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Nutrition for Older Adults Priscilla Riedel-Cohan MS, RD, LD, SFNS Lesson Objectives Compare the calorie and nutrient needs of the individual in the later years of the life cycle to that of earlier years. Discuss disease conditions and obstacles to adequacy that may be experienced by the older adult. Calories and Activity Energy needs decrease as people age. This is due to: Decreased activity level Decreased metabolic rate Decreased muscle tone It is important to ensure that older adults do not suffer from the “dwindles.” This is described as: Decreased physical ability to function Diminished mental function Malnutrition Social withdrawal Weight loss Protein and the Older Adult Protein needs remain the same in older adulthood as they did when the adult was younger. The RDA for protein is 0.8 grams per kilogram (kg) of body weight. Alternate protein sources may be necessary because traditional protein foods may be hard to chew. Soft protein foods may be best. Carbohydrate, Fiber, and the Older Adult Carbohydrates remain important for nourishing the brain. Fiber is necessary to help alleviate the constipation that some older adults experience in later life. High fiber foods may include fresh fruits and vegetables as well as high fiber grain products. It is important to make sure foods can be chewed and swallowed, so fiber is often offered in the form of over-the-counter products like Metamucil. Fat, Arthritis, and the Older Adult Good sources of essential fatty acids in the diet continue to be important. Food sources of omega-3 and omega-6 fatty acids include nuts, legumes, and coldwater fish like salmon. Saturated fat and trans fatty acids may contribute to heart disease. A low fat diet may help alleviate the symptoms of rheumatoid arthritis, but it does not address the symptoms of osteoarthritis. Osteoarthritis may be addressed with weight loss. Vitamins and the Older Adult Vitamin A absorption generally improves in later life. Vitamin D synthesis declines and may contribute to osteoporosis. This is particularly important to address with the elderly who are confined to the indoors. Vitamin B12 deficiency is likely with the decrease in production of intrinsic factor necessary for its absorption or when meats are diminished in the diet due to chewing or swallowing difficulties. Water, Minerals, and the Older Adult Dehydration is a major concern for the older adult. It is believed that some dementia or loss of mental function in the elderly may be due to chronic dehydration. The sense of thirst is diminished in the elderly. They are more at risk as a result to become dehydrated. The elderly must make a conscious effort to drink fluids often. A high fiber diet requires the older adult to also consume more water. Iron status generally improves later in life. Zinc deficiency is somewhat common in the elderly primarily because of drug/nutrient interactions. This blunts the sense of taste. Calcium absorption declines with age. Osteoporosis is common in this population. Lactose-free milk can offer an alternative for those individuals who complain of discomfort from drinking milk. A low-dose vitamin/mineral supplement may be helpful to all older adults to ensure nutrient needs are met. Nutrition and Longevity There are 6 factors that have been found to influence the physiological age of an individual. Of those, 3 are nutrition-related: Moderation of alcohol use Regular, nutritious meals Weight control Nutrition and Alzheimer’s Disease There are weak links between the onset of Alzheimer’s disease and nutrition. Research is on-going. Regular meals and wise food choices continue to be at the forefront of good health for people with Alzheimer’s disease. Food Choices of Older Adults Many factors may influence the food choices of the older adult. In particular, older adults experience obstacles to an adequate dietary intake. Tooth loss Inability to chew or swallow Marital or social status Disposable income Multiple medications Social services programs available to the elderly include: Social Security Medicare Food Stamps Meals on Wheels Child and Adult Care Food Program In Summary… The older adult experiences many changes in their nutritional needs at this stage of the life cycle. Their nutritional status may be compromised by disease or other obstacles to adequacy. Caregivers play a major role in maintaining the nutritional health of the older adult.