Improving Nutrition in the Elderly
During the "golden years," good nutrition is just as important as ever, but many older adults become malnourished for a variety of reasons. If you or someone you care for is having trouble getting proper nutrition, here are some practical tips.
Malnutrition and Older Adults
While many people seem to focus their diets solely around trying to lose weight and prevent disease, the nutrition problems facing the elderly can be quite different.
For many elders, it's not a matter of eating too much, but rather a matter of not getting enough. And this all comes at a time of life when getting adequate nutrition—including protein, fiber, hydration, vitamins, and minerals—is as important as ever.
Adding to the problem is that many older people deal with a variety of chronic medical conditions. These conditions can contribute to poor nutrition and can also be worsened by poor nutrition.
Several factors can cause malnutrition in older adults, including the following:
- Loss of appetite. Older adults lose their appetites for many reasons, including physical disease, mental illness, or emotional distress.
- Decreased sense of taste and/or smell. Many of the diseases that affect older adults and the medications they take can reduce the sense of smell and taste, making it difficult and even unpleasant to eat. An estimated one-third of all older adults report dissatisfaction with their sense of taste.
- Difficulty chewing and/or swallowing. Poor dentition affects many older adults and can contribute to a vicious cycle of malnutrition; as older people become malnourished and lose weight, their dentures may not fit correctly, making it even more difficult to eat. Swallowing problems also affect many older adults, making eating difficult.
- Loss of physical strength or mobility. Elders who are frail or immobile are often unable to shop and cook. Even something as simple as opening a can of soup or a frozen dinner and putting it into the microwave can be difficult for someone who is physically debilitated.
- Chronic diseases and medications. Older adults often have at least one chronic medical condition and often take a slew of different medications. Certain disease states, as well as side effects from medications, can interfere with appetite, digestion, and even absorption of certain nutrients.
- Mental and emotional factors. Mental illness, such as ]]>depression]]> and age-related ]]>dementia]]> , and social isolation affect many elders and can dampen their desire and ability to eat.
- Financial insecurity. Financial problems can make it difficult for many older adults to get the nutrition they need.
Although there are many reasons why older people may become malnourished, there are also many practical ways for dealing with the problem.
If you or someone you care for is experiencing malnutrition or unintentional weight loss, the best first step is to see your doctor, who may be able to diagnose an underlying medical condition or alter a medication regimen that may be contributing to the problem. A doctor can also provide a referral to a registered dietitian, who can design a personalized eating plan.
In addition, here are some "everyday" tips for preventing malnutrition in older adults:
Make meals and snacks nutrient-dense. This means making nutrient-rich foods the focus of the meal. For example, instead of plain chicken broth, try a hearty chicken and vegetable soup. Casseroles, stews, and roasts are also good meal ideas.
Add extra calories without extra volume. For people who have a small appetite, there are ways to boost nutrition without adding lots of extra food. For example:
- Add extra sauces, gravies, and grated cheese to entrees and side dishes.
- Stir powdered skim milk into milk, milkshakes, and cold and hot cereals.
- Add honey, molasses, or maple syrup to hot cereal.
- Sprinkle wheat germ into hot and cold cereals, and add it to baked goods, such as breads and muffins.
Use herbs and spices liberally when preparing foods. Because many elders have diminished sense of taste and smell, making food as flavorful as possible is important. Try cooking with garlic and onion powder, salt-free seasoning blends, and fresh and dried herbs, such as basil, oregano, thyme, rosemary, and cilantro.
Make meals colorful and appealing. Instead of regular mashed potatoes, try mashed sweet potatoes for a colorful and nutritious boost. Instead of plain buttered noodles, try pasta with a vibrant red tomato sauce.
Serve several small meals and snacks, instead of three big ones. Older people with diminished appetites are often overwhelmed by large meals, so serving smaller, more frequent meals and snacks can help them feel less overwhelmed and more able to eat what they need.
Don't fill up on non-nutritious items. For people with a small appetite, it's important not to fill up on things like coffee, tea, and soft drinks, which can take the place of more nutritious items.
Serve up a variety of foods. Research shows that elderly adults eat more when presented with a variety of foods to choose from. Here are some strategies to increase the variety on the table:
- Strive to include foods from every food group and of all different colors.
- Invite friends over for a pot luck dinner.
- Go out for a buffet-style Sunday brunch.
Make mealtime enjoyable and social. When possible, invite friends or family over for meal times or visit community-based senior meal sites for social interaction during meals.
Use nutrition supplements when necessary. While a well-balanced diet is the best bet, some people may find it easier to sip a nutrition supplement drink (available at supermarkets and drug stores) than to eat a meal.
Take advantage of services that are available. Many communities offer a wide range of nutrition services for older adults, including community dining sites, home-delivered meals, and home visits with registered dietitians. Research shows that meal services, such as Meals on Wheels, can improve or help maintain nutritional status in seniors. Contact your local town or city hall, department of health, or community hospital to find out what services are available in your area.
Administration on Aging
American Dietetic Association
Meals on Wheels
Canadian Council on Food and Nutrition
Dietitians of Canada
Hollis JH, Henry CJ. Dietary variety and its effect on food intake of elderly adults. J Hum Nutr Diet. 2007;20:345-351.
Keller HH. Meal programs improve nutritional risk: a longitudinal analysis of community-living seniors. J Am Diet Assoc. 2006;106:1042-1048.
Rawson NE. Age-related changes in perception of flavor and aroma. Generations. 2003;27:20-26.
Last reviewed May 2009 by ]]>Maria Adams, MS, MPH, RD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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