Chapter 5

Nutrition and the Elderly

Outline

Introduction Screening &

Intervention Basic Nutrition

Overview

Special Considerations Physiological Impact

of Aging on Nutrition Summary

Summary of Factors that Influence Nutrition in the Elderly Physiological

– Health Status

– Chronic Disease

– Changes in appetite

– Physical disability

– Sensory acuity

– Physical activity

– Use of alcohol or other drugs

– Lifelong diet habits

Socioeconomic– Culture/ethnicity– Income– Education– Lifestyle– Nutrition knowledge &

practice– Cooking skills– Susceptibility to food fads– Institutionalization

More factors:

Psychological– Belief system

– Motivation-Self-image

– Mental state

– Degree of independence

– Feeling of usefulness

– Presence or absence of spouse

– Social contacts-loneliness

Environmental– Type & location of housing

– Adequacy of cooking facilities

– Proximity of family & friends

– Availability, accessibility, & adequacy of food supply

– Health service

Screening and Intervention Nutrition Screening

Initiative: the premise of the initiative is that nutrition status is a “vital sign” that is just as important in evaluating a person’s health & well-being as the traditional vital signs of blood pressure & pulse.

Basic Nutrition Overview:

Essential Nutrients: 6 classes of nutrients– Carbohydrates– Proteins– Fats– Vitamins– Minerals– Water

• These nutrients are essential for promoting growth,, maintenance, & repair of our bodies.

Carbohydrates: Simple carbohydrates: sugars Complex carbohydrates:

starches At least 50% or more of our

calories should come from eating foods that are good sources of complex carbohydrates because they are nutrient rich & have fiber.

Include grains, legumes (dried beans & peas), fruits & vegetables, cereals, pasta, & rice.

Simple carbohydrates:Sugar Cane High in simple sugars,

(monosaccharides-cakes, candies, cookies, & sodas (empty calorie foods)= high in calories & low in nutrient value. Fruit & fruit juices also have simple sugars, but they come packaged from Nature with many essential nutrients. No more than 20% of total carbohydrates. Simple sugars: Glucose (the sugar in blood);Fructose(the sugar in fruit-honey);

Galactose (sugar made from milk sugar)

Fiber: complex carbohydrate

Major sources=whole grains,fruits, legumes, vegetables, nuts & seeds.

Much of the fiber in our diet is processed away when whole grains are refined & the bran portion is removed.

Not an essential nutrient, necessary to keep our intestinal tract healthy. Binds water, causing softer, bulkier stools that move through the intestinal tract more quickly.

Fiber:

Researchers believe diets with adequate fiber help reduce risk of colon cancer.

Fiber also thought to bind carcinogens, or cancer-causing agents, & stools with more water lessen the potency of the cancer-causing agents in the waste material.

Adequate fiber helps prevent constipation, diverticular disease, & hemorrhoids. Soluble fiber(legumes,oats,rice,fruit)may cholesterol levels.

Protein:

Proteins are the main substances that the body uses to build & repair tissues such as muscle, blood, internal organs, hair, nails,& bones. Proteins are part of hormones, antibodies, & enzymes. Enzymes are proteins that catalyze the biochemical reactions that take place in the metabolism of the body.

Fats:

Primary function of fats, or lipids, in the body is as a rich source of energy. Fat helps insulate & regulate body temperature, it surrounds internal organs & protects them from external injury, & it is the carrier of the fat-soluble vitamins A,D,E,& K.There are two essential fatty acids-linoleic & linolenic acid. Fat calories should account for no more than 30% of total calories.

Vitamins:

Vitamins are substances that are needed by the body to maintain metabolism, growth, & development.

There are 13 vitamins, 2 categories. Water-soluble=Vitamins C &B complex.Fat soluble-A,D,E,K.

Minerals: There are 23 minerals that

are essential for human nutrition.

Perform numerous functions in the body, including metabolism, maintenance of fluid balance,bone & teeth formation,blood clot-ting,muscle& nerve function&red cells.

Planning meals-good nutrition

Adequacy Balance Calorie Control Moderation Variety

Food Guide Pyramid:

Foundation= bread, cereal, rice, & pasta.

Next=fruits & vegetables

Next=milk, yogurt, & cheese

Next=meat, poultry, fish, dry beans, eggs & nuts.

Top=fats,oils,sweets.

Food Preparation for the Elderly:

Small, frequent meals Low in fat,sugar,

cholesterol, & salt. Convenience foods that

are healthy. Quick & easy snacks. Cheerful environment. Regular exercise. Shop & eat with

neighbors.

Liquid Nutritional Supplements:

Ensure Sustacal

Boost

Choice DM

250cal-9g.protein6gfat 240cal-14.5gprotein

9g fat 240cal.-10.2g.protein

4.1g.fat 250cal.-10.6g.protein

12 g.fat.

Drugs that affect appetite:

Decongestant Amphetamines Appetite suppressant

drug Appetite stimulant Lithium Tranquilizers Steroids

Dental Health:

Total loss of teeth in 55% in adults older than 85

44% age 75-84 30% age 65-74.

Thirst, Dehydration, GI Tract

Dehydration: Dry lips; Sunken eyes; Swollen tongue; Increased body temperature; Decreased blood pressure; Constipation; Decreased urine output; Nausea

GI Tract: Increase dietary fiber

Liver-GB, Pancreas, Cardiovascular Liver function

complicated with alcohol abuse.

Gallbladder malfunction = gallstones.

Cardiovascular:Heart healthy diet and exercise.

Drug & Nutrient Interactions

Value of Appropriate Nutrition:

The value of appropriate nutrition screening & intervention cannot be underestimated in providing quality care for the elderly.

Good nutrition not only optimizes health & well-being, it helps prevent the onset of many chronic diseases.