Source: A Place for Mom

Dr. Lindsay Jones-Born is a naturopathic physician who provides a breadth of expertise about how nutritional needs change as we age.

Eating well is important for good nutrition at any age, but it is even more necessary for older adults because nutritional needs change. Adequate nutrition is necessary for health, quality of life and vitality. Unfortunately, for a variety of reasons, many seniors do not eat as well as they should. This can lead to poor nutrition or malnutrition. Reducing calorie intake can also easily get mistaken as a disease or illness.

How Our Bodies Change As We Age

There are many reasons our bodies change as we get older, including perceptual, physiological and general age-related conditions. These changes all influence the performance of each person’s body as a whole, which in turn influences our eating, nutritional intake, and overall health.

Perceptual Changes

Perceptual changes later in life can influence our nutrition, such as changes in hearing, smell, and taste:

• Hearing: Diminished or loss of hearing affects our ability to maintain good nutrition. The difficulty and frustration from the inability to hold a conversation with our eating partner out at a restaurant or at a social function can limit one’s food experience.
• Smell: The loss of smell can have a huge impact on the types of meals one chooses to eat as there is less satisfaction. This can lead to poor food choices.
• Taste: One of the most common complaints is in regards to the diminished taste in food. As taste buds decrease, so does our taste for salty and sweet — often times making food taste more bitter or sour. This may cause people to eat fewer fruits and vegetables.

Physiological Changes

One reason nutritional needs change is due to physiological changes that occur later in life:

• Energy: Expenditure generally decreases with advancing age because of a decrease in basal metabolic rate and physical activity, thus decreasing the needs of calories.
• Function: Our bodies also begin to experience a decrease in kidney function, redistribution of body composition and changes in the nervous system.

Other Aging-Related Changes

Other changes in body function may impact nutritional intake, such as:

• Dentition: The makeup of a set of teeth (including how many, their arrangement and their condition) can change. The loss of teeth and/or ill-fitting dentures can lead to the avoidance of hard and sticky foods. Older people with dental problems may avoid some fruits and vegetables, such as apples or uncooked carrots, because of this.
• Gastrointestinal Changes: Chronic gastritis, constipation, delayed stomach emptying, and gas may also lead to avoiding fruits and vegetables, as well as other healthy foods. Thus, the food categories that should be emphasized may get eliminated instead.

These factors alone may contribute to why 3.7 million seniors are malnourished. They may also shed light on the importance of educating caregivers and aging seniors on specific dietary need options, as well as catered senior diets and nutritional needs.

Seniors, Malnutrition and Vitamin Deficiencies

Malnutrition is seen in varying degrees in the elderly, along with varying vitamin and calcium deficiencies. Malnutrition is due to undernutrition, nutrient deficiencies or imbalances. Most physicians do not see frank malnutrition anymore, such as scurvy. Instead, they encounter milder malnutrition symptoms, such as loss of appetite, general malaise or lack of overall interest and wellness.

Common deficiencies of nutrients of dietary origin include inadequate intake of vitamins A, B, C, D, and E, folic acid, calcium, and niacin. Malnutrition may also be the result of some socioeconomic risk factors, such as the following:

• Fear of personal safety (which affects the ability to go grocery shopping)
• Lack of health insurance (which may cause malnutrition to go undetected)
• Financial concerns
• Institutionalization or hospitalizations (that do not ensure adequate nutrition)
• Lack of interest in cooking or eating alone
• Loss of a spouse or family member

How To Improve Nutrition for Seniors

Clearly, good nutrition plays a vital role in the quality of life in older persons. This is why preventative medicine and focusing on good eating habits is crucial.

Health professionals recommend following a preventative health maintenance nutritional program, such as the Dietary Guidelines for Americans, from the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS). It describes two eating plans:

1. The USDA Food Patterns
2. The DASH (Dietary Approaches to Stop Hypertension) Eating Plan

What Is the Recommended Daily Nutrition for Seniors?

The USDA Food Patterns recommends that people 50 or older choose healthy meals every day from the following:

• Fruits — 1½ to 2 ½ cups
  What is the same as ½ cup of cut-up fruit? A 2-inch peach or ¼ cup of dried fruit.
• Vegetables — 2 to 3½ cups
  What is the same as one cup of cut-up vegetables? Two cups of uncooked leafy vegetables.
• Grains — 5 to 10 ounces
  What is the same as one ounce of grains? A small muffin, a slice of bread, a cup of flaked, ready-to-eat cereal, or ½ cup of cooked rice or whole-grain pasta usually equal one ounce of grains.
• Protein foods — 5 to 7 ounces
  What is the same as one ounce of meat, fish or poultry? One egg, ¼ cup of cooked beans or tofu, ½ ounce of nuts or seeds or one tablespoon of peanut butter.
• Dairy foods — 3 cups of fat-free or low-fat milk
  What is the same as one cup of milk? One cup of yogurt or 1½ to 2 ounces of cheese. One cup of cottage cheese is the same as ½ cup of milk.
• Oils — 5 to 8 teaspoons
  What is the same as oil added during cooking? Foods such as olives, nuts, and avocado have a lot of oil in them.
• Solid fats and added sugars (SoFAS) — keep the amount of SoFAS small
  If you eat too many foods containing SoFAS, you will not have enough calories for the nutritious foods you should be eating.

Ensuring adequate nutrition and proper intake of fats and nutrients will help keep older adults feeling more vital, and ultimately, more healthy. This form of prevention is far more effective than intervention later down the line. You can also learn more about the U.S. Department of Health and Human Services DASH eating plan to decide whether it’s right for your loved one.

What About Nutrition for Seniors Who Choke on Water?

Dysphagia describes the condition where someone may have difficulty swallowing. In most instances, the person may struggle to swallow solid foods. However, the University of Michigan confirms that people may struggle with swallowing liquids as well.1 This is why some people may appear to choke on water.

When older adults struggle to swallow solids, pureeing the meals helps to make swallowing easier. Ironically, the same solution also works for ensuring water intake in people who choke on liquids, because pureeing thickens the liquid. Eating pureed meals reduces the risk of dehydration while also helping to resolve swallowing problems.
The University of Virginia also recommends using milk or nutrition shakes to puree food.2 This helps older adults to increase their intake of calcium and other healthy fats. Essential nutrients, such as Calcium, is important for the body for all life stages, but particularly for the elderly, whose bones become more brittle as they get older.

About The GreenFields Continuing Care Community

The GreenFields Continuing Care Community provides for the physical, social, and spiritual needs of residents in a Christian environment. In addition to skilled nursing, subacute rehabilitation, and outpatient therapy at GreenField Health & Rehabilitation Center, The GreenFields offers a variety of living arrangements and support levels based on individual needs. This includes independent living apartments in GreenField Manor; assisted living apartments in GreenField Court; and memory care and enhanced assisted living in GreenField Terrace.