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
citizens nutrition
 Physiological Changes
Bodys 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 after
age 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 individuals 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