H A N D B O O K O F
Nutrition
in the Aged
F O U R T H E D I T I O N

CRC Press is an imprint of the
Taylor & Francis Group, an informa business
Boca Raton London New York
H A N D B O O K O F
Nutrition
in the Aged
F O U R T H E D I T I O N
Edited by
Ronald Ross Watson
CRC Press
Taylor & Francis Group
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Library of Congress Cataloging‑in‑Publication Data
Handbook of nutrition in the aged / editor, Ronald R. Watson. ‑‑ 4th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978‑1‑4200‑5971‑7 (hardcover : alk. paper)
1. Aging‑‑Nutritional aspects‑‑Handbooks, manuals, etc. 2. Older people‑‑Nutrition‑‑Handbooks,
manuals, etc. 3. Nutrition disorders in old age‑‑Handbooks, manuals, etc. I. Watson, Ronald R.
(Ronald Ross)
[DNLM: 1. Nutrition Physiology. 2. Aged. 3. Aging‑‑physiology. 4. Dietary Supplements. 5.
Nutritional Requirements. WT 115 H2365 2009]
QP86.C7 2009
613.2084’6‑‑dc22 2008038181
Visit the Taylor & Francis Web site at

and the CRC Press Web site at

v
Contents
Preface ix
Acknowledgments xi

Editor xiii
List of Contributors xv
SECTION I Nutritional Requirements for Health in the Aged
Chapter 1 Nutrition and Electrolytes in the Elderly 3
Marthe J. Moseley
Chapter 2 Vitamins and Health in Older Persons 15
David R. Thomas
Chapter 3 Undernutrition and Refeeding in Elderly Subjects 29
Patrice Brocker and Stéphane M. Schneider
SECTION II Nutrition and Promotion of Health
Chapter 4 Nutrition and the Geriatric Surgery Patient 47
Sheldon Winkler, Meredith C. Bogert, and Charles K. Herman
Chapter 5 The Role of Micronutrients in Preventing Infections in the Elderly 67
Alia El-Kadiki
Chapter 6 Antioxidants and Heart Disease 75
Vijaya Juturu and Vidyasagar Sriramoju
Chapter 7 Cardiometabolic Syndrome, Diabetes and Oxidative Stress:
Focus on the Aging Population 91
Hussein Naji Yassine and Craig S. Stump
Chapter 8 Calcium and Vitamin D in Aging Populations 103
Zhao Chen and Jeffrey Stanaway
vi Handbook of Nutrition in the Aged, Fourth Edition
Chapter 9 Lipid Absorption in Aging 113
Laurie Drozdowski, Claudiu Iordache, Trudy Woudstra, and
Alan B. R. Thomson
Chapter 10 Caffeine and the Older Person 149
Hilary A. Wynne
Chapter 11 Vitamin K and Health in the Aged 167
Jennifer Truong and Sarah L. Booth
Chapter 12 The Role of Diet in Slowing or Accelerating Aging 181

Saeed Hosseini and Reza Ghiasvand
Chapter 13 Nutrition and Cancer Prevention: An Overview 189
Elaine B. Trujillo and John A. Milner
SECTION III Bioactive Foods as Nutrients in Health Promotion
Chapter 14 Potential Role of Resveratrol in Preventing Inammation and Diseases
Associated with Obesity and Aging 219
Kathleen LaPoint and Michael K. McIntosh
Chapter 15 Health Benets of Phytochemicals for Older Adults 229
Giuliana Noratto, Rosemary Walzem, Lisbeth Pacheco, and
Susanne U. Mertens-Talcott
Chapter 16 Management of Insulin Resistance with Chinese Herbs 249
Jianping Ye and Jun Yin
Chapter 17 Nutritional Antioxidants and Prevention of Cataract 267
William G. Christen
Chapter 18 Herbal Treatment of Ischemia 281
Baowan Lin
Contents vii
SECTION IV Fruits and Vegetables to Prevent Illness
Chapter 19 Can Fruit and Vegetable Consumption Oppose the Negative
Health Effects of Tobacco? 311
Eliane Kellen and Geertruida E. Bekkering
Chapter 20 Weight Loss in Elderly People 321
Aránzazu Aparicio, Laura Mª Bermejo,
Elena Rodríguez-Rodríguez, and Rosa M. Ortega
Chapter 21 Food Intake Regulation and Aging 333
Roger B. McDonald and Jessica Coppola
Index 349

ix
Preface

Nutrient requirements for optimum health and function of aging physiological systems often are
quite distinct from those required for young ones. Recognition and understanding of the special
nutrition problems of the aged are being intensively researched and tested, especially due to the
increases in the elderly in the general population. In developed countries, economic restrictions and
physical inactivity during aging can signicantly reduce food intakes, contributing to nutritional
stresses and needs. Many disease entities and cancers are found with higher frequency in the aged.
Cancer, trauma, or infectious disease can alter intakes or requirements for various nutrients. Thus,
specic foods and nutritional supplementation may be helpful in treatment of aged adults, including
cancer patients.
Many adults and elderly are using foods and nutrients well above the recommended daily allow-
ance, which may not always be needed for optimal health. Thus, dietary alcohol and high calorie
intakes associated with causation and exacerbation of alcoholism or diabetes, respectively, will
form a section of health promotion in seniors. To some extent, treatment of these conditions with
diet or nutritional supplements is a unique problem in the aged.
The major objective of this book is to review in detail health problems occurring with signi-
cant frequency in aging adults and nutritional therapies to overcome them. The effects of the aging
processes, changes in social status, and nancial conditions signicantly affect the approaches to
treatment and study of nutritional and health problem in the aging adult and the elderly. In sum-
mary, to understand their health problems, increasing numbers of older adults and elderly in the
population require detailed study and directed research using nutritional therapies.
This book, the 4th edition, was created by enhancing and updating key chapters by the authors
who wrote them in the 3rd edition. Some new topics and chapters are included:
Nutrition and Nutritional Needs
Undernutrition
Mechanistic Studies of Nutrition in the Aged
Nutritional Therapies and Supplementation
•
•
•
•


xi
Acknowledgments
Special appreciation is extended to the National Health Research Institute (non-prot) http://www.
naturalhealthresearch.org. Its support for educating scientists and the lay public about nutrition in
foods and dietary supplements stimulated the idea for this book. The institute provided support
for Bethany L. Stevens, the editorial assistant. Her excellent work with the authors and publish-
ers greatly supported the editors in their work. Dr. Ronald R. Watson is particularly thankful for
decades of research support by H. B. and Jocelyn Wallace through the Wallace Research Founda-
tion, facilitating his studies of dietary supplements including nutrients in health promotion. This
research support encouraged a longstanding interest in nutrition in healthy aging that led to the
editing of this book. The assistance of Nguyen T. Nga, library specialist at the Arizona Health Sci-
ences Library, is very much appreciated.

xiii
Editor
Ronald Ross Watson, Ph.D., has worked at researching the role of bioactive nutrients, dietary
supplements, and alternative medicines for 30 years. Dr. Watson has been and currently is funded to
do such research by grants from the U.S. National Institute of Heart, Lung and Blood, and compa-
nies and private foundations to study effects of nutrients and dietary supplements to modify age and
autoimmune diseases. He has recently completed several successful clinical trials in osteoarthritis
patients using bioactive nutriceuticals. Dr. Watson has edited 62 scientic books, including several
dealing with heart disease and conditions such as aging and AIDS that promote immune dysfunc-
tion as well as heart disease.
Dr. Watson is currently professor, Health Promotion Sciences, Mel and Enid Zuckerman Col-
lege of Public Health and the Sarver Heart Center in the School of Medicine, University of Arizona
in Tucson.

xv
List of Contributors

Aránzazu Aparicio, MSc, PhD
Departamento de Nutrición
Facultad de Farmacia
Universidad Complutense
Madrid, Spain
Geertruida E. Bekkering, PhD
Department of General Practice
Katholieke Universiteit Leuven
Comprehensive Cancer Institute
Leuven, Belgium
Laura M
a
Bermejo, MSc, PhD
Departamento de Nutrición
Facultad de Farmacia
Universidad Complutense
Madrid, Spain
Meredith C. Bogert, DMD
Department of Restorative Dentistry
Temple University School of Dentistry
Philadelphia, Pennsylvania
Sarah L. Booth, PhD
Vitamin K Laboratory
USDA Human Research Center on Aging
Tufts University
Boston, Massachusetts
Patrice Brocker, MD
Professor of Geriatrics,
Université de Nice Sophia-Antopolis
Nice, France

Zhao Chen, PhD
Mel and Enid Zuckerman College of

Public Health
University of Arizona
Tucson, Arizona
William G. Christen, ScD
Brigham and Women’s Hospital
Harvard Medical School
Boston, Massachusetts
Jessica Coppola, PhD
Department of Family and

Consumer Sciences
Sacramento City College
Sacramento, California
Laurie Drozdowski, MSc, PhD
Division of Gastroenterology
University of Alberta
Edmonton, Alberta
Alia El-Kadiki
Chemical Pathology Department
Royal Hallamshire Hospital
Shefeld, United Kingdom
Reza Ghiasvand, PhD
Medical Sciences
University of Tehran
Tehran, Iran
Charles K. Herman, MD
Pocono Health Systems

East Stroudsburg, Pennsylvania
and
Albert Einstein College of Medicine
New York
Saeed Hosseini, MD, PhD
EMRC
Tehran University of Medical Sciences
Tehran, Iran
Claudiu Iordache, MD, MSc
Division of Gastroenterology
University of Alberta
Edmonton, Alberta
Vijaya Juturu, PhD, FACN
Nutrition 21 Inc.
Purchase, New York
xvi Handbook of Nutrition in the Aged, Fourth Edition
Eliane Kellen, MD, PhD
Department of General Practice
Katholieke Universiteit Leuven
Comprehensive Cancer Institute
Leuven, Belgium
Kathleen LaPoint, MS
Department of Nutrition
University of North Carolina-Greensboro
Greensboro, North Carolina
Baowan Lin, MD
Department of Neurology
Miller School of Medicine
University of Miami
Miami, Florida

Roger B. McDonald, PhD
Department of Nutrition
University of California
Davis, California
Michael K. McIntosh, PhD, RD
Department of Nutrition
University of North Carolina-Greensboro
Greensboro, North Carolina
Susanne U. Mertens-Talcott
Department of Nutrition and Food Science
Texas A&M University
College Station, Texas
John A. Milner, PhD
Nutritional Science Research Group
National Cancer Institute
National Institutes of Health
Rockville, Maryland
Marthe J. Moseley, PhD, RN, CCRN,
CCNS, CNL
Clinical Nurse Specialist, Critical Care
South Texas Veterans Health Care System
San Antonio, Texas
and
Rocky Mountain University of Health
Professions
Provo, Utah
Giuliana Noratto
Department of Nutrition and Food Science
Texas A&M University
College Station, Texas

Rosa M. Ortega, PhD
Departamento de Nutrición
Facultad de Farmacia
Universidad Complutense
Madrid, Spain
Lisbeth Pacheco
Department of Nutrition and Food Science
Texas A&M University
College Station, Texas
Elena Rodríguez-Rodríguez, PhD
Departamento de Nutrición
Facultad de Farmacia
Universidad Complutense
Madrid, Spain
Stéphane M. Schneider, MD, PhD
Nutritional Support Unit
ARCHET University Hospital
Nice, France
Vidyasagar Sriramoju
Institute for Ultrafast Spectroscopy and Lasers
The City College of New York
New York, New York
Jeffrey Stanaway
Healthy Aging Lab
Mel and Enid Zuckerman College of Public
Health
University of Arizona
Tucson, Arizona
Craig S. Stump, MD, PhD
Section of Endocrinology, Diabetes and

Hypertension
University of Arizona
Tucson, Arizona
David R. Thomas, MD, FACP, AGSF, GSAF
Division of Geriatric Medicine
St. Louis University Health Sciences Center
St. Louis, Missouri
Alan B. R. Thomson, MD, PhD
Division of Internal Medicine
University of Alberta
Edmonton, Alberta
List of Contributors xvii
Elaine B. Trujillo, MS, RD
Nutritional Science Research Group
National Cancer Institute
National Institutes of Health
Rockville, Maryland
Jennifer Truong, MD
Vitamin K Laboratory
USDA Human Nutrition Research Center on
Aging
Tufts University
Boston, Massachusetts
Rosemary Walzem
Department of Nutrition and Food Science
Texas A&M University
College Station, Texas
Sheldon Winkler, DDS
Maurice H. Kornberg School of Dentistry
Temple University

Philadelphia, Pennsylvania
and
College of Dental Medicine
Midwestern University
Glendale, Arizona
Trudy Woudstra, MSc, MD
Division of Gastroenterology
University of Alberta
Edmonton, Alberta
Hilary A. Wynne, MA, MD, FRCP
Care of the Elderly Services
Royal Victoria Inrmary
Newcastle upon Tyne, United Kingdom
Hussein Naji Yassine, MD
Division of Endocrinology
Section of Endocrinology, Diabetes and
Hypertension
Tucson, Arizona
Jianping Ye, MD
Pennington Biomedical Research Center
Louisiana State University System
Baton Rouge, Louisiana
Jun Yin, MD, PhD
Pennington Biomedical Research Center
Louisiana State University System
Baton Rouge, Louisiana