nutrition . older adult nutrition

older adult nutrition: big picture

• older adults have needs that are very individualized (ex: less people in household, passing away, children leaving) 

• nutrition status and needs of older adults are multifactorial

• the main focus of nutrition intervention in this age group is to maintain health and quality of life across a continuum of aging 

physiology of aging

• aging is considered the gradual decline of organ function, beginning as early as 30s to 40s

• it is a multifactorial conequences of the interaction between behaviors/lifestyle and genetic makeup

• can be altered by diseases, health behaviors (diet, physical activities), life style choices (substance abuse), socioeconomic condition (access to medical care and preventative services)

bodily systens: changes

• GI TRACT (oral, stomach, intestines)- difficulty in chewing / swallowing

• Body composition

• - sacropenia (loss of muscle mass)

• cardiovascular and respiratory system

• renal system

• skeletal system

• immune, nervous, endocrine

factors that affect diet

• medical

• physical

• social

• cultural

• economic

diet options keep shrinking in this age group

factors that influence aging and quality of life 

• medical / health status 

• physical / functional status 

• cognition 

• environmental 

barriers can inhibit food intake (in slides)

many factors affect food choices: psychological, physiological, behavioral, health, social, function, environmental

nutrition requirements for older adults

• macronutrients

• -energy (energy needs lower/decreased - 1. less exercise 2.metabolisim slows down 3.lean muscle mass is replaced with fat)

• -protein (need more for tissue repairment, etc)

• -fiber (keeps you full. still important. fiber is great if you want to eat less, but can be a problem for adults who build it up

• -fluid

my plate for older adults 

fruits and vegs

healthy oils

herbs and spices = to enhance flavor of foods and reduce the need to add salt in this age group

fluids

grains

dairy

protein

nutrient requirements for older adults

Micronutrients, cont.
• B12, folate
• Calcium (little lighter) - (vascular, muscular, nerve, blood clotting) - absorption
• Vitamin D (promote protein synthesis in muscle) – skin, kidney (this age group does not go out as much)
• Iron – intake vs. prevalence of deficiency (less common here due to periods stopping)
• Zinc – no known increased needs, but higher risk of deficiency
• Sodium – why does sodium intake increase in this age group?
• Antioxidants – cancer, CVD, AMD; can go overboard
• Carotenoids – alpha-carotene, beta-carotene, lutein, zeaxanthin, lycopene, beta-cryptoxanthin

complementary and alternative medicine (CAM)

CAM includes supplements, herbs, also acupuncture, others 

complementary (used together WITH traditional medicine)

alternative (used INSTEAD of traditional medicine)

integrative (used together with traditional medicine)

• more than half of older adults report CAM, including supplements 

• only 22% of older adults who use complementary practices, including dietary supplements, discuss with their physician 

nutritional risk factors in older adults 

Efforts to consume a healthy diet can be
negatively affected by: physiologic and
medical factors, social factors, economic
factors, physical/functional limitations
• What is the driving economic situation for
many (most?) older adults?
• >10% below poverty level; median income
was $25,601 in 2018

>85 yrs old = the inability to work on a fixed income at this age group. changes what they can afford to buy- might not buy much food if by themselves. 

• What are common psychological
concerns? Social? Cognitive?

what does it take to make a meal ? (in class discussion)

• if i were 75 years old, very complicated to cook a meal

• cooking involves physical movements: chopping , cutting, carrying groceries

• differences in cognitive

Foodborne illness is deadly in this age group. Across the population,
according to the CDC:
• 48 million get sick from food yearly
• 128,000 are hospitalized
• 3,000 die (from food borne illness)
• Undercooked food, poor handwashing, and high-risk foods are main
culprits
• What are some high-risk foods?

lunch meat, soft cheeses, melons (not washed/refrigritated), sushi, undercooked eggs

Nutrition Services & Programs for Older
Adults

Administration for Community Living
• 28% of older adults live alone; increases with age (44% of women over 75 years live alone)
• Medicare; Affordable Care Act – limited coverage of nutrition services
• Home and Community-Based Services Waiver program under the
Social Security Act – nutrition services include home-delivered meals,nutrition risk-reduction counseling, nutrition supplements
• Older Americans Act – home delivered meals (Meals on Wheels);
congregate meal

Nutrition Services & Programs for Older Adults,
cont

USDA Nutrition Programs
• SNAP (electronic debit card)
• Commodity Supplemental Food Program (monthly food package)
• The Emergency Food Assistance Program (food pantries)
• Child and Adult Care Food Program (day centers)
• Senior Farmers Market Nutrition Program (vouchers)

physical activity

What is different about the benefits of PA in older adults compared to
previous age groups we have discussed?
• Functional
• Therapeutic PA
• Social
• Incorporating the four components: strength, endurance, flexibility,
balance