Nutrition in the Elderly Flashcards
What is the top 8 leading causes of death for adults >65 yo?
- Heart dx
- cancer
- COPD
- Stroke
- Alzheimer’s
- Diabetes
- Flu/Pneumonia
- Nephritis
What are nutrients that are commonly deficient in the diets of the elderly?
Fluid Fiber Protein Vit B12 Vit D
How much does basal metabolism decrease for 50-70 yo? >70 yo?
50-70: down 10%
>70 yo: down 20-25%
T/F Elderly eat 1/3 fewer calories and decrease protein intake.
True.
What are some obstacles to healthy eating in older populations?
Acronym: MEALS on WHEELS
Medications Emotional (depression, anxiety) Alcoholism Late life paranoia or bereavement Swallowing problems
Oral factors
Nosocomial infections
Wandering or dementia Hyperthyroidism, hypercalcemia, hypoadrenalism Enteral problems Eating problems Low salt, therapeutic diets Social isolation
What is a better indicator of nutritional status, aside from albumin?
Mini Nutrition Assessment 83% sensitive food intake change weight loss mobility psychological stress BMI
What are some automatic warrants for a nutrition consults?
dialysis
enteral/parenteral nutrition
wounds
low Braden score
What are 2 methods of indirect calorimetry?
- *Oxygen consumption v. carbon dioxide excretion
* *Respiratory Quotient
What are predictive equations of calorie needs in healthy non-overweight people?
Harris-Benedict
Mifflin St. Jeor (can also be used in obese patients)
ICU calorie need measurements?
Penn State 1998 (obese vented)
Penn State 2003 (non-obese vented)
What determines protein needs?
normal: 0.7-0.8 g/kg
geriatric: 0.8-1 g/Kg
stress & wounds need higher protein
kidney failure, decrease protein
dialysis can raise protein again.
plant protein better tolerated in cases of encephalopathy
Why should enteral nutrition be first line always, if possible?!
b/c if you use IV nutrition, run risk of decreasing blood flow to gut & causing damage.
T/F Medically-assisted nutrition and hydration should be considered medical interventions rather than basic provisions of comfort
True.
T/F Dehyration is a form of malnutrition.
T
What are some recommendations to increase fluid intake?
Keep water by the table/bed at all times
Remind them to drink even if they aren’t thirsty
Focus on whole foods that can provide some hydration
All beverages (except for high sources of caffeine) can be used to meet fluid recommendations
What are the benefits of fiber? How many grams/day?
15 g/day
gastric motility
improved glycemic control
reduced cholesterol
How many grams of protein/meal should the elderly eat?
25-30 grams/meal
How should the elderly get their Vitamin D & Calcium?
8 oz of milk
1 oz of cheese
6 oz of yogurt
What is the upper limit of amount of folic acid/day?
1000 micrograms/day
don’t want to mask Vit B12 deficiency
What are the daily recommendations for food in elderly?
5 ½ oz of protein 5-6 oz of grains (1/2 should be whole grains) 3 cups of dairy 2-3 cups of veggies 2-3 cups of fruit Less than 6 teaspoons of oils
What are the macronutrient recommendations?
Carb: 45-65% Protein: 15-20% Fat: 25-35% 7-10% sat. fat Choelsterol 200-300 mg/day
What are the macronutrient recommendations?
Carb: 45-65% Protein: 15-20% Fat: 25-35% 7-10% sat. fat Cholesterol 200-300 mg/day
What do you do with obese elderly people?
Encourage them to not gain weight.
Don’t decrease their BMI less than 25, prob leave them alone in case they get sick & need extra reserves.
What are the physical activity guidelines for older adults?
Cardio/Aerobic exercise 3 to 7 days per week 1,000 to 2,000 calories burned per week Walking, swimming, jogging Resistance training 2 to 3 days per week, 8 to 20 reps with 2-3 rounds, whole body routines, resistance bands, free weights Balance/Flexibility – Daily
