{"id":501,"date":"2019-03-11T19:33:23","date_gmt":"2019-03-11T19:33:23","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/?post_type=chapter&#038;p=501"},"modified":"2019-04-15T14:17:51","modified_gmt":"2019-04-15T14:17:51","slug":"13-8-old-age-and-nutrition","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/chapter\/13-8-old-age-and-nutrition\/","title":{"raw":"13.8: Old Age and Nutrition","rendered":"13.8: Old Age and Nutrition"},"content":{"raw":"<div id=\"zimmerman_1.0-ch13_s07_n01\" class=\"learning_objectives \">\r\n<div id=\"skills\">\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Learning Objectives<\/h3>\r\n<ul>\r\n \t<li>Summarize nutritional requirements and dietary recommendations for elderly adults.<\/li>\r\n \t<li>Discuss the most important nutrition-related concerns during the senior years.<\/li>\r\n \t<li>Discuss the influence of diet on health and wellness in old age.<\/li>\r\n<\/ul>\r\n<\/div>\r\n<span style=\"font-size: 1rem;text-align: initial\">Beginning at age fifty-one, requirements change once again and relate to the nutritional issues and health challenges that older people face. After age sixty, blood pressure rises and the immune system may have more difficulty battling invaders and infections. The skin becomes more wrinkled and hair has turned gray or white or fallen out, resulting in hair thinning. Older adults may gradually lose an inch or two in height. Also, short-term memory might not be as keen as it once was.<\/span><span id=\"zimmerman_1.0-fn13_037\" class=\"footnote\" style=\"font-size: 1rem;text-align: initial\">Beverly McMillan,\u00a0<em class=\"emphasis\">Illustrated Atlas of the Human Body<\/em>\u00a0(Sydney, Australia: Weldon Owen, 2008), 260.<\/span>\r\n\r\n<\/div>\r\n<\/div>\r\n<p id=\"zimmerman_1.0-ch13_s07_p02\" class=\"para \">In addition, many people suffer from serious health conditions, such as cardiovascular disease and cancer. Being either underweight or overweight is also a major concern for the elderly. However, many older adults remain in relatively good health and continue to be active into their golden years. Good nutrition is often the key to maintaining health later in life. In addition, the fitness and nutritional choices made earlier in life set the stage for continued health and happiness.<\/p>\r\n\r\n<div id=\"zimmerman_1.0-ch13_s07_s01\" class=\"section\">\r\n<div id=\"section_1\" class=\"mt-section\">\r\n<h2 id=\"Older_Adulthood_(Ages_Fifty-One_and_Older):_The_Golden_Years-624\">Older Adulthood (Ages Fifty-One and Older): The Golden Years<\/h2>\r\n<p id=\"zimmerman_1.0-ch13_s07_s01_p01\" class=\"para \">An adult\u2019s body changes during old age in many ways, including a decline in hormone production, muscle mass, and strength. Also in the later years, the heart has to work harder because each pump is not as efficient as it used to be. Kidneys are not as effective in excreting metabolic products such as sodium, acid, and potassium, which can alter water balance and increase the risk for over- or underhydration. In addition, immune function decreases and there is lower efficiency in the absorption of vitamins and minerals.<\/p>\r\n\r\n<div id=\"zimmerman_1.0-ch13_s07_s01_fx01\" class=\"informalfigure small block\">\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"279\"]<img class=\"internal\" src=\"https:\/\/med.libretexts.org\/@api\/deki\/files\/4091\/imageedit_17_6567127242.jpg?revision=1\" alt=\"imageedit_17_6567127242.jpg\" width=\"279\" height=\"295\" \/> <em>Figure\u00a013.8.1:\u00a0Regular exercise, along with a nutritious diet, can help older adults maintain their health. Image used with permission (Public Domain;\u00a0National Institutes of Health).<\/em>[\/caption]\r\n<p class=\"para\"><\/p>\r\n\r\n<\/div>\r\n<p id=\"zimmerman_1.0-ch13_s07_s01_p02\" class=\"para \">Older adults should continue to consume nutrient-dense foods and remain physically active. However, deficiencies are more common after age sixty, primarily due to reduced intake or malabsorption. The loss of mobility among frail, homebound elderly adults also impacts their access to healthy, diverse foods.<\/p>\r\n\r\n<div id=\"zimmerman_1.0-ch13_s07_s01_s01\" class=\"section\">\r\n<div id=\"section_2\" class=\"mt-section\">\r\n<h3 id=\"Energy-624\">Energy<\/h3>\r\n<p id=\"zimmerman_1.0-ch13_s07_s01_s01_p01\" class=\"para \">Due to reductions in lean body mass and metabolic rate, older adults require less energy than younger adults. The energy requirements for people ages fifty-one and over are 1,600 to 2,200 calories for women and 2,000 to 2,800 calories for men, depending on activity level. The decrease in physical activity that is typical of older adults also influences nutritional requirements.<\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<div id=\"zimmerman_1.0-ch13_s07_s01_s02\" class=\"section\">\r\n<div id=\"section_3\" class=\"mt-section\">\r\n<h3 id=\"Macronutrients-624\">Macronutrients<\/h3>\r\n<p id=\"zimmerman_1.0-ch13_s07_s01_s02_p01\" class=\"para \">The AMDRs for carbohydrates, protein, and fat remain the same from\u00a0<a title=\"13.5: Older Adolescence and Nutrition\" href=\"https:\/\/med.libretexts.org\/Bookshelves\/Nutrition\/Book%3A_An_Introduction_to_Nutrition_(Zimmerman)\/13%3A_From_Childhood_to_the_Elderly_Years\/13.5%3A_Older_Adolescence_and_Nutrition\" rel=\"internal\">middle age into old age<\/a>. Older adults should substitute more unrefined carbohydrates for refined ones, such as whole grains and brown rice. Fiber is especially important in preventing constipation and diverticulitis, and may also reduce the risk of colon cancer. Protein should be lean, and healthy fats, such as omega-3 fatty acids, are part of any good diet.<\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<div id=\"zimmerman_1.0-ch13_s07_s01_s03\" class=\"section\">\r\n<div id=\"section_4\" class=\"mt-section\">\r\n<h3 id=\"Micronutrients-624\">Micronutrients<\/h3>\r\n<p id=\"zimmerman_1.0-ch13_s07_s01_s03_p01\" class=\"para \">An increase in certain micronutrients can help maintain health during this life stage. The recommendations for calcium increase to 1,200 milligrams per day for both men and women to slow bone loss. Also to help protect bones, vitamin D recommendations increase to 10\u201315 micrograms per day for men and women. Vitamin B<sub class=\"subscript\">6<\/sub>\u00a0recommendations rise to 1.7 milligrams per day for older men and 1.5 milligrams per day for older women to help lower levels of homocysteine and protect against cardiovascular disease. As adults age, the production of stomach acid can decrease and lead to an overgrowth of bacteria in the small intestine. This can affect the absorption of vitamin B<sub class=\"subscript\">12<\/sub>\u00a0and cause a deficiency. As a result, older adults need more B<sub class=\"subscript\">12<\/sub>\u00a0than younger adults, and require an intake of 2.4 micrograms per day, which helps promote healthy brain functioning. For elderly women, higher iron levels are no longer needed postmenopause and recommendations decrease to 8 milligrams per day. People over age fifty should eat foods rich with all of these micronutrients.<\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<div id=\"zimmerman_1.0-ch13_s07_s02\" class=\"section\">\r\n<div id=\"section_5\" class=\"mt-section\">\r\n<h2 id=\"Nutritional_Concerns_for_Older_Adults-624\">Nutritional Concerns for Older Adults<\/h2>\r\n<p id=\"zimmerman_1.0-ch13_s07_s02_p01\" class=\"para \">Dietary choices can help improve health during this life stage and address some of the nutritional concerns that many older adults face. In addition, there are specific concerns related to nutrition that affect adults in their later years. They include medical problems, such as disability and disease, which can impact diet and activity level. For example, dental problems can lead to difficulties with chewing and swallowing, which in turn can make it hard to maintain a healthy diet. The use of dentures or the preparation of pureed or chopped foods can help solve this problem. There also is a decreased thirst response in the elderly, and the kidneys have a decreased ability to concentrate urine, both of which can lead to dehydration.<\/p>\r\n\r\n<div id=\"zimmerman_1.0-ch13_s07_s02_s01\" class=\"section\">\r\n<div id=\"section_6\" class=\"mt-section\">\r\n<h3 id=\"Sensory_Issues-624\">Sensory Issues<\/h3>\r\n<p id=\"zimmerman_1.0-ch13_s07_s02_s01_p01\" class=\"para \">At about age sixty, taste buds begin to decrease in size and number. As a result, the\u00a0<span class=\"margin_term\">taste threshold<\/span>\u00a0is higher in older adults, meaning that more of the same flavor must be present to detect the taste. Many elderly people lose the ability to distinguish between salty, sour, sweet, and bitter flavors. This can make food seem less appealing and decrease the appetite. An intake of foods high in sugar and sodium can increase due to an inability to discern those tastes. The sense of smell also decreases, which impacts attitudes toward food. Sensory issues may also affect the digestion because the taste and smell of food stimulates the secretion of digestive enzymes in the mouth, stomach, and pancreas.<\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<div id=\"zimmerman_1.0-ch13_s07_s02_s02\" class=\"section\">\r\n<div id=\"section_7\" class=\"mt-section\">\r\n<h3 id=\"Gastrointestinal_Problems-624\">Gastrointestinal Problems<\/h3>\r\n<p id=\"zimmerman_1.0-ch13_s07_s02_s02_p01\" class=\"para \">A number of gastrointestinal issues can affect food intake and digestion among the elderly. Saliva production decreases with age, which affects chewing, swallowing, and taste. Digestive secretions decline later in life as well, which can lead to atrophic gastritis (inflammation of the lining of the stomach). This interferes with the absorption of some vitamins and minerals. Reduction of the digestive enzyme lactase results in a decreased tolerance for dairy products. Slower gastrointestinal motility can result in more constipation, gas, and bloating, and can also be tied to low fluid intake, decreased physical activity, and a diet low in fiber, fruits, and vegetables.<\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<div id=\"zimmerman_1.0-ch13_s07_s02_s03\" class=\"section\">\r\n<div id=\"section_8\" class=\"mt-section\">\r\n<h3 id=\"Dysphagia-624\">Dysphagia<\/h3>\r\n<p id=\"zimmerman_1.0-ch13_s07_s02_s03_p01\" class=\"para \">Some older adults have difficulty getting adequate nutrition because of the disorder dysphagia, which impairs the ability to swallow. Any damage to the parts of the brain that control swallowing can result in dysphagia, therefore stroke is a common cause. Dysphagia is also associated with advanced dementia because of overall brain function impairment. To assist older adults suffering from dysphagia, it can be helpful to alter food consistency. For example, solid foods can be pureed, ground, or chopped to allow more successful and safe swallow. This decreases the risk of aspiration, which occurs when food flows into the respiratory tract and can result in pneumonia. Typically, speech therapists, physicians, and dietitians work together to determine the appropriate diet for dysphagia patients.<\/p>\r\n\r\n<div id=\"zimmerman_1.0-ch13_s07_s02_s03_n01\" class=\"video \">\r\n<div class=\"note1\">\r\n<div class=\"textbox\">\r\n<h3 class=\"boxtitle\">DYSPHAGIA<\/h3>\r\n\r\n<hr \/>\r\n\r\nThis video provides information about the symptoms and complications of dysphagia.\r\n<div class=\"mt-video-widget mt-video-width-50\">\r\n<div>\r\n\r\n[embed]https:\/\/www.youtube.com\/embed\/Wd-3Csr8K3A[\/embed]\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<div id=\"zimmerman_1.0-ch13_s07_s02_s04\" class=\"section\">\r\n<div id=\"section_9\" class=\"mt-section\">\r\n<h3 id=\"Obesity_in_Old_Age-624\">Obesity in Old Age<\/h3>\r\n<p id=\"zimmerman_1.0-ch13_s07_s02_s04_p01\" class=\"para \">Similar to other life stages, obesity is a concern for the elderly. Adults over age sixty are more likely to be obese than young or middle-aged adults. As explained throughout this chapter, excess body weight has severe consequences. Being overweight or obese increases the risk for potentially fatal conditions that can afflict the elderly. They include cardiovascular disease, which is the leading cause of death in the United States, and Type 2 diabetes, which causes about seventy thousand deaths in the United States annually.<span id=\"zimmerman_1.0-fn13_038\" class=\"footnote\">Centers for Disease Control, National Center for Health Statistics. \u201cDeaths and Mortality.\u201d Last updated January 27, 2012.\u00a0<a class=\"link external\" href=\"http:\/\/www.cdc.gov\/nchs\/fastats\/deaths.htm\" target=\"_blank\" rel=\"external nofollow noopener\">http:\/\/www.cdc.gov\/nchs\/fastats\/deaths.htm<\/a>.<\/span>\u00a0Obesity is also a contributing factor for a number of other conditions, including arthritis.<\/p>\r\n<p id=\"zimmerman_1.0-ch13_s07_s02_s04_p02\" class=\"para \">For older adults who are overweight or obese, dietary changes to promote weight loss should be combined with an exercise program to protect muscle mass. This is because dieting reduces muscle as well as fat, which can exacerbate the loss of muscle mass due to aging. Although weight loss among the elderly can be beneficial, it is best to be cautious and consult with a health-care professional before beginning a weight-loss program.<\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<div id=\"zimmerman_1.0-ch13_s07_s02_s05\" class=\"section\">\r\n<div id=\"section_10\" class=\"mt-section\">\r\n<h3 id=\"The_Anorexia_of_Aging-624\">The Anorexia of Aging<\/h3>\r\n<p id=\"zimmerman_1.0-ch13_s07_s02_s05_p01\" class=\"para \">In addition to concerns about obesity among senior citizens, being underweight can be a major problem. A condition known as the\u00a0<span class=\"margin_term\">anorexia of aging<\/span>\u00a0is characterized by poor food intake, which results in dangerous weight loss. This major health problem among the elderly leads to a higher risk for immune deficiency, frequent falls, muscle loss, and cognitive deficits. Reduced muscle mass and physical activity mean that older adults need fewer calories per day to maintain a normal weight. It is important for health care providers to examine the causes for anorexia of aging among their patients, which can vary from one individual to another. Understanding why some elderly people eat less as they age can help health-care professionals assess the risk factors associated with this condition. Decreased intake may be due to disability or the lack of a motivation to eat. Also, many older adults skip at least one meal each day. As a result, some elderly people are unable to meet even reduced energy needs.<\/p>\r\n<p id=\"zimmerman_1.0-ch13_s07_s02_s05_p02\" class=\"para \">Nutritional interventions should focus primarily on a healthy diet. Remedies can include increasing the frequency of meals and adding healthy, high-calorie foods (such as nuts, potatoes, whole-grain pasta, and avocados) to the diet. Liquid supplements between meals may help to improve caloric intake.<span id=\"zimmerman_1.0-fn13_039\" class=\"footnote\">Morley, J. E. \u201cAnorexia of Aging: Physiologic and Pathologic.\u201d\u00a0<em class=\"emphasis\">Am J Clin Nutr<\/em>\u00a066 (1997): 760\u201373.\u00a0<a class=\"link external\" href=\"http:\/\/www.ajcn.org\/content\/66\/4\/760.full.pdf\" target=\"_blank\" rel=\"external nofollow noopener\">http:\/\/www.ajcn.org\/content\/66\/4\/760.full.pdf<\/a>.<\/span>\u00a0Health care professionals should consider a patient\u2019s habits and preferences when developing a nutritional treatment plan. After a plan is in place, patients should be weighed on a weekly basis until they show improvement.<\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<div id=\"zimmerman_1.0-ch13_s07_s02_s06\" class=\"section\">\r\n<div id=\"section_11\" class=\"mt-section\">\r\n<h3 id=\"Vision_Problems-624\">Vision Problems<\/h3>\r\n<p id=\"zimmerman_1.0-ch13_s07_s02_s06_p01\" class=\"para \">Many older people suffer from vision problems and a loss of vision. Age-related macular degeneration is the leading cause of blindness in Americans over age sixty.<span id=\"zimmerman_1.0-fn13_040\" class=\"footnote\">American Medical Association,\u00a0<em class=\"emphasis\">Complete Guide to Prevention and Wellness<\/em>\u00a0(Hoboken, NJ: John Wiley &amp; Sons, Inc., 2008), 413.<\/span>\u00a0This disorder can make food planning and preparation extremely difficult and people who suffer from it often must depend on caregivers for their meals. Self-feeding also may be difficult if an elderly person cannot see his or her food clearly. Friends and family members can help older adults with shopping and cooking. Food-assistance programs for older adults (such as Meals on Wheels) can also be helpful.<\/p>\r\n<p id=\"zimmerman_1.0-ch13_s07_s02_s06_p02\" class=\"para \">Diet may help to prevent macular degeneration. Consuming colorful fruits and vegetables increases the intake of lutein and zeaxanthin. Several studies have shown that these antioxidants provide protection for the eyes. Lutein and zeaxanthin are found in green, leafy vegetables such as spinach, kale, and collard greens, and also corn, peaches, squash, broccoli, Brussels sprouts, orange juice, and honeydew melon.<span id=\"zimmerman_1.0-fn13_041\" class=\"footnote\">American Medical Association,\u00a0<em class=\"emphasis\">Complete Guide to Prevention and Wellness<\/em>\u00a0(Hoboken, NJ: John Wiley &amp; Sons, Inc., 2008), 415.<\/span><\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<div id=\"zimmerman_1.0-ch13_s07_s02_s07\" class=\"section\">\r\n<div id=\"section_12\" class=\"mt-section\">\r\n<h3 id=\"Neurological_Conditions-624\">Neurological Conditions<\/h3>\r\n<p id=\"zimmerman_1.0-ch13_s07_s02_s07_p01\" class=\"para \">Elderly adults who suffer from dementia may experience memory loss, agitation, and delusions. One in eight people over the age sixty-four and almost half of all people over eighty-five suffer from Alzheimer\u2019s, which is the most common form of dementia. These conditions can have serious effects on diet and nutrition as a person increasingly becomes incapable of caring for himself or herself, which includes the ability to buy and prepare food, and to self-feed.<\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<div id=\"zimmerman_1.0-ch13_s07_s03\" class=\"section\">\r\n<div id=\"section_13\" class=\"mt-section\">\r\n<h2 id=\"Longevity_and_Nutrition-624\">Longevity and Nutrition<\/h2>\r\n<p id=\"zimmerman_1.0-ch13_s07_s03_p01\" class=\"para \">The foods you consume in your younger years influence your health as you age. Good nutrition and regular physical activity can help you live longer and healthier. Conversely, poor nutrition and a lack of exercise can shorten your life and lead to medical problems. The right foods provide numerous benefits at every stage of life. They help an infant grow, an adolescent develop mentally and physically, a young adult achieve his or her physical peak, and an older adult cope with aging. Nutritious foods form the foundation of a healthy life at every age.<\/p>\r\n\r\n<div id=\"zimmerman_1.0-ch13_s07_s03_n01\" class=\"key_takeaways \">\r\n<div id=\"section_14\" class=\"mt-section\">\r\n<div class=\"textbox key-takeaways\">\r\n<h3>Key Takeaways<\/h3>\r\nAs adults age, physical changes impact nutrient needs and can result in deficiencies.\u00a0The daily energy requirements for adults ages fifty-one and over are 1,600 to 2,200 calories for women and 2,000 to 2,800 calories for men, depending on activity level.\u00a0Older adults are more susceptible to medical problems, such as disability and disease, which can impact appetite, the ability to plan and prepare food, chewing and swallowing, self-feeding, and general nutrient intake.\u00a0A nutrient-dense, plant-based diet can help prevent or support the healing of a number of disorders that impact the elderly, including macular degeneration and arthritis.\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<div id=\"zimmerman_1.0-ch13_s07_s03_n02\" class=\"exercises \">\r\n<div id=\"section_15\" class=\"mt-section\">\r\n<h3 id=\"Discussion_Starter-624\">Discussion Starter<\/h3>\r\n<ol id=\"zimmerman_1.0-ch13_s07_s03_l02\" class=\"orderedlist\">\r\n \t<li>Revisit the predictions you made at the beginning of this chapter about how nutrient needs might change as a healthy young adult matures into old age. Which predictions were correct? Which were incorrect? What have you learned?<\/li>\r\n<\/ol>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>","rendered":"<div id=\"zimmerman_1.0-ch13_s07_n01\" class=\"learning_objectives\">\n<div id=\"skills\">\n<div class=\"textbox learning-objectives\">\n<h3>Learning Objectives<\/h3>\n<ul>\n<li>Summarize nutritional requirements and dietary recommendations for elderly adults.<\/li>\n<li>Discuss the most important nutrition-related concerns during the senior years.<\/li>\n<li>Discuss the influence of diet on health and wellness in old age.<\/li>\n<\/ul>\n<\/div>\n<p><span style=\"font-size: 1rem;text-align: initial\">Beginning at age fifty-one, requirements change once again and relate to the nutritional issues and health challenges that older people face. After age sixty, blood pressure rises and the immune system may have more difficulty battling invaders and infections. The skin becomes more wrinkled and hair has turned gray or white or fallen out, resulting in hair thinning. Older adults may gradually lose an inch or two in height. Also, short-term memory might not be as keen as it once was.<\/span><span id=\"zimmerman_1.0-fn13_037\" class=\"footnote\" style=\"font-size: 1rem;text-align: initial\">Beverly McMillan,\u00a0<em class=\"emphasis\">Illustrated Atlas of the Human Body<\/em>\u00a0(Sydney, Australia: Weldon Owen, 2008), 260.<\/span><\/p>\n<\/div>\n<\/div>\n<p id=\"zimmerman_1.0-ch13_s07_p02\" class=\"para\">In addition, many people suffer from serious health conditions, such as cardiovascular disease and cancer. Being either underweight or overweight is also a major concern for the elderly. However, many older adults remain in relatively good health and continue to be active into their golden years. Good nutrition is often the key to maintaining health later in life. In addition, the fitness and nutritional choices made earlier in life set the stage for continued health and happiness.<\/p>\n<div id=\"zimmerman_1.0-ch13_s07_s01\" class=\"section\">\n<div id=\"section_1\" class=\"mt-section\">\n<h2 id=\"Older_Adulthood_(Ages_Fifty-One_and_Older):_The_Golden_Years-624\">Older Adulthood (Ages Fifty-One and Older): The Golden Years<\/h2>\n<p id=\"zimmerman_1.0-ch13_s07_s01_p01\" class=\"para\">An adult\u2019s body changes during old age in many ways, including a decline in hormone production, muscle mass, and strength. Also in the later years, the heart has to work harder because each pump is not as efficient as it used to be. Kidneys are not as effective in excreting metabolic products such as sodium, acid, and potassium, which can alter water balance and increase the risk for over- or underhydration. In addition, immune function decreases and there is lower efficiency in the absorption of vitamins and minerals.<\/p>\n<div id=\"zimmerman_1.0-ch13_s07_s01_fx01\" class=\"informalfigure small block\">\n<div style=\"width: 289px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"internal\" src=\"https:\/\/med.libretexts.org\/@api\/deki\/files\/4091\/imageedit_17_6567127242.jpg?revision=1\" alt=\"imageedit_17_6567127242.jpg\" width=\"279\" height=\"295\" \/><\/p>\n<p class=\"wp-caption-text\"><em>Figure\u00a013.8.1:\u00a0Regular exercise, along with a nutritious diet, can help older adults maintain their health. Image used with permission (Public Domain;\u00a0National Institutes of Health).<\/em><\/p>\n<\/div>\n<p class=\"para\">\n<\/div>\n<p id=\"zimmerman_1.0-ch13_s07_s01_p02\" class=\"para\">Older adults should continue to consume nutrient-dense foods and remain physically active. However, deficiencies are more common after age sixty, primarily due to reduced intake or malabsorption. The loss of mobility among frail, homebound elderly adults also impacts their access to healthy, diverse foods.<\/p>\n<div id=\"zimmerman_1.0-ch13_s07_s01_s01\" class=\"section\">\n<div id=\"section_2\" class=\"mt-section\">\n<h3 id=\"Energy-624\">Energy<\/h3>\n<p id=\"zimmerman_1.0-ch13_s07_s01_s01_p01\" class=\"para\">Due to reductions in lean body mass and metabolic rate, older adults require less energy than younger adults. The energy requirements for people ages fifty-one and over are 1,600 to 2,200 calories for women and 2,000 to 2,800 calories for men, depending on activity level. The decrease in physical activity that is typical of older adults also influences nutritional requirements.<\/p>\n<\/div>\n<\/div>\n<div id=\"zimmerman_1.0-ch13_s07_s01_s02\" class=\"section\">\n<div id=\"section_3\" class=\"mt-section\">\n<h3 id=\"Macronutrients-624\">Macronutrients<\/h3>\n<p id=\"zimmerman_1.0-ch13_s07_s01_s02_p01\" class=\"para\">The AMDRs for carbohydrates, protein, and fat remain the same from\u00a0<a title=\"13.5: Older Adolescence and Nutrition\" href=\"https:\/\/med.libretexts.org\/Bookshelves\/Nutrition\/Book%3A_An_Introduction_to_Nutrition_(Zimmerman)\/13%3A_From_Childhood_to_the_Elderly_Years\/13.5%3A_Older_Adolescence_and_Nutrition\" rel=\"internal\">middle age into old age<\/a>. Older adults should substitute more unrefined carbohydrates for refined ones, such as whole grains and brown rice. Fiber is especially important in preventing constipation and diverticulitis, and may also reduce the risk of colon cancer. Protein should be lean, and healthy fats, such as omega-3 fatty acids, are part of any good diet.<\/p>\n<\/div>\n<\/div>\n<div id=\"zimmerman_1.0-ch13_s07_s01_s03\" class=\"section\">\n<div id=\"section_4\" class=\"mt-section\">\n<h3 id=\"Micronutrients-624\">Micronutrients<\/h3>\n<p id=\"zimmerman_1.0-ch13_s07_s01_s03_p01\" class=\"para\">An increase in certain micronutrients can help maintain health during this life stage. The recommendations for calcium increase to 1,200 milligrams per day for both men and women to slow bone loss. Also to help protect bones, vitamin D recommendations increase to 10\u201315 micrograms per day for men and women. Vitamin B<sub class=\"subscript\">6<\/sub>\u00a0recommendations rise to 1.7 milligrams per day for older men and 1.5 milligrams per day for older women to help lower levels of homocysteine and protect against cardiovascular disease. As adults age, the production of stomach acid can decrease and lead to an overgrowth of bacteria in the small intestine. This can affect the absorption of vitamin B<sub class=\"subscript\">12<\/sub>\u00a0and cause a deficiency. As a result, older adults need more B<sub class=\"subscript\">12<\/sub>\u00a0than younger adults, and require an intake of 2.4 micrograms per day, which helps promote healthy brain functioning. For elderly women, higher iron levels are no longer needed postmenopause and recommendations decrease to 8 milligrams per day. People over age fifty should eat foods rich with all of these micronutrients.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"zimmerman_1.0-ch13_s07_s02\" class=\"section\">\n<div id=\"section_5\" class=\"mt-section\">\n<h2 id=\"Nutritional_Concerns_for_Older_Adults-624\">Nutritional Concerns for Older Adults<\/h2>\n<p id=\"zimmerman_1.0-ch13_s07_s02_p01\" class=\"para\">Dietary choices can help improve health during this life stage and address some of the nutritional concerns that many older adults face. In addition, there are specific concerns related to nutrition that affect adults in their later years. They include medical problems, such as disability and disease, which can impact diet and activity level. For example, dental problems can lead to difficulties with chewing and swallowing, which in turn can make it hard to maintain a healthy diet. The use of dentures or the preparation of pureed or chopped foods can help solve this problem. There also is a decreased thirst response in the elderly, and the kidneys have a decreased ability to concentrate urine, both of which can lead to dehydration.<\/p>\n<div id=\"zimmerman_1.0-ch13_s07_s02_s01\" class=\"section\">\n<div id=\"section_6\" class=\"mt-section\">\n<h3 id=\"Sensory_Issues-624\">Sensory Issues<\/h3>\n<p id=\"zimmerman_1.0-ch13_s07_s02_s01_p01\" class=\"para\">At about age sixty, taste buds begin to decrease in size and number. As a result, the\u00a0<span class=\"margin_term\">taste threshold<\/span>\u00a0is higher in older adults, meaning that more of the same flavor must be present to detect the taste. Many elderly people lose the ability to distinguish between salty, sour, sweet, and bitter flavors. This can make food seem less appealing and decrease the appetite. An intake of foods high in sugar and sodium can increase due to an inability to discern those tastes. The sense of smell also decreases, which impacts attitudes toward food. Sensory issues may also affect the digestion because the taste and smell of food stimulates the secretion of digestive enzymes in the mouth, stomach, and pancreas.<\/p>\n<\/div>\n<\/div>\n<div id=\"zimmerman_1.0-ch13_s07_s02_s02\" class=\"section\">\n<div id=\"section_7\" class=\"mt-section\">\n<h3 id=\"Gastrointestinal_Problems-624\">Gastrointestinal Problems<\/h3>\n<p id=\"zimmerman_1.0-ch13_s07_s02_s02_p01\" class=\"para\">A number of gastrointestinal issues can affect food intake and digestion among the elderly. Saliva production decreases with age, which affects chewing, swallowing, and taste. Digestive secretions decline later in life as well, which can lead to atrophic gastritis (inflammation of the lining of the stomach). This interferes with the absorption of some vitamins and minerals. Reduction of the digestive enzyme lactase results in a decreased tolerance for dairy products. Slower gastrointestinal motility can result in more constipation, gas, and bloating, and can also be tied to low fluid intake, decreased physical activity, and a diet low in fiber, fruits, and vegetables.<\/p>\n<\/div>\n<\/div>\n<div id=\"zimmerman_1.0-ch13_s07_s02_s03\" class=\"section\">\n<div id=\"section_8\" class=\"mt-section\">\n<h3 id=\"Dysphagia-624\">Dysphagia<\/h3>\n<p id=\"zimmerman_1.0-ch13_s07_s02_s03_p01\" class=\"para\">Some older adults have difficulty getting adequate nutrition because of the disorder dysphagia, which impairs the ability to swallow. Any damage to the parts of the brain that control swallowing can result in dysphagia, therefore stroke is a common cause. Dysphagia is also associated with advanced dementia because of overall brain function impairment. To assist older adults suffering from dysphagia, it can be helpful to alter food consistency. For example, solid foods can be pureed, ground, or chopped to allow more successful and safe swallow. This decreases the risk of aspiration, which occurs when food flows into the respiratory tract and can result in pneumonia. Typically, speech therapists, physicians, and dietitians work together to determine the appropriate diet for dysphagia patients.<\/p>\n<div id=\"zimmerman_1.0-ch13_s07_s02_s03_n01\" class=\"video\">\n<div class=\"note1\">\n<div class=\"textbox\">\n<h3 class=\"boxtitle\">DYSPHAGIA<\/h3>\n<hr \/>\n<p>This video provides information about the symptoms and complications of dysphagia.<\/p>\n<div class=\"mt-video-widget mt-video-width-50\">\n<div>\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"Swallowing Disorders\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/Wd-3Csr8K3A?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"zimmerman_1.0-ch13_s07_s02_s04\" class=\"section\">\n<div id=\"section_9\" class=\"mt-section\">\n<h3 id=\"Obesity_in_Old_Age-624\">Obesity in Old Age<\/h3>\n<p id=\"zimmerman_1.0-ch13_s07_s02_s04_p01\" class=\"para\">Similar to other life stages, obesity is a concern for the elderly. Adults over age sixty are more likely to be obese than young or middle-aged adults. As explained throughout this chapter, excess body weight has severe consequences. Being overweight or obese increases the risk for potentially fatal conditions that can afflict the elderly. They include cardiovascular disease, which is the leading cause of death in the United States, and Type 2 diabetes, which causes about seventy thousand deaths in the United States annually.<span id=\"zimmerman_1.0-fn13_038\" class=\"footnote\">Centers for Disease Control, National Center for Health Statistics. \u201cDeaths and Mortality.\u201d Last updated January 27, 2012.\u00a0<a class=\"link external\" href=\"http:\/\/www.cdc.gov\/nchs\/fastats\/deaths.htm\" target=\"_blank\" rel=\"external nofollow noopener\">http:\/\/www.cdc.gov\/nchs\/fastats\/deaths.htm<\/a>.<\/span>\u00a0Obesity is also a contributing factor for a number of other conditions, including arthritis.<\/p>\n<p id=\"zimmerman_1.0-ch13_s07_s02_s04_p02\" class=\"para\">For older adults who are overweight or obese, dietary changes to promote weight loss should be combined with an exercise program to protect muscle mass. This is because dieting reduces muscle as well as fat, which can exacerbate the loss of muscle mass due to aging. Although weight loss among the elderly can be beneficial, it is best to be cautious and consult with a health-care professional before beginning a weight-loss program.<\/p>\n<\/div>\n<\/div>\n<div id=\"zimmerman_1.0-ch13_s07_s02_s05\" class=\"section\">\n<div id=\"section_10\" class=\"mt-section\">\n<h3 id=\"The_Anorexia_of_Aging-624\">The Anorexia of Aging<\/h3>\n<p id=\"zimmerman_1.0-ch13_s07_s02_s05_p01\" class=\"para\">In addition to concerns about obesity among senior citizens, being underweight can be a major problem. A condition known as the\u00a0<span class=\"margin_term\">anorexia of aging<\/span>\u00a0is characterized by poor food intake, which results in dangerous weight loss. This major health problem among the elderly leads to a higher risk for immune deficiency, frequent falls, muscle loss, and cognitive deficits. Reduced muscle mass and physical activity mean that older adults need fewer calories per day to maintain a normal weight. It is important for health care providers to examine the causes for anorexia of aging among their patients, which can vary from one individual to another. Understanding why some elderly people eat less as they age can help health-care professionals assess the risk factors associated with this condition. Decreased intake may be due to disability or the lack of a motivation to eat. Also, many older adults skip at least one meal each day. As a result, some elderly people are unable to meet even reduced energy needs.<\/p>\n<p id=\"zimmerman_1.0-ch13_s07_s02_s05_p02\" class=\"para\">Nutritional interventions should focus primarily on a healthy diet. Remedies can include increasing the frequency of meals and adding healthy, high-calorie foods (such as nuts, potatoes, whole-grain pasta, and avocados) to the diet. Liquid supplements between meals may help to improve caloric intake.<span id=\"zimmerman_1.0-fn13_039\" class=\"footnote\">Morley, J. E. \u201cAnorexia of Aging: Physiologic and Pathologic.\u201d\u00a0<em class=\"emphasis\">Am J Clin Nutr<\/em>\u00a066 (1997): 760\u201373.\u00a0<a class=\"link external\" href=\"http:\/\/www.ajcn.org\/content\/66\/4\/760.full.pdf\" target=\"_blank\" rel=\"external nofollow noopener\">http:\/\/www.ajcn.org\/content\/66\/4\/760.full.pdf<\/a>.<\/span>\u00a0Health care professionals should consider a patient\u2019s habits and preferences when developing a nutritional treatment plan. After a plan is in place, patients should be weighed on a weekly basis until they show improvement.<\/p>\n<\/div>\n<\/div>\n<div id=\"zimmerman_1.0-ch13_s07_s02_s06\" class=\"section\">\n<div id=\"section_11\" class=\"mt-section\">\n<h3 id=\"Vision_Problems-624\">Vision Problems<\/h3>\n<p id=\"zimmerman_1.0-ch13_s07_s02_s06_p01\" class=\"para\">Many older people suffer from vision problems and a loss of vision. Age-related macular degeneration is the leading cause of blindness in Americans over age sixty.<span id=\"zimmerman_1.0-fn13_040\" class=\"footnote\">American Medical Association,\u00a0<em class=\"emphasis\">Complete Guide to Prevention and Wellness<\/em>\u00a0(Hoboken, NJ: John Wiley &amp; Sons, Inc., 2008), 413.<\/span>\u00a0This disorder can make food planning and preparation extremely difficult and people who suffer from it often must depend on caregivers for their meals. Self-feeding also may be difficult if an elderly person cannot see his or her food clearly. Friends and family members can help older adults with shopping and cooking. Food-assistance programs for older adults (such as Meals on Wheels) can also be helpful.<\/p>\n<p id=\"zimmerman_1.0-ch13_s07_s02_s06_p02\" class=\"para\">Diet may help to prevent macular degeneration. Consuming colorful fruits and vegetables increases the intake of lutein and zeaxanthin. Several studies have shown that these antioxidants provide protection for the eyes. Lutein and zeaxanthin are found in green, leafy vegetables such as spinach, kale, and collard greens, and also corn, peaches, squash, broccoli, Brussels sprouts, orange juice, and honeydew melon.<span id=\"zimmerman_1.0-fn13_041\" class=\"footnote\">American Medical Association,\u00a0<em class=\"emphasis\">Complete Guide to Prevention and Wellness<\/em>\u00a0(Hoboken, NJ: John Wiley &amp; Sons, Inc., 2008), 415.<\/span><\/p>\n<\/div>\n<\/div>\n<div id=\"zimmerman_1.0-ch13_s07_s02_s07\" class=\"section\">\n<div id=\"section_12\" class=\"mt-section\">\n<h3 id=\"Neurological_Conditions-624\">Neurological Conditions<\/h3>\n<p id=\"zimmerman_1.0-ch13_s07_s02_s07_p01\" class=\"para\">Elderly adults who suffer from dementia may experience memory loss, agitation, and delusions. One in eight people over the age sixty-four and almost half of all people over eighty-five suffer from Alzheimer\u2019s, which is the most common form of dementia. These conditions can have serious effects on diet and nutrition as a person increasingly becomes incapable of caring for himself or herself, which includes the ability to buy and prepare food, and to self-feed.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"zimmerman_1.0-ch13_s07_s03\" class=\"section\">\n<div id=\"section_13\" class=\"mt-section\">\n<h2 id=\"Longevity_and_Nutrition-624\">Longevity and Nutrition<\/h2>\n<p id=\"zimmerman_1.0-ch13_s07_s03_p01\" class=\"para\">The foods you consume in your younger years influence your health as you age. Good nutrition and regular physical activity can help you live longer and healthier. Conversely, poor nutrition and a lack of exercise can shorten your life and lead to medical problems. The right foods provide numerous benefits at every stage of life. They help an infant grow, an adolescent develop mentally and physically, a young adult achieve his or her physical peak, and an older adult cope with aging. Nutritious foods form the foundation of a healthy life at every age.<\/p>\n<div id=\"zimmerman_1.0-ch13_s07_s03_n01\" class=\"key_takeaways\">\n<div id=\"section_14\" class=\"mt-section\">\n<div class=\"textbox key-takeaways\">\n<h3>Key Takeaways<\/h3>\n<p>As adults age, physical changes impact nutrient needs and can result in deficiencies.\u00a0The daily energy requirements for adults ages fifty-one and over are 1,600 to 2,200 calories for women and 2,000 to 2,800 calories for men, depending on activity level.\u00a0Older adults are more susceptible to medical problems, such as disability and disease, which can impact appetite, the ability to plan and prepare food, chewing and swallowing, self-feeding, and general nutrient intake.\u00a0A nutrient-dense, plant-based diet can help prevent or support the healing of a number of disorders that impact the elderly, including macular degeneration and arthritis.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"zimmerman_1.0-ch13_s07_s03_n02\" class=\"exercises\">\n<div id=\"section_15\" class=\"mt-section\">\n<h3 id=\"Discussion_Starter-624\">Discussion Starter<\/h3>\n<ol id=\"zimmerman_1.0-ch13_s07_s03_l02\" class=\"orderedlist\">\n<li>Revisit the predictions you made at the beginning of this chapter about how nutrient needs might change as a healthy young adult matures into old age. Which predictions were correct? Which were incorrect? What have you learned?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-501\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Old Age and Nutrition. <strong>Authored by<\/strong>: Medical LibreTexts Contributors. <strong>Provided by<\/strong>: LibreTexts. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/med.libretexts.org\/Courses\/Sacramento_City_College\/SCC%3A_Nutri_300_(Coppola)\/Chapters\/13%3A_From_Childhood_to_the_Elderly_Years\/13.8%3A_Old_Age_and_Nutrition\">https:\/\/med.libretexts.org\/Courses\/Sacramento_City_College\/SCC%3A_Nutri_300_(Coppola)\/Chapters\/13%3A_From_Childhood_to_the_Elderly_Years\/13.8%3A_Old_Age_and_Nutrition<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\">CC BY-NC-SA: Attribution-NonCommercial-ShareAlike<\/a><\/em><\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section>","protected":false},"author":44985,"menu_order":7,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Old Age and Nutrition\",\"author\":\"Medical LibreTexts Contributors\",\"organization\":\"LibreTexts\",\"url\":\"https:\/\/med.libretexts.org\/Courses\/Sacramento_City_College\/SCC%3A_Nutri_300_(Coppola)\/Chapters\/13%3A_From_Childhood_to_the_Elderly_Years\/13.8%3A_Old_Age_and_Nutrition\",\"project\":\"\",\"license\":\"cc-by-nc-sa\",\"license_terms\":\"\"}]","CANDELA_OUTCOMES_GUID":"","pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-501","chapter","type-chapter","status-publish","hentry"],"part":484,"_links":{"self":[{"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/chapters\/501","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/wp\/v2\/users\/44985"}],"version-history":[{"count":6,"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/chapters\/501\/revisions"}],"predecessor-version":[{"id":954,"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/chapters\/501\/revisions\/954"}],"part":[{"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/parts\/484"}],"metadata":[{"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/chapters\/501\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/wp\/v2\/media?parent=501"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/pressbooks\/v2\/chapter-type?post=501"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/wp\/v2\/contributor?post=501"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/sunyltnutrition\/wp-json\/wp\/v2\/license?post=501"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}