Posted by ProPortion Foods Blog on Jul 30, 2019 in Uncategorised
Globally, for the first time, there are more people over 65 than under five years of age. In 2017, 3.8 million Australians were aged 65 years and over, according to a survey by the Australian Institute of Health and Welfare. This comprises 15% of the population, compared to just 5% in 1937. This “demographic time bomb” is still in steep ascent, expected to reach 8.8 million older Australians – more than one in five people – by 2057, and 12.8 million, or one in four people, by 2097. The profile of this older cohort itself is expected to shift upwards.
Living longer can have several impacts on health and wellbeing, including dysphagia. The condition can occur at any age but is most common with aging, affecting up to one in five community-dwelling older adults and around half of those living in aged care facilities.
This report on The Future of Dysphagia will provide an overview of our aging population, explore dysphagia management, and where we are headed. Click the button below to download your free report.
In 2008 the Australian government released its Closing the Gap Strategy, which laid out plans to achieve health equality for Aboriginal and Torres Strait Islander people by 2030.
How is it tracking?
Not well, according to a 10-year review by the Australian Human Rights Commission – if anything, the gap has grown.
Of all Australian population groups, Aboriginal and Torres Strait Islander people still suffer the worst health outcomes, and their lives are about 10 years shorter than the rest of the populace.
According to Robert Tickner from the Australian Red Cross, “It is a national disgrace that, despite our reputation as one of the world’s most bountiful food producers, so many Australians cannot get adequate, nutritious and affordable food.”
Poor nutrition is a key contributor to the overburden of health issues faced by Indigenous Australians, which include overweight and obesity, malnutrition, heart disease, type 2 diabetes, chronic kidney disease and tooth decay.
These diseases contribute to at least three-quarters of their mortality gap.
Food insecurity is a big part of the problem. Much of this is due to poverty. Many Indigenous Australians also live in remote communities where healthy food is hard to come by. What is available is expensive because of transport costs.
As a result, fresh fruit and vegetable intake is very low, and “discretionary foods” make up 41 percent of their daily energy intake. Sugar consumption – largely from sweetened drinks – is nearly 50 percent more than the World Health Organisation’s recommendations.
Combined with easy access to unhealthy food and drinks, poor education and nutrition literacy is also part of the problem.
Many community-based programs have helped, the most successful being those with multi-level strategies that encourage community involvement at every stage of their development and implementation to make sure they are culturally appropriate and address local needs.
Some programs have focussed on improving the food supply through local retail outlets, school and community gardens, food provision by community organisations, and community store nutrition policies.
Nutrition education can also help, if delivered in conjunction with making healthy food accessible through cooking education, budgeting advice, and group-based lifestyle programs.
But these are band aid solutions to the overarching problem: there have been no nationally coordinated nutrition ventures since the National Aboriginal and Torres Strait Islander nutrition strategy and action plan expired in 2010.
The situation can be traced to many historical factors; indeed, all the evidence suggests that before European settlement Indigenous Australians enjoyed good health and a varied diet of nutritious fresh plant and animal foods.
Now they suffer socioeconomic disadvantage with low income and unemployment, institutional racism, low access to primary health care and poor quality, overcrowded housing, all of which contribute to ill-health and mortality.
Health equality is a basic human right. Treating diseases and improving nutrition and food security are important, but the review argues that underlying structural factors also need to be tackled before Australia can close the gap.
Many people who are living longer after a sedentary lifestyle are paying the price. The diseases osteoporosis and sarcopenia are on the rise, and their underlying biological similarities and common risk factors are creating a new syndrome: osteosarcopenia.
This syndrome exacerbates each disease’s associations with high risk of frailty, falls, fractures, hospitalisation and mortality; indeed, a study confirmed that osteosarcopenia is linked with poorer physical function than sarcopenia alone.
Early diagnosis and intervention for this “hazardous duet” are imperative, so here’s what to know.
Osteoporosis affects more than 60% of Australians over 50 years. It happens with aging when bone tissue starts deteriorating, resulting in porous bones and increased risk of fracture – even with minor falls. It can be diagnosed with a bone mineral density scan.
Sarcopenia, on the other hand, refers to accelerated loss of skeletal muscle mass and strength with aging. Affecting around one in three older adults, it can be harder to detect – especially if a person is overweight. Handgrip is typically used to measure muscle strength and gait to assess physical performance.
Bones and muscles both release hormones that impact the metabolism and functions of other tissues, and crosstalk with fat cells – together these three groups are the biggest constituent of connective tissue.
When muscle and bone tissues break down, they are typically infiltrated with fat cells which creates toxicity and inflammation and interferes with the crosstalk between them.
The only way to diagnose osteosarcopenia is with combined detection of each disease.
A history of falls and/or fractures should sound warning bells. Shortened stature is also a clue to fractures of the vertebrae due to osteoporosis. Muscle weakness and wasting can point to sarcopenia, and genetics play a role in both conditions.
People with these risk factors should be regularly screened for each disease, and experts agree that all postmenopausal women over 65 should have bone mineral density scans regardless.
Factors that lead to high risk of osteosarcopenia include older age, being female, endocrine disorders, sex steroids, low protein intake, smoking, inadequate dietary calcium intake, low vitamin D levels, and minimal mobility and function.
It is better to treat osteosarcopenia as one condition, using an integrated approach, rather than the two contributing diseases separately.
Inactivity is a primary, modifiable cause of muscle wasting and bone density loss, as the health of both bones and muscles relies on mechanical stimulus. Resistance training – increasing muscle strength – is most important.
Regular weight-bearing and muscle-strengthening exercises that target agility, strength, posture and balance have demonstrated benefits and are recommended at least three times a week for 20 minutes or more.
Protein is vital for bone and muscle and is recommended at more than 0.8 mg/kg body weight per day. Calcium and vitamin D also have dual benefits for bone and muscle; together with protein they can help reduce falls, fractures and disability.
Regular activity and a healthy diet with adequate nutrition are also the most effective ways to prevent age-related deterioration of bone and muscle and retain independence and optimal quality of life.