Sports Medicine: Just the Facts

activity into their normal daily lives such as walk-

ing to a store or gardening.

3. The goal should be for the person to feel pleas-
   antly tired a few hours after the activity with the
   aim to increase the activity slowly until a desired
   level of fitness is obtained (Shephard and Balady,
   1999).

THE EXERCISE PRESCRIPTION

• The exercise prescription should include both aerobic
  and resistance exercise.
  
  
  1. Aerobic exercise in the form of walking from a
     more moderate to vigorous pace is very attainable
     for most if not all community dwelling elders espe-
     cially if barriers of environment and safety are
     taken into account.
  
  
  2. Aerobic exercise should be performed on most
     days of the week with the goal of achieving 30 min
     of moderate to vigorous intensity exercise daily
     (Christman and Andersen, 2000; Evans, 1999).
     This can also be achieved by splitting the 30-min
     goal into two or three sessions.
  
  
  3. Discuss “warming up and warming down” as part
     of the prescription (Seto and Brewster, 1991) as
     this will prevent musculoskeletal injuries, cate-
     cholamine burst, reduce the risk of arrhythmias
     and fainting, and allow for central venous return.
  
  
  4. Resistance training is necessary to counter the
     muscle atrophy of aging and disuse (Frontera et al,
     1988; Evans, 1996; Fiatarrone et al, 1990). Current
     research indicates that for healthy persons of all
     ages even those with chronic diseases, a single set
     of 15 repetitions performed a minimum of 2 days
     per week can develop and maintain muscle mass,
     endurance, and strength (Taaffe et al, 1999).
     a. Each work-out session should include 8–10 dif-
     ferent exercises that train the major muscle
     groups, targeting the lower back, abdominals,
     leg extensors and flexors, chest, biceps, triceps,
     shoulder, and calf and hip abductors and adduc-
     tors (Feigenbaum and Pollock, 1999).
     b.To minimize the possibility of orthopedic risk,
     the exercise should start at a lower intensity
     level such as 10 repetitions and with low weight
     and progress slowly over 2–4 weeks.
  
  
  
  

NUTRITION

• Nutrition has been named a priority for Healthy People
  2010 (U.S. Department of Health and Human Services,
  2000). An individual’s age, chronic diseases, functional

impairments, polypharmacy, and age-related physio-

logic and socioeconomic changes may all act in concert

to make an older adult nutritionally at risk.

• Good general nutrition beginning early in life and
  maintained throughout the life span is important for
  overall health and is one approach to successful aging.
  Nutrition has been associated with a reduction in dis-
  ability and death from heart disease and with its social
  and nurturing aspects that may lead to increased phys-
  ical activity, physical functioning, independence, and
  overall quality of life (Evans, 1995b).


• Guidance on proper nutrition may impact the overall
  health of the older athlete than actually enhance per-
  formance (Rock, 1991).

NUTRITIONAL REQUIREMENTS FOR

OLDER ADULTS (Evans, 1995b; Rock,

1991; Morley, 1988; Ausman and Russell,

1999; Casa, 2003)

•Physiologic changes associated with aging can have

an impact on the older adult’s nutritional requirement

(Tables 97-6, 97-7). Nutritional advice for the aging

athlete will more likely affect his or her overall health

rather than improve performance.

•A multivitamin supplement may be indicated for older

individuals consuming 1000 kcal/day or less.

Important vitamins and minerals for older individuals

include vitamin D and B 12 , iron (18 mg/day), and cal-

cium 1500 mg/day.

• Dehydration is a particular problem of the elderly and
  often goes unrecognized.


• Dehydration may be responsible for 7% of hospitaliza-
  tions in community dwelling elders. Dehydration is usu-
  ally the result of excessive losses or inadequate intake.


• Among the older athlete, dehydration is common
  especially if there is poor education on hydration,
  improper timing of consumption of meals, poor vigi-
  lance to hydration state, and in general overall poor
  physical conditioning.

570 SECTION 7 • SPECIAL POPULATIONS

TABLE 97-6 Nutrition and Physiologic Changes

in the Elderly

SYSTEM/PHYSIOLOGIC

CHANGE RESULTANT AFFECT

Taste and smell; progressive loss Decreasing food intake secondary

of taste buds; decreased saliva to perceived changes in

production palatability

Decreased metabolic rate secondary Decreasing caloric consumption

to decreased lean muscle mass

Decreased gastrointestinal motility; Early satiety

slower gastric emptying

Decreased ability to concentrate Decreased thirst and dehydration

urine