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Nutrition: Key to Healthy Long Term Care Presented to HOTWAGS June 11, 2008 Suzy Weems, PhD, RD, CSSD, LD Good Nutrition: Essential to Successful Aging • Essential for – Health – Functionality – Positive quality of life • Nutrition ‘s role may be – Preventative – Management Good Nutrition: Essential to Successful Aging • Nutrition facilitates healthy aging by – Lowering the risk for diseases – Improving / maintaining mental function – Improving physical function – Socially engaging in life Nutrition Intervention Lowers Risk for Disease • 80% older population have 1 chronic disease • 50% have 2 or more chronic diseases • Average 75 year old has 3 chronic diseases and takes 5 prescription drugs • 9 out of 10 of these have a condition that could be improved through nutrition intervention – 52 – 168 million folks are hypertensive – 54 – 164 million have high cholesterol levels – 132 – 330 million are diabetic Nutrition Intervention – Mental Function • Cognition – Nutrients • Vitamins B-6, B-12, Folate • Minerals – Iron • Water – Food sources • • • • Lean protein Fruits Vegetables Whole grains • Attitude Nutrition Intervention – Physical • Functional • Dentures • GI tract changes • Change in body mass • Muscle mass • Fat mass • Water • Loss of bone • Posture • Security with activity Nutrition Intervention – Physical • Eyes – Retinal degeneration • β-carotene • Dark green or yellow/orange fruits and veggies – Visual acuity • Fruits • Vegetables • Phytochemicals + vitamins Nutrition Intervention • Brain – Short term memory • B-6 + Ascorbic acid – Problem solving • Riboflavin + folate + Ascorbic Acid + B-12 – Dementia • Thiamin + niacin + zinc – Brain tissue degeneration • Pyridoxine • α-tocopherol Nutrition Intervention – Social • Spouse / significant other – Person – Pet – Plant • Congregate Meals • Meals delivered Specific Challenges for Optimizing Long Term Nutritional Care • Eating – Food is a basic need – Mechanical issues • Appetite – Meet sensory needs – Taste – Feel – Smell • Restrictive diets – Balance the Benefits & Risks Specific Challenges for Optimizing Long Term Nutritional Care • Polypharmacy – Drugs – Herbs – Supplements • Psychological -- depression • Balance – Quality of Life & Nutritional Status Solutions /Strategies • Dentition – Check with dentist – Alter food texture • • • • Chop Steam Stew Grate or grind hard foods – grated carrots & raisin salad Solutions /Strategies • Osteoporosis – Weight bearing exercise + calcium rich diet • • • • Milk – skimmed or buttermilk Yogurt Cheese Lots of green ‘leafies’ Solutions /Strategies • Challenges with visual acuity – Bright distinct colors – food – Contrast on plate – Big print – Magnifying help with labels Solutions / Strategies • Challenges with hearing – Check hearing – ASK for info – Check with the ‘waiter’ Solutions / Strategies • Challenges with smell / taste – Variety of food flavors – Special diet? Try • • • • Lemon juice Vinegar Dill Curry – Reawaken senses to fresh, flavorful foods with texture Practical Strategy – Eat Food • Lean Protein – – Muscle Mass / Function – + iron, zinc, B-12, B-6 – + calcium, riboflavin, B-12 Practical Strategy – Eat Food • Fruits – + vitamin C – + β-carotene & other carotenoids – Potassium – Fiber Practical Strategy – Eat Food • Vegetables – + vitamin C – + β-carotene & other carotenoids – Fiber Practical Strategy – Eat Food • Whole Grain – + vitamin E – + thiamin, riboflavin, niacin – Fiber – Incomplete process • Selected Fats (nuts, oils, etc) – Omega – 3 fatty acids – Vitamin E Take Home Message • Good Nutrition is a major determinate for successful aging • Good Nutrition is essential for – Health – Independence – Quality of Life • Message – – Food is the key Or . . . The better choice