Diet Lansia

Chapter 15

Diet during Late Adulthood

Objectives

• Explain nutritional and caloric needs of people age 65 and over

• Of chronic diseases discussed, explain development

• Identify physiological, economic, and psychosocial problems that can affect senior citizen’s nutrition

Physiological Changes

• Body’s functions slow with age– Ability to replace worn cells reduced

• Metabolic rate slows• Bones become less dense• Lean muscle mass reduced• Eyes lose focus on nearby objects– Some people develop cataracts

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Physiological Changes

• Poor dentition common• Heart and kidneys less efficient• Hearing, taste, and smell less acute• Immune system may be compromised if

chronic poor nutrition

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Physiological Changes

• Osteoarthritis can be debilitating• Excess weight and some vitamin deficiencies

may affect some forms of arthritis• Healthy nutrition and exercise can be

beneficial for those with arthritis• No connection between specific food and

arthritis

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Physiological Changes

• Digestion affected by decreased secretion of hydrochloric acid and enzymes

• Decrease in synthesis of intrinsic factor leads to deficiency of vitamin B12

• Reduced intestinal tone causes constipation or, in some cases, diarrhea

Psychosocial Changes

• Psychosocial problems can increase as one grows older:– Feeling of uselessness– Loss of self-esteem– Loss, grief, and loneliness– Loss of independence

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Psychosocial Changes

• Economic changes:–May affect food choices–May reduce social activities

Sidestepping Potential Problems

• Healthy lifestyle and active social life throughout life can prevent or delay physical deterioration and psychological depression during senior years

• Food-drug and drug-drug interactions can affect nutritional status–Must be monitored closely

Nutritional Requirements

• Daily protein requirement remains at 0.8 g per kilogram of body weight– After age 65, may be advisable to increase to 1.0 g

• Vitamin requirements do not change afterage 51– Except for slight decrease in RDAs for thiamin,

riboflavin, and niacin

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Nutritional Requirements

• Need for iron decreased after age 51 in women due to menopause

• Calorie requirement decreases approximately 1 to 2 percent per decade

• Activity often decreases• Weight gain common if caloric intake not

reduced

Food Habits of Senior Citizens

• Established food habits may be especially difficult to change

• The following may cause difficulties in food selection and preparation:– Decreased income during retirement– Lack of transportation– Physical disability– Inadequate cooking facilities

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Food Habits of Senior Citizens

• Grief, loneliness, boredom, or difficulty in chewing can cause anorexia

• Many consume diets deficient in:– Protein– Vitamin C, vitamin D, vitamin B6, vitamin B12, and

folate– Calcium, zinc, and iron– Calories

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Food Habits of Senior Citizens

• Encourage variety and nutrient-dense foods• Water important to help prevent constipation,

maintain urinary volume, prevent dehydration, and avoid urinary tract infections

Food Fads

• Senior citizens may spend money on unnecessary vitamins, minerals, and foods in search of eternal life or youth

Appropriate Diets

• Based on MyPyramid• When special health problems exist, adapt

normal diet to meet individual’s needs• Federal government provides states with funds

to serve senior citizens hot meals at noon in senior centers

Transportation for Senior Citizens

• Federal government provides transportation for those otherwise unable to reach senior center for meals

• Meals-on-Wheels project provides food for homebound individuals– Participating people pay according to ability

Stop and Share

• Consider the following question:–What makes this segment of the population

susceptible to food faddists?

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Stop and Share

• Some older people consciously or unconsciously search for eternal life, if not youth

• Food faddists may pick this segment of population to profit from ignorance

• Some older people with chronic disease may hope such products will bring relief

Special Considerations for the Chronically Ill Older Adult

• Osteoporosis• Arthritis• Cancer• Diabetes mellitus• Hypertension• Heart disease

Osteoporosis

• Condition in which amount of calcium in bones reduced–Making them porous

• Can have bone density scan with special x-ray to determine condition

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Osteoporosis

• Contributors:– Sedentary life– Diet low in calcium, vitamin D, and fluoride– Estrogen loss– Excessive phosphorus in diet• E.g., sodas, processed foods

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Osteoporosis

• Possible preventive measures:– Estrogen replacement therapy (ERT)– 1,500 mg of calcium per day– Exercise

Arthritis

• Disease that causes joints to become painful and stiff

• Excess weight worsens symptoms• Aspirin or anti-inflammatory drugs may help– But may cause gastric bleeding and anemia

• No cure

Cancer

• Contributors:– Diet consistently high in fat– Diet low in fiber and vitamin A

• Research continues about role of nutrition in development of cancer

Diabetes Mellitus

• Chronic disease that develops when body does not produce sufficient amounts of insulin or does not use it effectively for normal carbohydrate metabolism

• Diet very important for treatment

Hypertension

• High blood pressure can lead to strokes• Associated with diets high in salt or possibly

low in calcium• Most Americans ingest two to six times the

amount of salt needed each day

Heart Disease

• Heart attack and stroke–Major causes of death in U.S.

• Arteries become blocked– Preventing normal passage of blood

• Atherosclerosis– Plaque accumulates in walls of artery as result of

diet high in cholesterol and saturated fats

Effects of Nutrition

• Cumulative over many years• Effects of lifetime of poor eating habits cannot

be cured overnight• Prevention should begin in childhood• Nutrition can be used to help stabilize

condition of client with chronic disease

Considerations for the Health Care Professional

• Each client has individual needs• Important to remember that older clients have

feelings worth addressing• Incapacitation that can accompany old age is

terrible indignity– Deserves special care

Conclusion

• Elderly segment of population continues to increase

• Nutrient needs of elderly a growing concern• Many chronic diseases of elderly could be

delayed or avoided by maintaining good nutrition throughout life