Table Of ContentNutritional Intervention
in the Aging Process
Nutritional Intervention
in the Aging Process
Edited by
H.James Armbrecht
John M. Prendergast
Rodney M. Coe
With 68 Illustrations
Springer-Verlag
New York Berlin Heidelberg Tokyo
H. James Armbrecht, Ph.D., GRECC, St. Louis VA Medical Center, and St. Louis Univer
sity School of Medicine, St. Louis, Missouri 63104, U.S.A.
John M. Prendergast, M.D., GRECC, St. Louis VA Medical Center, and St. Louis University
School of Medicine, St. Louis, Missouri 63104, U.S.A.
Rodney M. Coe, Ph.D., GRECC, St. Louis VA Medical Center, and Department of Com
munity Medicine, St. Louis University School of Medicine, St. Louis, Missouri 63104,
U.S.A.
Library of Congress Cataloging in Publication Data
Main entry under title:
Nutritional intervention in the aging process.
l. Aging-Nutritional aspects. 2. Aged-Nutrition. I. Armbrecht, H. James. II. Pren
dergast,John M. III. Coe, Rodney M.
QP86.N855 1984 613.2/0880565 84-5488
© 1984 by Springer-Verlag New York, Inc.
Softcover reprint of the hardcover 1st edition 1984
All rights reserved. No part of this book may be translated or reproduced in any form with
out written permission from Springer-Verlag, 175 Fifth Avenue, New York, New York
10010, U.S.A.
The use of general descriptive names, trade names, trademarks, etc., in this publication,
even if the former are not especially identified, is not to be taken as a sign that such names,
as understood by the Trade Marks and Merchandise Marks Act, may accordingly be used
freely by anyone.
While the advice and information in this book are believed to be true and accurate at the
date of going to press, neither the authors nor the editors nor the publisher can accept any
legal responsibility for any errors or omissions that may be made. The publisher makes no
warranty, express or implied, with respect to the material contained herein.
Copyright is not claimed for contributions prepared by employees of, or under restrictive
contract with, the United States government. These include Chapters 5, 9, II, 12, 14, and
18.
Typeset by Publishers Phototype International Inc., Carlstadt, New Jersey.
ISBN-13: 978-1-4612-9765-9 e-ISBN-13: 978-1-4612-5272-6
DOl: 10.1007/978-1-4612-5272-6
Contents
Preface
IX
Contributors
XI
Part I. Effect of Aging on Nutrition
l. Sociological Factors that Influence Nutritional Status in
the Elderly
Rodney M. Coe and Douglas K. Miller 3
2. Age-related Changes in Taste and Smell that Affect
Nutritional Adequacy
Carol]. Dye 13
3. Impact of Aging on Protein Metabolism
Vernon R. Young 27
4. Atherosclerosis and Plasma Lipid Transport with Aging
Gustav Schonfeld 49
5. Changes in Calcium and Vitamin D Metabolism with Age
H.james Armbrecht 69
Part II. Effect of Nutrition on Aging-Length of Life
6. Dietary Restriction and Metabolism and Disease
Edward]. Masoro 87
7. Dietary Restriction and Biological Variables
Charles H. Barrows,jr. and Gertrude C. Kokkonen 95
Contents
Vl
8. Aging in the Food-restricted Rat: Body Temperature,
Receptor Function, and Morphologic Changes in the
Brain
Christopher D. West, Ladislav Volicer, and
Deborah W. Vaughan 111
9. Dietary Antioxidants, Membrane Lipids, and Aging
Grace Y. Sun and Albert Y. Sun 139
10. Membrane Changes Associated with Alcohol Use and
Aging: Possibilities for Nutritional Intervention
W. Gibson Wood and R. Strong 159
Part III. Effect of Nutrition on Aging-Functional
Ability
11. Calcium Supplementation and Osteoporosis
Louis V. A violi 183
12. Carbohydrate Metabolism and Diabetes in the Aged
Alan B . Silverberg 191
13. Nutritional Intervention During Immunologic Aging:
Past and Present
S.JillJames and Takashi Makinodan 209
14. Effects of Nutritional Factors on Memory Function
Arthur Cherkin 229
15. Modifying the Effects of Environmental Chemicals by
Dietary Manipulation: A Search for Hemeprotein
Peroxidase Inhibitors
Bernard B. Davis and Terry V. Zenser 251
Part IV. Nutrition and Aging-Evaluation and
Management
16. Nutritional Evaluation of the Institutionalized
Elderly
John M. Prendergast 269
17. Nutritional Management of the Elderly
Virginia M. Herrmann 293
Contents Vll
18. Problems in Nutritional Management of the Elderly
Margaret A. Flynn 307
19. Interrelationship of Exercise and Nutrition in the Elderly
John W. Shepard,Jr. 315
Index 333
Preface
There has been much popular and scientific interest in the fields of nu
trition and aging in recent years. As the importance of proper nutrition
in children and young adults becomes more fully understood, it is natural
to wonder if proper nutrition could playa similar role in later life. Recent
research has indicated that nutrition can potentially intervene in the ag
ing process in at least two ways. First, studies in animals and humans have
shown that nutrition can be used to improve functional status, which, in
turn, is related to perceived quality of life. Second, nutritional manipu
lation has been used to extend maximal life span in laboratory animals.
How these interesting findings apply to the human situation remains to
be explored.
The purpose of this book is twofold. The first is to present recent ad
vances in our basic knowledge of how nutrition and aging interact with
each other. The second is to discuss some applications of this knowledge
to the care of the elderly patient.
The interaction between aging and nutrition is complex because each
may act on the other in either a synergistic or antagonistic fashion. Aging
may alter the nutritional status of the elderly by affecting the way nu
trients are absorbed and utilized by the body. Aging may also influence
food intake and, therefore, nutritional status by decreasing the palatabil
ity of food. The environment of the elderly may change so they are less
likely to eat well-balanced meals.
On the other hand, nutrition may increase length and quality of life.
Intriguing animal studies have demonstrated that dietary restriction and
antioxidant consumption may result in longer maximal life span. Proper
nutrition may improve functional status by preserving bone integrity,
cardiovascular and immune functions, and memory.
Discussions of these issues are presented in four sections. Part I is an
overview of the effects of aging on nutrition; its five chapters review evi
dence of the influence of age-related changes on nutritional status. The
concerns range broadly from general social and cultural factors to spe-
x Preface
cific psychophysiologic ones and biochemical processes in the metabolism
of vitamins, proteins, and lipids. Papers in the second section reverse
the focus and examine evidence for the effects of nutritional manipula
tion on the dimensions of longevity as a facet of aging. These five pre
sentations discuss dietary restriction and metabolism, nervous system
structure, and membrane functions. Part III examines the effects of nu
tritional manipulation on functional abilities with respect to osteoporosis,
diabetes mellitus, immune disorders, environmental chemicals, and
memory. The final section shifts to clinical applications of nutritional
knowledge for assessment and management of elderly patients in differ
ent environmental settings.
One of the challenges in treating the elderly is to avoid negative inter
actions between nutrition and aging. Poor nutrition resulting from phys
iologic and psychosocial factors may lead to an acceleration of the aging
process and the aggravation of age-related diseases. Increased aging and
disease can, in turn, lead to a further decline in nutritional status. This
downward spiral can be difficult to reverse. We hope that this book will
help to generate new ideas for preventing that downward spiral. Al
though it may be years before it can be used to extend maximal life span,
nutritional intervention can playa significant role today in maintaining
the functional status and, thus, the quality of life for the elderly.
We wish to express our appreciation for financial and administrative
support for the conference that led to this publication, which was pro
vided to the St. Louis Geriatric Research, Education, and Clinical Center
(GRECC) by a continuing education grant from the Veterans Adminis
tration Office of Academic Affairs through the Office of Geriatrics and
Extended Care; from the VA 's South Central Regional Medical Educa
tion Center (RMEC); and St. Louis University School of Medicine. Sup
port was also received from Ayerst Laboratories, Mead Johnson
Laboratories, the National Dairy Council, Norwich-Eaton Pharmaceuti
cals, and Ross Laboratories.
Preparation of this volume has been greatly helped by the cooperation
of individual contributors who submitted their manuscripts so promptly;
by the GRECC office staff: Cheryl Duff who efficiently handled the many
administrative tasks associated with the conference and this publication,
and Sharon Smith and Sandy Melliere, who both provided technical as
sistance and moral support. We also thank the staff of Springer-Verlag.
While many have taken part in this project, we alone assume respon
sibility for this final product, which we hope will be informative and stim
ulate further research on nutritional interventions.
H.J. Armbrecht
J .M. Prendergast
R.M. Coe
Contributors
H. JAMES ARMBRECHT, PhD GRECC, St. Louis VA Medical Center and
St. Louis University School of Medicine, St. Louis, Missouri 63104 U.S.A.
LOUIS V. AVIOLI, MD Washington University School of Medicine, and,
Jewish Hospital of St. Louis, St. Louis, Missouri 63110 U.S.A.
CHARLES H. BARROWS, JR., ScD Laboratory of Cellular and Compara
tive Physiology, Gerontology Research Center, NIA, Baltimore City Hos
pital, Baltimore, Maryland 21224 U.S.A.
ARTHUR CHERKIN, PhD GRECC, Sepulveda VA Medical Center, and,
UCLA School of Medicine, Los Angeles, California 90024 U.S.A.
RODNEY M. COE, PhD GRECC, St. Louis V A Medical Center, and, St.
Louis University School of Medicine, St. Louis, Missouri 63104 U.S.A.
BERNARD B. DAVIS, MD GRECC, St. Louis VA Medical Center, and, St.
Louis University School of Medicine, St. Louis, Missouri 63104 U.S.A.
CAROL]' DYE, PhD St. Louis VA Medical Center, and, Washington Uni
versity, and, St. Louis University, St. Louis, Missouri 63104 U.S.A.
MARGARET A. FLYNN, PhD University of Missouri School of Medicine,
Columbia, Missouri 65212 U.S.A.
VIRGINIA M. HERRMANN, MD St. Louis University School of Medicine,
St. Louis, Missouri 63104 U.S.A.
Contributors
Xli
S. JILL JAMES, PhD GRECC, Wadsworth VA Medical Center, Los An
geles, California 90073 U.S.A.
GERTRUDE C. KOKKONEN, BS Laboratory of Cellular and Comparative
Physiology, Gerontology Research Center, NIA, Baltimore City Hospital,
Baltimore, Maryland 21224 U.S.A.
TAKASHI MAKINODAN, PhD GRECC, Wadsworth VA Medical Center,
and, UCLA School of Medicine, Los Angeles, California 90024 U.S.A.
EDWARD J. MASORO, PhD University of Texas, San Antonio, Texas
78284 U.S.A.
DOUGLAS K. MILLER, MD St. Louis University School of Medicine, St.
Louis, Missouri 63104 U.S.A.
JOHN M. PRENDERGAST, MD GRECC, St. Louis VA Medical Center, and,
St. Louis University School of Medicine, St. Louis, Missouri 63104 U.S.A.
GUSTAV SCHONFELD, MD Lipid Research Center, Washington Univer
sity School of Medicine, St. Louis, Missouri 63110 U.S.A.
JOHN W. SHEPARD,JR., MD GRECC, St. Louis VA Medical Center, and,
St. Louis University School of Medicine, St. Louis, Missouri 63104 U.S.A.
ALAN B. SILVERBERG, MD St. Louis University School of Medicine, St.
Louis, Missouri 63104 U.S.A.
R. STRONG, PhD GRECC, St. Louis VA Medical Center, and, St. Louis
University School of Medicine, St. Louis, Missouri 63104
ALBERT Y. SUN, PhD Sinclair Comparative Medicine Research Farm,
University of Missouri, Columbia, Missouri 65212 U.S.A.
GRACE Y. SUN, PhD Sinclair Comparative Medicine Research Farm,
University of Missouri, Columbia, Missouri 65212 U.S.A.
DEBORAH W. VAUGHAN, PhD Boston University Medical School, Bos
ton, Massachusetts 02118
LADISLAV VOLICER, MD Boston University Medical School, and, Bed
ford VA Medical Center, Bedford, Masachusetts 02118 U.S.A.
CHRISTOPHER D. WEST, PhD Harvard Medical School, and, Boston Uni
versity Medical School, Boston, Massachusetts 02118 U.S.A.
