Transcript Chapter 5

Chapter 5
Nutrition and the Elderly
Outline
 Introduction
 Special Considerations
 Screening &
 Physiological Impact
Intervention
 Basic Nutrition
Overview
of Aging on Nutrition
 Summary
Summary of Factors that
Influence Nutrition in the Elderly
 Physiological
– Health Status
– Chronic Disease
– Changes in appetite
– Physical disability
– Sensory acuity
– Physical activity
– Use of alcohol or other
drugs
– Lifelong diet habits
 Socioeconomic
– Culture/ethnicity
– Income
– Education
– Lifestyle
– Nutrition knowledge &
practice
– Cooking skills
– Susceptibility to food
fads
– Institutionalization
More factors:
 Psychological
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Belief system
Motivation-Self-image
Mental state
Degree of independence
Feeling of usefulness
Presence or absence of
spouse
– Social contacts-loneliness
 Environmental
– Type & location of housing
– Adequacy of cooking
facilities
– Proximity of family &
friends
– Availability,
accessibility, &
adequacy of food
supply
– Health service
Screening and Intervention
 Nutrition Screening
Initiative: the premise
of the initiative is that
nutrition status is a
“vital sign” that is just
as important in
evaluating a person’s
health & well-being as
the traditional vital
signs of blood
pressure & pulse.
Basic Nutrition Overview:
 Essential Nutrients: 6 classes of nutrients
– Carbohydrates
– Proteins
– Fats
– Vitamins
– Minerals
– Water
• These nutrients are essential for promoting growth,,
maintenance, & repair of our bodies.
Carbohydrates:
 Simple carbohydrates: sugars
 Complex carbohydrates:
starches
 At least 50% or more of
our calories should come
from eating foods that are
good sources of complex
carbohydrates because
they are nutrient rich &
have fiber.
 Include grains, legumes
(dried beans & peas),
fruits & vegetables,
cereals, pasta, & rice.
Simple carbohydrates:Sugar
Cane
 High in simple sugars,
(monosaccharides-cakes, candies,
cookies, & sodas (empty calorie
foods)= high in calories & low in
nutrient value. Fruit & fruit
juices also have simple sugars,
but they come packaged from
Nature with many essential
nutrients. No more than 20% of
total carbohydrates. Simple
sugars: Glucose (the sugar in
blood);Fructose(the sugar in
fruit-honey);
 Galactose (sugar made from milk
sugar)
Fiber: complex carbohydrate
 Major sources=whole
grains,fruits, legumes,
vegetables, nuts &
seeds.
 Much of the fiber in
our diet is processed
away when whole
grains are refined &
the bran portion is
removed.
 Not an essential
nutrient, necessary to
keep our intestinal
tract healthy. Binds
water, causing softer,
bulkier stools that
move through the
intestinal tract more
quickly.
Fiber:
 Researchers believe diets with
adequate fiber help reduce risk of
colon cancer.
 Fiber also thought to bind
carcinogens, or cancer-causing
agents, & stools with more water
lessen the potency of the cancercausing agents in the waste
material.
 Adequate fiber helps prevent
constipation, diverticular disease,
& hemorrhoids. Soluble
fiber(legumes,oats,rice,fruit)may 
cholesterol levels.
Protein:
 Proteins are the main
substances that the body
uses to build & repair
tissues such as muscle,
blood, internal organs,
hair, nails,& bones.
Proteins are part of
hormones, antibodies, &
enzymes. Enzymes are
proteins that catalyze the
biochemical reactions that
take place in the
metabolism of the body.
Fats:
 Primary function of fats, or lipids, in the
body is as a rich source of energy. Fat helps
insulate & regulate body temperature, it
surrounds internal organs & protects them
from external injury, & it is the carrier of
the fat-soluble vitamins A,D,E,& K.There
are two essential fatty acids-linoleic &
linolenic acid. Fat calories should account
for no more than 30% of total calories.
Vitamins:
 Vitamins are substances
that are needed by the
body to maintain
metabolism, growth, &
development.
 There are 13 vitamins, 2
categories. Watersoluble=Vitamins C &B
complex.Fat solubleA,D,E,K.
Minerals:
 There are 23 minerals
that are essential for
human nutrition.
 Perform numerous
functions in the body,
including metabolism,
maintenance of fluid
balance,bone & teeth
formation,blood clotting,muscle& nerve
function&red cells.
Planning meals-good nutrition
 Adequacy
 Balance
 Calorie Control
 Moderation
 Variety
Food Guide Pyramid:
 Foundation= bread,
cereal, rice, & pasta.
 Next=fruits &
vegetables
 Next=milk, yogurt, &
cheese
 Next=meat, poultry,
fish, dry beans, eggs &
nuts.
 Top=fats,oils,sweets.
Food Preparation for the Elderly:
 Small, frequent meals
 Low in fat,sugar,
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cholesterol, & salt.
Convenience foods that
are healthy.
Quick & easy snacks.
Cheerful environment.
Regular exercise.
Shop & eat with
neighbors.
Liquid Nutritional Supplements:
 Ensure
 250cal-9g.protein6gfat
 Sustacal
 240cal-14.5gprotein
 Boost
 Choice DM
9g fat
 240cal.-10.2g.protein
4.1g.fat
 250cal.-10.6g.protein
12 g.fat.
Drugs that affect appetite:
 Decongestant
 Amphetamines
 Appetite suppressant
drug
 Appetite stimulant
 Lithium
 Tranquilizers
 Steroids
Dental Health:
 Total loss of teeth in
55% in adults older
than 85
 44% age 75-84
 30% age 65-74.
Thirst, Dehydration, GI Tract
 Dehydration: Dry lips;
Sunken eyes; Swollen
tongue; Increased body
temperature; Decreased
blood pressure;
Constipation; Decreased
urine output; Nausea
 GI Tract: Increase dietary
fiber
Liver-GB, Pancreas,
Cardiovascular
 Liver function
complicated with alcohol
abuse.
 Gallbladder malfunction =
gallstones.
 Cardiovascular:Heart
healthy diet and exercise.
 Drug & Nutrient
Interactions
Value of Appropriate Nutrition:
 The value of appropriate
nutrition screening &
intervention cannot be
underestimated in providing
quality care for the elderly.
Good nutrition not only
optimizes health & well-being,
it helps prevent the onset of
many chronic diseases.