NUTRITION
ACROSS THE LIFESPAN FOR HEALTHY AGING

Proceedings of a Workshop

Leslie Pray, Rapporteur

Food Forum

Food and Nutrition Board

Health and Medicine Division

THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by contracts between the National Academy of Sciences and the National Institutes of Health (HHSN263201200074I); U.S. Department of Agriculture (59-1235-2-114, AG-3A94-P-15-0095, CNPP-IOM-FY-2015-01, and FS_NAS_IOM_FY2015_01); and U.S. Food and Drug Administration (HHSP233201400020B/HHSP23337012), with additional support by Abbott Laboratories, Incorporated; Cargill, Inc.; The Coca-Cola Company; ConAgra Foods; Dr Pepper Snapple Group; General Mills, Inc.; Kellogg Company; Kraft Heinz; Mars, Inc.; Monsanto; Nestlé Nutrition; Ocean Spray Cranberries, Inc.; PepsiCo; and Tate & Lyle. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-45748-4
International Standard Book Number-10: 0-309-45748-3
Digital Object Identifier: https://doi.org/10.17226/24735

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Copyright 2017 by the National Academy of Sciences. All rights reserved.

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2017. Nutrition Across the Lifespan for Healthy Aging: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24735.

PLANNING COMMITTEE FOR A WORKSHOP ON NUTRITION ACROSS THE LIFESPAN¹

PAMELA STARKE-REED (Chair), Deputy Administrator, Nutrition, Food Safety and Quality, Agricultural Research Service, U.S. Department of Agriculture, Beltsville, Maryland

JOHANNA DWYER, Senior Nutrition Scientist, Office of Dietary Supplements, National Institutes of Health; Director, Frances Stern Nutrition Center, Tufts-New England Medical Center; Professor, Tufts University Medical School and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts

GORDON L. JENSEN, Senior Associate Dean for Research, Professor of Medicine and Nutrition, The University of Vermont Larner College of Medicine, Burlington

CATHERINE KWIK-URIBE, Global Director, Health and Nutrition, Mars, Inc., Germantown, Maryland

SHARON A. ROSS, Program Director, Nutritional Science Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, Maryland

MARY T. STORY, Professor of Global Health and Community and Family Medicine, Associate Director, Education and Training, Duke Global Health Institute, Duke University, Durham, North Carolina

REGINA L. TAN, Director, Office of Food Safety, Food and Nutrition Service, U.S. Department of Agriculture, Alexandria, Virginia

CONNIE WEAVER, Distinguished Professor and Department Head, Department of Nutrition Science, Purdue University, West Lafayette, Indiana

___________________

¹ The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.

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FOOD FORUM¹

SYLVIA ROWE (Chair), SR Strategy, LLC, Washington, DC

ARTI ARORA, The Coca-Cola Company, Atlanta, Georgia

CONNIE AVRAMIS, Unilever Research and Development, Englewood Cliffs, New Jersey

FRANCIS (FRANK) BUSTA, University of Minnesota, St. Paul

PAUL M. COATES, Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland

DAVID B. COCKRAM, Abbott Laboratories, Incorporated, Columbus, Ohio (through December 2016)

NAOMI FUKAGAWA, Agricultural Research Service, U.S. Department of Agriculture, Beltsville, Maryland

DAVID GOLDMAN, Food Safety and Inspection Service, U.S. Department of Agriculture, Washington, DC

DANIEL A. GOLDSTEIN, Monsanto, St. Louis, Missouri

DANIELLE GREENBURG, PepsiCo, Purchase, New York

SONYA A. GRIER, American University, Washington, DC

JEAN HALLORAN, Consumers Union, Yonkers, New York

JACKIE HAVEN, Center for Nutrition Policy and Promotion, U.S. Department of Agriculture, Alexandria, Virginia

KATE J. HOUSTON, Cargill Inc., Washington, DC

LEE-ANN JAYKUS, North Carolina State University, Raleigh

GORDON L. JENSEN, Pennsylvania State University, University Park (through December 2016)

HELEN H. JENSEN, Iowa State University, Ames

RENÉE S. JOHNSON, Library of Congress, Washington, DC

WENDY L. JOHNSON-ASKEW, Gerber Products Company, Florham Park, New Jersey

CHRISTINA KHOO, Ocean Spray Cranberries, Inc., Lakeville, Massachusetts

VIVICA KRAAK, Virginia Tech, Blacksburg

SUSAN M. KREBS-SMITH, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland

CATHERINE KWIK-URIBE, Mars, Inc., Germantown, Maryland

CHRISTOPHER JOHN LYNCH, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland

___________________

¹ The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.

SUSAN MAYNE, U.S. Food and Drug Administration, College Park, Maryland

KAREN McINTYRE, Health Canada, Ottawa, Ontario, Canada

S. SUZANNE NIELSEN, Purdue University, West Lafayette, Indiana

ERIK D. OLSON, Natural Resources Defense Council, Washington, DC

ROBERT POST, Chobani, LLC, New York, New York

KRISTIN REIMERS, ConAgra Foods, Omaha, Nebraska

CLAUDIA RIEDT, Dr Pepper Snapple Group, Plano, Texas

SARAH ROLLER, Kelley Drye & Warren LLP, Washington, DC

SHARON A. ROSS, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland

JACQUELINE SCHULZ, The Kraft Heinz Company, Northfield, Illinois (through December 2016)

LISA SPENCE, Tate & Lyle, Hoffman Estates, Illinois

PAMELA STARKE-REED, Agricultural Research Service, U.S. Department of Agriculture, Beltsville, Maryland

MAHA TAHIRI, General Mills, Inc., Minneapolis, Minnesota

REGINA TAN, Office of Food Safety, Food and Nutrition Service, U.S. Department of Agriculture

Health and Medicine Division Staff

HEATHER DEL VALLE COOK, Co-Director

LESLIE J. SIM, Co-Director

ANNA BURY, Research Assistant

GERALDINE KENNEDO, Administrative Assistant

ANN YAKTINE, Director, Food and Nutrition Board

Reviewers

This Proceedings of a Workshop has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published Proceedings of a Workshop as sound as possible and to ensure that the Proceedings of a Workshop meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this Proceedings of a Workshop:

Although the reviewers listed above provided many constructive comments and suggestions, they did not see the final draft of the Proceedings of a Workshop before its release. The review of this Proceedings of a Workshop was overseen by JAMES M. NTAMBI, University of Wisconsin–Madison. He was responsible for making certain that an independent examination of this Proceedings of a Workshop was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this Proceedings of a Workshop rests entirely with the rapporteur and the institution.

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Contents

1 INTRODUCTION

2 CHANGING LANDSCAPE: DEMOGRAPHICS, HEALTH STATUS, AND NUTRITIONAL NEEDS

The Changing Face of Older Americans: Key Indicators of Well-Being

Healthy Aging Perspective

Discussion with the Audience

3 THE SPECTRUM OF AGING AND HEALTH OVER THE LIFESPAN

Early-Life Origins of Metabolic Disease and Aging

Biomarkers of Aging

Overweight and Obesity in Older Persons: Impact on Health and Mortality Outcomes

Discussion with the Audience

4 CHANGES IN ORGAN SYSTEMS OVER THE LIFESPAN

Selected Age-Associated Changes in the Cardiovascular System

The Role of Nutrition in Cardiovascular Health and Disease in Aging

The Cardiovascular System: Discussion with the Audience

Skeletal Systems

Muscular Systems

Skeletal and Muscular Systems: Discussion with the Audience

Age-Associated Changes in Taste and Smell Function

Nutrition and Oral Health in Aging

Sensory and Oral Health: Discussion with the Audience

Nutrition and the Microbiome

Noninvasive Methods for Assessing Nutritional Regulation of Neonatal Gut Gene Expression and Host–Microbe Interactions

The Gut and Gut Microbiome: Discussion with the Audience

Dietary Interventions for Healthy Aging

5 MOVING FORWARD

Nutrition to Promote Healthy Aging

Questions for the Field

Questions from the Audience

Patterns of Dietary Intake Across the Lifespan and Opportunities to Support Healthy Aging

Discussion with the Audience

Supporting Healthy Aging Across the Lifespan: The Role of the Food Industry

Nutrient Gaps Across the Lifespan and the Role of Supplementation in a Healthy Diet

Discussion with the Audience

6 HEALTHY AGING: WHAT IS IT? ARE THERE ACCEPTABLE MARKERS TO UTILIZE IN DEVELOPING STRATEGIES TO PROMOTE IT?

Meydani’s Remarks

Panelist Remarks

Panel Discussion with the Audience

Closing Remarks

REFERENCES

APPENDIXES

A WORKSHOP AGENDA

B ACRONYMS AND ABBREVIATIONS

C SPEAKER AND MODERATOR BIOSKETCHES

Box and Figures

BOX

1-1 Statement of Task

FIGURES

2-1 Population aged 65 and over and aged 85 and over, selected years, 1900-2014, and projected years, 2020-2060

2-2 Educational attainment of the U.S. population aged 65 and older, selected years, 1965-2015

2-3 State-specific healthy life expectancy at age 65, 2007-2009

3-1 The relationship between interleukin (IL)-6 serum levels (x-axis) and probability of mobility disability (y-axis)

3-2 Change over time in interleukin (IL)-6 according to meal type

3-3 Mortality risk (i.e., hazard ratio relative to a body mass index [BMI] of 23) as a function of BMI

4-1 Bone mass as a function of age

4-2 Annual incidence of common diseases, based on 2013 data

4-3 Digitized images of the cross-sectional computed tomography (CT) scans of the midthighs of a 70-year-old female (left) and an 85-year-old female (right)

4-4 Percentage of olfactory cells responding to an odor as a function of age group

4-5 Change in bacterial diversity in the gut microbiome over time in mice fed a high-fiber diet versus those initially fed a low-fiber diet and then later fed a high-fiber diet

4-6 Percentages of five phyla found in the gut microbiota of breastfed (BF) and formula-fed (FF) infants

4-7 Survival (percentage of the population surviving) as a function of days (in humans, mice, and worms) or generations (in yeast)

4-8 Change in the human survival curve over time, 1541-1991

4-9 Survival curves for two strains of mice (DBA and C57BL/6), both females and males, on three different diets: regular diet (AL; black curves), 20 percent calorie-restricted diet (20 percent CR; blue curves), and 40 percent calorie-restricted diet (40 percent CR; red curves)

5-1 Average Healthy Eating Index (HEI) scores of the U.S. population, aged 2 years and older, as a function of the National Health and Nutrition Examination Survey (NHANES) cycle, 1999-2000 to 2009-2010

5-2 Average Healthy Eating Index (HEI) scores of the U.S. population as a function of the National Health and Nutrition Examination Survey (NHANES) cycle, 2005-2006 to 2011-2012, by age group

5-3 Percentage of the U.S. population aged 1 year and older who are below, at, or above recommended minimums or limits for certain food groups and other dietary components

5-4 Average daily intakes (yellow dots) compared with recommended intake ranges (blue bars) for selected food groups and other dietary components, by age, for both males (the left graph of each pair) and females (the right graph of each pair)

5-5 Areas in the 2015-2020 Dietary Guidelines for Americans (DGA) in which guidance includes specific statements focused on older individuals

5-6 Percentage of the U.S. population aged 2 years and older with nutrient intakes below Estimated Average Requirements (EARs), taking into account either (1) only intake of foods with naturally occurring nutrients (“naturally occurring”); (2) intake of all foods, including fortified foods (“with fortification”); or (3) intake of all foods plus dietary supplements (“with supplements”)