Nutrition Needs for the Older Adult

Presented By: Megan Lasko, Sodexo Dietetic Intern

Lehigh Valley Active Life

May 19, 2017

Warm-Up Activity: Tasting Time!

With Ingredients like Almonds, Yogurt, and Dates –These Muffins are PACKED with What Important

Nutrient?

Presentation Overview

• Part 1: Healthy Eating for Older Adults: Overview• USDA’s MyPlate

• Tufts University’s MyPlate for Older Adults

• Part 2: Nutrient Needs for Older Adults• #1: Calcium

• #2: Vitamin D

• #3: Vitamin B12

• #4: Potassium

• #5: Fiber

Part 1:

Healthy Eating for Older Adults: Overview

USDA’s MyPlate

Image Source: https://www.choosemyplate.gov/MyPlate

Image Source: http://hnrca.tufts.edu/myplate/

Tufts University’s Human Nutrition Research on Aging’s:

MyPlate for Older Adults

Difference #1: Healthy Oils

Difference #2:Fluids

Prepare Protein Foods with Healthy Oils, Herbs, and Spices vs. Saturated Fats (Butter, Cheese)

Difference #1: Healthy Oilsa

• Liquid Vegetable Oils + Soft Margarines:• Important fatty acids• Fat-soluble vitamins• Good replacement for solid fats like butter and lard, which contain saturated fats that

can harm the heart

• Cook with Healthy Oils:• Salad dressing• Brown meats• Saute fruits and veggies• Moisten fish and seafood

• Common liquid vegetable oils: canola, corn, olive, peanut, sesame, soybean, safflower, sunflower, walnut

aInformation adapted and image from Tufts HRNCA website3

Difference #2: Fluidsa

• ↓ Thirst Perception with Age• But the body still needs fluids to regulate body temperature, transport

nutrients, and lubricate joints

• Incorporate More Fluids into Your Diet:• All fluids count!

• Water: Carry a special water bottle everywhere you go or add flavor with fresh lemon, lime, or orange wedges

• Coffee/tea/fruit juices

• Popsicles

• Soups and broths: Add a small bowl of soup to dinners and lunches!

• Fresh fruits and veggies have water content! (i.e. bell peppers, broccoli, grapes, grapefruit, strawberries, tomatoes, watermelon, apricots, nectarines, and more!)

aInformation adapted and image from Tufts HRNCA website3

Part 2:

Nutrient Needs for Older Adults

Nutrient Vocabulary and Food Label Intro• Recommended Dietary Allowance (RDA): Recommended daily intake values of

nutrients that vary by gender and age.

• Adequate Intakes (AI): Used when evidence is insufficient to establish an RDA.

• Daily Value (DV): A single value based on RDAs/AIs, expressed on food labels as percent daily value (%DV), indicating the percent of the DV for each nutrient that a serving of the food provides. • Purpose: Helps consumers determine the level of various nutrients in a standard serving of

food in relation to their approximate requirement for it.

• >20% DV=Food is “high” in that nutrient

• <5% DV=Food is “low” in that nutrient

• Fortified (Food Fortification): process of adding micronutrients (essential trace elements and vitamins) to food.

Nutrient Need #1: Calcium (Ca)

• Function: Maintain Bone Strength

• Adequate Dietary Ca=Adequate Blood Ca=Ca Remains in Bone

• Inadequate Dietary Ca=↓ Blood Ca=Ca Leeched from Bones • Weakened Bones, ↑ Risk Falls/Fractures

• Concerns for Older Adults:• Deficient Ca Intake (↑ lactose intolerance)

• Decreased Ca Absorption

• Decreased estrogen in post-menopausal women= ↑ bone loss

99% Ca located in bone 1% in blood

Most Abundant Mineral in the Human Body!

How to Get Enough Calcium (Ca)• Do it with Dairy! 3 Servings/day• 1 C Plain, Low-Fat Yogurt: 415 mg Ca (42% DV)

• 1.5 oz. Cheddar or Part-Skim Mozzarella Cheese: 333 mg Ca (33% DV)

• 1 C Non-Fat* Milk: 299 mg Ca (30% DV)

• ½ C Vanilla Ice Cream: 84 mg Ca (8% DV)

• Dairy-Free, Calcium-Rich:• Almond Milk (Fortified), 1 Cup: 450 mg Ca (45% DV)

• 6 oz. Ca-Fortified Orange Juice: 261 mg Ca (26% DV)

• Sardines, Canned, with Bones: 325 mg Ca (33% DV)

• Salmon, Pink, canned w/ Bones: 181 mg Ca (18% DV)

• Almonds, Whole, ¼ cup: 95 mg Ca (10% DV)

• Dates: 15 mg Ca/date (2% DV/date)

• Supplements?*↑ Fat Content of Milk=↓ Ca Content

RDA:• 51-70 years:

• Males: 1,000 mg• Females: 1,200 mg

• 71+ years: 1,200 mg, males and femalesDV: 1,000 mg

Nutrient Need #2: Vitamin D (“D”)Fat-Soluble Vitamin, Naturally Present in Few Foods, Added to Others, &

Synthesized via Skin + Sunlight

• Function: Like Ca, D also Helps Maintain Bone Health• Promotes Ca Absorption in Gut

• Maintains Ca and Phosphate Concentrations for Normal Bone Mineralization

• Facilitates Bone Growth and Remodeling

• Concerns for Older Adults:• ↑ Age=↓ Sun Exposure

• ↑ Age =↓ Ability of Skin to Make D

• ↑ Age= ↓ Liver/Kidney Ability to Activate D

• ↑ Age= ↓ D Receptors on Target Organs (i.e. the Gut)

How to Get Enough Vitamin D (D)• Foods Naturally High in Vitamin D (There are Very Few!)• Salmon (Sockeye), 3 oz. Cooked: 447 IU (112% DV)

• Tuna Fish, 3 oz. Canned in Water: 154 IU (39% DV)

• Eggs (in the Yolk), 1 Large: 41 IU (10% DV)

• The Good News: Many Foods are Fortified with D!• Ready to Eat Cereals with 10% of DV for D, ¾ - 1 C: 40 IU (10% DV)

• Milk (Non-, Low-, or Whole Fat), 1 Cup, Vitamin D fortified: 115-124 IU (29-31% DV)

• Fortified Orange Juice, 1 Cup: 115-125 IU (34% DV)

• Margarine, 1 Tablespoon, Vitamin D Fortified: 60 IU (15% dv)

• *Check Labels!*

• Supplements?

RDA: • 51-70 years: 600 IU• 71+ years: 800 IUDV: 400 IU

Nutrient Need #3: Vitamin B12 (“B12”)

Water-Soluble Vitamin Naturally Present in Foods & Added to Others

• Function: • Proper Red Blood Cell Formation

• Brain and Nerve Health

• DNA Synthesis

• Concerns for Older Adults:• Decreased Hydrochloric Acid, or Stomach Acid, Production/Secretion!

• Why Does This Matter…? (See Next Slide…)

Normal B12 Digestion:

B12

+ Stomach Acid

= Free B12

PROTEIN IN FOOD

PROTEIN IN FOOD

B12 Can Now Be Absorbed in

Gut for Use in the Body!

B12 Digestion with ↓ Stomach Acid Secretion:

B12

PROTEIN IN FOOD

B12 Cannot Be Absorbed

Properly – Still Attached to Food

Protein!

How to Get Enough Vitamin B12 (B12)

• Focus on the Fortified:

• Do NOT Need to Be Cleaved from Proteins via Stomach Acid √

• Breakfast Cereals fortified with 25-100% DV of B12

• *Check Labels!*

• Naturally Occurring B12:

• Do need to be Cleaved from Proteins via Stomach Acid

• Clams & Beef Liver, 3 oz. Cooked: ~80 mcg (>1000% DV)

• Red meat, 3 oz. Cooked: 5 mcg (80% DV)

• Trout or Salmon, 3 oz., Cooked: ~5 mcg (80% DV)

• Tuna Fish, Light, Canned in Water, 3 oz.: 3.5 mcg (42% DV)

• Milk (1 C), yogurt (1 C), cheese (1 oz.): 1 C: ~1 mcg (18% DV)

• Supplements? May Be Beneficial. Talk to your doctor.

Total Cereal: 100% of Daily B12 Needs!

RDA: 14+ years: 2.4 mcgDV: 6.0 mcg

Nutrient Need #4: PotassiumA Very Important Mineral For the Human Body – Found in Many

Foods!

• Function: Another Nutrient that is Important for Bone Health

• Builds and Maintains Muscles

• Controls Electrical Activity of the • Maintains Healthy Bones

•Concerns for Older Adults:• “Nutrient of Concern” in the Elderly (Not Getting Enough!)• ↑ Dietary Potassium Intake=↓ Dietary Sodium Intake:

• ↓ Risk High Blood Pressure

• ↓ Risk Kidney Stones

How to Get Enough Potassium

•To Keep it Simple:

EAT YOUR FRUITS AND VEGETABLES

•Especially: Bananas, Artichokes, Baked Potatoes, Prunes, Apricots, Broccoli, Brussel Sprouts, Raisins, Tomatoes, Oranges/Orange Juice

•Fish – Haddock, Perch, Salmon: Also Great Source of Potassium!

AI: 14+ years: 4700 mgDV: 3500 mg

Nutrient Need #4: Fiber

A Type of Carbohydrate in Plant Foods that the Body Cannot Digest or Absorb

• Function: Bowel Health and Regularity

• ↓ Bad Cholesterol (↓ Risk of Disease)• Blood Sugar Control (↓ Risk Type 2 Diabetes)

• Concerns for Older Adults:• ↓ Intestinal Motility, ↓ Physical Activity, ↓ Dietary Fiber=

↑ Constipation

How to Get Enough Fiber

Fruits, Veggies, Whole Grains, Legumes!

• Foods with 4+ Grams Fiber=Good Source

• All Fruits and Veggies! (Avoid Peeling the Skins)

• Whole Grains:• Whole Wheat Breads, Crackers, Bagels, Muffins, Pasta

• Oatmeal, Oat Bran, Grits

• Cereals w/ “Fiber” or “Bran” in the Name

• Popcorn

• Increase Intake Slowly

• Drink Plenty of Water

RDA: (51+ years)• Men: 30 g• Women: 21 gDV: 25 g

Let’s Play JEOPARDY!

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Accessed May 5, 2017.

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