Vu Ngo, D.C., MSACN, CCSP, CPT

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The information provided is based on current evidence to provide a basic guide to optimal diet and nutrition, and it has been created after taking into consideration a limited income, living alone, and preparing own meals. This nutritional guide is simply that, a basic roadmap to better nutrition, but each individual, especially within the aging adult population, as well as those with medical conditions, may require a detailed assessment by a nutritional specialist to develop a specific diet and nutrition plan that is customized to meet nutritional needs.

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As we grow up, we may have developed dietary habits that can contribute to malnutrition and chronic disease, and we may have never really had an opportunity for nutritional guidance to improve our diet to get the most out of food (Campbell, 2013). With the aging U.S. population and the intimate relationship of nutrition and chronic disease, the role of food choice and diet is very important. Optimal nutrition is important for longevity as well as quality of life (Havala, 1992), and the unique nutritional needs of an aging adult must be properly addressed. This nutritional guide will improve the dietary choices and nutrition for the aging adult. Our goal in providing this nutrition guide is to empower our older adults to make better food choices and improve nutrition, which will help delay the onset of or improving upon chronic disease, improving physical health, improving longevity of life, as well as improving overall quality of life (National Council on Aging). By providing the proper nutritional knowledge and tools, we will be able to combat chronic diseases such as muscle loss from inactivity and protein deficiency, bone loss from deficiency in vitamin D and calcium, and reduced metabolic activity with the consumption of more frequent small portion meals (Campbell, 2013).

 

 

 

Choose Healthy and Nutrient Dense Foods

• Nutrient Density means that your food is rich in vitamins, mineral, and other important nutrients, without having high amounts of added sugars, sodium, and trans- or saturated fats (American Heart Association, Inc., 2019)

• Nutrient Dense foods can be assessed on the USDA’s website, ChooseMyPlate.gov

• Learn to assess the nutrition facts label on foods

• As a general rule of thumb:

  • 30% of a meal plate = Vegetables

  • 30% of a meal plate = Grains

  • 20% of a meal plate = Fruits

  • 20% of a meal plate = Protein

• You can also prioritize healthy foods (American Heart Association, Inc., 2019)

  • Choose less processed foods

  • Choose USDA Organic when possible

  • Choose whole fruits and vegetables

  • Choose whole grains over refined grains

  • Choose beans, seeds, and lean meats

  • Choose to stay hydrated with water or unsweetened drinks, and avoid sugary flavored drinks

• Prepare meals at home and minimize eating out

 

Staying Within Your Budget

• Plan your meals and recipes to ensure you are getting the right amount and the most nutrients

• Know your serving sizes, which can be found online at websites such as EatRight.org and ChooseMyPlate.gov

• Check your local paper, mail, and old receipts for coupons and deals

• Make a shopping list before you go to the market

• Different markets will have different deals, spending a little more time shopping can bring home affordable organic foods

(NY Office of Temporary and Disability Assistance, 2016)

 

Make Meals More Enjoyable

• Share meals with loved ones, friends, family, and neighbors

• Prepare for meals together

• Go grocery shopping as a group

• Enjoy mealtime together as a time to catch up and share stories

(Robinson & Segal, 2019)

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Social and Psychological Influences on Diet

• Culture may be one of the largest influences in the diet of an aging population, as culture is something we are born into and grow up with, having a much longer period to cement dietary behaviors (Orji & Mandryk, 2014)

• The aging older adult is less likely to have a large social network, and one great option is having access to a senior center, which can be a catalyst for improving health and well-being. A senior center acts as a social hub to expand the social network, to meet and mingle, and to participate in group activities (Bloom, et al., 2017)

• Our dietary habits do not typically change with age, and furthermore from a psychological point, there is a reluctance to try new foods, and older adults may choose diets consisting of easily prepared or easy to eat foods, and choosing foods with familiar tastes or textures (van den Heuvel, Newbury, & Appleton, 2019)

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Potential Barriers to Good Nutrition

• Aging older adults are predisposed to nutrient deficiency with decreased physical activity, decreased lean muscle mass, and increased adiposity (Porter Starr, McDonald, & Bales, 2015). Metabolic processes slow down and the ability to absorb nutrients from food also declines (Pray, Boon, Miller, & Pillsbury, 2010)

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Problems with Malnutrition and Symptoms to Recognize

• Chronically low intakes of nutrients from the diet would lead to varying conditions based on the nutrient. This list is an incomplete list, but provides some common nutrients and problems with deficiency.​

  • Low intake of fiber can cause problems with the normal population of healthy bacteria in our digestive tract, increasing LDL cholesterol and decreasing HDL cholesterol, abnormal blood glucose responses, poor bowel movement and constipation, unhealthy weight gain, and general overall health (Mentzer, 2018)

  • Sodium deficiency can cause headache, nausea, vomiting, fatigue, and muscle cramps. Too much sodium can cause hypertension, cardiovascular disease, kidney disease, and osteoporosis.

  • Potassium deficiency can cause weakness, fatigue, constipation, and an irregular heartbeat which can be fatal

  • Vitamin C deficiency can cause scurvy, with weak tropocollagen bonds leading to weakened tissues, as well as bleeding gums, pinpoint hemorrhages, and corkscrew hairs

  • Vitamin E deficiency can cause neurological problems

  • Selenium deficiency can cause Keshan disease, which causes a heart lesion

  • Vitamin D deficiency can cause bone demineralization and leads to osteomalacia in adults, leading to soft bones causing pain and increased risk of fractures

  • Calcium deficiency can cause hypocalcemic tetany, it can lead to rickets in children, and osteopenia and osteoporosis

  • Phosphorus deficiency can cause decreased bone and teeth development, as well as muscle weakness, rickets, and bone pain

  • Vitamin A deficiency can cause night blindness, and gradual development of xeropthalmia then blindness, and chronic vitamin A deficiency can also lead to hyperkeratosis with rough and irritated skin

  • Iron deficiency presents as microcytic hypochromic anemia caused by low hemoglobin and clinically presents with a slow metabolism with fatigued, weakness, apathy, headaches, and decreased immune function

  • Zinc deficiency can cause dermatitis, hair loss, impaired immune function, and skeletal abnormalities

  • Thiamin deficiency can cause dry beriberi which affects the nervous system causing loss of muscle function, numbness, and/or tingling, or wet beriberi which affects the cardiovascular system causing pitting edema and cardiomegaly

  • Riboflavin deficiency can cause sore red eyes and eyelids, angular stomatitis, glossitis, cheilosis, and scrotal dermatitis

  • Niacin deficiency can cause pellagra, with symptoms of dementia, dermatitis, and diarrhea

  • Vitamin B6 deficiency can cause seborrheic dermatitis, microcytic hypochromic anemia, convulsions, depression, confusion, and neurological deficits

  • Vitamin B12 deficiency can cause megaloblastic anemia or neurological abnormalities such as decreased mental function and peripheral neuropathy

  • Folate deficiency can cause megaloblastic anemia

(Lindshield, 2018)

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Seeking Medical Care

• Nutritional deficiencies can be difficult to identify until they are more severe.

• Potential earlier signs that prompt immediate medical care include:

  • A weakened immune system, which can be identified by an increased frequency of sickness or infections

  • Poor wound healing or easily bruising

  • Muscle weakness, poor hand-eye coordination, or unintentionally dropping objects

  • Deep bone pain in the absence of any trauma

  • Decreased cognitive function, such as increased forgetfulness, abnormal confusion, or minor incoherency

• This list of potential problems of malnutrition is incomplete, but can act as a guide to help in the early identification of any nutritional deficiencies.

• In the event that there are any symptoms as seen above, prompt medical care should be sought and a comprehensive examination by a medical professional is necessary.

(Mayo Clinic Staff, 2019)​