FINALS: NILS 2 REVIEWER Aging is characterized by a gradual Aging is a multifactorial consequence of

decline in organ function beginning as the interactions between genes and

Physiology of Aging Changes in body composition or early as 30 to 40 years of age. environment and may be altered through
physiological function that occur with nutrition, physical activity, and other
Preview Nutrition is well recognized as age may also influence nutritional In the absence of disease, aging alone
one of the major determinants of lifestyle choices.
requirements. does not lead to overt disease; however,
successful aging. physiologic changes that occur as part of The presence and rate of progression of
Declines in muscle mass and bone aging can make the occurrence of age-related changes differ significantly
From early in life, eating a nutritious diet, density and functional status and
maintaining a healthy body weight, and disease more likely. among individuals and may influence
changes in gastrointestinal functioning, how a disease manifests, its severity,
leading a physically active lifestyle are immune function, nutrient absorption, For example, alterations to the skeletal
key influential factors in helping and its consequences.
and metabolism may interfere with the system, such as changes in bone
individuals avoid the physical and capability of older adults to meet turnover and loss of bone mass, make Some of these changes can be slowed
mental deteriorations associated with nutritional needs, especially when osteoporosis and associated fractures with good health habits, including diet,
aging. calorie needs are reduced. more likely. exercise, and appropriate medical
Aging and life expectancy are dynamic interventions, whereas others are
Therefore, it can be difficult to separate thought to be part of normal aging.
processes influenced by genetics, the alterations related to aging from those
environment, and lifelong choices. related to disease Ultimately, the combination of changes
Age-related changes in body systems can lead to a decline in health and
Life Expectancy functional capacity and can contribute to
influence and are influenced by disease
risk and development. • Every person in every country in the an increase in susceptibility to injury and
world should have the opportunity to live vulnerability to disease.”
Distinguishing normal age-related a long and healthy life.
changes from those associated with
disease and disuse can be complicated • Today, adults who reach 65 years old
in older adults because of dynamic and have a life expectancy of an additional
interdependent causes and 19.5 years, and the 85-and-over
consequences. population is projected to more than
double from 6.4 million in 2016 to 14.6
Older adults experience numerous million in 2040.
physiological changes and medical
conditions that either lead to or require a • Along with general trends in the U.S.
change in nutritional requirements and population, Hispanic, Native American,
food intake. Alaskan Native, African American,
Asian, Hawaiian, and Pacific Islander
Efforts to consume a healthy diet can be populations are also living longer.
influenced by health status, changes in
taste perception, decreased olfactory
ability, difficulty chewing and Defining Aging
swallowing, and changes in digestion
and absorption and nutrient metabolism. Beginning before conception, nutrition is
dynamic in its effect on human
These factors may occur naturally with development and growth and, ultimately,
aging or as a result of illness or the aging process.
medication side effects.
 • The first is that aging is programmed, overlapping and interdependent osteoporosis
and the second is that the accumulation consequences.
of damage leads to aging.
• In older adults, whether changes are Physiological Metabolic Changes
• Genes may function to improve associated with normal aging or Decreased kidney function
longevity by offering disease protection, diseases, medication use, or physical Impact on Nutrition
whereas others may function in disuse, if the initiating factors can be Reduced ability to concentrate urine
combination with environment and determined and then prevented or contributes to increased fluid needs
lifestyle choices. treated, the disease or the Health-Related Consequences
consequences can be averted. Increased risk for dehydration
• Despite the genetic predisposition to Alterations in drug metabolism
Factors that influence aging and long life for some individuals, Selected Physiologic and Metabolic
quality of life environmental factors and lifelong Changes with Age and the Effects on
health-related behaviors, such as diet, Body Systems, Nutrition, and Health Physiological Metabolic Changes
physical activity, smoking and alcohol Decreased immune
use “and body weight maintenance are Physiological Metabolic Changes function
Decreased total Changes expenditure Impact on Nutrition
of critical importance to longevity and
Impact on Nutrition Increased needs for highquality
quality of life.
Decreased energy requirements proteins, antioxidants, vitamin B6,
Increased importance of nutrient- vitamin E, and zinc
dense food choices Health-Related Consequences
Health-Related Consequences Increased susceptibility to
Increased risk of obesity illness and disease

Aging System Physiological Metabolic Changes Physiological Metabolic Changes

Decreased muscle mass and strength Decreased immune
Impact on Nutrition function
functional impairment could limit food Gastrointestinal changes;
choices atrophic gastritis and increased
Decreased need for energy gastric pH
Increased need for high-quality Slow gastric motility
• Age-related changes in the body may protein Impact on Nutrition
influence how a disease manifests and Health-Related Consequences Increased requirements for folate,
progresses, as well as its severity . Increased risk for sarcopenia and calcium, vitamin K, vitamin B12, and
functional dependency iron
• Disability in old age is associated with Increased need for fluids and fiber
age-related conditions, such as Health-Related Consequences
coronary heart disease, adult-onset Physiological Metabolic Changes Increased risk for pernicious
diabetes, and Alzheimer’s disease, Reduced skin synthesis of vitamin D anemia and vitamin B12 deficiency
which are ultimately the main causes of (cholecalciferol) Increased risk for constipation
death in people older than the age of Impact on Nutrition
65.5 Increased requirement for vitamin D
• “Throughout the years, numerous and calcium Gastrointestinal Changes
aging theories have been proposed, • Distinguishing normal age-related Health-Related Consequences • Gastrointestinal changes affect older
which generally fall into two groups. changes from changes related to Decreased bone density and skeletal adults along the length of the
disease, medication use, and physical mass gastrointestinal (GI) tract, beginning with
disuse can be complicated because of Increased risk for bone fractures and
oral health in the mouth and continuing • Delayed emptying of gastric contents, Upper GI Changes years and 51–73% in patients who have
to the anus. reduced lower esophageal sphincter suffered a stroke
functioning, reduced peristalsis, hiatal
• Changes that occur along the length of hernia, and frequently used medications Nutritional status may be compromised
the GI tract are important in determining to treat conditions common in older in older adults who have difficulty
nutritional requirements, medication adults all affect esophageal functioning. chewing and swallowing if they avoid
dosing, and medical nutritional therapy meats, fresh fruits, and fresh
to treat chronic diseases and conditions Changes in gastric function vegetables, as these foods can be
difficult to chew and swallow
Changes Along the GI Tract with Age • In the stomach “and small intestine of
older adults, digestive secretions are • Delays in stomach emptying and
reduced, resulting in decreased capacity declines in gastric output have been
Oral cavity changes for nutrient absorption from foods. found to occur with age. Whether
• The first signs of micronutrients gastroparesis is a result of age or other
• Atrophic gastritis interferes with normal underlying conditions, such as atrophic
deficiencies and malnutrition often absorption of vitamin B12 and leads to a
appear in the oral tissues gastritis, is unclear.
deficiency of this vitamin.
• Chronic diseases and medication in • Atrophic gastritis results in a
Pancreas, gallbladder, liver changes “decreased secretion of acid and
older adults can lead to complications in
the oral cavity that result in pain, tooth • Pancreatic and gallbladder secretions intrinsic factor in the stomach, which
loss, xerostomia, and problems with and liver function all decline with age. contribute to vitamin B12 malabsorption
chewing and swallowing, which in pernicious anemia.
contribute to poor appetite and impaired • Changes in liver function could
influence the effectiveness of • The prevalence of atrophic gastritis is
ability to eat and drink. frequently reported in adults older than
medications, side effects of medications,
Esophageal changes and nutrient digestion, absorption, and 80 years.
metabolism. • Declines in liver, gallbladder, and
• “Dysphagia is associated with Impairments in the oral cavity and
advancing age because of age-related Small intestine changes pancreas function can have profound
changes in taste and smell with age,
physiologic changes in swallowing. effects on the digestion and absorption
• Nutrient digestion and absorption are disease, and medication use can
of fat, protein, and carbohydrates as well
• Dysphagia is common in older adults affected by changes that occur along the contribute to inadequate intake, lead to
as some vitamins and minerals.
with psychiatric diseases and small intestine. malnutrition, and worsen disease and
neurodegenerative diseases such as health outcomes. • A decline in the production of enzymes
dementia or stroke. Large intestine changes necessary to digest foods also occurs
These changes are of particular concern
with age. Impaired ability to digest
• Medications that can cause confusion, • “Slowing of gastrointestinal motility with in older adults. Swallowing disorders are
dietary fat, for example, may result in
decrease alertness, or affect age along with a low-fiber diet, low fluid common in this group; however,
inadequate energy and malabsorption of
consciousness or swallowing may intake, and medication use contribute to research suggests that conditions of
some nutrients.
contribute to delays in swallowing constipation. impaired swallowing, such as
response. dysphagia, result from disease rather Lower GI Changes
than aging.
• Gastroesophageal reflux disease The small intestine is where the
(GERD) and peptic ulcer disease are Any disruption in normal swallowing can digestion of protein, fat, and nearly all
common causes of dyspepsia in older be considered dysphagia. The carbohydrates is completed and where
adults. prevalence of dysphagia in the general most nutrients are absorbed.
population is 16–23% and increases
with age to 27% for those older than 76
Constipation, one of the most common - Pancreatic insufficiency • These changes in body composition • The burden of poor health from excess
gastrointestinal conditions of older - Pancreatitis can interfere with the ability to maintain body weight and body fat will continue to
adults, is multifactorial. It can frequently - Hepatitis independence in daily activities and increase in the older adult population
be attributed to diet, behavior, and - Cirrhosis result in increased frailty, declining with the rising number of older adults
physical inactivity - Cholestasis physical functioning, and worsening and their longer life expectancies.
- Fatty Liver health.
Optimizing GI health is fundamental to • Currently, almost 80% of adults 65
maximizing older patients’ ability to Large Intestine: • Loss of skeletal muscle mass and years and older are classified as
consume a healthful and varied diet. strength, called sarcopenia, is overweight, and 40% are obese.
- Constipation widespread among older adults,
Disruption in normal functioning of the - Diverticular disease affecting 10–40% of those older than 55 • Similar to younger age groups,
small intestine can have a profound - Diarrhea years. This number is expected to rise to overweight and obesity in older adults
effect on nutritional wellbeing. - Inflammatory bowel disease more than 200 million cases by 2050. are the result of poor food choices,
- Rectal Incontinence primarily the consumption of a low-
Dehydration, dementia, functional • Sarcopenia has many interrelated quality diet with excessive caloric intake,
limitations, chronic disease, and Esophagus: causes and is part of a complex cycle and an inactive lifestyle.
neurologic diseases such as multiple that includes worsening of disease
sclerosis and Parkinson’s disease are - Dysphagia • Older adults who are overweight have
- GERD burden and illness, nutritional
additional factors that may play a role in inadequacy, increased disability, and an increased risk of chronic diseases
constipation in elderly people. Stomach: functional dependence. such as heart disease, diabetes,
metabolic syndrome, and cancer.
The colon, for many older adults, is a - Atrophic gastritis • Optimizing nutritional intake with
source of discomfort, symptoms, and - Peptic ulcer disease adequate calories, high-quality protein, • On the other hand, unintentional weight
disease predominantly associated with - Dyspepsia and appropriate dietary supplements, loss and low BMI in elderly adults are
disorders in motility, such as combined with progressive resistance often suggestive of underlying disease
constipation. Small Intestine: associated with poor health outcomes
strength training, are the most effective
interventions to prevent and reverse and are markers for deterioration in well-
There are many myths and - Bacterial overgrowth
sarcopenia being.
misunderstandings about the - Diaccharidase deficiency
gastrointestinal effects of various foods - Celiac disease
Overweight and Obesity • When sarcopenia and obesity occur
in older adults that can lead to - Enteritis simultaneously, the condition is termed
unnecessary dietary restrictions and - Inflammatory bowel disease sarcopenic obesity. Sarcopenic obesity
inadequate nutrient intake. is detrimental to physical functioning and
contributes to worsening of health status
Changes along the gastrointestinal in older adults.
Changes in Body Composition with
tract that can cause nutritional
Age
deficiencies and disease Cardiovascular and Respiratory
System Changes with Age
Mouth/Oral Cavity:
• A decline in cardiovascular function is
- Dentition a major physical impairment associated
- Decreased salivation with aging.
- Decreased taste and smell
• Approximately 78% of adults older than
Accessory Organs (Liver, • Body weight generally increases until 60 years and 90% of adults 80 years and
Gallbladder, Pancreas) the 5th decade of life, after which adults older have a cardiovascular disease.
experience a loss of muscle mass and
- Decreased digestive secretions an increase in body fat.
• Age-associated changes in trans fat) levels hypercoagulability, important factor contributing to
cardiovascular performance are Omega-3 Decrease the risk of vascular smooth dehydration in older adults.
observed beginning in middle age; fatty acids arrhythmias that can muscle cell
however, an increasingly sedentary lead to sudden proliferation, and • Chronic kidney disease is more
lifestyle contributes significantly to a death, decrease endoplasmic common in adults older than 65 years
progressive deconditioning of the triglycerides, slow reticulum stress). (38%) than in younger people, and
cardiorespiratory system. the rate of Alcohol Drinking too much Medicare spending is in excess of $84
atherosclerotic alcohol can raise billion dollars to manage this condition in
• Normal aging leads to progressive plaque, and slightly triglycerides and lead the population.
wear and tear on the structure and lower blood to high blood
function of the heart; however, these pressure. pressure, heart • Kidneys are affected by the aging
atherosclerotic changes are strongly Dietary Excess dietary sugar failure, and stroke. process and also by illness,
sugar provides added Other problems of medications, and other conditions such
influenced by environmental factors,
calories and may excessive alcohol as diabetes, cardiovascular disease,
especially diet.
lead to weight gain, consumption are hypertension, and obesity.
• Modifiable lifestyle choices such as overweight, and cardiomyopathy,
dietary habits, body weight, smoking, obesity and cardiac arrhythmia, • Chronic kidney disease itself increases
contribute to and sudden cardiac the risk of heart disease, heart attacks,
and physical activity determine risk for
metabolic syndrome death. and strokes and is related to other health
atherosclerosis and heart disease in
and risk factors for Dietary fiber Aids in lowering LDL problems such as high blood pressure
older adults. diabetes, CVD, and cholesterol and edema, anemia, weakened
cancer. immunity, depression, osteoporosis, and
Energy Is central to the malnutrition.
intake management of body Renal System Changes with Aging
weight, which affects • In older adults with kidney disease,
lipoprotein functional declines, unintentional weight
levels, insulin loss, and sarcopenia are undesirable
sensitivity, plasma
consequences that contribute to frailty,
glucose, and blood
worsen disease burden, and have
pressure.
profound effects on health and quality of
Dietary Plays a role in the
Sodium development and life.
management of HTN Changes in Skeletal Health with
Dietary Protective effects Aging
antioxidants against CHD risk
(especially
vitamin E
Vitamin B6, May lower plasma • It is estimated that by age 60, the
vitamin B12, HCY levels average person has lost approximately
and (moderate elevations 25% of their kidney function.
Dietary factors associated with risk of
folate in HCY levels
heart disease
increase • Kidney changes and loss of renal
the risk of CHD by function can affect the older adult’s
Dietary Role in
promoting platelet ability to maintain fluid and electrolyte
Components Cardiovascular
activation, oxidative balance.
Health
Dietary fat Plays a role in the stress,
endothelial • Reduced ability of the kidneys to
(especially regulation of concentrate urine also can be an
dietary circulating lipoprotein dysfunction,
Genetics • Other essential nutrients: iron, zinc, Nutrition and Immune Health • Vitamin B12: Delays dementia
copper, B vitamins, carotenoids, protein, onset
• Peak bone mass largely determined by and essential fatty acids • Chronic poor nutrition accelerates
genetics immune system decline in older adults • Vitamin D: Potentially prevents
Nutrient Overconsumption to Avoid depression and
Lifestyle Factors • Research focuses on the role of: neurodegenerative diseases
• Excessive intake of protein,
• Diet, exercise, body weight, hormonal phosphorus, sodium, alcohol, vitamin A, • Nutrition status, dietary protein, Challenges for Older Adults
status, medication, tobacco and alcohol and caffeine can negatively affect bone antioxidants, probiotics, omega
use, and illness impact bone loss rate health fatty acids • Neurological declines can hinder
the ability to access and
Vitamin D Physical Activity for Elderly Adults • Caloric restriction and physical consume a nutritious diet
activity in mitigating immunologic
• Essential for bone health and • Surgeon General emphasizes that aging Endocrine System Changes
calcium/phosphorus balance reducing the risk of falls is the biggest
• Older adults often have poor vitamin D benefit of physical activity for older
status due to reduced skin synthesis and adults Nervous System Changes
absorption Immune System Changes
• Limited sunlight exposure decreases Immunosenescence
vitamin D synthesis, affecting calcium
absorption and bone quality • After age 50, immune system functions
begin to deteriorate
Osteoporosis
• Decline in immune function reduces
the body’s ability to fight infections,
increasing morbidity and mortality

Age-Related Immune Changes Neurological Changes in Older Hormonal Changes in Aging

Adults
• Reduction in number/function of • Hormones regulate nutrient intake and
immune cells and receptors • Reduction in nerve cells and utilization
decreased brain and spinal cord weight
• Decreased immune response leads to • Nutritional status impacts circulating
higher susceptibility to infections and • Slower message processing time hormone levels
illnesses, such as: impacts:
Age-Related Hormonal Alterations
• Pneumonia • Food sensation and intake
• Aging leads to changes in hormone
Osteoporosis
• Upper respiratory infections (e.g., • Gastrointestinal function in production and activity
• Most common bone disease; involves influenza) digestion and nutrient absorption
• Hormonal changes may be due to
loss of bone mass and strength, natural aging or secondary to disease
• Urinary tract infections Nutritional Impact on Brain Function
increasing fracture risk.
• Pressure sores • Folic Acid: Preserves memory in Impact on Metabolism and Health
Key Nutrients for Bone Health
aging
• Foodborne illnesses • Alters energy and nutrient metabolism
• Calcium, vitamin D, phosphorus,
• Vitamins B6 & B12: Essential for
vitamin K, magnesium, fluoride • Contributes to the development of
neurotransmitter synthesis
frailty and sarcopenia (muscle loss)
Hematologic Changes: Anemia • Chronic GI bleeding as a percentage of total calories; Dietary Guidance for Older Adults
however, total calorie requirements
• Use of gastric acid- tend to decline with advancing age, Importance of Nutrient -Dense Diet:
suppressing agents requiring the selection of more
• Nutritional intervention can help nutritious foods to meet individual • Essential for well-being, preventing
address underlying causes of anemia nutrient needs. Certain vitamins and health decline, and reducing functional
minerals, as well as aspects of their dependency and frailty
Gastrointestinal and Metabolic Health metabolism in relation to the aging
in Older Adults process and chronic diseases, Dietary Recommendations:
require special consideration for • Healthy older adults can follow general
Increased GI Complications:
older adults. (Modify their diet based adult dietary guidelines
• Aging impacts esophagus, stomach, on their condition) • Adherence may become challenging
and colon function with increased frailty and illness
Nutritional Challenges in Older
• Common issues: dysphagia, GERD, Adults Chronic Disease Risks:
constipation, fecal incontinence • Older adults are at higher risk for
• Importance of Nutrient-Dense Diet: conditions such as: • Cardiovascular
Impact of Obesity:
Anemia in Older Adults • Essential for maintaining health disease, cancer, osteoporosis,
• Obesity from poor diet, inactivity, and and well-being in aging sarcopenia
• Nearly 10% of older adults suffer from aging increases health risks • Poor nutrition can lead to health
anemia complications, polypharmacy, Supporting Healthy Aging:
• Leads to loss of lean mass, increase in and reduced independence
• Associated with: body fat, and functional impairment • Following a nutritious diet, staying
• Functional impairment and Chronic Disease Interplay: • Factors Affecting Nutritional active, and managing weight are key
physical decline Status: factors in promoting health in older age
• Genetics, aging, diet, and activity • Age-related biological changes
• Increased hospitalization rates influence CVD and other diseases Pinggang Pinoy Food Guide
and socioeconomic factors
• Reduced mobility and quality of • Decreased food intake,
• Systems affected: kidneys, skeletal, Development and Purpose:
life sedentary lifestyle, and reduced
immune, nervous, and endocrine • Created by FNRI-DOST for Filipino
energy expenditure
Importance of Nutritional Evaluation Nutritional Management: adults, with versions for children,
• Risks of Malnutrition: adolescents, elderly, pregnant, and
• Key factors to assess: • Prioritize dietary interventions for lactating women
• Older adults are at higher risk
• Inadequate intake of folate, vitamin treatment and minimizing harm • Aims to promote healthy eating habits
due to challenges in meeting
B12, and iron and optimum nutrition through a familiar
• Goals: Preserve quality of life and nutritional needs
plate model
support well-being • Chronic health conditions can
• Alcohol use or abuse Food Group Proportions:
alter nutrient requirements due
Nutritional Recommendations and • Glow Foods (Fruits & Vegetables):
• Reduced cobalamin absorption to changes in:
Requirements for Older Adults Half of the plate
due to: • Digestion, absorption, and
• Grow Foods (Proteins like meat, eggs,
metabolism
• Atrophic gastritis fish, beans, and legumes): One-sixth of
Preview • Therapeutic dietary the plate
• Helicobacter pylori adjustments for disease
• Go Foods (Carbohydrates like rice,
management
infection • Macronutrient needs for older adults corn, bread, oatmeal, and root crops):
are similar to those for younger adults One-third of the plate
 Vitamin D - Vitamin D is essential methionine and Carotenoi - Carotenoids with
Benefits: in promoting bone homocysteine. ds vitamin A activity,
• Easy-to-understand visual guide for health. - Deficiency can cause such as lutein and
balanced, nutritious meals on a per- - Vitamin D has a well- megaloblastic zeaxanthin, are
meal basis established function anemia and found in the macula
in bone metabolism, hyperhomocysteine of the eye and may
calcium mia. help to prevent the
homeostasis, and the - High consumption of onset and
NUTRIENT OF CONCERN
prevention of folic acid can mask a progression of age-
IN OLDER ADULTS osteoporosis. serious vitamin B12 related macular
- Higher levels of deficiency. degeneration (AMD).
Nutrient Consideration for the vitamin D have been Vitamin - Vitamin B12 is a Carotenoids with
Older Adults found to be B12 coenzyme in nucleic antioxidant activity
Water Sufficient fluids must associated with a acid metabolism. can help reduce the
be provided in efforts to reduction in cancer - Vitamin B12 risk of cataracts.
prevent dehydration. risk. deficiency causes
Adequate fluids sustain - Vitamin D has also megaloblastic Energy
homeostasis in the been found to exert a anemia.
body and aid in moving protective effect - Older adults may Energy and Nutrient Needs in Older
nutrients to cells, against have suboptimal Adults
metabolizing cardiovascular levels of vitamin B12
medications, and disease, arthritis, due to inadequate
eliminating waste Declining Energy Requirements:
multiple sclerosis, diet or poor
products. and diabetes • Caused by reduced energy
absorption resulting
Fiber Fiber is important for mellitus. from a lack of intrinsic expenditure, loss of lean body mass,
gastrointestinal health, Zinc - Zinc is a functional factor or atrophic and decreased physical activity
improves lipoprotein component of many gastritis. • Older adults require fewer calories to
levels, reduces risk enzymes and - Vitamin B12 maintain weight
factors for coronary proteins and is deficiency can lead to
heart disease, and aids involved in the changes in mental Nutrient Needs:
in weight management regulation of gene status, peripheral • Nutrient requirements often stay the
and the maintenance of expression. neuropathy, balance same or increase with age
normal blood glucose - Zinc deficiency can disturbances, and • Balancing lower energy needs with
levels. Consuming too contribute to high homocysteine nutrient intake is critical
much fiber can cause conditions common levels.
gastrointestinal in the older adult, Iron - “Iron is a structural
distress, and too little Risks of Imbalance:
such as loss of component of
fiber can lead to appetite, hair loss, • Failure to reduce caloric intake may
hemoglobin.
constipation. delayed wound - Iron deficiency leads lead to overweight and associated
Calcium Calcium is essential in healing, skin to microcytic health risks
promoting healthy abnormalities, hypochromic anemia. • Emphasis on nutrient-dense food
bones and teeth. impaired taste, and - Iron deficiency in choices is vital
Calcium also has an depression. older adults is
important role in blood Folate - Adequate folate frequently caused by Dietary Guidance:
clotting, muscle functions with a GI bleed, poor • Focus on a variety of nutrient-dense
contraction, and nerve vitamins B6 and B12 nutrition intake, and foods from all food groups
transmission. in the metabolism of medication side • Associated with better nutritional status
effects.” and overall health
 Carbohydrate constipation, anddecreases diverticula Protein
formation. • Healthy Fat Choices:
Carbohydrate Recommendations for • Weight Management: Fiber delays • Limit trans and saturated fats and Protein Intake and Sarcopenia in
Older Adults gastric emptying and promotes a cholesterol sources. Older Adults
sensation of fullness. • Total fat intake: <30% of total calories.
Dietary Guidelines Emphasis: • Saturated fat intake: <10% of total Impact of Reduced Protein:
• Meet carbohydrate needs with Recommendations: calories. • Age-related changes in body
nutritious whole grains, fruits, and • Fiber intake: 25–35 g/day • Cholesterol intake: <300 mg/day from composition and skeletal muscle loss
vegetables • Adequate Intake (AI): 30 g/day for men all animal sources. lead to reduced body protein and
• Limit daily intake of added sugar and 21 g/day for women (aged 51+) • Trans fats: Avoid entirely or limit to sarcopenia.
• Most Americans consume less than <0.5% of total calories. • Consequences include:
Impact of Simple Sugars: recommended levels. • Increased frailty and skin fragility
• Low nutrient content and contribute to Essential Fatty Acids • Impaired wound healing and
excess calories Sources of Fiber: immune function
• Can lead to inadequate intake of • Fruits, vegetables, legumes, whole Essential Fatty Acids and Healthy
essential nutrients grains, and cereals Aging Protein Intake Recommendations:
• Reducing sugars ensures sufficient • Minimize processed foods and • Adequate high-quality dietary protein is
nutrient intake without excess "empty prioritize natural, whole-grain products. Key Nutrients: essential to prevent sarcopenia.
calories" Linoleic acid (omega-6) and linolenic • Average intake:
Considerations for Frail Older Adults: acid (omega-3) are essential fatty acids. • Men: Generally within
Healthy Choices: • High-fiber foods can reduce appetite • Deficiency leads to reduced production recommended levels.
• Focus on whole grains and fiber-rich and nutrient intake, impacting body of important eicosanoids: • Women (60+): Often below
carbohydrates weight. • Arachidonic acid recommended levels.
• Better nutrient content and support • Adequate fluid intake is essential to • Eicosapentaenoic acid (EPA) • 50% of women and 30% of men (71+)
weight maintenance prevent constipation and fecal • Docosahexaenoic acid (DHA) fail to meet protein recommendations
• Ideal for maximizing nutrient intake impaction.
while keeping energy intake appropriate Role of Omega-3 Fatty Acids: Food Group Consumption:
Fats • Found in seafood and associated with • Most older adults meet weekly
Dietary Fiber healthy aging. recommendations for meat, poultry, and
Fat Recommendations for Older • Benefits include: eggs.
Dietary Fiber for Older Adults Adults • Improved cell maintenance • Underconsumed Foods:
• Lower blood pressure and heart • Seafood, dairy, fortified soy
Health Benefits: • Dietary Guidelines: rate alternatives, beans, peas, and lentils.
• Diabetes Management: Soluble fiber • Keep fat and carbohydrate intake • Reduced inflammation • These foods provide key nutrients
slows glucose absorption and reduces within recommended ranges to lower • Decreased risk of unhealthy aging often lacking in older adults' diets:
postprandial blood glucose levels. risks of heart disease, obesity, and • Vitamin D, essential fatty acids, and
• Cardiovascular Health: diabetes. Additional Nutrient Support: dietary fiber.
Recommended by the American Heart • Minimum fat intake: 10% of total energy • Omega-3 fatty acids and folic acid
Association to reduce CVD risk. to ensure adequate calorie and essential contribute to cardiovascular health and Protein Intake Challenges and
• Cancer Prevention: Supported by the fatty acid intake. reduced inflammation. Recommendations for Older Adults
National Cancer Institute to lower cancer • Fat Intake for Frail Older Adults:
risk. • Fats provide concentrated energy for Challenges to Protein Consumption:
• Digestive Health: Insoluble fiber those struggling to maintain weight. • Reduced appetite
increases fecal bulk, reduces • Excessive fat limitation can lead to • Functional and social limitations
weight loss and nutrient deficiencies. • Economic hardship
Impact of Inadequate Protein: Vulnerability to Dehydration: • Difficulty in achieving adequate intake Recommendations:
• Accelerates sarcopenia and other •More likely during: due to physiological and lifestyle •Older adults should monitor B vitamin
morbidities •Illness, hospitalization, or metabolic changes. intake and absorption.
• Worsens common diseases and stress •Symptoms like confusion or
conditions in older adults •Extreme weather conditions The B Vitamins forgetfulness should prompt
• Increases susceptibility to disease and •Cognitive changes, depression, or assessment for vitamin deficiencies.
poor clinical outcomes forgetfulness can lead to fluid imbalance B Vitamins and Their Importance in
•Older adults with limited functional Older Adults Calcium and Vitamin D
High-Quality Protein Sources: independence are at higher risk
• Protein with high biological value Key Vitamins: Calcium, Vitamin D, and Bone Health
(animal sources): Importance of Hydration: •Vitamin B12, B6, and Folate: in Older Adults
• Provides essential amino acids, •Maintaining adequate fluid intake is •Act as coenzymes in one-carbon
iron, vitamin B12, and other nutrients crucial for preventing dehydration and metabolism and homocysteine Key Roles:
• Should be included regularly in the supporting overall health in older adults. metabolism.
diet •Deficiency leads to •Calcium:
Micronutrients: Vitamins and hyperhomocysteinemia, an •Vital for blood function, muscle
Strategies to Improve Protein Intake: Minerals independent risk factor for vascular contraction, vasodilation/
• Distribute protein-rich foods evenly disease. vasoconstriction, blood clotting, and
across meals Vitamin and Mineral Requirements nerve transmission.
• Include high-quality protein in every for Older Adults Vitamin B12 Absorption Challenges: • Essential for bone health and
meal •Common in 10–30% of older adults due prevention of osteoporosis.
• Prioritize protein-rich foods over Age-Related Changes: to: • Vitamin D:
supplementation for: • Nutrient absorption, utilization, and •Decreased gastric acid and intrinsic • Enhances intestinal calcium
• Cost, accessibility, socialization, activation decline with age, increasing factor absorption.
and dietary variety benefits dietary requirements. •Atrophic gastritis with small bowel • Supports bone health, skeletal
• Vitamins like Vitamin D and Vitamin bacterial overgrowth muscle formation, and protein
Water B12 are particularly impacted by •Medication use affecting digestion synthesis.
physiological aging. and absorption •Reduces risk of frailty, falls, and
Water and Fluid Balance in Older mobility limitations.
Adults Recommendations for Older Adults: Health Implications: • Linked to reduced risk of
• Some vitamin and mineral •Low levels of vitamin B12, B6, or folate depression, cardiovascular disease,
Body Water Changes: requirements remain unchanged. are linked to: cancer, and diabetes.
•Lower percentage of body water due to: • Emphasis on nutrient-dense food •Higher risk of vascular disease
•Loss of lean body mass consumption to meet nutritional needs. •Depression and mental status Deficiency in Older Adults:
•Accumulation of body fat, which • Separate recommendations provided changes (e.g., confusion, • Common due to:
contains less water than muscle for: forgetfulness, balance •Reduced dietary intake and skin
• Ages 51–70 disturbances) synthesis
Factors Affecting Water Balance: • Ages 70+ •Decreased renal production and
•Decreased thirst sensation Folic Acid Fortification: limited sunlight exposure
•Altered kidney function (reduced urine Challenges in Meeting Nutritional •Raises serum folate levels, initially •Avoidance of dairy by those with
concentration ability) Goals: aimed at reducing neural tube defects, lactose intolerance
•Illness and limitations in daily activities • Increased need for essential nutrients with additional vascular benefits.
reducing fluid intake with advancing age.
•Environmental factors, medication use,
and voluntary restriction
Vitamin D Recommendations: Dietary Recommendations: Iron Deficiency in Older Adults: Health Benefits of Zinc:
• 600 IU daily for adults aged 51–70 • Follow a low-sodium dietary pattern: •Rare due to cessation of menstrual iron •May improve immune function if
years • Reduce intake of high-sodium losses in women after menopause. deficiency exists.
• 800 IU daily for adults over 70 years foods and beverages. •Average dietary intake typically meets •Protects retinal health and reduces the
• Supplementation (1,000–2,000 IU • Adopt the DASH diet, which the RDA of 8 mg/day for adults 51+. risk of age-related macular
daily) may be needed for: includes: •Deficiency can occur due to: degeneration.
• Limited sunlight exposure • High amounts of • Prolonged poor intake,
• Poor dietary calcium and vitamin D vegetables, fruits, whole gastrointestinal bleeding,
intake grains, low-fat dairy, fish, malabsorption, or medical conditions. Risk Factors for Zinc Deficiency:
poultry, beans, and nuts. •Stress, particularly in hospitalized older
Additional Bone Health Nutrients: • Low amounts of sweets, Absorption Challenges: adults.
• Protein, vitamins A and K, magnesium, sugar-sweetened •Iron is absorbed in the small intestine. •Increased risk of impaired immune
and phytoestrogens are important for beverages, red meats, and • Conditions like small intestine function and vision loss.
overall bone health. saturated fats. inflammation or achlorhydria (low
• Rich in potassium, calcium, stomach acidity) can reduce absorption. Supplementation
Sodium magnesium, dietary fiber, Recommendations:’
and protein. Health Impacts of Low Iron: •Multivitamin supplements
Sodium Intake and Health in Older • Can lead to anemia with symptoms recommended for patients with:
Adults Benefits of DASH Diet: such as: •Pressure injuries.
• Lowers blood pressure. •Decreased energy, fainting •Diagnosed or suspected
Sodium Intake Statistics: • Reduces cardiovascular disease risk episodes, pale skin, irregular deficiencies.
• Average daily intake for older adults: factors. heartbeat, cold extremities, and •Zinc supplementation should be used
• Ages 60+: 2,800 mg (women) and headaches. under medical supervision.
3,800 mg (men) Key Actions:
• Ages 70+: 2,400 mg (women) and • Monitor sodium intake regularly. Recommendations: Potential Risks of Excess Zinc:
3,200 mg (men) • Focus on reducing processed food •Include iron-rich foods in the diet. •May inhibit wound healing and immune
• Most exceed the recommended consumption and increasing nutrient- •Iron supplementation is appropriate for function.
Tolerable Upper Intake Level (UL) of dense, whole foods. older adults with diagnosed anemia. •Can alter absorption of other minerals
2,300 mg/day. and lower HDL cholesterol.
Iron Zinc
Health Impacts of High Sodium: Antioxidants
• Linked to hypertension, cardiovascular Iron Intake and Deficiency in Older Zinc Intake and Supplementation in
disease, and low bone mineral density. Adults Older Adults Antioxidants and Their Importance in
• Older adults often have reduced Older Adults
sodium excretion ability and greater salt Factors Affecting Iron Intake: Zinc and Aging:
sensitivity. •Reduced meat consumption due to: •No consistent evidence that aging Key Antioxidants:
•Taste changes, medication use, affects zinc absorption or increases •Vitamins A, E, and C:
Sources of Dietary Sodium: economic challenges, and poor requirements. •Linked to reduced disease rates
• Processed and commercially prepared dentition. •Zinc deficiency risk is higher in older through protective mechanisms.
foods: adults due to lower average intake •Found in fruits, vegetables, and
• Mixed dishes (e.g., sandwiches, Key Dietary Sources of Iron: compared to healthy fats.
pizza, and seafood dishes) •Well-absorbed sources include: the RDA.
• Canned soups, packaged meals, • Beef, fish, pork, tofu, legumes,
processed meats, cheese, and and fortified breakfast cereals.
snack foods.
Health Benefits: •Various cancers arrhythmia, and sudden cardiac Usage Among Older Adults:
•Associated with lower prevalence of: •Age-related macular degeneration death. • Over half use CAM; nearly 25% of
•Degenerative diseases (AMD) •Liver Damage: adults aged 85+ take herbal products or
•Cardiovascular disease •Dementia •Excessive alcohol use contributes supplements.
•Age-related macular degeneration •Cardiovascular disease to progressive liver damage (e.g., • 88% of adults 65+ take dietary
•Cancer •Arthritis fatty liver, hepatitis, cirrhosis). supplements, though only 24% are
•May protect against cognitive diagnosed with a nutritional deficiency.
impairment and decline. Impact of Aging: Alcohol Detoxification: • Common nutrients in supplements:
•Supports physiological functions and •Aging increases oxidative stress, which •Enzymes required for alcohol vitamins, minerals, herbs, amino acids,
reduces oxidative stress. is exacerbated by chronic diseases. detoxification: enzymes.
•Low blood levels of carotenoids in older •Alcohol dehydrogenase and
Functions of Specific Antioxidants: adults can impact disease progression acetaldehyde dehydrogenase Benefits:
•Vitamin E: and accelerate aging. (require thiamin). •Help meet nutrient requirements when
•Prevents lipid peroxidation, •Certain medications can impact alcohol dietary intake is insufficient.
maintains cell integrity, and supports Dietary Sources of Carotenoids: metabolism, increasing the need for • Useful for older adults needing extra
immune and blood clotting •Carrots, sweet potatoes, spinach, kale, thiamin- dependent enzymes. calories or protein to maintain health and
functions. tomatoes, and other brightly colored weight.
•Sources: Vegetable oils, nuts, fruits and vegetables are rich sources. Recommendations:
seeds, whole grains, dark leafy •Alcohol use in older adults should be Risks of Supplement Use:
greens. Supplementation Considerations: discouraged. • Potential for exceeding Tolerable
•Vitamin C: •Older adults considering vitamin A or •Older adults on medications may need Upper Intake Levels (UL), especially for
•Facilitates collagen synthesis, carotenoid supplements for vision increased dietary thiamin intake to meet fortified nutrients.
wound healing, immune function, protection or improvement should detoxification demands. •Adverse interactions between
and iron absorption. consult their physician. botanical/herbal supplements and
•Sources: Fruits and vegetables. •Research is ongoing to determine Nutrient Supplementation medications.
optimal intakes, timing, and duration for • Only 22% of older adults discuss
Recommendations: carotenoids in aging and disease Dietary Supplements and supplement use with healthcare
•Promote a diet high in fruits, prevention. Complementary Medicine in Older providers, limiting safety and efficacy
vegetables, and healthy fats to meet Adults guidance.
antioxidant needs. Alcohol
•Use high-dose antioxidant supplements Complementary and Integrative Key Nutrients for Supplementation:
only with medical supervision due to Alcohol Consumption and Its Effects Medicine (CAM): • Fiber, antioxidants, calcium, vitamin D,
potential risks. in Older Adults • CAM includes practices and products and vitamin B12 are often low in older
not part of mainstream medicine. adults’ diets and should be considered
Carotenoids Prevalence: •Complementary: Used with for supplementation.
•8% of adults 65 years and older report conventional medicine.
Carotenoids and Their Importance in excessive alcohol consumption. •Alternative: Used in place of Recommendations:
Older Adults conventional medicine. • Use multivitamin/mineral supplements
Health Risks: •Integrative: Combines if dietary variety is limited.
Antioxidant Properties: •Cardiovascular Issues: conventional and unconventional • Consult healthcare providers to ensure
•Protect against oxidative stress caused •Raises triglycerides. practices. safe and effective use.
by free radicals, which contribute to •Increases risk of high blood
tissue damage and pressure, heart failure, stroke,
age-related diseases. cardiomyopathy, cardiac
•Help reduce the risk of: