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2014-12-06 22:21:28
Life Nutrition

Dietary recommendations and nutritional assessments in the older adults
Show Answers:

  1. Dietary recommendations- What 3 adaptations did groups like University of Florida and Tufts developed for older adults?
    -addition of fluids/water

    -addition of vitamin-mineral supplements

    -advice on physical activity
  2. Nutrient recommendations: when do nutrient recommendation change?
    As scientists learn more about effects of foods on human functions
  3. Nutrient recommendations: Which formula predicts energy needs in healthy adults up to 80 yrs old?
    Mifflin- St. Jeor formula
  4. AMDR: total fat percent of calories
    20-35 percent of calories
  5. AMDR: percent of CHO from calories
  6. AMDR: percent of protein from calories
  7. Protein needs: how much g/kg body weight do several researcher report that older adults should take in?
    • 1 to 1.3 g/kg body weight
    • *might be due to more protein is trapped in liver and its inefficient process of protein synthesis
  8. Protein needs: what are inactive, older adults living alone be susceptible to?
    Having low protein intakes
  9. Protein needs: when is nitrogen balance easier to achieve (3)
    -protein is high quality

    -adequate calories are consumed

    -individuals participate in resistance training
  10. Protein needs: how many grams per meal should be spread through out the day to maximize muscle protein synthesis?
    ~20 grams per meal
  11. What's take home message on slide 9?
    When older adults consumed slightly higher than RDA .8 grams, they lost less LBM or gain more LBM
  12. recommendation for fluid: what happens to the total amount of water as one ages?
    • Total amount of water in body decreases with age
    • *more prone to dehydration
  13. How many glasses of fluid per day will prevent dehydration in most adults?
    More or equal to 6 glasses
  14. recommendation for fluid: what rule of thumb should one follow when trying to individualize fluid recommendations?
    1 mL of fluid/kcal

    *minimum of 1500 mL
  15. Which 6 nutrients do old people have trouble with?
    -vitamin A

    -vitamin D

    -Vitamin E



  16. Nutrients of concern) what happens to plasma levels & liver stores with age? And what is this linked to?
    They both increase which may be linked to decrease clearance from the blood
  17. Nutrients of concern) vit. A: Older adults are more vulnerable to...
    Toxicity & possible liver damage than deficiency
  18. Nutrients of concern) what is the UL for vitamin A?
    3000 MCG
  19. Nutrients of concern) vita. A: will beta-carotene damage the liver?
  20. Nutrients of concern) vita D.: 3 factors that put older adults at risk for deficiency
    -limited exposure to sunlight

    -institutionalization or homebound

    -certain medications
  21. Nutrients of concern) which 2 medications affect vita D?

  22. What do vita. e and vita. k do?
    They interact with each other
  23. Nutrients of concern) what does vita e. provide?
    antioxidant properties
  24. Nutrients of concern) what does vita. k do? (2)
    -blood coagulation

    -bone health
  25. Nutrients of concern) need adequate intake of magnesium for... (3)
    -bone health

    -nerve activity

    -glucose utilization
  26. Nutrients of concern) which 2 drugs may lead to overdose in magnesium?
    -magnesium hydroxide

    -citrate laxatives
  27. Nutrients of concern) what does adequate intakes of potassium offset?
    Excessive NA intakes
  28. Nutrients of concern) what is potassium?
    electrolyte that controls water balance with sodium
  29. Nutrients of concern) b12: despite adequate intake, what do 30% of older adults have?
    Decrease b12 levels
  30. Nutrients of concern) b12: what is decreased levels of b12 linked to?
    Decrease levels of HCL & Pepsin resulting in inability to split B12 from protein carriers
  31. Nutrients of concern) b12: which 2 types of b12 are better absorbed and why?
    Synthetic or purified b12 because it is not protein bound
  32. Age associated changes in metabolism) Folate/Folic acid AND Absorption
    Can be impaired
  33. Age associated changes in metabolism) which 3 medications affect folate metabolism ?


  34. Age associated changes in metabolism) what can folate in excess result in?
    • Masks b12 deficiency
    • *more common in elderly
  35. Age associated changes in metabolism) what is calcium needed for?
    Bone health
  36. Age associated changes in metabolism) which 3 nutrients does calcium interfere with?


  37. Age associated changes in metabolism) why was the UL for calcium lowered?
    bc of toxic effects
  38. When considering supplements, it may be useful with those who...(5)
    -lack appetite resulting from illness, loss of taste/smell, or depression

    -diseases in GI tract

    -poor diet due to food insecurity, loss of function, or disinterest

    -avoids specific food groups

    -takes medication or other substances that affect absorption or metabolism
  39. What should one ensure when taking supplements? (4)(
    -vitamin/mineral balance

    -safe dose

    -labels like US pharmacopoeia or NSF code

    -safety of product
  40. 2 exercise guidelines who should follow
    -strength training activities

    -aerobic exercise
  41. What is fitness after 50 screening tool?
    Screening tool to identify potential contraindications or problem areas
  42. What is a risk factor?
    Characteristic that increases likelihood of becoming malnourished
  43. What are some nutritional risk factors? (9)
    -hunger, poverty, low food & nutrient intake

    -functional disability

    -social isolation or living alone

    -urban & rural demographic areas

    -depression, dementia, dependency

    -poor dentition & oral health

    -diet related acute or chronic diseases


    -minority, advanced age
  44. What is an indicator?
    • Observable and recordable
    • *specific sign or symptom
  45. Major indicator of poor nutritional status in older Americans (9)
    -weight loss over time

    -low of high ideal BW

    -reduction in serum proteins

    -change in functional status

    -inappropriate food intake

    -reduction in mid arm muscle circumference

    -increase or decrease in triceps skin fold


    -specific diseases
  46. What does screening do? (2)
    - identify individuals at high nutritional risk

    -determine whether extensive nutrition assessment should be performed
  47. What does assessment do> (3)
    -identifies risk factors for malnutrition in individuals which can be treated with MNT

    -determine the nutritional status of individuals and identifies at risk and malnourished patients

    -establishes nutritional diagnosis
  48. 4 special concerns for screening and assessment in the older adults
    -poor short term memory

    -cognitive impairment

    -time consuming

    -multiple health conditions
  49. What 3 groups created nutrition screening initiative ?
    -American academy of family physicians

    -academy of nutrition and dietetics

    -national council on aging
  50. What does the nutrition screening initiative do?
    Integrates a list of warning signs of poor nutritional health in older adults
  51. What does the nutrition screening initiative promote?
    Public awareness of nutrition concerns of older adults
  52. When should nutrition screening intiatitive be used?
    In community settings
  53. Mini- nutritional assessment (MNA): how many items does it use?
    6 screening items
  54. Mini- nutritional assessment (MNA): what 3 things does it include?
    -dietary intake


    -blood chemistries

    *more extensive than the NSI
  55. 4 methods of assessment

    -biochemical and lab tests

    -clinical signs/symptoms/observations

    -dietary evaluation
  56. What does anthopometric data measure? (4)
    -height, weight, BMI

    -IBW, UBW

    -waist circumference

    • -energy stores
    • *TSF, MAC
  57. Biochemical and lab tests (6)
    -protein status

    -hematological status




  58. Biochemical and lab tests: protein status (3)


  59. Biochemical and lab tests: hematological status (4)



  60. Biochemical and lab tests: liver (3)

    -aspartame aminotransferase

    -alkaline aminotransferase
  61. Biochemical and lab tests: renal (2)

  62. Biochemical and lab tests: diabetes (3)


  63. Biochemical and lab tests: lipids (4)



  64. clinical signs, symptoms, observations: (6)
    -current medical diagnosis

    -medical and surgery history




    -physical examination
  65. Dietary evaluation: 2 ways to measure actual intakes
    • -diet history
    • *24 hr recall, food freq food records

  66. Dietary evaluation: 3 ways to determine adequacy and needs

    -predictive equations

    -indirect calorimetry
  67. 7 considerations for educational materials for older adults
    -larger type size

    -serif lettering

    -bold type

    -high contrats

    -non-glossy paper

    -avoid blue, green, & violet color

    -reading level of 5th to 8th grade
  68. 3 nutritional programs serving older adults
    • -USDAs supplemental nutrition assistance program
    • *SNAP

    -seniors farmers market nutrition programs

    • -the older American act programs
    • *administered by US department of health and human services
  69. 2 examples of older American act programs
    -meals on wheels home delivered meal programs

    -nutrition services for tribal & native older American groups
  70. Senior nutrition program: why was it created? (2)
    -To alleviate poor nutritional intake

    -reduce social isolation among older adults
  71. Senior nutrition program: why do older adults do not eat adequately? (4)
    -lack of income

    -lack of skills

    -limited mobility

    -feelings of isolation & loneliness
  72. Senior nutrition program: comparing to non participants, participants had
    31% higher intake of recommended nutrients