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Nutritional Considerations for Older Adults

Nutritional Considerations for Older Adults. Tamara Deschaine, RDN, LD, CDE. Objectives. Identify nutrients of concern for older adults and good sources of those nutrients Describe adequate protein intake and good sources of protein

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Nutritional Considerations for Older Adults

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  1. Nutritional Considerations for Older Adults Tamara Deschaine, RDN, LD, CDE

  2. Objectives • Identify nutrients of concern for older adults and good sources of those nutrients • Describe adequate protein intake and good sourcesof protein • Discuss concerns with dehydration and adequate fluid intake for older adults

  3. Nutrients of Concern • Calcium and vitamin D • Vitamin B12 • Fiber • Potassium Credit:DanielVincek - stock.adobe.com

  4. Calcium and Vitamin D • Essential to maintain bone health • Vitamin D produced in response to the sun- synthesis declines with age & older adults tend to spend more time indoors, supplementation may be required • Low vitamin D results in decreased calcium storage in bones • Recommended daily intake of calcium is 1,000 mg (females) & 1,200 mg (males) • Recommended daily intake of vitamin D is 600-800 IU

  5. Sources of Calcium and Vitamin D

  6. Vitamin B12 • Required for red blood cell formation, neurologic function and DNA synthesis • Long-term use of acid-blocking medications (PPIs) may contribute to B12 deficiency; decreased absorptive capacity with age • Low B12 status associated with cognitive decline • Supplementation may be needed • Recommended daily intake is 2.4 mcg • Sources of B12 include:animal products such as meat, fish, poultry, eggs, milk and milk products, and fortified cereals

  7. Dietary Fiber • Fiber helps to lower risk for heart disease and type 2 diabetes • Keeps GI tract healthy and protects against diverticular disease and some cancers • Recommended daily intake is 22.4 grams (females) and 28 grams (males)

  8. Sources of Dietary Fiber • High fiber bran cereals • Beans (all types) • Split peas/green peas • Chickpeas and lentils • Pear/apple w/ skin • Pumpkin seeds/sunflower seeds • Avocado • Orange/banana • Berries • Chia seeds • Baked potato/sweet potato with skin • Air-popped popcorn • Almonds/pistachios/pecans/hazelnuts/peanuts • Prunes/dates/figs • Quinoa • Winter squash

  9. Potassium • May lower risk of high blood pressure and is associated with increased bone mineral density • Risk of low potassium (hypokalemia) with diuretic and laxative use • Recommended daily intake is 4,700 mg • Good sources of potassium include: baked potatoes with skin, prunes, spinach, beans, plain yogurt, fish, tomatoes/tomato juice, bananas, broccoli and cantaloupe

  10. Protein • “Nutrient of concern” according to 2015 Dietary Guidelines report • Link between low protein intake and loss of muscle mass (sarcopenia) • Protein needed to retain skeletal muscle • Loss of muscle mass decreases functional status in older adults • Recommended daily intake is at least 45 grams (females) and 60 grams (males) MedlinePlus

  11. Sources of Protein • Lean meats • Fish and seafood • Tofu/soy/edamame • Beans • Nuts/seeds • Dairy products • Protein Supplements/nutritional shakes

  12. Hydration & Fluid Needs • Risk of dehydration from decreased thirst sensation and decreased fluid intake for reasons such as problems with urinary incontinence, ambulation, manual dexterity or cognition • Loss of 2-3% of body fluid can cause physical and cognitive impairment • Signs of dehydration include dry mouth, poor skin elasticity, confusion, low BP, rapid heart rate, dark yellow urine/decreased urine output • Adequate fluid intake can decrease risk of constipation and is important for eliminating waste from the body • Fluids needs are 1.5-2 liters per day (includes fluid from foods)

  13. Conclusion • All people - especially older adults - need a variety of foods to ensure nutritional needs are met • Modify textures as neededand honor food/fluid preferences to make foods easy to eat and enjoyable • Food-based approach is ideal for meeting nutrient requirements, but supplementation may be needed (vitamins B12 and D) • Consult with a Registered Dietitian Nutritionist for guidance London Resident Magazine

  14. Resources • Shlisky J, Bloom DE, Beaudreault AR, Tucker KL, Keller HH, Freund-Levi Y, Fielding RA, Cheng FW, Jensen GL, Wu D, Meydani SN. “Nutritional Considerations for Healthy Aging and Reduction in Age-Related Chronic Disease.” Advanced Nutrition. 2017;8:17-26. • U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at https://health.gov/dietaryguidelines/2015/guidelines/. • Wolfram, Taylor. “Special Nutrient Needs of Older Adults.” Academy of Nutrition and Dietetics. May 2018. www.eatright.org. • Picetti D, Foster S, Pangle AK, Schrader A, George M, Wei JY, Azhar G. “Hydration health literacy in the elderly.” Nutr Healthy Aging. 2017;4(3):227-237. • Vitamin D, Calcium, Vitamin B12, & Potassium: Fact Sheets for Health Professionals. National Institutes of Health, Office of Dietary Supplements. Aug 7, 2019. Accessed Sep 9, 2019.

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