Nutrition is a human right and important for healthy aging
One out of two older adults are at risk of suffering from malnutrition. Early diagnosis and intervention are key to preventing malnutrition’s adverse health outcomes, which can threaten healthy aging. The American Society for Parenteral and Enteral Nutrition (ASPEN) has designated October 4—8 as Malnutrition Awareness WeekTM with the theme of Nutrition Is a Human Right. As part of this effort, ASPEN is highlighting several steps that can be taken to battle malnutrition.
Diagnosing and addressing malnutrition
Malnutrition occurs when overnutrition or undernutrition lead to changes in body composition and ability to function. Inflammation can occur, and both conditions frequently lead to the loss of the body’s protein stores (muscle mass), which can impact active aging.
Asking these questions can be the first step in identifying a person’s risk for malnutrition. A team of medical professionals will then evaluate an individual’s medical history, social and environmental situation and presenting symptoms to make a diagnosis. Calorie intake, weight trends, fluid retention, body fat, muscle mass loss and overall functionality are among the clinical criteria that will be evaluated. Early recognition and treatment are key to improving health outcomes for people who suffer from malnutrition.
Addressing and improving malnutrition can help
- Reduce hospital readmissions;
- Support healthy aging;
- Improve the quality of healthcare; and
- Decrease healthcare costs.
Things to watch for at home
- Appetite changes. As we age, many physiological changes can impact appetite, including changes to the digestive system and changes in hormones. Additionally, a person’s environment, mood, current medical condition and medication regimen can also affect appetite.
- Dehydration. Signs of dehydration include extreme thirst, decreased urination, dark urine color, dizziness, fatigue and confusion. Low blood volume, urinary and kidney problems and even seizures are just a few of the many risks associated with dehydration.
- Dentition. As we age, our teeth can become weak, which can result in tooth loss. Difficulty in chewing also tends to increase with age, leading older adults to get fatigued during meals and eat less. The inability to chew properly can also impact the taste and texture of foods, further impacting how much older adults eat.
- Sensory changes. Aging can impact our taste and smell. Almost 63% of people over the age of 80 have evidence of olfactory impairment, which affects the sense of smell. Foods that used to be “favorites” can often be perceived as “too salty,” “too sweet” or “too bland.” This can lead to disinterest in eating.
- Swallowing changes. Occasionally, older adults develop dysfunctional swallowing, called dysphagia. You may notice some older adults coughing more frequently during meals, which can be a sign of difficulty swallowing and can reduce how much they eat. If you identify increased coughing with meals, refer the older adult to a speech language pathologist for an evaluation.
Tips for improved nutrition
The most efficient way to address malnutrition is to prevent it by providing adequate calories and protein to help meet energy needs and inhibit loss of muscle mass. An older adult’s diet should include a variety of fruits and vegetables, whole grains, lean proteins and foods rich in calcium.
Here are some additional steps that can be taken.
- Increase caloric density of meals and snacks. “Caloric density” is the number of calories in a certain amount of a food. One easy way to increase caloric density is to add condiments or “extras” whenever possible. For example, preparing foods with olive oil or butter will add calories without adding volume. Topping foods with dried fruit, chopped nuts, bacon bits, cheese, mayonnaise or avocado will also add extra calories.
- Increase eating frequency. Eating multiple small meals throughout the day rather than just three large meals can help an older adult eat more without feeling overly full. Eating more frequently throughout the day can also help those struggling with taste and smell changes.
- Add liquid calories between meals. Drinking a fluid can be an easier way to increase calorie intake, especially if an older adult has a poor appetite. Liquid calories are typically well tolerated and can also help prevent dehydration. Fluids such as whole milk, shakes, smoothies or oral nutritional supplements can add up to 350 calories in just eight ounces. If an older adult quickly feels full, consider providing these higher-calorie beverages between meals rather than during meals, to help increase the amount they may drink.
With increased awareness about malnutrition and a willingness to take action on the part of older adults, we can all help support nutrition as a human right and promote active aging.
Rachel Bayse, MA, RDN, LD, is an ASPEN Malnutrition Committee member and a clinical dietitian at UF Health, University of Florida Health, Jacksonville, Florida.
ASPEN Malnutrition Solution Center provides resources for healthcare professionals and consumers.
Why Nutrition Is Important tip sheet is a resource for healthcare professionals.
Caring for Your Nutrition tip sheet is a consumer guide for older adults.
Note: This information is not intended to replace a one-on-one relationship with a qualified healthcare professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from research. The view expressed here are not necessarily those of the ICAA, we encourage you to make your own health and business decisions based upon your research and in partnership with a qualified professional.