Bài giảng dinh dưỡng an toàn vệ sinh thực phẩm dinh dưỡng cho người cao tuổi đh y tế công cộng

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TRNG I HC Y T CễNG CNG DINH DNG CHO NGI CAO TUI MC TIấU Trỡnh by c c tm quan trng ca dinh dng cho ngi cao tui Phõn tớch c c im c th ca ngi cao tui Trỡnh by c dinh dng khuyn ngh cho ngi cao tui www.hsph.edu.vn NGI CAO TUIH L AI? www.hsph.edu.vn Defining the "Elderly" - who are they? Depending on the selection criteria, you will find different opinions on when "old age" begins Apart from individual differences, there are also differences associated with health status, social environment, and the other stresses of life that everyone experiences The starting point for old age has been set at 65 years in most national and international dietary recommendations www.hsph.edu.vn Quóng i ngi di nht Jeanne Calment (1875-1997) (122 tui v 164 ngy, Arles, France) l ngi gi nht lch s cú tui c xỏc minh bng cỏc ti liu hin i Photos: http://en.wikipedia.org/wiki/Jeanne_Calment www.hsph.edu.vn Ngi cao tui chc chn khụng lõu na s l ton cu Vn ch l chuyn nh th k 20 ang dn tr thnh ch cú nh hng rt ln th k 21 Kofi Annan, Nguyờn tng th ký LHQ (2004) www.hsph.edu.vn Nhng thay i v cu trỳc dõn s: 2000, 2025 & 2050 www.hsph.edu.vn T l dõn s ngi cao tui Tờn nc 1991 (%) 2020(%) Thu in 22.8 28.9 Thu s 19.7 31.0 Anh 20.7 26.6 M 16.9 24.6 Trung Quc 8.9 16.5 n 6.1 10.4 (Global Aging Comparative Indicators and Future trends Bureau of Census, U.S Department of Commerce 1991) www.hsph.edu.vn Chuyn dch dõn s hc n nm 2050 S ngi cú tui hn 60 s tng t 650 triu (nm 2006) lờn n gn t Phn trm s ngi trờn 60 tui c d oỏn l s tng gp ụi t 10% ti 21% www.hsph.edu.vn T l sinh www.hsph.edu.vn Sinh lý học dinh dng Giảm khối xơng c im: Gim tng hp tng hp vitamin D Lng vitamin D n vo khụng , Thi gian tip xỳc vi nng gam dn Ri lon: Loóng xng v tng nguy c góy xng Thoỏi hoỏ xng Khc phc: B sung Vitamin D Th dc www.hsph.edu.vn Bng chng mc kt hp ch n v gy xng loóng xng Bng chng Gimnguyc Thuyt phc VitaminD Canxi Hotngthlc Gnnh chc chn Cỏth www.hsph.edu.vn Khụng liờn quan Tngnguyc Khuphnnhiu ru Cõnnngthp Flo Trỏicõyvrau Ruvaphi Snphmunnh Phtpho Natricao Proteinthp Proteinquỏcao Sinh lý hc v dinh dng ỏp ng dch gim c im: Chc nng TB Limpho T gim Cỏc ri lon: D mc bnh Khú hi phc Khc phc: Ch n b sung vitamin, khoỏng www.hsph.edu.vn Sinh lý hc v dinh dng H tim mch c im: Tng Cholesterol Tng LDL-cholesterol Tng homocysteine (folate, vitamin B12 v B6) Cỏc ri lon: Tim mch: cao huyt ỏp, t qu Khc phc: Ch an Tp luyn www.hsph.edu.vn Sinh lý hc v dinh dng Chc nng nhn thc c im: Khu giỏc, v giỏc gim Gim kh nng nhn thc Cỏc ri lon: ic Hay quờn (Alzheimer) Khc phc: B sung vitamin Tp luyn www.hsph.edu.vn Sinh lý hc v dinh dng Chc nng th giỏc c im: c nhõn mt Cỏc ri lon: Th lc gim Khc phc: Ch n giu cỏc cht chng oxy hoỏ (vit.C, E, beta- caroten) www.hsph.edu.vn DINH DNG V CHM SểC NGI CAO TUI www.hsph.edu.vn Nguyờn tc ch n Nguyờn tc chung: cung cp nng lng, protein, x, calcium, cỏc vitamin D, B12, B6 v folate Gim mc n: iu , theo dừi cõn nng, khụng nờn vt quỏ cõn nng nờn cú Gim ng, mui, thc an toan (tht, thc n ng vt), ch n thiờn v kim n thc n mm www.hsph.edu.vn Ch n v luyn n hn hp giu m, bộo ngun gc thc vt n nhiu rau ti, qu chớn ung Ngi mc bnh mn tớnh Ngi ang dựng thuc B dung vitamin v khoỏng cht Hot ng th lc www.hsph.edu.vn Nhu cu dinh dng nh hng ca nhu c dinh Thay iin khibody c th composition v cỏc orch c nng physiologic Change th cht function Impact on nutrient requirementdng Decreased mass (sarcopenia) Gim muscle c (sarcopenia) Decreased need for energy Decreased bone density (osteopenia) Gim mt xng (loóng xng) Decreased immune function Increased need for calcium, vitamin D Tng nhuneed cu vit B6vitamin , k Increased for B6, vitamin Ev E, zinc Decreased gastric mi acid (atrophic gastritis, Gim lng acid d) dy Helicobacter pylori Tng nhuneed cu vitamin for B12, 12B, acid folic folic, acid, calci v Increased vitamin km calcium, iron, zinc a Decreased skin capacity cholecalciferol Gim kh nng tng hpforVit D ca da Tng nhuneed cu vitamin for D Increased vitamin D Gim kh nng sinh húa c calci Tng nhu cu calci v vitamin D Gim ch nng d n synthesis Decreased calcium bioavailability Gim nhu cu nng lng Tng nhu cu calci v vit D Gim kh nng thu caofgan Decreased hepaticp uptake retinol Increased need for calcium, vitamin D Gim nhu need cu vitamin for A Decreased vitamin A Decreased Gim hiu efficiency qu c ch inmetabolic chuyn húa utilisation of Tng nhuneed cu Vitamin for vitamin Increased B6 B6 pyridoxal Tng tỡnh trng stress oxy húa Increased oxidative stress status Gim nhu cu caroten, vitamin C v E Tng nng cỏc húc mụn u nang Increased need for carotenoids, vitamin C, Gi E cu folate, vitamin B6, v vitamin vitamin nhu Increased levels of homocysteine Increased need for folate, vitamin B6, vitamin B12 B120 Source: Binns (Ed) Dietary Guidelines for Older Australians, 1999 www.hsph.edu.vn Hng dn ch n cho NCT c n a dng cỏc loi thc phm dinh dng Gi cho cỏc c luụn hot ng khe mnh v gi cõn nng c th n ớt nht ba ngy Chỳ ý gi thc phm: ch bin v lu gi chỳng ỳng cỏch n tht nhiu rau (gm c u) v hoa qu n nhiu ng cc, bỏnh m v pasta n ch n ớt cht bộo bóo hũa Ung lng nc va hoc/v cỏc loi nc khỏc Nu bn ung ru hóy hn ch lng ung vo 10 Chn loi thc phm ớt mui v hn ch dựng mui 11 n thc n cú nhiu calci 12 Dựng ng cho thờm cỏch iu www.hsph.edu.vn Chính sách với ngi cao tuổi Sc kho v n ung Nh v mụi trng Gia ỡnh Bo tr xó hi Li tc Vic lm (Khuyn cỏo ca liờn hp quc) www.hsph.edu.vn Nhng li ớch ca th dc Cỏc bi trỡ: tng cng th lc v nõng cao sc khe ca tim, phi, v h tun hon Cỏc bi dựng sc: giỳp xõy dng c v gim cỏc nguy c loóng xng, giỳp gim au viờm khp & giỳp nhng ngi b bnh phc hi chc nng Cỏc bi cõn bng : giỳp trỏnh ngó Cỏc bi un do: giỳp c th dai [kớch thớch trớ nóo hot ng] www.hsph.edu.vn Khụng bao gi l quỏ gi th thao! www.hsph.edu.vn Useful Websites & Resources AIHW, Older Australia at a glance: 4th edition (2007) Aged Care, Dept of Health and Ageing: http://www.health.gov.au/ Australian Government Directory of Services for Older People 200708 (PDF 989 KB) (2007) The National Strategy for an Ageing Australia (2001) Promoting Healthy Ageing in Australia (PMSEIC, 2003) Department of Family and Children's Services, Office of Seniors Interests (WA): http://www.osi.wa.gov.au/ Aged & Community Services WA: http://www.acwa.com.au/default.aspx?t=153 Council on the Ageing (COTA): http://www.cota.org.au/ The National Aged Care Alliance (the Alliance): http://www.naca.asn.au/about.html Aged Care Australia: http://www.agedcare.org.au/ Australian Institute of Health and Welfare Aged Care Unit: http://www.aihw.gov.au/ National Ageing Research Institute: http://www.mednwh.unimelb.edu.au/ International Federation on Ageing: http://www.ifa-fiv.org/ National Institute of Ageing (US): http://www.nia.nih.gov/ WHO Publications www.hsph.edu.vn ...MC TIấU Trỡnh by c c tm quan trng ca dinh dng cho ngi cao tui Phõn tớch c c im c th ca ngi cao tui Trỡnh by c dinh dng khuyn ngh cho ngi cao tui www.hsph.edu.vn NGI CAO TUIH L AI? www.hsph.edu.vn... mt ca sc khe, t tr s sinh cho n ngi gi Mt ch n tt cho SK Lm gim c t l t vong núi chung v Gim c nguy c mc cỏc bnh mn tớnh Cú nhiu bng chng gn y cho thy cú mi liờn h gia dinh dng v sc khe tinh... www.hsph.edu.vn í NGHA CA CHM SểC DINH DNG CHO NGI CAO TUI www.hsph.edu.vn Gỏnh nng lờn Chm súc sc khe ban u Tng chi phớ CSSK Chuyn i t cỏc bnh truyn nhim Dõn s gi sang mn tớnh Bin i xó hi www.hsph.edu.vn
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