥用,老年人的合理膳食原则,4,3,2,5,1,中国人口老龄化现状,一、中国人口老龄化现状：,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,我国从1999年迈入老年型社会以来，人口老龄化进入快速发展阶段。截止2015年底，我国总人口达13.46 亿，其中60岁及以上人口2.220 亿，占总人口的16.1%; 65岁及以上人口1.438亿，占总人口的10.5%。与1999 年相比，我国老龄化率年均增速达到0.37%。人口快速老龄化，一方面，对养老资源提出巨大挑战; 另一方面，也给经济和社会发展也带来巨大影响。,二、老年人的生理代谢特点：,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,1、消化系统 老年人牙根、牙龈均逐渐萎缩。牙齿松动，开始脱落。胃肠道粘膜变薄，绒毛萎缩脱落，平滑肌纤维衰弱无力，胃肠消化液的分泌量下降、蠕动减少，不能很好地将碳水化合物、脂肪、蛋白质等 分解成葡萄糖、氨基酸、甘油等简 单物质，造成小肠吸收困难，肠蠕 动功能减退，胃排空时间延长，影 响消化和吸收。,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,2、循环系统 老年人的心血管系统、肾脏出现程度不等的形态学改变。由于动脉血管壁弹性的减退、脂质代谢能力降低、血脂增加、血粘稠度增加, 老年人心搏量减少,一般65岁老年人的心排血量相当于其25岁时的70%。,二、老年人的生理代谢特点：,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,3、体成分改变 随意年龄的增长，体内脂肪组织逐渐增加，而瘦体重逐渐减少，此外，脂肪在体内储存部分呈现一种向心性分布的趋势。体成分改变的具体表现为：（1）细胞数量减少，肌肉组织的重量减少而出现肌肉萎缩。有研究表明:老年人肌肉的重量随着年龄的增长而减轻,男性青年25岁肌肉发育高峰时,约占其基本体重的40%,而到60岁时,其肌肉的重量将减少至其体重的20%左右。（2）体水分减少，主要为细胞内液减少。（3）骨骼中的矿物质减少、无机盐则逐渐增多,造成骨的弹性和韧性减退,所以容易发生骨折和骨裂。,二、老年人的生理代谢特点：,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,4、代谢 基础代谢降低。与中年人相比大约降低1520。这与代谢速率减慢、代谢量减少有关。 合成代谢降低，分解代谢增高。合成与分解代谢失去平衡，引起细胞功能下降。,二、老年人的生理代谢特点：,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,5、体内氧化反应 人体组织的氧化反应可产生自由基。自由基对细胞的损害主要表现为对细胞膜的损害，尤其损害亚细胞器如线粒体、微粒体及溶酶体的膜。由于细胞器上磷脂所含多不饱和脂肪酸量多，对自由基更为敏感。自由基作用于多不饱和脂肪酸形成脂质过氧化产物，主要有丙二醛和脂褐素，在衰老过程中脂褐素大量堆积，可沉积于内脏及皮肤组织中，老年人心肌和脑组织中脂褐素沉着率明显高于青年人，如沉积于脑及脊髓神经细胞则可引起神经功能障碍。自由基除损害细胞膜产生脂质过氧化物以外，还可使一些酶蛋白质变性，引起酶的活性降低或丧失。,二、老年人的生理代谢特点：,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,6、免疫功能 老年人胸腺萎缩、重量减轻，T淋巴细胞数目明显减少，因此免疫功能下降，容易患各种疾病。,二、老年人的生理代谢特点：,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,三、老年人的营养需要：,1.能量 老年人对能量的需要降低，所以膳食能量的摄入主要以体重来衡量。老年人的体重应维持在正常稳定水平，不应过度苛求减重，体重过高或过低都会影响健康。从降低营养不良风险和死亡风险的角度考虑，老年人的BMI应不低于20为宜。,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,三、老年人的营养需要：,2.蛋白质 老年人机体组成中蛋白质总量减少，对蛋白质的消化率和利用率都降低，且老年人易患病，如果不供给充足的优质蛋白质，会造成负氮平衡。老年人每天摄人蛋白质可按112gkg体重供给，在膳食总热能中应占12 15 ，其中优质蛋白质的供给应占50 。中国居民膳食营养素参考摄入量建议老年人膳食蛋白质RNI男女分别为65g/d和55g/d。,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,三、老年人的营养需要：,3.脂肪 由于老年人胆汁分泌减少和脂酶活性降低而对脂肪的消化功能下降，因此，脂肪的摄入不宜过多，脂肪供能占膳食总能量的2030为宜。其中要求亚油酸达到总能量的4，-亚麻酸达到总能量的0.6。,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,三、老年人的营养需要：,4.碳水化合物 由于老年人糖耐量低、胰岛素分泌减少且对血糖的调节作用减弱，易发生血糖增高。有报告认为蔗糖摄人多可能与动脉粥样硬化等心血管病及糖尿病的发病率有关，因此老年人不宜食含蔗糖高的食品；过多的糖在体内还可转变为脂肪，并使血脂增高。但是，水果和蜂蜜中所含的果糖，既容易消化吸收，又不容易在体内转化成脂肪，是老年人理想的糖源。建议碳水化合物提供的能量占总能量50%65%为宜。而且，老年人应降低单糖、双糖和甜食的摄入量，增加膳食中膳食纤维的摄入。,x,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,三、老年人的营养需要：,5.矿物质（1）钙(Ca) 老年人对钙的吸收率一般在20以下。钙的摄入不足易使老年人出现钙的负平衡，体力活动的减少又可降低钙在骨骼中的沉积，以致骨质疏松症及骨颈骨折比较多见。因此，钙的充足供应十分重要，我国营养学会推荐每日膳食钙的供给量为800mg1000mg可满足老年人的需要。,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,(2)铁(Fe) 铁(Fe)是红细胞中血红蛋白的组成部分，食物中的铁仅有一部分能进入血液。维生素C 能增加铁的吸收。在肉类中的铁比植物中铁被人体吸收的好。老年人胃肠吸收铁的功能降低,铁的含量缺乏,易患缺铁性贫血病。,三、老年人的营养需要：,三、老年人的营养需要：,(3)纳（Na） 老年人钠盐摄入每天6g为宜，高血压、冠心病病人以5g/d为宜。(4)其他 微量元素硒、锌、铜和铬在每天膳食中亦必须有一定的供给量以满足机体的需要。,x,6.维生素 维生素A：老年人由于食量减少，生理功能减退，易出现维生素A缺乏。膳食中维生素A的推荐供给量为每日800ug。 维生素D：老年人因户外活动减少，由皮肤形成的维生素D量降低，加之肝、肾功能衰退致使通过肝、肾转化为1，25(OH) D 的活性形式减少，易出现维生素D缺乏。故每日维生素D的摄入量应达到l0ug(400IU)。,三、老年人的营养需要：,ADD YOUR TITLE HEREOne should give up anger; one should abandon pride; one should overcome all fetters. One should give up One should give up anger; one should abandon pride,四、保健品的滥用,中国保健协会2008年数据显示，我国每年保健品的销售额约为2000亿元人民币，其中老年人消费占了50% 以上;中国消费者协会的一项调查显示有70% 以上的保健食品存在虚假宣传、夸大功效的现象。 53.90% 老年人对保健品了解，23.42%老年人认为保健品是灵丹妙药;有23.79% 认为其可治疗慢性疾病、24.00%认为可以调理生理功能;认为保健品可辅助治疗(17.47%)或有滋养功效(11.33%) 的老年人则相对较少。,?,五、老年人的合理膳食原则,1.食物多样，谷类为主，粗细搭配 2.多吃蔬菜水果和薯类 3.每天吃奶类、大豆或其制品 4.常吃适量的鱼、禽、蛋和瘦肉 5.减少烹调用油，吃清淡少盐膳食 6.食不过量，天天运动，保持健康体重 7.三餐分配要合理，零食要适当 8.每天足量饮水，合理选择饮料，如饮酒应限量 9.多做户外活动，维持健康体重 10.吃新鲜卫生的食物 11.食物要粗细搭配、松软、易于消化吸收12.重视预防营养不良和贫血 ,五、老年人的合理膳食原则,平衡膳食宝塔“十个拳头”饮