Nutritional Needs of Older Persons

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Nutritional Needs of Older Persons

• FCS 5151
• Burns

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Session Outcomes

• Calculate protein and calorie needs for a variety
  of simulated older adults
• Evaluate nutritional quality of a variety of
  simulated older adults

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Caloric Recommendations

• Main goal is to maintain a healthy body weight
• Decrease in physical activity, lean muscle mass,
  and BMR equals fewer calories needed
• Nutrient dense foods are critical
• Basal Energy Expenditure using Harris Benedict
  equation

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Specific macronutrient recommendations Protein

• Functions of protein in body
• Same needs per kg body weight as younger adults
• 12-14 of calories and based on serum albumin
  level
• Quality of protein is important as well
• .8 g/kg is the RDA

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Determining Protein Need

• Based on height and weight, how much is needed?
• Are enough calories eaten so that protein does
  not have to be used for energy?
• If marginal amounts of protein are eaten, is the
  protein of high quality?
• Are there additional needs wound healing, tissue
  repair, surgery, fracture, infection?
• Is the individual exercising?

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Moment of Application

• Using the appropriate formula, calculate your
  caloric and protein needs
• Now, think of an older adult in your
  lifecalculate his/her caloric and protein needs

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Specific macronutrient recommendations CHO/Fiber

• Functions of CHO and fiber in body and food
• 45-65 kcalories from CHO
• lt11 tsp of refined sugar daily
• 14 grams of fiber/1000 kcalories
• Need to increase fluid as well
• Soluble vs insoluble
• More likely to be lactose intolerant

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Specific macronutrient recommendations Fat

• Functions of fat in the body and food
• Maintain moderate-low fat diet
• 20-35 kcalories from fat
• lt10 from saturated fat
• 300 mg dietary cholesterol
• Fat intake and recommendations vary with degree
  of oldness

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Fluid recommendations

• Functions of water
• 1 mL/kcal
• What fluid counts?
• Dehydration is very common
• Physiological state in which the cells lose water
  to the point of interfering with the metabolic
  processes
• Risk factors

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Risk Factors of Dehydration

• Less sensitivity to thirst
• Fear of incontinence
• Difficulty of accessing fluids
• Trouble swallowing
• Problems holding a cup or glass
• Decreased kidney function
• Forgetfulness

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Effects of Dehydration

• Upper body muscle weakness
• Speech difficulty
• Confusion
• Dry mucous membranes in nose and mouth
• Dry tongue
• Sunken appearance of eyes in their sockets

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Nutritional Intervention

• WATER, WATER, WATER
• Tea
• Low-fat milk
• Cranberry juice
• Other fruit and vegetable juices

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What do you think?

• Should the diet be supplemented with a dietary
  supplement?
• Which supplement?
• Who should take?

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A few considerations

• Does the supplement contain a balance of vitamins
  and minerals?
• When all supplements and fortified foods are
  combined, is the dose still safe?
• Does the supplement contain the needed nutrients?
• Is the supplement safe?

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Sodium Recommendations

• Functions of sodium in the body
• 2400 mg for males and females
• Relationship of increased intake and high blood
  pressure well established
• Young old v oldest-old

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Session Outcomes

• Calculate protein and calorie needs for a variety
  of simulated older adults
• Evaluate nutritional quality of a variety of
  simulated older adults