Student name: MAN HO YAN

1. Title of the Study

The title of this study is “The relationship between dietary habits, exercise, and constipation among elderly in Hong Kong.

2. Objectives of the Study

There are three objectives in this study.
First of all, this study is to identify the cause and effect, as well as the potential disease that may cause because of constipation.

The secondary objective is to evaluate the effectiveness in dietary habits and doing exercise on constipation among elderly.

Last but not least, is to raise the awareness in preventing constipation among elderly in Hong Kong.

3. Literature Review
   1. Constipation

Constipation is based on symptoms regarding the bowel. For instance, have difficulty to pass the substance inside the intestine towards outside through the bowel, eventually blocking the intestine and cause various disease like inflammation (Neighbors et.al, 2015).

According to Wong (2016), people suffering constipation will experience difficulty in passing stools and a change in the shape of stool defecations. The stools are usually hard and irregular shape. Rome III will be used to diagnosis for functional gastrointestinal disorders. People with the following situations at least 3 months can be described as constipation. Straining, hard or lumpy stools, incomplete defecations, intestinal blockage or obstruction, fewer than three stools per week etc. (Schuster et al., 2015).

2. Dietary Habit

In general, dietary fiber and fluid intake are the two nutrients that can help in preventing constipation (Tremayne et al., 2016). Fiber acts as a laxative effect as well as increasing water content and fecal bulk inside the intestine and thus, stimulate the bowel movement to induce peristalsis and secretion. Fiber can also soften the feces and enhance water content, and to add bulk to the stool allowing it moves quicker and easier (Eswaran et al., 2013).

For elderly, an average of 21 to 30 grams of dietary fiber per day is recommended. Elderly can intake dietary fiber from grains, legumes, fruits, and vegetables. (American Dietetic Association, 2008). However, for elderly who suffered from diabetics should not consume a large amount of fruit as fruit may contain relatively high level of fructose which may affect their health condition. They are recommended to intake more vegetables or grains to get enough amount of dietary fiber per day.

In contrast, elderly should avoid consuming oily foods, with little or even no fiber food if they are suffered from constipation. For instance, cheese, fried food, meat, etc. (National Institute of Diabetes and Digestive and Kidney Diseases, 2014).

An adequate amount of fluid intake is also one of the nutritional factors to prevent constipation. This can help in softening the stools, letting them pass out easier. Generally, 6-8 glasses per day of water or fluid including soup, vegetable juice, fruit juice, are recommended for a healthy elderly (Annells, 2003). Some elderly may have a problem with their kidneys, they should follow medical advice from their family doctor.

3. Exercise

Inadequate amount of doing exercise may increase the risk of having constipation. Elderly may not want to walk around because of their body condition. However, a simple walking or other low-level of exercise is already enough to improve bowel movement. This kind of exercise is called non-exercise physical activity (NEPA) (Huang, 2014).

NEPA is recommended for elderly for a better bowel movement. The study has found that the people ought to have a regular defecation time every day to clear their intestine. The most suitable time is having a 30-minute walk after the meal. (Annells, 2003). Have a regular NEPA can assist in gastrointestinal reflex and stimulation of the bowel.

Regarding elderly who are long-term bed rest or inability, a kind of abdominal massage can be performed. The aim is to increase the action of the intestine and peristalsis and to lower the transit time, resulting in easier for the stool to pass through. The massage can be performed twice a week, each time last for 10 to 20 minutes (Connor, 2014).

4. Progress updated and Work accomplished

The topic has been modified into “The relationship between dietary habit, exercise, and constipation among elderly in Hong Kong.” In terms of the keywords for finding information, they are “constipation in Hong Kong”, “elderly”, “nutrition”, “exercise”, “gastrointestinal”, “abdominal” and “constipation treatment for elderly”. More information and journals have been found in the progress, like the details of dietary and exercise etc. Some of them come from Hong Kong and some of them come from other countries. This progress has started to have a deeper look in related criteria, such as dietary habit, exercise etc. The above journals and supporting information from other countries may help in completing the objectives of this report.

5. References

American Dietetic Association. (2008). Position of the American Dietetic Association: Health Implications of Dietary Fiber. Journal of the American Dietetic Association, 108(10), 1716-171.

Annells, M. & Koch, T. (2003). Constipation and the preached trio: diet, fluid intake, exercise. International Journal of Nursing Studies, 40, 843-852.

Connor, M. (2014). Using abdominal massage in bowel management. Nursing Standard, 28(45), 37-42.

Eswaran, S., Muir, J. & Chey, W.D. (2013). Fiber and Functional Gastrointestinal Disorders. The American Journal of Gastroenterology, 108, 718-727.

Huang, R., Ho, S.Y., Lo, W.S. & Lam, T.H. (2014). Physical Activity and Constipation in Hong Kong Adolescents. PLOS ONE, 9(2).

Neighbors, M. & Tannehill-Jones, R. (2015). Human Diseases (4^th ed.). Stamford: Cengage Learning.

Schuster, B.G., Kosar, L. & Kamrul, R. (2015). Constipation in older adults. Canadian Family Physician, 61, 152-158.

Tremayne, P. & Harrison, P. (2016). Gastrointestinal care for older people. Nursing Standard, 30(45), 53-62.

Wong, T.L., Wong, K.W. & Chao, V.K. (2016). A review on the management of constipation in adult in primary care setting. The Journal of The Hong Kong College of Family Physicians, 38(1). Retrieved 20 March from: http://www.hkcfp.org.hk/Upload/HK_Practitioner/2016/hkp2016vol38mar/discussion_paper.html

6. Working Timeline