Introduction

One in eight Americans is 65 years of age or older. This number is growing and will continue to do so with the aging of the baby boomers. The oldest old, people who are at least 85 years of age, is the fastest-growing segment of America's senior population.

What You Will Learn

You will learn the importance of good nutrition in helping the elderly to:

• Remain independent.
• Maintain quality of life.
• Prevent or reduce the effects of age-related diseases.

MyPlate Review

USDA MyPlate

The U.S. Department of Agriculture MyPlate is a tool that guides Americans in selecting which foods to eat and how much to eat each day to be healthy. MyPlate contains five food groups: fruits, vegetables, grains, protein foods and dairy. Each day, people of all ages should eat a variety of foods from each food group. Foods containing solid fats and added sugars, such as cookies, pies, cakes and sodas should be limited. For more information on healthful eating and physical activity, go to www.choosemyplate.gov. Look for the SuperTracker to create a personalized meal plan. You can also set goals and track your food intake and physical activity

Changes That May Affect Nutritional Status in the Elderly

Physical and body function changes take place during aging and can result in changes in nutrient needs. These changes can contribute to decreased food intake, unintentional weight loss and malnutrition. Not everyone experiences all these changes.

Here are some changes that may occur:

• Sense of taste
• Sense of smell
• Hearing loss
• Diminished eyesight
• Poor oral health. A healthy mouth, teeth and gums are needed for elders to eat well.
• Difficulty swallowing
• Deteriorating mental status
• Social isolation
• Lack of transportation to grocery store, medical appointments, etc.
• Access to a nutritionally adequate diet
• Poverty. Poverty is a strong indicator of malnutrition risk. About 20% of adults are poor. Older women experience nearly twice the poverty rate of older men.
• Fixed income. As expenses increase, seniors may reduce their food intake. Costly medications can decrease the money available to buy food.
• Medications. Some medicines cause dry mouth. Drink more water or suck on hard candy (such as lemon drops) to increase saliva flow.

Why Good Nutrition in Older Adults Is Important

Because Americans are living longer, it is important for us all to plan well for a long life. It is never too early nor late to begin. Aging well depends on several factors, some of which include the following: personal health and well-being, lifestyle issues (housing, leisure activities, lifelong learning) and finances. It is important to remember and understand that today's choices do have consequences in later life.

In this lesson, we will focus on only one factor of aging well: health.

Research has shown that nutritional status influences the progress of many diseases and that having good nutritional status can help to reduce the length of hospital stays.

Being well-nourished is important for several reasons:

• Health is improved.
• Dependence is decreased.
• Illnesses are shorter.
• Disease progression is delayed.
• Quality of life is improved or maintained.

Nutritional Concerns Based on What Adults Eat

The United States Department of Agriculture (USDA) Continuing Survey of Food Intakes by Individuals (CSFII) provides up-to-date information on food intake by Americans. This survey indicated that adults have low intakes of fiber, magnesium and zinc. These results could be improved by eating more whole grains, fruits, dark green vegetables and legumes. Consuming low-fat dairy products is important in that it can help to boost calcium levels. The study also found more adults to be overweight than before. Adults' diets could benefit overall by simply decreasing intakes of foods and beverages that are high in fats and sugars. Low activity levels were also shown to contribute to the large numbers of adults who were overweight. For better health, adults should become more active, incorporating activities into their everyday living.

Nutrients to be concerned about:

Vitamin A supplements: The need for supplements containing vitamin A decrease with age, making toxicity from supplements more common as one ages. Adequate vitamin A can be obtained in the diet alone through several different food sources. Breakfast cereals, juices, dairy products and other foods are fortified with vitamin A. Also, dark green and yellow, orange and red vegetables and fruits contain beta carotene and other vitamin A precursors, which the body can use to form vitamin A.

Protein: Protein needs increase with age. Low-protein and calorie intake can make a person more likely to get sick and can also make it harder to recover from an illness. Foods that are excellent sources of protein include meat, poultry, fish and eggs. Other sources of protein include the following foods: dairy foods, such as milk, yogurt and cheese; soy products, such as tofu and soy milk; beans and peas; nuts and seeds.

Vitamin D (the sunshine vitamin): Vitamin D is needed for the absorption of calcium. Calcium and vitamin D work together to build strong teeth and bones. Luckily, most individuals are able to receive enough vitamin D from sunshine alone. This is why vitamin D is known as the sunshine vitamin. Your body produces vitamin D when your skin is exposed to the sun for 10-15 minutes every day. Some individuals have been shown to have much lower levels of vitamin D, including African-Americans and other individuals with dark skin. This is believed to be due to less formation of the vitamin from the action of sunlight on the skin. The elderly, as well as adults and children are at risk of vitamin D deficiency. Some good dietary sources of vitamin D include fatty fish, such as salmon, tuna and mackerel, mushrooms, beef liver, egg yolks and cheese. Milk, yogurt, orange juice, breakfast cereals and other foods are fortified with vitamin D. Cod liver oil is rich in vitamin D. Some individuals prefer getting their daily intakes of vitamin D from a multivitamin; however, levels found in most multivitamins are too low.

Vitamin B-12, vitamin B-6 and folate: These are believed to prevent some of the decline in cognitive function that is associated with aging. Deficiencies of these nutrients, along with low intakes of vitamin C and riboflavin, may result in poor memory. Folate, along with these other two B vitamins, is believed to play some role in fighting heart disease and some types of cancer. Further research is still needed in this area, however. Folic acid has recently been fortified in several foods, making it much easier now than in past years to receive adequate amounts from the diet. Good dietary sources of folic acid include enriched breads, flour, cornmeal, pastas, rice and other grain products.

Cholesterol: Cholesterol is a waxy substance. There are two types of cholesterol: dietary and endogenous. Dietary cholesterol comes from animal foods we eat, such as meat, cheese, and eggs. Endogenous cholesterol is made by the liver, which acts to link cholesterol to carrier proteins in the body called lipoproteins that let it dissolve in blood. It is then transported all through the body. Cholesterol plays some essential roles in the body, such as in the formation of cell membranes, some hormones and vitamin D. While too much cholesterol can be problematic, very low levels of cholesterol can be as well. Very low levels may be a sign of disease and of decreased mental ability.

Beta carotene (forms vitamin A), vitamin C and vitamin E: These are all antioxidants. Beta carotene is a precursor for vitamin A. But unlike vitamin A supplements, which can occur with too high of a vitamin A intake, this is not the case with beta carotene. Beta carotene is essentially safe at all levels. Adequate levels of vitamin C can be consumed from the diet. Excellent food sources of vitamin C include citrus fruits or citrus juices, berries, green and red peppers, tomatoes, broccoli and spinach. Many breakfast cereals are also fortified with vitamin C. Vitamin E is an antioxidant that destroys free radicals. Free radicals damage cells and may contribute to heart disease and cancer. Vitamin E is found in foods, such as nuts and seeds and vegetable oils. All three of these compounds can help prevent the formation of cataracts of the eye, which can help prolong eyesight.

Zinc and other nutrients are believed to help improve immune function or one's ability to fight disease.

Water is important for the body to function as it should. Dehydration is a major problem in older adults, especially in those 85 and older. There are several factors that can contribute to decreased intakes of fluid in older individuals. These can include the loss of sense of thirst, medication side effects, difficulty in getting to or in using the toilet, or fear of being unable to control one's bladder. It is important to find ways of incorporating water throughout the day as to prevent dehydration.

How to Improve Diets of the Elderly

 Ways to improve the diet of an elderly person include:

• Following the USDA MyPlate Plan.
• Eating more whole-grain bread and cereals.
• Eating more fruit.
• Eating dark green vegetables.
• Eating more lean meat, legumes and other meat alternatives.
• Drinking more skim and low-fat milk and eat more skim and low-fat dairy products.
• Decreasing intakes of foods high in fats and sugars that provide few other nutrients.
• Drinking more water throughout the day.
• Including nutritious foods that are enjoyable and chewable.
• Following any special diets prescribed by the doctor.
• Eating meals at regular times.
• Trying to eat smaller meals. They may be better tolerated.
• Making snacks count!
• Following instructions when taking medicine. Some medicines must be taken after eating or with milk. If medicine is not taken as prescribed, you may become sick.
• Eating a snack before getting out of bed in the morning if your blood pressure tends to drop when you get up. Also, to help stabilize your blood pressure, sit on the side of the bed for a few minutes before getting up.
• Exercising!

Physical Activity

Research shows that there are advantages to both aerobic and weight-bearing exercise. Older Americans are shown to be less likely to participate in fitness activities. These activities can be important to older Americans.

Walking and weight training have been shown to improve an older person's balance and ability to walk. This makes them more independent and less likely to fall and be injured. Also, regular physical activity that is done several days each week reduces the risk of developing several illnesses.

Regular physical activity improves health by reducing risk of:

• Premature death
• Premature heart disease death
• Developing diabetes
• Developing high blood pressure
• Developing colon cancer.

Exercise also reduces feelings of depression and anxiety, helps control weight and helps build and maintain healthy bones, muscles and joints. Exercise helps older adults become stronger and better able to move without falling.

Exercise does not have to be strenuous in order to provide health benefits. Older adults who have been inactive for a while can begin exercise programs by doing short intervals of moderate physical activity (5- to 10-minute intervals). Gradually, they can build up to the desired amount of exercise. Both muscle-strengthening and aerobic activities should be included in the exercise program. Stronger muscles can help reduce the risk of falling and can help to improve one’s ability to perform the routine tasks of daily life. Among adults aged 65 years and older, walking and gardening, along with yard work, are some of the most popular physical activities.

It is important for seniors who want to begin an exercise program to first consult their doctors before beginning the program!

For Greater Home Independence

There are products that make it easier for older Americans to prepare and eat food. Some of the available products are:

• Easy jar opener

• Utensils with thick handles

• Liquid level indicator

 
Need More Help?

• Call the Eldercare Locator, a toll-free telephone service that puts callers in touch with information about state and area agencies serving the elderly in their communities. You can reach the Eldercare Locator by calling 800-677-1116 , Monday through Friday, 8 a.m. to 7 p.m. You can also go to http://www.eldercare.gov for more information. The Eldercare Locator is a public service of the U.S. Administration on Aging. For other services, go to the National Association of Area Agencies on Aging’s website at http://www.n4a.org.
• Participate in research-based educational programs sponsored by the LSU AgCenter's Louisiana Cooperative Extension Service. The LSU AgCenter's website is: www.lsuagcenter.com
• Participate in the Supplemental Nutrition Assistance Program (SNAP) if qualified and not already doing so. You can first check your income with the Federal Poverty Income Guidelines to see if the income guidelines are met. The Department of Health and Human Service’s website location is www.dhhs.gov. For more information on SNAP, go to the Department of Children and Family Services website at www.dcfs.louisiana.gov.
• Participate in feeding programs for senior citizens or the USDA commodity food-distribution program if you meet the qualifications. Commodity foods are distributed quarterly. The Department of Health and Human Services' website location is listed above.
• Participate in church, community or hospital-sponsored activities for senior citizens.
• Participate in meetings sponsored by the American Association of Retired Persons. The American Association of Retired Persons' website location is www.aarp.org
• And, lastly, this is a site that is designed to help seniors get the help they need from the government www.seniors.com

Summary

Because Americans are living longer, it is important to plan for a long life. The keys to enjoying later life are understanding and planning for what lies ahead. It is never too early nor too late to begin.

Aging well and leading a quality life depend on personal health and well-being as well as lifestyle choices such as housing, leisure activities, volunteering, and lifelong learning. Today's choices do have consequences in later life.

To promote health, eat according to the USDA Dietary Guidelines and MyPlate, and exercise!