Chapter 3Macronutrient Requirements for

Older Adults

Nutrient Recommendations

• Dietary Reference Intakes– Basis for planning and assessing diets of healthy

people– Additional interpretation may be necessary• Multiple medical conditions

Nutrition Recommendations

Major Components of Energy Expenditure

Nutrition Recommendations

• Energy Needs– Energy balance• Energy intake• Energy expenditure• Estimated Energy Requirement (EER)–Prediction equations should be used cautiously

– Decline in energy requirements– Decline in energy expenditure– Body weight changes

Dietary Carbohydrates

• Sources– Complex carbohydrates– Simple carbohydrates

• Carbohydrate Recommendations– Complex, unrefined carbohydrates– Acceptable Macronutrient Distribution Range– DRI: 45% - 65% of daily calories– 2005 Dietary Guidelines for Americans– Discretionary Calories

Dietary Carbohydrates

• Dietary Fiber– Not digestible– Functional fibers– Total fiber– Nonviscous fiber• Reduce postprandial blood glucose

– Viscous fibers• Fat and cholesterol absorption

Dietary Carbohydrates

• Dietary Fiber– Food sources• Few processed, more natural foods and whole-

grains• Increase satiety

– Ensure adequate water intake• Few processed, more natural foods and whole-

grains• Increase satiety

Water Balance andRecommended Intakes

• Essential nutrient– Required for metabolic reactions– Medium for transport

• Support vital body functions– Balancing input and output

Water Balance andRecommended Intakes

• Water Intake– Body composition influences total body water• Lean tissue• Fat

– Controllers of balance • Thirst• Renal function• Imbalances more likely during times of stress

Water Balance andRecommended Intakes

• Intake (cont.)– Controllers of Balance• Thirst–Sensation delayed and reduced

• Forgetfulness or deliberate fluid restriction

Fluid Output

• Factors that contribute to fluid output– Normal physiologic losses– Age-related impairments• Cardiac output• Blood pressure• kidney

– Medications– Environmental conditions

Fluid Output

• Dehydration– Body water out > water input– Risks• Inadequate intake• Reduced total body water• Lifestyle factors associated with age

– Complications– Associated with increased morbidity and mortality

Fluid Output

Fluid Output

• Water Recommendations– Total water intake– Methods for

estimating Daily Fluid Requirements

Fluid Output

• Water Recommendations– Factors that influence fluid requirements• Physiologic• Environmental• Social• Medications

Fats

• Lipids found in the body– Triglycerides• Valuable energy source• Carry fat-soluble vitamins• Carry phytochemicals• Carry essential fatty acids

– Source of energy

Essential Fatty Acids

• Linoleic acid– Omega-6 fatty acid– Component of cell membranes– Sources: Nuts, seeds, and vegetable oils

• Linolenic acid– Omega-3 fatty acid– Neurologic growth and development– Precursor for EPA and DHA– Sources: Canola, soybean, and flax seed oils, nuts,

seeds, soybeans and fatty fish

Heart Disease in Older Adults

• Risk factor– Elevated total cholesterol levels– HDL cholesterol levels below 35 mg/dL

• Adult Treatment Panel III (NCEP) recommendations

Proteins

• Physiologic Aging and Protein Requirements– Consequences of reduced body protein– Dietary recommendations– Benefits of exercise

• Dietary Protein– Trend towards decreased protein intake with age– High biological value protein sources

Conclusion

• Consume a nutrient-dense diet• Strive to maintain a healthy body weight• Strive to maintain a physically active lifestyle• Reduce fat, saturated fat, trans fat, and simple

sugars• Meet fluid and fiber needs