Older Adult Nutrition

There is no definitive answer to the question, what age are you considered an Older Adult?

A person is eligible for membership in the American Association of Retired Persons (AARP) when they turn 50 years old. Many restaurants and business organizations offer senior discounts beginning at age 55. Retailers providespecial “Senior Shopping Hours” to those age 60 and above. A person can begin receiving Social Security retirement benefits at age 62 (although the recommended age is 66 or 67, depending on the year you were born). At age 65, a person becomes eligible for Medicare benefits. The National Council on Aging (NCOA) identifies older adults as people aged 60+, and the National Association of Area Agencies on Aging which was instituted in 1973 under the Older Americans Act (OAA) responding to Americans aged 60 and above needing community services.The Centers for Disease Control and Prevention (CDC) identifies the Older Adult Population as being aged 60 years or older.Terms synonymous with “Older Adult” are as varied as the definition and include OAP (Older Adult Person), Elderly Person, Aging Adult, Geriatric and Senior, to name a few. For this webpage, we define older adult as anyone 65 years old or above.

Nutrition Related Conditions & Diseases Experienced by Older Adults

How Healthy Eating Contributes to Prevention & Reduces Risks of Chronic Conditions

6 in 10 adults in the United States are affected by chronic diseases, and 4 in 10 of them have two or more conditions, according to The Centers for Disease Control and Prevention (CDC). Of adults age 65 and older, 80% are affected by at least one of these conditions, while 68% have two or more. The CDC suggests four lifestyle behaviors pose significant risks: use of tobacco, lack of physical activity, poor nutrition and excessive use of alcohol.

Several of the top ten disease conditions reported by the National Council on Aging affecting Medicare covered adults aged 65+ are nutrition related: hypertension (high blood pressure), high cholesterol, diabetes, and heart failure; even chronic kidney disease, depression and Alzheimer’s can be affected by poor nutrition. Family genetics, age and gender play significant roles in determining risk factors; however, the outcome of many nutrition-related chronic conditions can be managed and improved with simple habit changes to diet and lifestyle.

Hypertension is the major contributing risk factor for all of the cardiovascular diseases and is directly related to a poor diet or lifestyle, particularly intakes of sodium and potassium. If left untreated or unmanaged, hypertension can also lead to kidney disease and diabetes. Recommendations include maintaining a balance of sodium and potassium (most diets are too high in sodium and too low in potassium). Limiting sodium (salt) intake to no more than 1500 mg per day, and increasing potassium intake to 4700 mg per day, limit, along with physical activity of 150 minutes per week, limiting stress and the use of alcohol and following a healthy diet such as the DASH diet (Dietary Approach to Stop Hypertension) or Mediterranean diet that both emphasize eating fruits, vegetables, whole grains, low-fat dairy, seafood, healthy oils and nuts can make a difference within 14 days.

High Cholesterol Elevated (high) cholesterol is also associated with an increased risk of cardiovascular diseases (see above). Recommended levels of total serum cholesterol (TC) for adults = 120-199 mg/dL (desirable); 200-239 mg/dL (borderline high); >240 mg/dL (high). High-density lipoprotein (HDL) levels = >45 mg/dL (male) & >55 mg/dL (female). Low-density lipoprotein (LDL) = <130 mg/dL (desirable); 130-159 mg/dL (borderline high); >160 mg/dL (high). The Recommended Dietary Allowance (RDA) for how much cholesterol you should eat per day is 300 milligrams (mg). Reading the Nutrition Facts Label can help in reducing the amount of dietary cholesterol, saturated fats and trans fats consumed from your diet.

Diabetes Type 2 Diabetes is affected by environment, heritage and lifestyle factors, and occurs when your body either doesn’t produce enough insulin or is resistant to insulin the body does produce. Susceptibility for developing diabetes increases after age 45; it can lead to complications of kidney, heart, nerve, and eye diseases, as well as other chronic conditions. Monitoring and managing blood glucose levels, along with weight management, physical activity and consuming a healthy diet, especially watching carbohydrate and caloric intake, are habits to incorporate into your life to assist in self-management.

Good Nutrition Makes a Difference Making smart food choices and choosing healthy meals will contribute to healthy aging. Here are tips for people age 65 or older:

Get enough fluids: Don’t wait until you notice you are thirsty! drink fluids often throughout the day limiting beverages with added sugars or salt; drink low-fat or fat-free dairy
Balance your meals and eat a variety of foods that are nutrient dense: proteins help your body fight infection and are used to repair and build tissues; carbohydrates provide energy and come from fruits, vegetables and dairy; fats also give you energy and help your body absorb essential vitamins and minerals but be careful not to consume too many saturated fats or trans fats; key vitamins and minerals for older adults include Vitamin D, Vitamin B12, Calcium, Magnesium, Potassium and Dietary Fiber

Use spices and herbs to flavor your foods: as you age, your sense of taste and smell may alter the way your favorite dishes taste (some medicines also contribute to this change)

Polypharmacy in Older Adults

Why is polypharmacy a concern for Older Adults?

As we get older, the possibility increases that the more medications we are prescribed, the more at risk we are for those medications to cause unfavorable drug interactions with other drugs or with the foods we eat. Our body can’t absorb nutrients and drugs at the same rate as when we are younger. Changes in our activities of daily living (also known as ADL) can have an impact on our mental capacity and our appetite, affecting the outcome of the medication.

What is polypharmacy?

Polypharmacy refers to multiple medications, including prescription, over the counter, and/or homeopathic, herbal products or dietary supplements, concurrently taken by one patient. Multiple can mean anywhere from two to eleven or more different drugs.

Older Adults comprise the population at highest risk for chronic health conditions necessitating the use of numerous medications, often prescribed by different physicians. 43% of older adults are prescribed five or more medications; close to 90% of older people are prescribed at least one medication.

Consequences of polypharmacy

Increased costs to healthcare system
Increased health care costs to patients
Increased hospitalizations
Increased comorbidities and comortalities

Increased risk of adverse drug and/or side effects
Increased risk of medication errors & overuse of medications
Increased risk of outpatient visits
Increased risk of inappropriate medication consumption
Increased risk of drug-drug, drug-disease or drug-food interactions

Increased risk of medication duplications
Increased risk of cognitive impairment or decline
Increased risk of reduced hearing and reduced vision
Increased risk of kidney & liver function
Increased risk of falling (increases morbidity & mortality in older adults)

Increased potential of physical harm
Increased risk of urinary incontinence
Increased risk of malnutrition due to malabsorption of nutrients

Talk to your Doctor and/or Pharmacist to discuss any adverse effects that medications you have been prescribed could be causing; find out if there are changes that could be made to your regimen.

General Tips for Older Adults (65+)

Smarter food choices promote healthier aging, helping to improve chronic diseases, thereby decreasing the need for polypharmacy. Follow guidelines from your doctor regarding your health conditions.

General dietary guidelines listed below can help you make positive changes to your lifestyle routine.

Get enough fluids

Water aids in digestion of essential nutrients
Don’t wait until you notice you are thirsty!

Drink fluids often throughout the day, limiting beverages with added sugars or salt
Drink low-fat or fat-free dairy

Balance your meals and eat a variety of foods that are nutrient dense

Protein helps your body fight infection and are used to repair and build tissues

Carbohydrates provide energy; an excellent source of fiber, minerals and vitamins, they come from fruits, vegetables, dairy and whole grains
Fats also give you energy and help your body absorb essential vitamins and minerals (Be careful not to consume too many saturated fats or trans fats)

Key vitamins and minerals for older adults

Vitamin D & Calcium: are necessary for bone health eat calcium rich foods & beverages, dark green, leafy vegetables and canned & fatty fish

Vitamin B12: is often difficult for those aged 50+ to absorb eat lean meat & fortified cereal (& some seafood/fish)

Potassium: helps lower blood & salt intake eat fruits, beans, vegetables & fat-free or low-fat dairy

Dietary Fiber: helps keep you regular & helps lower risk for heart disease & type 2 diabetes eat whole-grain cereals & breads, peas & beans and more vegetables & fruits

Reading the Nutrition Facts label found on most packaged foods can help Older Adults make smarter, healthy choices, helping to monitor their special nutrients needs. Based on a 2,000 calorie per day diet, here are the recommendations:

Check the Nutrition Facts Label to Choose foods with MORE of these nutrients to ensure receiving the recommended amounts on a daily basis (grams = g; milligrams = mg; international units = IU; daily values = /d)

Dietary Fiber: Men need approx. 17.5-18.5 g/d age 51+ Women need approx. 14.0-14.4 g/d, age 50+

Calcium: Men need approx. 1,000 mg/d (51-70yo); 1,200 mg/d (70+yo) Women need approx. 1,200 mg/d (51+yo)

Vitamin D: Men & Women need 600 IU/d (51-70yo); 800 IU/d (70+yo) According to research, a minimum of 1,000 IU/d for adults achieves sufficient vitamin D levels

Potassium: Adequate Intake for Men & Women 4,700 mg/d (50+yo) (Average intake is <2,900 mg/d for adults 65+yo)

Check the Nutrition Facts Label to Choose foods with LESS of these nutrients – most older adults consume higher amounts than necessary for optimal health as well as contributing to detrimental effects of many chronic diseases

Saturated fat: 20-35% of total caloric intake is acceptable for Fats; limits of no more than 8-10% should be Saturated fat (Men & Women)

Salt: Adequate intake for Men & Women 1,300 mg/d (51-70yo); 1,200 mg/d (70+yo) Restrictions in salt are due to chronic Hypertension affecting many Older Adults; Dietary Guidelines for Americans suggests no more than 1,500 mg/d of sodium (salt) for Older Adults 51+yo

Added Sugars: Recommended Daily Amounts of total CARBOHYDRATES for Men & Women 51+yo = 130 g/d; Added Sugars includes sugarsfound in packaged and processed foods and should be <50 g/d

Make an appointment with a Registered Dietitian (RD) or Registered Dietitian Nutritionist (RDN) to assist you with making lifestyle changes to improve your eating habits and alleviate any side effects caused by the medicines. RDs or RDNs can also help you better manage some medical conditions such as hypertension, diabetes or high cholesterol that might be causing appetite suppression, intestinal discomfort, constipation, dehydration, and unintended weight gain or weight loss, all of which could be impacting your meal patterns.

Food Safety for Older Adults

Why is Food Safety important for older adults? As people age, their immune system becomes weaker in its ability to fight off and protect against infections, putting them at risk for developing foodborne illnesses. Other changes making the elderly more prone to foodborne illness include a reduction of acid produced in the stomach (stomach acid destroys bacteria that contributes to illnesses), a prolonged amount of time the gastrointestinal tract retains food permitting the bacteria to develop, and the inability of the liver and kidneys to eliminate toxins and bacteria from the body. Additionally, older adults with chronic diseases such as diabetes, cancer or kidney disease are more susceptible to becoming ill from unsafe foods.

Food poisoning can lead to hospitalization or death for adults in this age group. Eating foods contaminated by parasites, viruses, mold or bacteria can cause anyone to become sick. The foods can be exposed to germs at any time during the growth process, harvesting, handling, storing or cooking. Signs and symptoms of food poisoning include stomach pains and/or cramps, diarrhea, chills and fever, nausea and vomiting. These can begin a few hours after consuming the spoiled food, but also can show up days or weeks later. The most common foodborne illnesses are Listeria and Salmonella.

Four areas of food safety origins

Microbial: viruses, bacterial (Listeria, Salmonella, Clostridium, Campylobacter, Staphylococcus, Bacillus and E. coli)
Chemical: pesticides, high levels of heavy metals (likely leaked from utensils or insufficient food cleanliness) or added chemical ingredients such as preservatives or food dyes
Personal hygiene: inadequate or unsanitary personal cleanliness (by food preparers or handlers)

Environmental hygiene: substandard sanitary conditions of environment (storage facilities)

Four steps to basic food safety

Clean: WASH YOUR HANDS! along with surfaces, countertops, utensils, cutting boards and preparation dishes. Use warm or hot soapy water for 20 seconds prior to and following using the bathroom, handling food, changing diapers or touching animals.
Separate: prevent cross-contamination by separating raw foods (meat, poultry, seafood and eggs) from cooked foods, including placing these items separately in your shopping cart. Use plastic bags found in the produce (or meat) department to help separate raw foods while in your cart. Additionally, use separate cutting boards for raw foods (vs. fruits and vegetables or other read-to-eat foods) during food preparation.

Cook: Cook foods at their proper temperatures. The U.S. Department of Agriculture recommends safe minimum internal temperatures for all meats and seafood at 145 oF, all ground meats at 160 oF, egg dishes at 160 oF, poultry at 165 oF and hot dogs and luncheon meats at 165 oF. (see the table listed for recommended safe minimum internal temperatures found in the article: https://www.fda.gov/food/people-risk-foodborne-illness/food-safety-older-adults-and-people-cancer-diabetes-hivaids-organ-transplants-and-autoimmune)
Chill: Promptly refrigerate foods after returning from the grocery store or after preparation. Bacteria multiplies swiftly between 40 oF and 140 oF. Keep your refrigerator temperature set at 40 oF or below and your freezer temperature set at 0 oF or below in order to lower risks of growing foodborne illnesses. Additionally, perishable foods should be stored within one hour if left in temperatures above 90 oF or within two hours after purchase or preparation.

More tips for food safety

Defrosting: Do Not refreeze after thawing; Use

refrigerator (keep in original wrapping)
microwave (cook immediately after thawing)
submerging food sealed in a bag in cold water

Storing: Remember to set your refrigerator and freezer temperatures properly as listed above in the “Chill” section

Keep hot food hot and cold food cold! (see bacteria risks above)

Store seafood, fish, poultry and meat in plastic bags or sealed containers on bottom shelves to prevent juices from dripping over other items stored in the refrigerator
Cook up to four days after purchase and use by the “best before” date or freeze if not planning to cook before that date
Store cut up vegetables and fruits in the refrigerator (not on counters)

Washing: Wash your hands! (see above)

Fruits and Vegetables under cool, drinkable water, using scrub brush for items with touch skins (carrots, melons, potatoes, etc)

Don’t soak Fruits and Veggies in the sink (bacteria can be transferred)
Utensils and kitchen surfaces can also spread bacteria—clean sinks, surfaces and food preparation materials immediately! Avoid using sponges which are difficult to stay bacteria-free (use paper towels instead)

Eating Out: Check out the “Cleanliness” rating (if available, posted near the front door)

Choose establishments with clean floors and tables
Don’t be shy asking how food is prepared (cooked to proper temperatures, avoid “raw”, etc.)

Avoid buffets (if possible) – food sitting out for unknown time and temperature could spoil easily
Refrigerate any leftovers within proper time frames (see above) or bring and cooler with ice packs if not going home immediately

Making smart food safety choices will contribute to healthy aging. If you suspect you have developed a foodborne illness, contact your healthcare provider immediately! If possible, save the food and/or packaging (annotate the time and date of occurrence and type of food; then wrap and freeze it tightly with the label “DANGER” -- it could be useful for diagnosing your symptoms and helping to prevent others from becoming sick). If the food was purchase or consumed at a restaurant or other outside-the-home establishment, contact your local public health department.

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Nutrition Experts

Older Adult Nutrition

Nutrition Related Conditions & Diseases Experienced by Older Adults

Polypharmacy in Older Adults

Food Safety for Older Adults

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