Mindanao State University- Iligan Institute of Technology

College of Nursing

NUTRITION FOR AGING ADULTS

Beluan

Flores

Mamoribid

Potoy

October 3, 2019
Introduction

Senescence is the deterioration of functional characteristics due to biological aging, or older

adulthood. Older adults focus their time on recreational enjoyment, continued professional or
career advancement, and some adjust to retirement and settling into new patterns of activities.

Gerontology is the study of aging and provides insights on the physical, mental, and social
aspects of later years. Preparation for aging actually begins earlier, to prepare the transition of
physical and social aspects of life. The level of wellness during these years of life reflects the
quality of life resulting from health behaviors through several life span stages.

The quality of life for older adults depends on the factors that influence daily experiences. These
experiences include physical activity, social interactions, spirituality, living arrangements,
emotional functioning and level of independence.

Physical, Mental, and Emotional Functioning

During the later years in life, individuals may struggle with death of a family or a friend. They
may also have difficulty in adjusting to retirement. These changes in their social status may lead
to isolation and depression without strong support people. Retirement may cause older adults to
face unexpected poverty, if they have not established finances earlier in life which may lead
them to have insufficient resources to meet their needs that could adversely negatively affect
their nutritional status.

Disorientation on senility is associated with aging, this could be caused by the improper use of
medications, marginal nutrient deficiencies, or dehydration. Older adults sometimes restrict their
fluid intake because of incontinence, nocturia, the excessive urination at night, or the inability to
go to the toilet on their own. Although nutrient needs remain stable, the effects of aging reduce
the ability of the body to synthesize and absorb nutrients.

Nutrition Well-Being

Nutrition status may be affected by restricted access to food and ability to prepare meals. Buying
for food may be a difficulty with aging adult’s problems with mobility to walk through stores or
lack of transportation. Funds for food may also be constrained may also be the problem as almost
all of the older adults have already retired. When foods are acquired, they may have problems
and difficulty with food preparation due to physical limitations. Due to these reasons, they may
lack the nutrients needed by the body, although the required nutrients are the same with middle-
aged adults.

Older Years

Age Group

People in their 60s, 70s, and 80s are considered as older adults.

Physical Activity

Early start on exercising regularly, prepares individual to enter these year with more stamina,
cardiovascular conditioning, and solid health-promoting habits that allows him/her to cope with
the deterioration of physical limitation of later years.

Recommended Exercise for Older Adults:

Muscle-Strengthening Activities

Older adults should participate in muscle-strength activities at least twice a week

that includes all muscle groups: legs, hip, back, chest, abdomen, shoulders, and
arms with one set of 8-12 repetitions of each exercise. Examples are gardening,
carrying groceries, doing yoga exercises and Tai Chi Exercises

Aerobic Activity

It is also known as endurance activities. Examples are brisk walking, jogging,

biking, dancing, and swimming. Older adults are required of at least 150 minutes
(2 hours and 30 minutes) of aerobic exercise per week. It is advised to participate
in aerobic activities three times a week.. It helps avoid excess fatigue and reduce
risk of injury.

Balance Activities

Older adults are at risk of falling, thus they need to participate in activities that
improve their balance, to reduce risk of accidental injuries due to fall. It is
recommended to participate in balance activities 3 days a week. Examples are
heel walking, sideway walking, toe walking, and standing from sitting position.

Living Arrangement

Living arrangement affects nutritional status. Older adults have many options to choose
from, ranges from retirement communities, living with other family members, or continue living
in their home.

Living in their Own Home or with Family Members

Living in one’s own home provides freedom to prepare and eat foods whenever
desired; illness however, may make shopping and cooking food difficult.
 Retirement Communities and Assisted Living Centers

These types of living arrangement consist of separate houses, condominiums or

apartments for residents which offer meals, laundry services, nursing care, transportation,
and social activities. Seniors live independently.

Nursing Homes or Long-Term Care Facilities

Older adults with health conditions may reside in long-term care facilities or
nursing homes. Extended or long-term care facility is also known as nursing home. This
care facility include independent living quarters for seniors such as; assisted living
facilities that provide levels of personal care for those with chronic health conditions and
are unable to care for themselves.

Nutrition Requirements

Vitamins

The Dietary Reference Intake (DRI) for vitamin intake of older adults remains constant except
for Vitamin D, and Vitamin B12.

Vitamin D

Vitamin D synthesis is reduced as people age. The AI for vitamin D intake for people
older than 50 years old increases to 15 mcg a day. People older than 70 years old need to
take Vitamin D, 15 mcg a day. Older adults either need to increase exposure to sunlight
or take Vitamin D supplement.

Vitamin B12

As people age, there is a decrease in the production of gastric juices and intestinal
enzymes which also reduce one’s digestion and absorption. The intrinsic factor required
for Vitamin B12 absorption also decreased which may cause pernicious anemia.
Supplements or consumption of foods with Vitamin B12 is necessary in order to meet the
RDA of 2.4 mcg a day.

Minerals

Zinc

As people age, taste receptors also decrease. One cause is the marginal deficiency of
Zinc. The deficiency of Zinc can heighten the bitter and sour flavors and reduces the
sweet and salty sensations. This change in taste can cause loss of appetite to older adults,
this can also cause them to use excessive salt and sugar to make food appealing to their
taste which can negatively affect their health and exacerbate diet-related health problems
such as diabetes and hypertension.

Iron

Iron requirements for premenopausal women are more than twice that for men, but after
the age of menopause those requirements decrease so that requirements are the same for
 both sexes RDA is 8 mg/day. Iron deficiency in the elderly is more commonly the result
of illness than inadequate intake.
Calcium

Ninety-nine percent of the calcium content of the human body is contained in the
skeleton, it makes sense that an adequate calcium intake should be an important part of
the nutritional plan for most elderly.

Protein

According to nitrogen balance studies, healthy adults have an average minimum dietary
protein requirement of 0.66 g per kg of ideal body weight, and a calculated RDA of 0.8 g per kg.
This recommendation is the same for both young and older adults. While appropriate for
establishing the minimum amount of protein required for short term homeostasis, balance studies
are not designed to determine optimal clinical outcomes, and a number of authors have suggested
that the protein requirement for the elderly should be increased to 1.0 to 1.2 g per kg per day or
higher, and recommendations for protein intake for adults over the age of 70 years

Water

The daily water intake required for adults is about 30 mL per kg, or about 1,500 to 2,500
mL. The percentage of whole body water decreases modestly with age, hence, loss of fluid is
more significant in the elderly. When confronted with dehydration, the elderly kidney, even in
the absence of disease, loses some ability to conserve water because of a loss in concentrating
ability

Problems in Nutrient Intake

Dental Health

Dental condition affects the intake of nutrients as it decrease chewing ability of older adults.
Loss of teeth caused by periodontal disease may limit ability to chew meat. Thus, older adults
opt for food they can gum rather than chew.
Oldest Years

Age Group

People in their 80s and 90s belong in these stage of life.

 Malnutrition and underweight become a concern during this age.

 Illness and accompanying medications may reduce appetite.

 Malnutrition is associated with increased complications.

 Risk for dehydration.

 Risk increases because of decreased ability of kidneys to concentrate urine, limited

movement, drug interactions, and malfunctioning thirst sensation.

 Limited ability to move may increase fears of incontinence that lead to decreased fluid
intake.

SIGNS OF DEHYDRATION IN OLDER ADULTS

Confusion

Weakness

A hot, dry body

Furrowed tongue

Decreased skin turgor (may not be valid finding in older adults)

Rapid pulse

Elevated urinary sodium

RISK FACTORS FOR MALNUTRITION

Alcoholism

Anorexia

Chewing and swallowing problems (dysphagia) Consuming only one meal a day

Dental difficulties

Depression or dementia

Diabetes

Diminished physical functioning

Feeding problems

Food purchasing/preparation difficulties Impaired acuity of taste and smell

Living in long-term care institution

Loss of spouse

Taking multiple medications

Nerve disorders

Poverty

Pulmonary disease

Surgery

10 simple Dietary Guidelines To Help You Stay Well Into Older Age:

1.) Balance your food intake with physical activity.

2.) Include a carbohydrate food at each meal.

3.) Aim for five servings of fruits & vegetables each day.

4.) Stay fit and strong by eating a variety of protein-rich foods each day.

5.) Keep your bones healthy by having three servings of low-fat dairy foods (milk, yoghurt, or
cheese) each day.

6.) Choose heart-healthy fats.

7.) Use less salt.

8.) Limit amount of foods high in ‘empty calories’ like biscuits, cakes, savoury snacks (crisps,
peanuts), sweets, confectionary.

9.) Stay hydrated.

10.) Alcohol should be enjoyed in moderation.

Some Important Nutrients To Consider:

1.) Fiber

2.) Calcium and Vitamin D

3.) Iron and Vitamin B12

EXERCISE!!!

STRATEGIES FOR OVERCOMING BARRIERS TO GOOD NUTRITION

 Counteract Decreased Senses of Taste and Smell

 Recommend smokers refrain from smoking at least 1 hour before meals.
 Suggest sipping water before and during the meal to moisten a dry mouth.
 Amplify flavors with the use of seasonings other than salt. Recommend chewing food
thoroughly to fully release flavor and aroma.
 Vary food textures and flavors.
 Encourage Social Interaction
 Find others who are willing to share food preparation and mealtimes.
 Investigate congregate meal programs available through senior citizen centers, religious
organizations, and hospital community outreach programs.
 Avoid noisy dining areas if hearing aids are used.
 Present Food Attractively
 Use colorful foods and table settings. Provide enough lighting to see food clearly.
 Provide Outside Support
 Arrange for Meals-on-Wheels for homebound adults.
 Refer eligible clients to the Food Stamp Program, Emergency Food Assistance Program,
Child and Adult Care Program,or community food banks or soup kitchens.
 Locate grocery stores with delivery service.
 Refer to the Expanded Food and Nutrition Education Program (EFNEP) of the
Cooperative Extension Service for recipes, meal suggestions, and budgeting assistance.
 Refer to home health nurse for routine nutrition screening and appropriate interventions.
Health promotion is an important focus in the present health care environment. As the
population ages, the potential strain on health care systems will increase because the greatest use
of health care services occurs during the last years of life.

Diet as a Factor in Health

Diet is a major factor in the development of conditions and diseases, including non-insulin-
dependent diabetes, coronary heart disease, atherosclerosis, stroke, and cancer—5 of the 10
leading causes of death in the United States. There is much speculation that if nutritional
interventions are instituted early, health care expenditures will be significantly reduced as a
result of a decrease in the incidence or the delayed onset of these conditions (Chernoff, 2001)

Health promotion integrates nutrition education and focuses on three areas of knowledge:
(1) Adequate intake of nutrients found in foods (rather than supplements)
(2) The relationship between diet and disease
(3) Moderate kcal intake coupled with regular exercise for physical fitness and obesity
prevention.

Techniques

Many strategies can be used for adult health promotion:

1. To reduce risk of diet-related disorders such as coronary heart disease, some cancers, type 2
DM and obesity, consider:

• Scheduling routine food shopping so staples such as fruits, vegetables, and grains are available
for meal preparation.

• When shopping, occasionally compare fat content of commonly purchased foods with similar
products; purchase the lower-fat product.

• Aiming to limit visible fat-containing foods.

• Reorganizing work and personal priorities if necessary to allow time for meal preparation and
consumption; for example, get up earlier for breakfast, pack a lunch or afternoon snack, preplan
easy-to-prepare dinner menus.

• Keeping track of dietary intake using MyPyramid or the Fruits & Veggies—More Matters plan.

2. To reduce osteoporosis risk and strengthen bone health, consider:

• Focusing on routine dietary habits—for example, drink a glass of milk at lunch each day. A
food pattern assessment can assist in creating a practical calcium consumption plan.

3. To decrease the risk of sodium-sensitive hypertension and coronary artery disease, consider:

• Adopting the DASH (Dietary Approach to Stop Hyper- tension) eating plan, this focuses on
increasing intake of fruits and vegetables.

• Learning food categories that are generally salty, and either consume them only occasionally
or, if available, purchase low-sodium versions of products
• Reducing overall fat intake, particularly saturated fat.
4. To achieve a healthy body weight and decrease the possibility of diet- and lifestyle-related
obesity, consider:

• Responding to actual hunger with low-fat, high-fibre foods (with occasional splurges), rather
than focusing on dietary restrictions.
• Exercising regularly to increase stamina, strength, and a sense of wellness. Depending on
conditioning, incorporate exercise gradually. A 10-minute walk may be comfortable for some,
but others can begin with more strenuous endeavours.

Prevention
1. Coronary heart disease
 Whole-grain breads and pasta, brown rice, whole-grain bagels
 Fresh, frozen, baked, or steamed fruits and vegetables
 Steamed, baked, or fresh foods
 Fat-free milk
 Fish, skinless poultry, lean cuts of meat (with fat trimmed away), soy products
 Egg whites, egg substitutes
2. Diabetes Mellitus 2
 Low-carb veggies- mushrooms, onions, eggplant, tomatoes, Brussels sprouts, and
low-carb squashes, like zucchini
 Greens- Try kale and spinach, and chard
 Flavourful, Low- calorie Drinks- water added with a fresh cut of lemon, cucumber,
cinnamon stick
 Whole-grain, Higher-fibre foods- legumes like dried beans, peas, and lentils
 Protein- Greek yogurt, cottage cheese, eggs, and lean meats.
3. Osteoporosis
 Calcium and vitamin D
 Protein- Lean red meat, poultry and fish, as well as eggs and dairy foods, are
excellent sources of animal protein. Vegetable sources of protein include legumes
(e.g. lentils, kidney beans), soya products (e.g. tofu), grains, nuts and seeds.
 Fruits and Vegetables
 B Vitamins and Homocysteine- Vitamins B6 and B12, as well as folic acid, play a
role in changing homocysteine into other amino acids for use by the body, so it is
possible that they might play a protective role in osteoporosis.
 Magnesium- Particularly good sources of magnesium include green vegetables,
legumes, nuts, seeds, unrefined grains and fish
 Vitamin A- animal origin, such as liver and other offal, fish liver oils, dairy foods and
egg yolk. Some plant foods contain a precursor of vitamin A, for example in green
leafy vegetables, and red and yellow coloured fruits and vegetables.
 Vitamin K- sources include leafy green vegetables such as lettuce, spinach and
cabbage, liver and some fermented cheeses and soya bean products
 Zinc- Sources of zinc include lean red meat, poultry, whole grain cereals, pulses and
legumes.

What is DASH?
Dietary Approaches to Stop Hypertension (DASH) is an eating plan to lower or control high
blood pressure. The DASH diet emphasizes foods that are lower in sodium as well as foods that
are rich in potassium, magnesium and calcium — nutrients that help lower blood pressure.
The DASH diet features menus with plenty of vegetables, fruits and low-fat dairy products, as
well as whole grains, fish, poultry and nuts. It offers limited portions of red meats, sweets and
sugary beverages.
References
Michele Grodner, Sara Long Roth, Bonnie C. Walkingshaw. (March 22, 2011). Life Span Health
Promotion:. In Nutritional Foundations and Clinical Applications A NURSING APPROACH
Fifth Edition (pp. 277-292). United States of America: ELSEVIER MOSBY.

The Journals of Gerontology: Series A, Volume 56, Issue suppl_2, 1 October 2001, Pages 47–53,
https://doi.org/10.1093/gerona/56.suppl_2.47
Coronary Artery Disease: How Your Diet Can Help. (2003, April 15). Retrieved from
https://www.aafp.org/afp/2003/0415/p1769.html.
Friedman, J. D. A. (n.d.). Diabetes-Friendly Diet: 7 Foods that Control Blood Sugar. Retrieved
from https://www.webmd.com/diabetes/features/diabetic-diet-6-foods-control-blood-sugar#2.
Nutrition. (n.d.). Retrieved from https://www.iofbonehealth.org/nutrition

The Journals of Gerontology: Series A, Volume 56, Issue suppl_2, 1 October 2001, Pages 47–53,
https://doi.org/10.1093/gerona/56.suppl_2.47
Coronary Artery Disease: How Your Diet Can Help. (2003, April 15). Retrieved from
https://www.aafp.org/afp/2003/0415/p1769.html.
Friedman, J. D. A. (n.d.). Diabetes-Friendly Diet: 7 Foods that Control Blood Sugar. Retrieved
from https://www.webmd.com/diabetes/features/diabetic-diet-6-foods-control-blood-sugar#2.
Nutrition. (n.d.). Retrieved from https://www.iofbonehealth.org/nutrition.
Sample menus for the DASH diet. (2018, February 24). Retrieved from
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-
20047110.