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Ageing of the human face

Now days the number of older person has increased because of modern health technology. Old age starts from 60 years. Usually at the age of 60 years, retirement is occurred. Ageing depends on heredity and environmental condition, nutrition and health condition of person. Many persons lead a healthy life style like a young person at the age of 80 years. On the contrary many persons seem to be weak at the age of 60 years. So, proper nutrition is needed for a geriatric person to lead a free
, purposeful, healthy life. There are many theories of ageing. One of them is free radicals. There is a continuous formation and accumulation of free radicals in the body with ageing process. These free radicals process lead to damage and changes in the structure of carbohydrate, protein, lipid and chromosomal material in cells. So, at the old age there is seen the physical and mental and immunological changes. For poor immunity older persons are more prone to diseases.

Changes in organ function with ageing:
i) Neurological changes:
Alzheimer’s disease is seen that leads to mental deterioration, loss of memory and also seen the loss of visual power.

ii) Skeletal changes and teeth changes:

Gum is weak and teeth are lost. There is a lack of calcium so, older persons suffers from osteoporosis. They also suffer from arthritis.

iii) Digestive power decreases:

•  Decrease in salivary secretion, causes feeling of xerostoma. Decrease the secretion of hydrochloric acid, intrinsic factors and pepsin. Constipation is seen due to prolong recto sigmoid transit.
•  Decrease metabolic rate due to reduction in physical activity. Immune competence is declined with age.
•  Decrease the cardio vascular function. There is a chance of getting atherosclerosis. High blood pressure is seen.
•  Decrease the renal function. Kidneys do not function properly. GFR (Glomerular Filtration Rate) can diminish.
•  During old age skin, hair, nail is changed.
•  Hamper the secretion of different hormones due to changing in endocrine gland.
• Now days very few numbers of joint families are seen. So, old age persons feel lonely and suffer from depression. Metabolic rate and physical activity are decreased with ageing.

Nutritional requirements:

Older persons require fewer calories than adult persons because during old age metabolic rate is decreased and there is reduction in physical activity.

Protein should be given10 -12 % of total calorie. If the older person suffers from diabetes, protein requirement should be increased. Milk protein is good for older persons.

Of the total calorie intake 15 % should come from fat. W- 3 fatty acids should be continued. Monounsaturated or polyunsaturated fatty acids should be consumed. Junk foods, deep frying food should be omitted from menu due to high blood pressure and heart disease.

Of the total calorie intake minimum 50 % should come from carbohydrate.

During old age calcium is needed that comes mainly from milk. Calcium is needed to prevent osteoporosis, dental decay. Requirements of other vitamins and minerals should be filled up by fresh vegetables, fruits and green leafy vegetables.

Older persons may take medicines due to various diseases, this medicine increase the requirement of vitamins and minerals. So, they have to eat multivitamin and multi-mineral tablet every day.

It is important to know that vitamin E is very effective for boosting immunity power.

They should be consumed fibre gradually. Others bowel discomfort, mental flatulence may occur. Fibre helps to prevent constipation and reduces cholesterol level.

Water should be intake to prevent dehydration. Dehydration can result in mental confusion, headache. Intake of water helps in elimination of waste from body. Water reduces the constipation problem. Water can be consumed in the form of so pups, fruit juices, butter milk etc.

Dietary guidelines:

•  Food should be soft and well cooked.
•  Food should be less spicy and salty.
•  Fried foods avoided like pokora , noodles etc.
•  Liquid or semisolid food should be included in the diet like porridge, soups, stew.
•  Beverages which contain caffeine should be omitted. It may cause insomnia.
•  Easily digestible steamed foods are included like idly.
•  W-3 fatty acid is good for health. It helps in reducing hair loss, impairment of vision, improper  digestion.
•  Fresh fruits and vegetables should be consumed which is the source of antioxidants.
•  Consumption of pulses should be avoided if patient suffer from gut.
•  Tobacco, betel leaves chewing, smoking should be stopped which may affect consumption of food.

A sample menu for old age person

Identification of specific characteristics of an individual:
Height- 150 cm

Weight- 60 kg

Age- 65 years

BMI-26.66kg/m2

Sex- female

Activity level- sedentary

Socio economic condition- middle income family

Religion- Hindu

Ideal body weight- 47 kg

Suffering from any disease- no

Any type of food allergy- no

Food habits- non vegetarian

Likes and dislikes of an individual- no

Time table	Menu
Early morning	1 cup tea without milk and sugar + 2 oats biscuits
Breakfast	Cornflakes with skimmed milk (  1 bowl)
Mid morning	1 whole fruit( guava/ apple/ papaya)
Lunch	Rice ( 50 gm)+ green leafy vegetables curry( 1 small bowl)+ other vegetables curry( 1 small bowl)+ dhal ( 1 small bowl)+ fish curry ( 1 piece fish)
Afternoon	1 fruit( guava/ apple/ papaya)
Evening snacks	Vegetable sandwich with potato, onion, carrot and any green leafy vegetables
Dinner	Roti (2 pieces) + vegetable curry+ raita.

We give 65 % from carbohydrate, 15 % from fat and protein is given 0.9 gm / kg body weight so protein requirement is 42.3 gm. Carbohydrate is given 269.1 gm and fat is given 27.6 gm.