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A. What causes it?

(Why What)

Elderly

1. Genetic

The physical well-being of the elderly is in large part determined by the genetic makeup he inherits from his ancestors. Elderly with more “robust” genes tend to be generally healthier, which finds itself reflected in their capacity to regulate food intake, their appetite, weight and body fat mass.

2. Gastrointestinal tract

The digestive system plays a critical role in the health of an elderly person. A healthy stomach enables the absorption of much-needed nutrients and the production of several important hormones. It also shapes a senior’s relationship to food: the ability to adequately estimate how much food ought to be consumed to reach satiation effectively prevents food addictions and overindulgence. Furthermore, evidence shows that seniors whose diet provides them with adequate nutrition are likely to develop a stronger immune system as well as an enhanced cognition (i.e. better focus, reasoning, processing speed).

3. Intestine system

The human intestines are home to a range of both good and harmful bacterial flora (80:20); its delicate balancing supports the well-functioning of bodily processes. This balancing enables the production of short-chain fatty acids (SCFA), that serve as key anti-inflammatory active agents.

4. Metabolic system

At rest, seniors manifest a higher basal metabolic rate (BMR) than adults. Their constant need for high energy intake linked to their physical development means that their bodies hold a capacity to quickly burn all the calories all ingested foods contain. For this reason, they are more physically fit and less likely to suffer from obesity than other age groups. Naturally, their BMR decreases over time.

5. Adipogenesis

The role of adipocytes -also known as “fat cells”- is to store excessive energy for future supply, while simultaneously synthesizing important hormones (e.g. the leptin hormone). Among seniors, hypertrophy and the proliferation of adipocytes -triggered by hyperplasia or adipogenesis- usually results in a significant augmentation of not only the accumulation of fat but also its distribution around the body. This, in turn, negatively impacts insulin sensitivity.

6. Hormone secretion

The hormonal system still plays an essential role throughout all the stages of child development. The growth hormone, for instance, facilitates bone and muscle growth, while the leptin hormone communicates to the brain its satiety. The interplay of these two hormones proportionately distributes fat in the body and therefore also narrow down the possibility of developing “belly fat”.

B. In the absence of the preventive

factors listed in the A section,

the following may occur :

1. Excessive fat accumulation

While most children are fortunate enough to inherit good genes from their parents, others are less so, which makes them prone to a range of genetically inherited metabolic conditions. These can involve several complications, such as excess of energy, the uneven distribution of body fat, which usually also involves the buildup of abdominal fat mass (belly fat). Down syndrome has also been linked with rare metabolic conditions in children.

2. Digestive abnormalities and malabsorption

Seniors with vulnerable digestive systems are prone to malabsorption syndrome and overeating. Compulsive eating results from a fast movement that takes place in the stomach and the small intestines.
Gut inflammation, in turn, is linked with fat retention, which can be particularly noticeable when located on the abdomen.

3. Enlarging fat cells

Bacterial flora ratio and interaction is what determines the overall health condition of the digestive and bowel system. A bacterial imbalance in the gut is likely to provoke an inflammation of the GALT, caused by a dysfunction in the proper distribution of fat around the body. This type of inflammation often triggers hypertrophy, which consists of the enlargement of fat cells. Contrary to popular belief, diet and exercise are not effective methods for tackling weight problems linked to hypertrophy in the abdominal area. The condition is frequently associated with metabolic syndrome and chronic diseases, such as high blood pressure, elevated lipid levels in the blood, diabetes, cerebral as well as coronary artery occlusion.

4. Metabolic abnormalities

Seniors who have a high basal metabolic rate (BMR) and therefore a properly functioning metabolism are more likely to be able-bodied. It has been shown that 40% of BMR stems from bone and muscle metabolism. In fact, 70% is composed of bones and muscles, and it is therefore no coincidence that among seniors, a well-developed muscle mass correlates with a highly efficient metabolic system.

5. Adipogenesis

Several studies have linked adult obesity to excessive adipogenesis. When fat cells are saturated with calories, the extracellular matrix (ECM) -a type of skin structure that ensures the smoothness of the skin- shrinks. This can trigger an inflammation around the adipocytes or elevate blood pressure, in turn increasing the likelihood of developing atherosclerosis.

6. Tough blood sugar control

Two hormones play a critical role in ensuring the well-functioning of the human organism: the growth and thyroid hormones. The stimulation of these hormones facilitates the storage of fat for energy retention, which takes the form of either fat accumulation or muscle development. A disruption in this hormonal mechanism, however, is likely to have a considerable impact on energy reserves (fat) and eventually lead to a weight-related disorder. Aside of hormones located in the endocrine system and other body cells, adipocytes are known for their production of the leptin hormone, which serves a signal to the entire body to indicate its satiety.

C. Building effective solutions

1. Further research

Scientific research has over the years shown a consistent interest in the alteration of genes that make an individual prone to carbohydrate cravings and obesity. The solutions that have been developed and made available to the public are various and therefore treatment ought to be tailored to individual needs. These can range from a simple medical prescription or a nutritional supplement intake, to a more serious intervention, such as a bariatric surgery. However, surgery treatment puts elderly patients at higher risk as they tend to take a longer time to recover, due to the physical decline linked with the aging process.

2. Preventing the fat absorption in the gastrointestinal tract

Several effective solutions effectively address obesity and body fat excess. The ingestion of dietary fibers -scientifically known as chitosan-saponin- are particularly effective in reducing fat absorption in the digestive system. By means of fastening itself to ingested fat, chitosan-saponin causes an inhibitory effect on fat absorption during food digestion and ensures its full discharge through the excretory system. Another solution directed at tackling weight disorders consists of the ingestion of lipase inhibitors, which target lipase enzyme activities that break down fat into smaller molecules. Japanese ginseng, polyphenols as well as specific pharmaceutical drugs are rich sources of lipase inhibitors.

3. Providing prebiotics and probiotics

Since bacterial imbalances in the gut can lie behind eating or weight-related disorders, prebiotics and probiotics can effectively restore the needed bacterial ratio for a well-functional digestive system. Prebiotics are non-digestible polysaccharides or dietary fibers, which support bacterial growth. Probiotics, on the other hand, are live microorganisms which when administered, have a positive health effect on a person’s microbiome. Fermented foods, such as kefir and kimchi, are well-known rich probiotic sources. The glucose-insulin homeostasis greatly benefits prebiotics and probiotics.

4. Boosting metabolic rate

The human body can be conceptualized as complex living vehicle, the smooth functioning of which depends on “fuel” and “combustion”, as a routine maintenance. Indeed, adequate nutrition and a good metabolism play a central role in maintaining health and physical fitness.

4.1 Having larger meal

It is possible to boost the metabolic system after having eaten a meal. In the aftermath of food ingestion, the body makes use of previously stored energy to digest and absorb to ingested food; this process is called the “thermal effect of food” (TEF). Carbohydrates and protein are also effective boosters of the metabolism. Indeed, food high in carbohydrates can increase an average person’s metabolic rate up to between 5-10%, and 15-30% between for food high in protein. When consumed, the latter satiates a person much faster than other foods, which can be instrumentalized to cut down surplus calories equivalent to 400 calories a day. The food type that is least effective at increasing the metabolic rate is high-fat food, which can either increase it of 3% or have no effect at all.

4.2 Weight training exercise for elders

During daytime, calories are most ‘burnt’ in the muscle tissue. Exercise that focuses on muscle building (e.g. weightlifting) therefore serves as an effective preventive method against fat accumulation in the body.

4.3 Drinking green tea and Oolong tea to increase fat burning

It has been evidenced that green and Oolong tea consumption helps the fat burning process from 10 to 17%.

4.4 Gaining weight due to sleeping late

Medical research has found a strong correlation between sleep deprivation a lowered metabolic rate. Indeed, a lack of sleep stimulates the production of the “hunger hormone” (ghrelin) while decreasing that of the “satiety hormone” (leptin). This explains why people who stay up longer at the night experience food cravings and therefore prone to develop weight problems.

4.5 Moderate coffee drinking

Several studies have shown that regularly consuming coffee can boost the metabolism up to 11% and facilitates the burning of surplus fat.

4.6 Consuming MCT-rich foods

A dietary substitution of LCT (Long Chain Triglycerides) with MCT (Medium Chain Triglycerides) can significantly improve the metabolism up to 12%. Coconut oil is rich in MCT, whereas LCT oil only boosts the metabolic rate at 0-3%. Despite the health benefits of MCT oil, it ought to be consumed in moderation, to prevent excessive calorie intake.

5. Preventing adipogenesis

A few studies have been carried out on preadipocyte to adipocyte inhibitory processes, by using Hsp90 blockers on PPAR-γ, Mineralocorticoid and Glucocorticoid Receptors (MR and GR). It was found that Hsp90 blockers minimize hormonal responses in adipocyte production, fat storage, and decrease the chances of developing metabolic syndrome. Further studies have also suggested that retinoic acid can inhibit adipogenesis. Piceatannol, which can be found in red wine, possess the same properties.

6. Metabolic and fat storage hormones

Hormonal balance is vital to physical fitness in elders. The hormones are responsible for metabolism and fat storage are:

6.1 Leptin: the satiety hormone

Leptin is a fat-based hormone that sends signals to the brain when the stomach is satisfied with its food intake. When it suffers from fructose excess, the liver transforms fat into adipocytes. The liver, in turn, stimulates the leptin hormone until the brain receptors no longer respond to it.

6.2 Cortisol: the stress

Cortisol is a stress hormone that is secreted by the adrenal gland. Cortisol levels are proportional to the degree to which a person is stressed as well as to the amount of sucrose which is transformed into fat in the body.

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