Guidelines for maintaining adequate nutrition in old age.

Nutrient requirements do not change markedly with advancing age, but life style, socioeconomic status, psychologic changes, and the presence of chronic disease alter nutrient intake in the elderly. It is important to recognize and deal with these factors in attempting to correct malnutrition and in prescribing dietary treatment. Malnutrition includes a variety of disorders: undernutrition, nutrient deficiencies and imbalances, and obesity. Frequent small feedings, with nutritional supplements for patients with profound weight loss, are the initial treatment for undernutrition. Iron supplements and a diet of foods rich in iron and in promoting iron absorption are required in treating iron deficiency anemia. Management of macrocytic anemia should include specific nutrient therapy plus improvement of diet to include leafy vegetables and animal foodstuffs. Diet is an important adjunct in treating chronic diseases. Maturity-onset diabetes mellitus often can be managed by diet alone, with attention to correct proportions of fat, carbohydrate, and protein and to the decreased caloric requirements of elderly patients. The importance of continuing dietary modifications in hyperlipidemia and hypertension is well known. Although dietary manipulation in osteoporosis is not curative, a diet high in calcium and containing adequate floride and vitamin D affords maximum dietary protection against progress of the disease.

Life style and nutrient intake in the elderly.

The life styles of the elderly population under study indicate that they had positive attitudes toward health in general and toward food and eating, Their food habits and beliefs were free from faddism, they were willing to try new foods and to change at least some of their food habits, and they had a good appetite for meals. Meal patterns and choice of foods, snacks, and food likes were toward foods of high nutritive value. They had comparatively few food dislikes, and the majority ate three meals a day. Many of the participants in this study had nutrient intakes of less than two-thirds the 1974 RDA'S. Food choices, meal patterns, and beliefs about food suggest that economic factors strongly influenced dietary adequacy and limited the food choices and size of servings. Black females appear to be the most disadvantaged group. All of these findings are a strong indicator of the need for group feeding programs for the elderly. Such meal programs should provide at least one-third of the daily nutrient needs, and should be pleasurable experiences using foods appropriate to the food habits and beliefs of the specific groups, their locale, and their cultural-economic backgrounds. These programs should also be accompanied by realistic nutrition education programs designed to provide guidance in buying and using foods of highest nutritive value within their resources. The need for such programs becomes increasingly urgent because of today's rapidly increasing food prices.