HANDBOOK OF CLINICAL NUTRITION AND AGING NUTRITION à AND à HEALTH Adrianne Bendich, Series Editor Handbook of Clinical Nutrition and Aging, Second Edition, edited by Connie Watkins Bales and Christine Seel Ritchie, 2009 Handbook of Nutrition and Pregnancy, edited by Carol J. Lammi-Keefe, Sarah Collins Couch, and Elliot H. Philipson, 2008 Nutrition and Health in Developing Countries, Second Edition, edited by Richard D. Semba and Martin W. Bloem, 2008 Nutrition and Rheumatic Disease, edited by Laura A. Coleman, 2008 Nutrition in Kidney Disease, edited by Laura D. Byham-Gray, Jerrilynn D. Burrowes, and Glenn M. Chertow, 2008 Handbook of Nutrition and Ophthalmology, edited by Richard D. Semba, 2007 Adipose Tissue and Adipokines in Health and Disease, edited by Giamila Fantuzzi and Theodore Mazzone, 2007 Nutritional Health: Strategies for Disease Prevention, Second Edition, edited by Norman J. Temple, Ted Wilson, and David R. Jacobs, Jr., 2006 Nutrients, Stress, and Medical Disorders, edited by Shlomo Yehuda and David I. Mostofsky, 2006 Calcium in Human Health, edited by Connie M. Weaver and Robert P. Heaney, 2006 Preventive Nutrition: The Comprehensive Guide for Health Professionals, Third Edition, edited by Adrianne Bendich and Richard J. Deckelbaum, 2005 The Management of Eating Disorders and Obesity, Second Edition, edited by David J. Goldstein, 2005 Nutrition and Oral Medicine, edited by Riva Touger-Decker, David A. Sirois, and Connie C. Mobley, 2005 IGF and Nutrition in Health and Disease, edited by M. Sue Houston, Jeffrey M. P. Holly, and Eva L. Feldman, 2005 Epilepsy and the Ketogenic Diet, edited by Carl E. Stafstrom and Jong M. Rho, 2004 Handbook of DrugNutrient Interactions, edited by Joseph I. Boullata and Vincent T. Armenti, 2004 Nutrition and Bone Health, edited by Michael F. Holick and Bess Dawson-Hughes, 2004 Diet and Human Immune Function, edited by David A. Hughes, L. Gail Darlington, and Adrianne Bendich, 2004 Beverages in Nutrition and Health, edited by Ted Wilson and Norman J. Temple, 2004 HANDBOOK OF CLINICAL NUTRITION AND AGING Second Edition Edited by CONNIE WATKINS BALES, PhD, RD, FACN Durham VA Medical Center and Duke University Medical Center, Durham, NC and CHRISTINE SEEL RITCHIE, MD, MSPH Birmingham VA Medical Center, University of Alabama at Birmingham, Birmingham AL Foreword by NANCY S.WELLMAN,PhD,RD,FADA Former Director, National Resource Center on Nutrition, Physical Activity and Aging, Florida International University, Miami, FL Past President, The American Dietetic Association Editors Connie Watkins Bales Christine Seel Ritchie Durham VA Medical Center and Duke Birmingham VA Medical Center University Medical Center University of Alabama at Birmingham Durham, NC Birmingham, AL Series Editor Adrianne Bendich GlaxoSmithKline Consumer Healthcare Parsippany, NJ ISBN 978-1-60327-384-8 e-ISBN 978-1-60327-385-5 DOI 10.1007/978-1-60327-385-5 Library of Congress Control Number: 2009920207 # Humana Press, a part of Springer Science Business Media, LLC 2004, 2009 All rights reserved. This work may not be translatedþ or copied in whole or in part without the written permission of the publisher (Humana Press, c/o Springer Science Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection withþ reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper springer.com Dedications Connie Watkins Bales dedicates this volume to her children, Audrey Ashburn Bales Britton and William Brittain Bales, in appreciation of all the ways they have enriched her life and with enthusiastic anticipation of all they are becoming. Christine Seel Ritchie dedicates this volume to the memory of her father, David John Seel, MD, FACS, a man of compassion who was devoted to life-long learning. Acknowledgements CWB would like to recognize and thank Tien Thi Ho who, as a Duke student assistant, worked tirelessly for two academic years on the management and copy editing of this text, contributing substantially to its quality. Thanks also to Justin (Cody) Maxwell and Caroline Friedman for their contributions to this project. CWB and CSR thank our series editor, Dr. Adrianne Bendich, for her encouragement to begin what has become an ongoing and exciting set of encounters with critical clinical issues in geriatric nutrition and the gifted and dedicated scientists who study them. Without the creative contributions of these scientist- authors, this book would not have been possible. vii Series Introduction The Nutrition and Health series of books have, as an overriding mission, to provide health professionals with texts that are considered essential because each includes (1) a synthesis of the state of the science, (2) timely, in-depth reviews by the leading researchers in their respective fields, (3) extensive, up-to-date fully annotated reference lists, (4) a detailed index, (5) relevant tables and figures, (6) identification of paradigm shifts and the con- sequences, (7) virtually no overlap of information between chapters, but targeted, inter- chapter referrals, (8) suggestions of areas for future research and (9) balanced, data-driven answers to patient/health professionals questions that are based upon the totality of evidence rather than the findings of any single study. The series volumes are not the outcome of a symposium. Rather, each editor has the potential to examine a chosen area with a broad perspective, both in subject matter as well as in the choice of chapter authors. The international perspective, especially with regard to public health initiatives, is emphasized where appropriate. The editors, whose trainings are both research and practice oriented, have the opportunity to develop a primary objective for their book; define the scope and focus; and then invite the leading authorities from around the world to be part of their initiative. The authors are encouraged to provide an overview of the field, discuss their own research and relate the research findings to potential human health consequences. Because each book is developed de novo, the chapters are coordinated so that the resulting volume imparts greater knowledge than the sum of the information contained in the individual chapters. ‘‘Handbook of Clinical Nutrition and Aging, Second Edition’’ edited by Connie Watkins Bales and Christine Seel Ritchie fully exemplifies the Nutrition and Health Series’ goals. The first volume of the handbook, published in 2004, was acknowledged by reviewers as the most comprehensive volume available concerning the role of clinical nutrition in preserving the health of older adults – especially those suffering from established chronic disease. The second edition is very timely as the fastest growing population in the US as well as globally is those over 60 years of age and especially the oldest-old, those over 80 years of age. This important text provides practical, data-driven options to enhance this at-risk population’s potential for optimal health and disease prevention with special emphasis on secondary disease prevention and therapeutic nutritional interventions. The overarching goal of the editors is to provide fully referenced information to health professionals, so that they may enhance the nutritional welfare and overall health of their older adult clients and family members. This excellent, up- to-date volume will add great value to the practicing health professional as well as those professionals and students who have an interest in the latest information on the science behind the aging process, and the potential for nutrition to modulate the effects of chronic diseases and conditions that are widely seen in the geriatric population. ix x Series Introduction Drs. Bales and Ritchie, who have edited the first and second editions, are internationally recognized leaders in the field of clinical nutrition and aging. Both editors are excellent communicators and they have worked tirelessly to develop a book that continues to be the benchmark in the field because of its extensive, in-depth chapters covering the most important aspects of the complex interactions between cellular functions, diet and nutrient requirements and their impact on the chronic diseases as well as the acute conditions that can adversely affect the quality of life and health of older individuals. The editors have chosen 40 of the most well-recognized and respected authors, internationally distinguished researchers, clinicians and epidemiologists, who provide a comprehensive foundation for understanding the role of nutrients and other dietary factors in the clinical aspects of nutritional manage- ment of the elderly. Hallmarks of all the 29 chapters include complete explanations of terms, with the abbreviations fully defined for the reader, and consistent use of terminology between chapters. Key features of this comprehensive volume include the informative bulleted summary points and key words that are at the beginning of each chapter and appendices that include a detailed list of relevant nutrition resources, including lists of books, journals and websites. Glossaries of terms and abbreviations