nutrition

2. ♣ WHAT IS THE OLD AGE?
♣ SIGNIFICANCE OF PROPER NUTRITION IN OLD AGE
♣ THE EFFECTS OF AGING
♣ NUTRTIONAL REQUIREMENT
♣ NUTRITION RELATED PROBLEMS
♣ CONCLUSION
♣ REFERENCES

4. “Old age is a privilege, social success and challenge.”
♠ Old age is a process which starts from the prenatal period and
continues until the end of life
♠ Old is not a disease but a biological process that no one can
avoid
♠ These are the changes of anatomic structure and physiological
functions which take place dependent on time
♠ World Health Organization (WHO) defines people of age 65
and above as “old age”

5. ♠ According to the progress of the old age and changes in body
functions; people between the age group are classified as :
♦ 65–74 :“young olds”
♦ 75–84 :“old
♦ 85 and above :“oldest old”.
♠ Nutrition for old age is known as Geriatric Nutrition

6. Geriatrics: The branch
of the medicine
dealing
with health problems
of the elderly i.e.
delaying the onset of
severely degenerating
aspects of aging and
treating the disease of
the aged.
Gerontology: Broad
area of science
concerned
with all the
psychological, social,
economic,
physiological and
medical problem of
elderly.

7. ♠Ageing is an inevitable, irreversible and progressive
phenomenon
♠Advancing age is accompanied by progressive physiological
changes in functions of most organs
♠ As people age, there also tends to be a concomitant increase
in chronic conditions such as
♦Hypertension
♦ Cardiovascular disease
♦ Osteoporosis, diabetes and
♦Dementias

8. ♠Nutrition has emerged as a major modifiable determinant of
chronic disease and age related decline
♠As we grow old, certain changes occur in our body, some
are visible like graying hair, wrinkling skin, loss of hearing
and weak eyesight
♠Several other changes occur internally, which we cannot see
♠Some of these changes influence the diet patterns of the
elderly

9. ♠ The nutritional needs of the elderly, especially those over 80
years of age, are very different
♠ Activity levels decrease and the body's metabolism also
slows down
♠ So we therefore require less energy and correspondingly
smaller quantities of food
♠ Even though the elderly need less energy, they need the same
amount or even more of vitamins and minerals
♠Some of these like vitamin E and C are known to have anti
ageing benefits as well as protect us from diseases like cancer,
heart disease and cataract

10. ♠ A liberal use of vegetables and fruits will help to provide
these nutrients
♠ Loss of teeth with advancing age leads to several dental
problems
♠ Many elderly are partially or totally toothless
♠ Chewing becomes extremely difficult
♠ Liquids or soft cooked, mashed foods are preferred by them
♠ Such foods may not supply sufficient nourishment and
supplements may be necessary

11. ♠The power to digest and absorb food gradually decreases
♠Elderly people commonly complain of heaviness, fullness in
the stomach, even gas formation and acidity
♠As we grow older, the pleasure of eating diminishes
♠ Food preferences also alter with advancing age
♠This occurs because of a decrease in the sensitivity of the
taste buds

12. ♠The ability to perceive tastes like sweet and salty diminishes
♠ The taste of food appears bland.
♠The diet should therefore be carefully selected
♠ Meals should be made more attractive and appealing by
including a variety of foods

13. PHYSIOLOGICAL
CHANGES
PSYCHOSOCIAL
CHANGES
ECONOMIC
CHANGES

14. ♠ The body’s functions slow with age, and the ability of
the body to replace worn cells is reduced
♠The metabolic rate slows
♠ Bones become less dense
♠ Lean muscle mass is reduced
♠Eyes do not focus on nearby objects as they once did,
and some grow cloudy from cataracts
PHYSIOLOGICAL CHANGES

15. ♠Poor dentition is common
♠ The heart and kidneys become less efficient and
♠Hearing, taste, and smell are less acute
♠If poor nutrition has been chronic, the immune system may
be compromised
♠Osteoarthritis and its debilitating effects are of great concern
to the elderly
♠Arthritis can limit the ability to perform activities of daily
living (ADLs)

16. ♠Excessive weight, certain vitamin deficiencies, and the type
of diet being followed may influence some types of arthritis
♠Digestion is affected because the secretion of hydrochloric
acid and enzymes is diminished
♠This in turn decreases the intrinsic factor synthesis, which
leads to a deficiency of vitamin B12
♠The tone of the intestines is reduced, and the result may be
constipation or, in some cases, diarrhea

17. ANOREXIA LOSS OF TEETH
PHYSCAL
DISCOMFERT
CHANGE IN BODY
COMPOSITION
CHANGE IN GASTRO
INTESTINAL TRACT
CHANGE IN
RESPIRATORY
FUNCTION

18. ♠Feelings do not decrease with age
♠Age does not diminish the desire to feel useful and
appreciated and loved by family and friends
♠Retirement years may not be “golden "if one suffers a
loss of self-esteem from feelings of uselessness
PSYCHOSOCIAL CHANGES

19. ♠Physical disabilities that develop in the senior years and
prevent one from going out independently can destroy a
social life
♠Becoming a resident of a nursing home can lead to
severe depression.
♠Problems such as these can diminish a person’s appetite
and ability to shop and cook.

20. Loss of self-
esteem
Loss of
independence
Depression

21. ♠Retirement typically results in decreased income
♠ Unless one has carefully prepared for it, this can affect
one’s quality of life by reducing
♦ social activities
♦Adding worry about meeting bills and
♠Causing one to select a less than healthy diet by choosing
foods on the basis of cost rather than nutrient content.
ECONOMIC CHANGES

23. ENERGY
♠Nutritional requirement change after 30 years
♠After the age of 35 the basal metabolic rate decrease due to
reduced muscle mass and other metabolically active tissue mass
♠Reduced physical activity which affects the energy needs

24. ♠Resting metabolic rate decreases approximately 15-20%
over the life span, primarily due to the changes in body
composition and reduction in physical activity
♠ The average body fat percentage in males increases from
about 15% when young to 25% at the age of 60 years.

25. ♠Requirement reduces
♠Impaired glucose intolerance can lead to hypoglycemia,
hyperglycemia, and type II diabetes mellitus
♠ Insulin sensitivity can be enhanced by balance energy intake,
weight management and regular physical activity
♠50 percent energy should derive from carbohydrate
♠ Whole grain cereals and pulses should be included in the diet
♠ Since caloric requirements are reduced, carbohydrates intake is
also reduced.
CARBOHYDRATE

26. PROTEIN
♠Decreased in skeletal tissue mass
♠Decrease in store of protein provided by is inadequate to meet
the need for protein synthesis
♠ Intake of 1.0gm/kg is safe during old age
♠ Protein rich food with milk and curd should be included
♠Due to decrease appetite and poor digestion, old people are
likely to consume less protein which may lead to edema,
anemia, and low resistance to infections
♠ Of the total caloric intake 11-12 percent should be from
protein.

27. LIPID
♠Dementia and Cardiovascular disease may share risk factors
like high intake of dietary total fat
♠Emphasis should be placed on reducing the intake of
saturated fat and choosing mono saturated or poly saturated
fat sources
♠Sufficient intake of ω-3 fatty acids helps in visual acuity,
hair loss, tissue inflammation, improper digestion, poor
kidney function and mental depression.

28. MINERALS

29. ♠Elderly are at risk of Vitamin D deficiency due to decreased
exposure to sunlight or decrease in renal mass
♠ Dietary supplements with calcium and vitamin D improves bone
density and prevent fractures
♠ People with Parkinson disease have low vitamin D levels.
VITAMIN

30. ♠Stress, smoking, and medication can increase vitamin c
requirement
♠The antioxidant vitamins such as vitamin E, carotinoids and
vitamin c enhances health of elderly
♠Vitamin C may be protective against cataract at an intake level
of b/w 150-250 mg/day
♠Vitamin E is potent nutrient for reducing decline in cellular
immunity that occur in elderly

31. ♠Changes in immune system can be overcome by taking
200 mg of vitamin E
♠ Requirement of vitamin B6 increased due to atrophic
gastritis, interferes with absorption
♠ Alcoholic and liver dysfunction are additional risk factor
for deficiency of vitamin B6
♠ Vitamin B6 have significant role in immune system.

32. ♠Alcoholism is a risk factor for folate deficiency
♠Severe deficiency of folic acid may result anemia and
elevated serum homo-cystiene level which is a risk for cardiac
diseases
♠ Consumption of folate rich food is needed
♠Causes for vitamin B12 deficiency are atrophic and bacterial
overgrowth, which decreases absorption and leads to
pernicious anemia.

33. ♠The kidney can function more adequately when there is a
sufficient fluid(1.5litres) to eliminate the waste solids
♠ Water stimulates peristalsis and thus aids in combating
constipation
♠ Water can be consumed as in the form of butter milk, fruit
juices porridge and soups
♠Some elderly individuals may having a fading sense of thirst
and may go long periods without fluid
♠Dehydration may result in mental confusion, headache and
instability
WATER

34. FIBRE
♠Fibre stimulates peristalsis
♠Rough fibre, bran and mature vegetables are not advised
for the aged
♠ The fibre of tender vegetables, fruits will make easier the
passage of the food mass down the intestinal tract
♠Fibres also help to reduce cholesterol which may reduce
atherosclerosis
♠ Excess of fibre may reduce the absorption of iron and
certain trace elements.

36. OBESITY
♠It is higher among elderly
♠ Because of more consumption of calorie and sedentary life
style
♠Obese are susceptible to diabetes ,cardio vascular disease ,
arthritis
OSTEOPOROSIS
♠Loss in bone density and bone mass
♠Its primarily found in middle age
♠Bone demineralization takes place at faster rate than bone
mineralization
♠Bone become porous lighter and fragile

37. DIABETES
♠It increases with age in both male and female
♠The elderly are at a risk of poor nutrition due to economic
pressure , reduced mobility , depression loneliness , aging tissues,
and inadequate food consumption
CARDIO VASCULAR DISEASE
♠Hypertension , acute myocardial infection, congestive cardiac
failure is high among elderly

38. CONSTIPATION
♠It is infrequent passes of stools which are more often drier or
harder than normal
♠ The stools becomes harder and drier because move to slowly
through colon
♠ The natural contraction and rhythm of colon might be
disturbed due to loss of tone , stress medication , illness ,
resisting the urge of defecate.

39. ANEMIA
♠Inadequate intake of iron causes fatigue , anxiety , lack of
energy and sleeplessness
♠Caused by low dietary intake lack of iron or vitamin c or
blood loss
MALNUTRITION
♠Due to various physiological and socio psychological
changes , food intake of the elderly may decreases

40. ♠The elderly are becoming an increasingly large, and their
nutritional needs are of growing concern
♠ It is becoming apparent that many of the chronic diseases of
the elderly could be delayed or avoided by maintaining good
nutrition throughout life
♠ Most nutrient requirements do not decrease with age, but
calorie requirements do

41. ♠When food habits of senior citizens must be changed,
adjustments require great tact and patience on the part of the
dietitian
♠Older people are easily attracted to food fads that promise
good health and prolonged life.

42. ♣B Sreelakshmi,"Dietetics" ,7th edition,New Age International
Publishers.
♣ Ruth A Roth, "Nutrition and Diet Therapy"10thedition.
♣Old age period and nutrition, Assistant Professor Emine
Aksoydan Baflkent University Faculty of Health Sciences
Department of Nutrition and Dietetics.
♣Subhangini a. joshiNutrition And Dietetics,4th edition,Tata
Mc Graw Hill Education private Limited, New Delhi