Nutrition Requirements

Jasmine is a new graduate with her Masters degree in Healthcare Administration and has decided to open up her own assisted living facility in Las Vegas, Nevada. As she has started her research in what it takes to open up an LTC, she realized that she had overlooked the dietary services aspect of running an assisted living facility. When initially planning to open her facility and considering the dietary services, Jasmine realizes that she has no idea the nutritional needs of older adults.

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What are the caloric needs of the older population? What important nutrients should be considered when planning the meals for older residents? Jasmine decides to contact her friend, Carolyn, who is currently employed as a nutritionist to help her.

INTRODUCTION

We, the authors of The Nutrition Services, wrote this to be an instructional guide for assisted living facilities to be able to provide better food and dietary services to residents. Yet, as we wrote Chapter 1: Nutritional Requirements of the Elderly, we quickly realized that this would also be a good source of information for adults over the age of 65, families with elderly relatives, and caretakers of older individuals. In this chapter, we talk about the approximated daily calorie needs for older adults and nutrients that are important to the diets of the older population. We hope that this chapter will be useful for directors and managers of LTCs, families, and other caretakers.

CALORIC NEEDS

In general, it is common knowledge that older adults are much less active than younger adults. This could be due to a number of reasons: choric diseases that cause pain, aching joints that make it difficult to exercise, or limited access to outdoor parks or gyms. For adults of all ages, when we are less active, our metabolism is much slower than when we are physically active. When planning the meals of older adults, it is important to consider the calories they consume in a day. This also heavily depends on how active the resident is, his/her body composition, how old the resident is, and his/her gender. Residents who are older and less active need to consume a lower number of calories in a day than residents who may be a few years younger and more physically active, or they will be susceptible to weight gain. As you can see in the chart to the right (Figure 1-1) shows the daily suggested calorie consumption for older adults – the suggestions are based on a man who is 5’10” and 154 lbs. and a woman who is 5’4” and weighs 126 lbs. The U.S. government suggests that the older male should consume up to 2,600 calories a day depending on his age and activity level (U.S. Dept. of Health and Human Services, 2015, appendix 2). For the woman, the U.S. government recommends that she consume up to 2,000 calories per day depending on her activity level and age as well (U.S. Dept. of Health and Human Services, 2015, appendix 2). It is important to remember that for everyone, calorie consumption is related to one’s goals. If an individual wants or needs to lose weight, they should consume a fewer calories per day. If a person wants or needs to gain weight, they need to consume a higher number of calories per day.

SPECIAL NUTRITION NEEDS

Due to changes in the body during the aging process, such as changes in the intestines, older adults need to consume more nutrients, either in their diets or through taking supplements. As the Institute of Medicine states, it is more difficult for older adults’ bodies to digest nutrients from foods (Pray et al, 2010, p 88). So, as an individual planning the meals for an older person, it is important to remember the importance of planning meals that are filled with many different nutrients to make up for how difficult it is for their bodies to absorb nutrients from foods. If an older adult does not consume daily recommended amounts of certain vitamins and minerals in their diet and their bodies have a hard time absorbing these nutrients, this may result in deficiencies. We will be looking at different micronutrients and macronutrients that are important to the diets of the older population and the foods that may contain these nutrients.

VITAMIN B12

There are many reasons why older adults do not hit their daily Vitamin B12 goals and one of the major causes seems to be changes in stomach acidity which can cause changes in absorption (Pray et al., 2010, p. 94). But Vitamin B12 is very important in the body as some of its functions include synthesizing DNA and helping in the nervous system. It is essential that older adults consume enough Vitamin B12 as deficiencies can lead to memory and balance problems, increased bone weakening, and an increased risk for heart disease. Some foods that are high in Vitamin B12 include: tuna, chicken breast, yogurt, eggs, and fortified cereals.

VITAMIN D

Vitamin D is very important in the diet of older adults as it is essential to bone health. Yet due to changes in the kidneys and the skin as adults age, the absorption of Vitamin D is harder for the aging population. Vitamin D can help protect older individuals from osteoporosis, is important in cell function, and is important in the immune system. Foods that contain high amounts of this vitamin include: egg yolks, cheese, orange juice, and yogurt. It is also important to consider encouraging older adults to go outside as the UVB rays are converted to Vitamin D in the body.

CALCIUM

Healthy bones are essential to the health of older adults. This is why calcium is the next nutrient we will be discussing in this chapter. In addition to being extremely important to bone and tooth health, calcium is needed for the proper function of muscles and plays an essential role in the nervous and endocrine systems. If an older adult is deficient in calcium, this can put them at risk for osteoporosis and scientists have found that this risk is higher for women after menopause and men over 70. Some foods that are good sources of calcium are: dairy products, kale, spinach, and fortified juice and cereals.

POTASSIUM

Potassium is seen to be beneficial in reducing blood pressure, especially when a high potassium diet is partnered with a low sodium diet. In addition to this, potassium is also needed in the body for proper muscle and kidney function. There are many everyday foods that contain high amounts of potassium and these include: bananas, spinach, lentils, tuna, brown rice, turkey breast, yogurt, and nuts.

FIBER

Fiber is mostly known for its role in helping adults stay “regular” and preventing constipation, but this nutrient also plays other important roles in the body. For diabetics, fiber has been seen to control blood sugar spikes and fiber also plays a role in maintaining a healthy heart. Because older adults are more susceptible to diabetes and heart disease, fiber can be incredibly beneficial to their diets. Fiber can be found in many foods including: spinach, nuts, apples, Brussels sprouts, grapes, and kidney beans.

MAGNESIUM

Magnesium is important in the body for many of these reasons. Some of magnesium’s functions in this body are assisting the body in synthesizing DNA and RNA, aiding in proper muscle function, and like many other nutrients we have discussed in this chapter, supporting the nervous system. Because of changes within the body as we age, including changes within the intestines and the kidneys, older adults have trouble absorbing this nutrient. So when developing a menu plan, some key foods to consider include: kidney beans, oatmeal, chicken breast, and almonds.

OMEGA-3 FATTY ACIDS

Omega-3’s are the final essential nutrient for older adults. Omega-3 fatty acids are essential in the structures of cells and play important roles in multiple body systems including the cardiovascular and immune systems. Scientists have also discovered that fatty acids can protect older individuals from Alzheimer’s disease. Some foods that are high in Omega-3 fatty acids include: flaxseed oil, canola oil, salmon, eggs, yogurt, chicken, kidney beans, and walnuts.

After her discussion with her friend, Carolyn, Jasmine has feels she has a solid foundation in her plans to open an assisted living facility and providing dietary services for older individuals. After her research and her discussion with a licensed nutritionist, Jasmine realized that it is incredibly important for older adults to eat well-balanced, nutrient-dense meals every single day. Because older adults need less calories per day, but require more nutrients per day, it is important to make sure all of their meals are carefully planned to ensure they do not overeat but also are not deficient in important nutrients.

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