Angeles College Nutrition and Diet Therapy Essay

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Hello I have attached the assignment questions as well as the power points discussed during our class. Case studies are from the text book. This is the text book we are using, please let me know if you have any questions.Dudek, Susan G. Nutrition Essentials for Nursing Practice, 8th edition.ISBN-13: 978-1496356109ISBN-10: 1496356101CHAPTER 14
NUTRITION FOR OLDER
ADULTS
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NUTRITION FOR OLDER ADULTS
• Approximately 1 out of 7 Americans, or 15.2% of the population, is 65 years or
older
• The older population is not only increasing; it is also getting increasingly older
• Older adults are a heterogeneous group that varies in






age
marital status
social background
financial status
health status
living arrangements
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AGING AND OLDER ADULTS
• Aging is a gradual, inevitable, complex process of progressive physiologic,
cellular, cultural, and psychosocial changes that begin at conception and end at
death
• As cells age, they undergo degenerative changes in structure and function that
eventually lead to impairment of organs, tissues, and body functioning

See Table 14.1
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NUTRITIONAL NEEDS OF OLDER ADULTS #1
• Age-related changes in metabolism, body composition, and nutrient absorption
are among the factors that alter calorie needs and nutrient requirements among
older adults.
• Dietary Reference Intake (DRI) references separate older adulthood into two
categories: ages 51 to 70 years and older than 70.
• Most DRIs remain constant throughout adulthood.
• Those older than 70 may require adjustments.
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NUTRITIONAL NEEDS OF OLDER ADULTS #2
• Calories
• Estimated calorie needs per day decrease with age resulting from a decrease in energy
expenditure
• Basal metabolic rate (BMR)
• Physical activity
• Thermic effect of processing food
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NUTRITIONAL NEEDS OF OLDER
ADULTS #3
• Protein
• The Recommended Dietary Allowance (RDA) for protein has been set at 0.8
g/kg for adults 19 years and older but is now in question:
• A body of data from studies supports recommending protein intakes
greater than the RDA for older people.
• Higher protein intakes are associated with greater muscle mass and better
muscle function with aging:
• Due to a decline in anabolic response to protein intake.
• Need may also be higher due to inflammatory and catabolic effects of
chronic and acute diseases.
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NUTRITIONAL NEEDS OF OLDER ADULTS #4
• Protein—(cont.)
• Nutritional need according to the PROT-AGE Study Group:
• Healthy older adults: 1.0 to 1.2 g/kg protein/day
• Older adults with an acute or chronic disease: 1.2 to 1.5 g/kg/d: those with
severe illness or injury or with marked malnutrition: as much as 2.0 g/kg/d
• Protein should be evenly distributed throughout the day to maximally
stimulate muscle protein synthesis
• At least 2.5 g of leucine per meal for healthy older adults
• Leucine is an essential amino acid that plays a key role in stimulating
skeletal muscle synthesis.
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NUTRITIONAL NEEDS OF OLDER
ADULTS #5
• Fiber
• The recommendation for fiber decreases for adults age 50 years and
older
• Based on median intake levels observed to protect against
coronary heart disease
• Helps prevent constipation
• wheat bran, whole grains, nuts, and the skins and seeds of
fruits and vegetables
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NUTRITIONAL NEEDS OF OLDER ADULTS
#6
• Vitamins
• After age 70, the RDA for vitamin D increases from 15 mcg/day (600 IU) to 20
mcg/day (800 IU) for both men and women.
• Vitamin D is well known for its role in maintaining skeletal health, and evidence
suggests that low vitamin D levels may be involved in age-related diseases, such as
• Cognitive decline
Hypertension
• Depression
Type 2 diabetes
• Osteoporosis
Cancer
• Cardiovascular disease
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NUTRITIONAL NEEDS OF OLDER
ADULTS #7
• Vitamin; Vitamin D—(cont.)
• Various risk factors place older adults at increased risk for vitamin D deficiency
• Dietary sources include
• fortified milk
• egg yolks
• fatty fish
• beef liver
• Supplements of vitamin D may be necessary to achieve adequacy
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NUTRITIONAL NEEDS OF OLDER
ADULTS #8
• Calcium
• Consuming adequate amounts of calcium is critical for optimum bone
health.
• Low bone mineral density and osteoporosis are common in the United
States, especially in older adults.
• Once bone loss has occurred, medications are necessary.
• After age 70, the RDA for calcium increases for men from 1000 mg/d to
1200 mg/d. For women, the increase to 1200 mg/day occurs at age 51.
• It is preferable that calcium be obtained from food.
• People who are unwilling or unable to consume adequate calcium through
food sources need calcium supplements.
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NUTRITIONAL NEEDS OF OLDER
ADULTS #9
• Vitamin B12
• Occurs only in animal products
• RDA for vitamin B12 does not change with aging
• Adults over the age of 50 are advised to meet their B12 requirement mostly from fortified
foods
• Status tends to decline with age due to a decrease in gastric acidity, which impairs the freeing
of vitamin B12 bound to protein in foods
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NUTRITIONAL NEEDS OF OLDER
ADULTS #10
• Iron
• The recommendation for iron for men does not change with aging.
• In women, the requirement decreases after menopause.
• Deficiency may occur in older adults secondary to
• low stomach acid
• the use of antacids
• chronic blood loss from diseases or medications
• Iron intake may be low in adults who do not regularly eat red meat.
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NUTRITIONAL NEEDS OF OLDER
ADULTS #11
• Vitamin and Mineral Supplements
• Food-related intakes of vitamin A, vitamin D, vitamin E, calcium, magnesium,
and potassium fall below recommended amounts for adults ages 50 years and
older
• Low-dose multivitamin and mineral supplements can help achieve adequate micronutrient
intakes, especially when food selection is limited
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QUESTION #1
Which food should be considered for inclusion into the diet of
a client diagnosed with a vitamin D deficiency?
a.
Apples
b.
Green beans
c.
Lean chicken
d.
Egg yolk
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ANSWER TO QUESTION #1
d. Egg yolks
Rationale: Dietary sources of vitamin D include fortified milk,
egg yolks, fatty fish, beef liver
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HEALTHY AGING #1
• Genetic and environmental “life advantages” have positive effects on both
length and quality of life.
• There is no universally agreed upon definition of healthy or successful
aging; criteria often cited include
• no major chronic diseases
• no cognitive impairment
• no physical disabilities
• no mental health limitations
• The goal of healthy aging is more important to extend healthy active years.
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HEALTHY AGING #2
• Healthy Eating
• Across the human life span, healthy eating patterns and diet quality are linked to
health promotion and disease prevention.
• A healthy eating pattern
• Provides the appropriate calories from a variety of foods across food groups
• Emphasizes nutrient-dense foods
• Limits saturated fats, sodium, refined starches, and added sugars
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HEALTHY AGING #3
• Healthy Eating Index
• The Healthy Eating Index (HEI-2015) shows that older adults (≥60 years)
• Do not consume recommended amounts of total vegetables, fruits, dairy, whole grains, and
seafood
• Additionally, older women do not consume adequate intakes of total protein foods
• Overconsume refined grains, added sugars, saturated fat, and sodium
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HEALTHY AGING #4
• The Mediterranean Diet (MedDiet)
• Mediterranean countries are among the healthiest countries in the world,
with relatively low rates of cardiovascular diseases and cancer and
greater longevity.
• This may be linked to the low saturated fat content of the MedDiet.
• It is relatively high in total fat with a high ratio of monounsaturated
fat to saturated fat coming primarily from virgin olive oil, nuts, and
fatty fish.
• It contains a moderate intake of red wine consumed during meals.
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HEALTHY AGING #5
• The Mediterranean Diet (MedDiet)—(cont.)
• Potential Age-Related Benefits
• Lower the risk of mild cognitive impairment and Alzheimer’s disease (AD)
• Less age-related brain shrinkage
• Prolonged survival
• Reduced risk of frailty, possibility even at late stages of life
• Greater chance of living beyond 70 years with greater health and well-being
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HEALTHY AGING #6
• MIND diet (Mediterranean–DASH Intervention for Neurodegenerative
Delay diet)
• A combination of the MedDiet and DASH diets, which are two diets shown to
lower blood pressure and reduce the risk of cardiovascular disease and diabetes.
• The goal is to reduce the risk of dementia and the decline in brain health that
usually occurs with aging.
• Fifteen foods are specifically named, with 10 that are encouraged and 5 that
should be limited.
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HEALTHY AGING #7
• MIND diet (Mediterranean–DASH Intervention for Neurodegenerative
Delay diet)—(cont.)
• Potential Age-Related Benefits
• Some indication that the diet substantially slows cognitive decline with age
• linked to a 53% decrease in the rate of AD
• Components Attributed to Benefits
• The MIND diet is high in vitamin E, DHA, B vitamins, vitamin C, and vitamin D, all of which
have been found to help prevent neuron aging
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HEALTHY AGING #8
• Physical Activity
• Regular physical activity
• Reduces the risk of falls and fall-related injuries in older adults
• See Box 14.1
• Lowers risk of all-cause mortality, cardiovascular disease, hypertension, type 2 diabetes,
dyslipidemia, certain cancers, and dementia
• Delayed progression of certain chronic illnesses, hypertension, and type 2 diabetes
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HEALTHY AGING #9
• Physical Activity—(cont.)
• Regular physical activity
• Encourages weight loss, particularly when combined with a lower calorie intake, and improved
weight maintenance
• Improves cognition, quality of life, sleep, bone health, and physical function
• Reduces risk of anxiety and depression
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QUESTION #3
Is the following statement true or false?
The goal for healthy aging to primarily to prolong life.
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ANSWER TO QUESTION #3
False.
Rationale: The goal of healthy aging is not only to prolong life but more
importantly to extend healthy active years.
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NUTRITION AND HEALTH CONCERNS OF OLDER ADULTS
#1
• How people rank their own health is an important indicator of overall health and
a significant predictor of mortality.
• 45% of community-dwelling adults aged 65 and older ranked their health as
excellent or very good, yet most older adults have at least one chronic health
condition.
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NUTRITION AND HEALTH CONCERNS OF OLDER ADULTS
#2
• Malnutrition
• Older adults generally perceive themselves as healthy while many are at risk of
malnutrition.
• Contributing factors
• The quality and quantity of food intake
• Food insecurity
• Acute or chronic physical or mental health conditions
• Loss of appetite is a key predictor of malnutrition in older adults.
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NUTRITION AND HEALTH CONCERNS OF OLDER ADULTS
#3
• Malnutrition—(cont.)
• Malnutrition impairs quality of life and is a strong predictor of short-term
mortality in older adults.
• Common symptoms of malnutrition.
• Confusion
• Fatigue
• Weakness
• These symptoms are often attributed to other conditions and are misdiagnosed or
unrecognized as malnutrition.
• See Box 14.2.
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NUTRITION AND HEALTH CONCERNS OF OLDER ADULTS
#4
• Nutrition Screening for Malnutrition
• Nutrition screening is appropriate in any setting where older adults receive
services or care
• The Academy of Nutrition and Dietetics recommends that the Malnutrition
Screening Tool (MST) be used to screen adults for malnutrition (undernutrition)
and asks
• Have you lost weight without trying?
• If yes, how much weight have you lost?
• Have you been eating poorly because of a decreased appetite?
• Each criterion is scored to determine malnutrition risk
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QUESTION #4
Is the following statement true or false?
Most adults older than 65 years of age have one chronic
health problem.
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ANSWER TO QUESTION #4
True
Rationale: Most of adults older than 65 years of age have one chronic health
problem.
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NUTRITION AND HEALTH CONCERNS OF OLDER ADULTS
#5
• Interventions to Improve Intake and Weight
• Increase the nutrient density of foods eaten by adding ingredients that provide calories and/or
protein (See Box 14.3)
• Homemade or commercial protein supplements
• Commercial supplements are more expensive
• Smoothies, milk shakes, and protein powder–based milk drinks can be consumed between
meals
• Taste fatigue may occur over time
• Not intended to replace food intake
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NUTRITION AND HEALTH CONCERNS OF OLDER ADULTS
#6
• Additional Considerations for Community-Dwelling Adults
• Eating with others may help improve the intake and nutritional status of those who live alone.
• Congregate meals and Meals on Wheels are also options.
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NUTRITION AND HEALTH CONCERNS OF OLDER ADULTS
#7
• Additional Considerations for Long-Term Care Residents
• A holistic approach is advocated that includes the individual’s personal
goals, overall prognosis, risk–benefit ratio, and quality of life.
• Mealtime should be made as enjoyable experience as possible.
• Family involvement increases resident intake.
• Honor food preferences whenever possible.
• Encourage independence in eating.
• Specialized utensils and dishes, finger foods, and tactile prompts
may facilitate independence.
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NUTRITION AND HEALTH CONCERNS OF OLDER ADULTS
#8
• Additional Considerations for Long-Term Care Residents—(cont.)
• Adopt a liberalized eating pattern.
• See Box 14.4
• Restrictive diets should be used only when a significant improvement in health can be
expected.
• Consistently and accurately record food intake.

Intakes
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