Download An Introduction to Family Nutrition: Aging

An Introduction to Family Nutrition:
Aging Boomers and the Elderly
Section 1: Welcome
Slide 1
Welcome to An Introduction to Family Nutrition, a Texas A&M AgriLife Extension Service
Professional Development Training Program. This six-part series covers nutrition issues
throughout the lifecycle and includes the following topics:

Overview

Baby’s First Year

Toddlers, Preschoolers, and Children

Tweens and Teens

Adults

Aging Boomers and the Elderly
Each session is approximately one hour in length.
This course will be presented in a voice-narrated format that allows you to follow along with a
PowerPoint slide presentation. A high-speed Internet connection is required to complete these
modules. Content for this module, An Introduction to Family Nutrition: Aging Boomers and the
Elderly, is divided into multiple sections (see menu bar on the left for course outline), enabling
you to complete and/or review content at your own pace. Printable handouts, if applicable, will
be presented prior to the section in which they are referenced.
In the next section, you will be directed to complete a brief, multiple-choice pre-learning
assessment. Once you have completed the pre-learning assessment, you will be free to advance
to the course content by checking the “Next Section” button at the bottom of the page. At the
conclusion of this session, you will be directed to complete a post-learning assessment that will
determine if you successfully pass the course.
If at any time you wish to take a break from the module, simply log out and return to the course
when you are ready to continue. When you sign back in to the session, you will be taken
directly to the section where you left off. To review a section you have already completed, click
on the desired section on the left menu bar.
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Section 2: Introduction and Learning Objectives
Slide 2
Thank you for your interest in the Introduction to Family Nutrition series. Aging Boomers and
the Elderly is the sixth and final session in our series. The previous sessions were: Overview;
Baby’s First Year; Toddlers, Preschoolers, and Children; Tweens and Teens; and Adults. I hope
you’ve had the opportunity to complete the sessions in their intended order as they build upon
each other.
In this session, we’ll be addressing the nutritional needs and concerns of Aging Boomers, which
we’re defining as adults aged 50 to 70 years. We’ll also address the nutritional needs and
concerns of the Elderly, which we’re defining as adults over 70 years of age.
After completing this session, reviewing the handouts provided, and performing the application
activity, the participant will be able to:

Describe what is meant by quality of life and explain how lifelong food choices relate to
quality of life,

Name two federal agencies that provide evidence-based information on the aging adult,

Compare and contrast the Instrumental Activities of Daily Living and the Activities of
Daily Living, and

List at least three important nutrient needs of the aging adult.
Slide 3
Each session in the Introduction to Family Nutrition series follows a similar format.
In this session we’ll describe the life stage and characteristics of aging boomers from 50 to 70
years of age and the elderly over the age of 70 years. Then we’ll address nutrition issues that
may be unique to these life stages. Afterwards, we’ll discuss guidance on healthful eating and
physical activity.
The session will end with a list of selected resources for further information.
Handouts are provided to reinforce and provide additional subject matter information.
Completion of the activity at the end of the session will help the participant apply the
presented information.
Section 3: Overview
Slide 4
There’s an exceptionally wide variance in the health and independence of older adults. Health
and life experiences are variable and greatly affect how people age. Some older adults live
independently into their 90s while others need institutional care in their 70s.
Regardless, adults want to preserve their quality of life and retain their independence. We’ll
address quality of life and Activities of Daily Living in more detail later in this session. We’ll also
briefly address the nutritional issues and concerns of older adults.
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Slide 5
Some of the key nutrition issues of baby boomers and the elderly that we’ll address in this
session are: maintaining a healthful weight, protein, vitamins and minerals, hydration,
foodborne illness, and hypertension.
Section 4: Life Stages and Characteristics
Slide 6
Older adults, regardless of their health and circumstances, want to maintain or improve their
quality of life. Adults may underestimate the role that healthful food and beverage choices,
physical activity, and social interaction plays in achieving their quality of life goals.
Nutrition and physical activity are directly associated with achieving optimal quality of life given
a person’s health, genetics, and life experiences.
Slide 7
Health can be defined as a broader concept than simply the absence of disease. Health includes
physical, mental, and social well-being. Quality of life is a subjective construct that includes
well-being and positive health.
Resilience is the mental and emotional ability to flourish or remain positive despite adversity.
Some research suggests this personality trait – resilience – is genetic in origin.
Slide 8
Quality of life is a subjective self-evaluation. It measures how one describes his or her health by
using a five point Likert-type scale that rates from excellent to poor.
Slide 9
Shown in this table, the majority of older adults surveyed rate their quality of life as good to
excellent. Even with advancing age, more than two-thirds of adults over the age of 85 years,
rate their quality of life as good or excellent.
Slide 10
Independence can be measured as a function of Activities of Daily Living. Instrumental Activities
of Daily Living require higher skill sets and may be the first to decline with advancing age and/or
poor health. Activities of Daily Living measure functional mobility and can indicate if someone is
in need of extensive care. In general, Activities of Daily Living are diminished in reverse order of
when they are learned.
Slide 11
Instrumental Activities of Daily Living include complex tasks, such as managing medications and
finances, driving a car, and food preparation. These activities can be objectively measured using
this checklist.
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Slide 12
In contrast, Activities of Daily Living include tasks that are more basic in nature, such as
dressing, using the bathroom, and eating.
As mentioned earlier, maintenance of the Instrumental Activities of Daily Living and the
Activities of Daily Living are dependent on genetics, health, and life experiences. However, the
loss of independence may or may not affect someone’s self-assessment of quality of life.
Slide 13
Frailty increases the risk for falls, hip fractures, and death. Frailty can be clinically defined as the
presence of three or more health indicators, which are: low muscle strength, unintentional
weight loss, feeling exhausted, poor physical performance, and/or the reduction in physical
activity. Some clinicians add the aspects of mood, cognition or intellect, and incontinence,
which is the inability to control bladder and/or bowel functions, to the evaluation for frailty.
One in 10 independently living adults aged 65 years or older is frail.
Section 5: Changes with Age
Slide 14
The acronym, DETERMINE, was developed as an assessment tool by the American Academy of
Family Physicians, the American Dietetic Association, and the National Council on Aging. The
American Dietetic Association is now called the Academy of Nutrition and Dietetics.
DETERMINE doesn’t diagnose poor nutrition but instead suggests risk factors for poor nutrition.
Individuals or their caregivers should discuss with the physician any risk factors that are present
to help determine if a clinical assessment for poor nutrition is needed.
The DETERMINE acronym lists risk factors associated with poor nutrition, such as: disease,
eating poorly, tooth loss, economic factors, reduced social contact, multiple medications,
involuntary weight loss, needing help with self-care, and being over the age of 80 years.
Slide 15
Many people may not know of the link between nutrition and functional independence. For
example, limited protein intake is a risk factor for the muscle wasting often associated with
aging. Also, a lack of adequate dietary calcium and/or physical activity across the lifespan
increases the risk for osteoporosis. Both weighing too much and weighing too little increases
the chances of functional decline.
Specific nutrients affect both short and long term health. Nutrients that may be underconsumed by older adults are calcium and potassium; vitamins D, E, and K; and water. Typical
dietary intakes of sodium exceed recommended limits.
New, but limited, research suggests that healthful diets help to preserve cognition, including
memory. Diets that don’t significantly raise blood insulin levels may help to maintain
intellectual capacity. Such diets include foods such as whole grains, legumes, vegetables, fruit,
and low-fat dairy as well as lean sources of protein. Foods with added sugars would be limited.
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Some research suggests omega-3 fatty acids from fish and seafood, and vitamins B12 and folate
may be helpful to retaining cognitive capacity.
Slide 16
Over half of older adults have hypertension, and many have heart disease. One in 5 have
diabetes. These diseases have well established dietary components. Older adults need to limit
sodium, solid fats, and added sugars.
Slide 17
With advancing age, physiological changes occur that are related to many body organs,
including the gastrointestinal tract, kidneys, and immune system, to name a few. Some of these
changes affect food and beverage intake, metabolism, and excretion. With advancing age, the
senses of taste and smell diminish, as well as the appetite. This can be worsened by the side
effects of medications. It becomes harder for the body to absorb the nutrients vitamin B12 and
iron. Older adults become dehydrated more readily than younger adults because their senses of
thirst and kidney functions are reduced.
Older adults are especially vulnerable to foodborne illness.
Slide 18
Older adults are more likely to eat slowly, be less hungry or thirsty, eat smaller meals, and
snack less often than younger adults. This can result in unintentional weight loss. It’s not
uncommon for adults over the age of 65 years to begin to lose weight without purposefully
dieting. While this may be a welcomed change to gaining weight, it can become a problem if
the adult becomes underweight.
Section 6: Nutrition Issues
Slide 19
Intentional weight loss by older adults may not always be recommended and should be
discussed with a physician. Weight loss, intentional or unintentional, results in the loss of both
adipose and lean body tissues. Loss of muscle mass in older adults and the elderly can affect
overall strength and mobility. Weight loss eating plans for older adults should be developed by
a Registered Dietitian to ensure protein and other nutrient needs are met.
Unintentional weight loss may be an early symptom of a medical condition and should be
brought to the attention of the physician.
Slide 20
The loss of lean tissue mass by older adults can be the result of weight loss and/or eating plans
that don’t include enough protein. As mentioned, this can affect mobility and the ability to live
independently.
Sarcopenia is the loss of muscle mass and strength, and this can occur regardless of a person’s
weight.
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Slide 21
Older adults should inform their physicians of any vitamin/mineral supplements they take.
Sometimes, certain vitamins and/or minerals can interact with medications.
Not unlike teens, older adults often fall prey to nutrition fads and misinformation. This may be
because they’re seeking a cure for a disease or relief from its symptoms. Herbal and other
botanical supplements aren’t regulated by the Food and Drug Administration and don’t have to
prove they’re effective or safe prior to going to market. Supplement claims made by the
manufacturers may be based on testimonials instead of evidence-based research. Older adults
should avoid these products unless under the advisement and supervision of a physician.
Slide 22
Older adults can become dehydrated more quickly than younger adults. This may be caused by
changes in kidney function, medication usage, or other medical conditions. Also, the sense of
thirst is diminished with age. Older adults need to drink fluids even when they’re not thirsty.
Frail adults shouldn’t become full on liquids so as to not be hungry for food. It’s best to drink
small amounts of liquid throughout the day instead of having large beverage servings with
meals.
Slide 23
A 26-page booklet titled Food Safety for Older Adults: A Need-to-Know Guide for Those 65 Years
of Age and Older is provided with this lesson. It was developed by the Food and Drug
Administration and the Food Safety and Inspection Service. The booklet provides evidencebased information for older adults and their care givers.
Foodborne illness can be severe and even fatal in older adults. It’s important to contact the
doctor if a foodborne illness is suspected.
Slide 24
Hypertension and pre-hypertension is common among older adults. Those with high blood
pressure may need to take medication to help maintain normal blood pressure. Reducing the
intake of salt, or sodium, can also be helpful for older adults. Since 70% of the total sodium
intake is from processed foods, it’s important to read food labels. Compare brands for sodium,
and consistently select those food items having the lower sodium level. Try to avoid foods with
20% or more of the Daily Value for sodium.
Accompanying this session are two resources associated with sodium. We’ve provided a
pamphlet from the Food and Drug Administration that’s called Using the Nutrition Facts Label:
A How-To Guide for Older Adults and a handout titled Salt and Sodium: 10 Tips to Help You Cut
Back.
Section 7: Healthful Eating and Physical Activity
Slide 25
Older adults should follow evidence-based eating plans instead of fad diets that eliminate food
items or food groups. Examples of evidence-based eating plans are: the MyPlate eating plan,
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the DASH diet, which stands for Dietary Approaches to Stop Hypertension, and the
Mediterranean Diet. More information on these eating plans can be found in the Dietary
Guidelines for Americans.
Older adults should increase their whole grains and fish consumption and reduce their
consumption of foods with added sodium, solid fat, or sugar. All adults should limit their alcohol
intake, if they choose to drink alcohol. Women should have no more than one serving of
alcohol each day, and men should have no more than two alcohol servings daily.
Older adults should discuss with their doctor their need for B12, calcium, and/or vitamin D
supplements. Doctors have tests to determine if you need these supplements.
Slide 26
As adults age, their need for calories decrease. This requires the careful selection of food
choices based on nutrient content to avoid eating plans with nutrient shortfalls.
Slide 27
With the elderly, getting enough calories to prevent unwanted weight loss and further muscle
loss can be a challenge. Food choices may need to be energy dense. A physician, nurse
practitioner, or Registered Dietitian should be able to offer advice.
Slide 28
It’s especially important that older adults stay active. This will help them to retain their
independence and cognition or intellectual performance.
A fact sheet is provided with this session on physical activity guidelines for adults.
Section 8: Resources
Slide 29
The websites listed on this slide offer science-based information on health, healthful eating,
and physical activity for aging adults. We’ve provided a handout with these selected resources.
Slide 30
This slide shows some informational, evidence-based resources on elder nutrition.
Section 9: Learning Application
Please print and complete An Introduction to Family Nutrition: Aging Boomers and the Elderly Activity that we’ve provided.
Section 10: Author
Slide 31
This lesson series was developed by Dr. Sharon Robinson, a Registered Dietitian and Licensed in
the state of Texas. She is an associate professor and Extension nutrition specialist with the
Texas A&M AgriLife Extension Service in College Station, Texas.
Educational programs of the Texas A&M AgriLife Extension Service are open to all people without regard to race, color, sex, disability, religion, age, or national origin.
The Texas A&M University System, U.S. Department of Agriculture, and the County Commissioners Courts of Texas Cooperating
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