Geriatric considerations - Nutrition: Nursing

Nutrition refers to the process in which nutrients are ingested and used by the body to support health and maintain essential functions like metabolism and tissue repair.

Nutritional needs fluctuate in response to age related physiologic changes and the development of acute or chronic conditions.

As the nurse, you'll consider how nutrition changes with aging and provide patient centered care based on your patient's nutritional needs.

Now, the required number of calories which reflect the available energy within food decreases with age due to a reduction in lean muscle mass and an increase in adipose or fat tissue in general.

The minimal daily recommended caloric intake for an older adult is 1200 calories per day. However, caloric needs also vary depending on factors like age, biological sex, body size activity levels and the presence of illness.

For instance, some older adults with conditions that restrict mobility or limit activity tolerance such as arthritis or heart failure may require fewer calories.

In contrast conditions that increase the metabolic rate like cancer may require consumption of more calories. Unlike caloric requirements, the amount of necessary nutrients remains stable as individuals age therefore, nutrient dense foods or foods with a high nutritional value are ideal for older adults.

First, carbohydrates include sugars and starches and are the main source of calories used for energy. So they should make up 45 to 65% of daily calories.

Carbohydrates can be simple or complex. Simple carbohydrates like honey or table sugar are easily broken down and are less nutrient dense.

Whereas complex carbohydrates like whole grains and fruits take longer to break down and are more nutrient dense. Complex carbohydrates also contain soluble fiber, which is a nondigestible form of fiber that has numerous benefits including increasing the bulk of stool, which helps prevent constipation, lowering blood cholesterol levels and slowing the increase in blood glucose levels after a meal.

Given their higher nutritional value, complex carbohydrates should comprise most of an individuals carbohydrate intake. Next, proteins are chains of amino acids and are crucial for physiologic processes like tissue repair proteins can also be used for energy though it's not their primary function.

Recommended protein intake is typically between 46 and 56 g per day. Proteins are considered complete or incomplete depending on the number of amino acids.

They provide complete proteins include nine essential amino acids. Our bodies are unable to make and include animal proteins like meat, fish, eggs and dairy.

On the other hand, incomplete proteins do not contain all nine essential amino acids and include plant proteins like legumes, nuts and whole grains.

Now, some high protein sources like cheese and whole milk are also high in fat, which can contribute to cardiovascular diseases like atherosclerosis and hypertension.

Therefore, high fat protein sources should be eaten in moderation and low fat protein sources like beans and lean meats should make up most of protein intake.

Then there are fats which are made of fatty acids. They provide another source of energy, essential fatty acids and help with absorption of fat soluble vitamins.

Around 20 to 35% of daily calories should come from fats. Fats can be saturated or unsaturated.

Based on their chemical structure. Saturated fats have single bonds and are saturated with hydrogen ions.

While unsaturated fats have double bonds and are not saturated with hydrogen ions. Sources of saturated fats include butter, coconut oil, sour cream and fatty meats.

Saturated fats can increase low density lipoprotein or LDL, which is a type of lousy cholesterol that's necessary in small amounts but can contribute to cardiovascular disease.

So, saturated fats should be limited sources of unsaturated fats include nuts, avocado and certain types of fish like salmon and tuna unsaturated fats should make up most of fat intake because they can increase high density lipoprotein or HDL, a healthy type of cholesterol that protects from cardiovascular disease.

Now, water makes up about 60% of the average adult body and most adults require 2000 to 3000 mL of fluid daily. Water is necessary for various physiologic processes like helping to eliminate waste products, regulating body temperature, transporting electrolytes and nutrients and forming certain bodily fluids such as tears, perspiration, and saliva.

With aging body water composition normally decreases to where older adults can have up to 10% less body water compared to younger individuals.

This is due to age related changes like a decrease in lean muscle and increase in fat as muscle contains more water than fat.

Other changes can include a decreased thirst, sensation, and diminished kidney function. As the nurse youll provide patient centered care based on your patients, nutritional needs begin by gathering information about your patients nutrition and hydration status.

This can include obtaining their height and weight and calculating their body mass index or BMI. To identify if they are underweight, overweight or have had a recent change in their weight.

Be sure to ask if any weight change was intentional or not. You can also ask about their appetite, what they typically eat each day and if they have any swallowing or digestive issues, additionally, evaluate their functional abilities related to preparing food and if they require assistance to access nutrient dense foods and clean drinking water, also check laboratory results related to nutrition including electrolytes, lipids, and glucose and consult with the registered dietician as needed.

Then reinforce education on consuming a healthy diet for general health and disease control. Encourage them to include the recommended portions of major food groups including grains, fruits, vegetables, dairy and meat and to choose foods that are nutrient dense, like leafy green vegetables, fresh fruit and lean meats.

Be sure to consider cultural and ethnic variations in food preferences, preparation and mealtime etiquette as well as any dietary restrictions like low sodium diets.

Lastly, if your patient needs assistance, accessing nutritious foods recommend referral to a supplemental nutrition assistance program or collaborate with the social worker as indicated.

All right. As a quick recap, nutrition refers to the process in which nutrients are ingested and used by the body to support health and maintain essential functions like metabolism and tissue repair.

Nutritional needs, fluctuate in response to age related changes and the development of acute or chronic conditions. As the nurse, you'll consider how nutrition changes with aging and provide patient centered care related to nutritional needs.