Nutrition and the Older Adult

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 percent 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 non-digestible 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 individual’s 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 grams 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’s 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 percent 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.