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Capstone
Spring 2010
Leeron Franco
Elderly Obesity
An interdisciplinary-based plan approach
Problem Statement
How can the roles retirement facilities play in
the obesity of their residents be changed
for the better?
Relevant Disciplines
 Biology: The science of life or living matter in all
its forms and phenomena, especially with
reference to origin, growth, reproduction,
structure, and behavior.
 Economics: The study of market forces and
their effects on human behavior.
 Sociology: The study of society and societal
interactions.
 Religion: A specific fundamental set of beliefs
and practices generally agreed upon by a
number of persons/sects.
Relevant Disciplines:
What roles do retirement facilities play in
the obesity of their residents?
Discipline
Assumption
Perspective
Biology
Genetics control ones biochemical
interactions of which effect obesity
in that person.
Views obesity as a result of
Genetic predispositions to gaining
weight.
Economics
Cheaper food (most likely
unhealthy) is easier to prepare and
serve.
Views obesity in terms of goods
and services provided to an obese
market.
Sociology
The living environment has a strong
influence on the dietary habits of
elderly people.
Sees societal influences as
playing a role in the eating
patterns of the elderly.
Religion
Certain religions have their own
specific dietary laws that may
hinder ones health and lead to
obesity.
Certain dietary laws must be
followed no matter the health
concerns.
Discipline
Theory
Insight
Biology
Obesity can be genetic ie. the risk of being
obese is greatest in those whose parents
were obese. The theory of ENPP1 has
identified that variants of ENPP1 are
associated with childhood and adult obesity
of which increase the risk of glucose
intolerance and type 2 Diabetes.
This theory recognizes the fact that there is a
certain genetic variable that predisposes
humans to being obese throughout their life. By
identifying and accommodating to this factor by
whatever means possible, may help curb weight
gain later in life.
Economics
The theory of supply and demand will find
the most affordable way to serve the most
amount of people with little regards for
health concerns.
The theory of supply and demand doesn’t work
in the best interest of the elderly when it comes
to the food served in retirement facilities.
Getting the most food for the lowest price is
always the goal. This usually isn’t the healthiest
choices for people.
Sociology
The Conflict theory is based entirely on
power and how those in power do all they
can to hold the majority of the population
down and to keep them from gaining power,
so as to secure their own position.
Conflict theorists would say that obesity is a
product of the living conditions, stress and poor
quality of food and health education that those
in power choose and enforce for those that
aren't in power. Those that are in power (law
makers, company owners, etc) willingly set up
society so that the cheaper the good is, the
better it is for them, and so most people might
only be able to afford cheap, unhealthy bulk
food and become susceptible to obesity.
Religion
The Law of Koshrut, also known as the
Jewish Dietary Law, inflicts restrictions on
certain foods allowed to be eaten.
The dietary laws of the Jewish people prevents
them from eating certain foods such as selfish
and swine. Also, the food must be blessed by a
Rabbi before it can officially be considered
kosher. The preparation is more thorough which
makes the food more expensive to buy. People
opt to buy the non-kosher meats and food
because it is a lot cheaper.
Justification of
Interdisciplinary Approach
Elderly obesity in long-term care facilities is a complex question that can only
be resolved through an interdisciplinary approach, research, and collaboration. In
order to understand this phenomena, I began by identifying the main causes of
obesity in the elderly, including social, religious, biological, and sociological factors. I
believe that retirement facilities play a significant role in the obesity of the elderly and
feel that with the use of an interdisciplinary approach, this would expose these factors
contributing to it.
Retirement facilities have such a great impact on the eating habits of the
elderly. For example, many facilities chose to serve the cheapest food because they
are catering to such a large group of people. Elderly people already face enough
challenges with less mobility and the feeling of their bodies shutting down. The food
that these facilities choose to serve to their residents, is most likely the only food they
eat throughout the day. At this point, many of the residents don’t drive, so they spend
most of their time in these long-term care facilities. Along with bad eating habits,
long-term care don’t always cater to the physical needs of the elderly. At this point in
their lives, the elderly try to do whatever they can to elongate their lives as much as
possible.
By looking at this problem from the interdisciplinary perspective, taking into
account the social, economic, biological, and religious influences on elderly eating, I
feel able to add new dimension to this area of study. Elderly obesity can only be
resolved when all of these factors come together to resolve this social dilemma.
Analysis:
The Problem With Elderly Obesity
Elderly obesity in retirement facilities has become a wide-spread societal problem, affected
by economic, biological, economical, and religious factors. Research has shown that genetics
play a significant role in a person’s weight throughout their entire life. Geneticists have come up
with a theory stating one specific gene can predispose a person to being obese due to its effect on
their metabolic components.
Economics plays a role in what food is being served in these facilities. Facilities try to find
the cheapest food to buy to serve such large amounts of people. Being that pasta is very cheap
and easy to prepare makes it a prime candidate for most of the dishes being served. Consuming
such high amounts of carbohydrates and not burning off the calories greatly affects the health of
the elderly.
Social research has shown that elderly living in these types of facilities are more prone to
infection and obesity. Long-term care facilities try to cater to the needs of their residents, however
they are a business and must make a profit as well. Because of this, they try to feed the residents
with the cheapest, not always the healthiest, types of food. This includes foods high in calories,
fat, and carbohydrates. Unfortunately having a salad bar is hard to maintain because produce is
considered expensive and doesn’t last as long as other food groups. These facilities also don’t
always go out of their way to offer physical activities, such as ay to offer physical activities, such
as yoga and aerobics because of the costs. These types of decisions make a difference in the
lives of the residents living there.
Religion plays a slightly smaller role in the foods the elderly consume. There are
retirement facilities that cater to elderly of a specific religion. For example, Jewish retirement
facilities need to offer a Kosher Menu because the Jewish People follow a strict dietary law, called
Kashrut, that prohibits them from consuming certain foods such as shellfish. Also, the actual
process of “kosherizing” the food is lengthy and expensive. This is were decisions need to be
made so the facility doesn’t end up losing money.
Due to these factors affecting the weight of the elderly, the solution has become complex
as the problem. All the factor’s in a person’s life (that they have control over) need to change in
order to avoid further complications with obesity and other health problems. The solution
proposed needs to be an integrated effort of these disciplines so as to be most effective.
Conflicts
Studies have shown that both nature and nurture influence obesity later in life. Many
scientists are for one or the other in terms of which has a greater influence on obesity in
the elderly. With this in mind, more scientists are leaning towards genetics being the
greater factor in obesity because it is based on factual evidence. In other words, some
people are predisposed to being obese even before they are born and allow their
environment to have any kind of influence on them.
Biology- Nature
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As a result of one specific gene,
nature makes people more susceptible
to being obese later on in life.
Apparently, the offspring of two obese
parents will inevitably become obese
themselves no matter what actions are
taken to avoid this.
Sociology- Nurture

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
People who are predisposed to being
obese because of their parents, may
avoid being obese themselves
because of certain actions they can
take (ie. Eating healthy foods and
exercising).
People brought up this way tend to
remain a normal weight because of
outside forces.
The environment is a determining
factor when it comes to obesity, this
may be a good or bad thing.
Common Ground
 The field of epigenetics studies other factors aside from genetics
that can affect a person’s genome and phenotype (physical
appearance). This gives credibility to the theory of the environment
(nurture) having some kind of influence on obesity.
 Epigenetics helps bridge hard and soft sciences (objective vs.
subjective subjects) such as biology and sociology by unifying them
into one theory. It accepts theories and perspectives of these
individual disciplines and combines them into a unified theory.
Common Ground Vocabulary
 Epigenetics- the approximately stepwise process by which genetic
information, as modified by environmental influences, is translated
into the substance and behavior of an organism.
 Hard science- any of the natural or physical sciences, as chemistry,
biology, physics, or astronomy, in which aspects of the universe are
investigated by means of hypotheses and experiments.
 Soft science- any of the specialized fields or disciplines, as
psychology, sociology, anthropology, or political science, that
interpret human behavior, institutions, society, etc., on the basis of
scientific investigations for which it may be difficult to establish
strictly measurable criteria.
**All definitions courtesy of Dictionary.com**
A new approach…
 The connection between hard and soft
sciences (in relation to elderly obesity) is
becoming more evident. An
interdisciplinary approach is necessary to
handle the convergence of these
disciplines to propose a solution.
 My experience gained through
volunteering at Kinneret has helped shape
my proposed solution, hoping to integrate
numerous disciplines.
An interdisciplinary proposal to
address elderly obesity via
Kinneret
My Observation
Volunteering at Kinneret’s dining services has opened my eyes to the foods
being offered to the residents. To start off, each resident is giving bread with butter
along with a small side of pasta salad. The meal following this appetizer depends on
the day, especially if it happens to be a holiday. On one occasion, I happened to
volunteer on Chinese Night. The menu included egg drop soup, fried rice, egg foo
yong, and chicken with vegetables. To top this off, the residents were given either a
cookie or slice of fruit for dessert. The food for that night was high in cholesterol, fat,
carbohydrates, and sodium.
On another occasion, I happened to have volunteered on the Sabbath. Being
that Kinneret is a Jewish retirement facility, this night called for a more festive menu
including matzo ball soup, salad, baked chicken or salmon, and mashed potatoes.
This is a typical menu for any Jewish family on a Friday night.
A great benefit about living at Kinneret is the keeping of Kashrut, also known as
the Jewish dietary laws. This puts restrictions on what they can not serve including
shellfish and swine. This means only kosher meat is being offered. Kosher meat is
prepared in a much cleaner environment then non-kosher meat which is why it is
much more expensive. Because of this and budget cuts, the rest of the menu is filled
with cheaper, unhealthy dishes. The breads, pastas, and rice being offered are not
the best choices for the elderly living there. Eating these types of foods all day
everyday puts a strain on their health.
I also noticed vending machines offering unhealthy snacks (for example
Snickers and Kit Kats) and sodas outside of the main room where the residents
spend most of their time. By doing this, the elderly are tempted to purchase these
snacks that only hurt them later on.
Education
 Have nutrition-trained staff to educate
the residents on making healthy
choices and portion control when it
comes to the food options being
offered to them.
 Offer healthy cooking workshops to
show the residents different dishes that
are easy to prepare, healthy, and
affordable.
 Have weekly meetings with a
Nutritionist/Dietician to evaluate the
residents and explain to them certain
foods they should avoid or eat more of
so as to live a longer, happier, healthier
life.
 Have pamphlets filled with healthy
eating choices and recipes available
Meal Plan
 Offer meal plans that provide

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more options that are low in fat
and sodium.
Incorporate fresh fruits and
vegetables into every dish being
prepared. This makes the plate
both colorful and healthy.
Feature heart-smart items such as
grilled fish, salads, and nuts.
Offer healthy snacks throughout
the day that help with memory and
focus, especially in the vending
machines.
Emphasize grilled, baked, or raw
goods rather than fried.
Physical Education
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Encourage the residents to get as much
exercise as they're capable of doing, even if
it's simply walking around the facility.
Providing well-lit sidewalks for them to use
throughout the day or night.
Offer exercise classes everyday that help
build strength and prevent the residents
from becoming weak and frail. Classes that
aren’t as intense such as yoga are great and
don’t require expensive machines.
Provide incentives for active residents such
as cheaper rent or better meal options.
Make the facility vibrant with flowers and
trees to add a sense of positive ambiance
when walking around.
Take weekly trips to places such as parks
and beaches that encourage exercising.
Set up residents with individual exercise
programs ran by a hired trainer.
Get involved with the community and
participate in Walk-A-Thons that fight
different health diseases such as cancer and
diabetes.
Have on-site active competitions that involve
the residents and their families. This builds
strength and memories to last forever!
Further Insight Into The Plan

Education: The more we educate the elderly are about their food intake, the better
off their personal health will be. Many of the residents at Kinneret come from
different backgrounds but if there was someone there to show them how to make
healthy food choices, they’d all be on the same page and feel more comfortable.
This will also get the seniors excited when it comes to eating. Training the staff can
be a cheaper alternative to hiring a dietician.

Meal Plan: Most elderly people want to live long and happy lives. In order to live a
long life, they must watch what they eat. Foods high in fat and cholesterol make the
elderly prone to infections and sickness. However, by adding more vegetables and
fruits to their menu, Kinneret will help build the immunity of their residents at fighting
off diseases. By changing the menu weekly to the vegetables that are on sale that
week, will help reduce the costs of Kinneret substantially.

Exercise: Physical activity is very important as a person grows older because if not,
their body begins to turn frail. By adding exercise programs, this encourages the
residents to work out and keep their bodies in shape. This is also a great way for the
seniors to get involved with the communittee and socialize with others. They will feel
a sense of personal accomplishment and connection towards others. Making these
activities fun helps when being associated with food. By exercising with equipment
already available (ex. chairs), Kinneret is saving money on buying high-tech gym
machines. Also, walk-a-thons are both for a good cause and free.
The Bottom Line
 Research has shown that genetic predispositions, economical,
sociological, and religious factors account for obesity in elderly
residents in retirement facilities.
 These factors are being studied by disciplinarians who look to find a
solution to this problem by incorporating the different disciplines
together.
 Studies have shown that obesity in elderly is not solely due to their
genes but also the environment in which they live in, i.e. theory of
Epigenetics.
 By applying an interdisciplinary approach to the problem, the
solution will be more successful because it integrates numerous
disciplines problems into one.
The End