15.3: Middle Age

Middle age is defined as the period from age thirty-one to fifty. The early period of this stage is very different from the end. For example, during the early years of middle age, many women experience pregnancy, childbirth, and lactation. In the latter part of this life stage, women face perimenopause, which is a transition period that leads up to menopause, or the end of menstruation. A number of physical changes take place in the middle-aged years, including the loss of bone mass in women due to dropping levels of estrogen during menopause. In both men and women, visual acuity declines, and by age forty there can be a decreased ability to see objects at a close distance, a condition known as presbyopia.^[1] All of these are signs of aging, as the human body begins to change in subtle and not-so-subtle ways. However, a middle aged person can remain vital, healthy, and near his or her physical peak with proper diet and adequate exercise.

During this stage of the human life cycle, adults begin to experience the first outward signs of aging. Wrinkles begin to appear, joints ache after a highly active day, and body fat accumulates. There is also a loss of muscle tone and elasticity in the connective tissue.^[2] Many people in their late thirties and in their forties notice a decline in endurance, the onset of wear-and-tear injuries (such as osteoarthritis), and changes in the digestive system. Wounds and other injuries also take longer to heal. Body composition changes due to fat deposits in the trunk. To maintain health and wellness during the middle-aged years and beyond, it is important to:

• maintain a healthy body weight
• consume nutrient-dense foods
• drink alcohol moderately or not at all
• be a nonsmoker
• engage in moderate physical activity at least 150 minutes per week

Energy and Macronutrients

The energy requirements for ages thirty-one to fifty are 1,800 to 2,200 calories for women and 2,200 to 3,000 calories for men, depending on activity level. These estimates do not include women who are pregnant or breastfeeding. Middle-aged adults must rely on healthy food sources to meet these needs. In many parts of North America, typical dietary patterns do not match the recommended guidelines. For example, five foods—iceberg lettuce, frozen potatoes, fresh potatoes, potato chips, and canned tomatoes—account for over half of all vegetable intake.^[3] Following the dietary guidelines in the middle-aged years provides adequate but not excessive energy, macronutrients, vitamins, and minerals.

The AMDRs for carbohydrates, protein, fat, fiber, and fluids remain the same from young adulthood into middle age. It is important to avoid putting on excess pounds and limiting an intake of SoFAAS to help avoid cardiovascular disease, diabetes, and other chronic conditions.

Micronutrients

There are some differences, however, regarding micronutrients. For men, the recommendation for magnesium increases to 420 milligrams daily, while middle-aged women should increase their intake of magnesium to 320 milligrams per day. Other key vitamins needed during the middle-aged years include folate and vitamins B6 and B12 to prevent elevation of homocysteine, a byproduct of metabolism that can damage arterial walls and lead to atherosclerosis, a cardiovascular condition. Again, it is important to meet nutrient needs with food first, then supplementation, such as a daily multivitamin, if you can’t meet your needs through food.

Preventive/Defensive Nutrition

During the middle-aged years, preventive nutrition can promote wellness and help organ systems to function optimally throughout aging. Preventive nutrition is defined as dietary practices directed toward reducing disease and promoting health and well-being. Healthy eating in general—such as eating unrefined carbohydrates instead of refined carbohydrates and avoiding trans fats and saturated fats—helps to promote wellness. However, there are also some things that people can do to target specific concerns. One example is consuming foods high in antioxidants, such as strawberries, blueberries, and other colorful fruits and vegetables, to reduce the risk of cancer.

Phytochemicals are also great nonessential nutrients that may promote body wellness.For example, carotenoids, which are found in carrots, cantaloupes, sweet potatoes, and butternut squash, may protect against cardiovascular disease by helping to prevent the oxidation of cholesterol in the arteries, although research is ongoing.^[4] According to the American Cancer Society, some studies suggest that a phytochemical found in watermelons and tomatoes called lycopene may protect against stomach, lung, and prostate cancer, although more research is needed.^[5]

Omega-3 fatty acids can help to prevent coronary artery disease. These crucial nutrients are found in oily fish, including salmon, mackerel, tuna, herring, cod, and halibut. Other beneficial fats that are vital for healthy functioning include monounsaturated fats, which are found in plant oils, avocados, peanuts, and pecans.

Menopause

In the middle-aged years, women undergo a specific change that has a major effect on their health. They begin the process of menopause, typically in their late forties or early fifties. The ovaries slowly cease to produce estrogen and progesterone, which results in the end of menstruation. Menopausal symptoms can vary, but often include hot flashes, night sweats, and mood changes. The hormonal changes that occur during menopause can lead to a number of physiological changes as well, including alterations in body composition, such as weight gain in the abdominal area. Bone loss is another common condition related to menopause due to the loss of female reproductive hormones. Bone thinning increases the risk of fractures, which can affect mobility and the ability to complete everyday tasks, such as cooking, bathing, and dressing.^[6]

Recommendations for women experiencing menopause or perimenopause (the stage just prior to the end of the menstruation) include:

• consuming a variety of whole grains, and other nutrient-dense foods
• maintaining a diet high in fiber, low in fat, and low in sodium
• avoiding caffeine, spicy foods, and alcohol to help prevent hot flashes
• eating foods rich in calcium, or taking physician-prescribed calcium supplements and vitamin D
• doing stretching exercises to improve balance and flexibility and reduce the risk of falls and fractures

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References

1. Polan EU, Taylor DR. (2003). Journey Across the Life Span: Human Development and Health Promotion. Philadelphia: F. A. Davis Company, 192–93. ↵
2. Polan EU, Taylor DR. (2003), Journey Across the Life Span: Human Development and Health Promotion. Philadelphia: F. A. Davis Company, 212–213. ↵
3. Drewnowski A, Darmon, N. (2005). Food Choices and Diet Cost: an Economic Analysis. The Journal of Nutrition, 135(4), 900-904. jn.nutrition.org/content/135/4/900.full. Accessed December 12, 2017. ↵
4. Voutilainen S, Nurmi T, Mursu J, Rissanen, TH. (2006). Carotenoids and Cardiovascular Health. American Journals of Clinical Nutrition, 83, 1265–71. www.ajcn.org/content/83/6/1265.full.pdf. Accessed December 9, 2017. ↵
5. Lycopene. American Cancer Society. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/DietandNutrition/lycopene. Updated May 13, 2010. Accessed November 29, 2017. ↵
6. Eating Right During Menopause.Academy of Nutrition and Dietetics. www.eatright.org/Public/content.aspx?id=6809. Updated January 2015. Accessed December 4, 2017. ↵