Nutritional Risk for Older Adults

January 4, 2010

Life expectancy increased more during the 20th century than in any other century. By 2030, one in three persons will be 50 years or older. Most significant in this growth has been the increase in the number of people 65 years and older. In addition, the percentage of those 85 years and older has increased significantly. A contributing factor to this longer life expectancy has been an increased emphasis on health promotion and disease prevention, including a focus on nutritional well being.

Proper nutritional intake is directly linked to the maintenance of health and prevention of disease throughout life. Studies indicate the factors contributing to nutritional risk among older adults are complex. For example, older adults receive a variety of costly and complex medical interventions while the routine availability of adequate food and fluids is often neglected. In 2000, national health care expenditures totaled $750 billion, 30% of which was associated with inappropriate dietary intake. Malnourished individuals experienced longer hospital stays and greater hospital costs.

A large percentage of older Americans have inadequate intakes of energy-rich foods and certain nutrients. Surveys indicate that a large percentage of older adults consume less than two thirds of the Recommended Dietary Allowances (RDA) of vitamins A and D and also experience shortages of several B vitamins. B vitamins are directly linked to maintenance of cognition and slowing of disease progression such as dementia and Alzheimer's disease.

Dietary supplements have been shown to improve energy and specific nutrient intake. Poverty is an indicator of nutrition risk. Approximately 17% of older adults are labeled as "poor" or "near poor." At best, many live on a fixed income. Thus, they may eat fewer meals to compensate for decreased income. Many who live alone may consume the same foods day after day.

Food safety also is a concern. To save expense, older adults were found to take more risk than younger adults regarding eating foods that have been around the house for a while and might be outdated.

What is the answer to this growing concern?

The first step is education. Older adults need to be aware of the nutritional requirements for healthy living. The dietary reference intakes include additional specific requirements for older adults, especially in the area of protein. Here is a great website for promoting nutritional health in the older adult population. It includes the modified Food Guide Pyramid for Older Adults and questions to ask to make early identification of any nutritionally related health problems: www.patienttalk.info/icn_fact_sheet_9.pdf.

In addition, these are some guidelines to follow from a well-known older adult nutritionist:

•Older adults need the same nutrients as younger people, but in differing amounts.

•As you get older, the number of calories needed is usually less than when you were younger. This is because basic body processes require less energy when there is a decline in physical activity and loss of muscles.

•Basic nutrient needs do not decrease with age. In fact, some nutrients are needed in increased amounts. The challenge is to develop an eating plan that supplies plenty of nutrients but not too many calories.

•Choose nutritious foods that are low in fat and high in fiber like whole grain breads and cereals, fruits and vegetables.

•Be sure to include moderate amounts of low-fat dairy products and protein foods like meat, poultry, fish, beans and eggs.

•Sweets and other foods high in sugar, fat and calories can be enjoyed from time to time but the key is to eat them sparingly.

•Calorie needs vary depending on age and activity level but for many older adults 1600 calories each day will meet energy needs. Chosen carefully those 1600 calories can supply a wealth of nutrients. The recommended number of daily servings from each group in the Food Guide Pyramid - with a few additions of fats, oils and sweets - will easily add up to 1600 healthful calories.

•Calcium is important at any age and may need special emphasis as you grow older. Calcium is a mineral that builds strong bones and helps prevent osteoporosis. Many older adults do not eat enough calcium-rich foods and the aging body is less efficient in absorbing calcium from food. In addition, many adults do not get enough weight-bearing exercise - like walking - to help keep bones strong.

•It is not too late to consume more calcium and reduce the risk of bone fractures. Eat at least two to three servings of calcium-rich foods every day. Low-fat milk, yogurt and cheese are good choices. Some dark green, leafy vegetables; canned salmon with edible bones; tofu made with calcium sulfate; and calcium-fortified soy milk can add a significant amount of calcium to your diet.

•Do some weight-bearing exercise like walking for a total of 30 minutes each day.

•The National Institutes of Health advise adults over 65 to consume 1500 mg of calcium daily. This amount may be difficult to achieve through food alone so for some people a calcium supplement is a wise choice. Supplements should be taken between meals. Remember, calcium can hinder the absorption of iron from other foods.

You can find more helpful guideline information at www.gicare.com/Diets/nutrition-for-older-adults.aspx online.