By the year 2030, one in five persons in the United States will be aged 65 or over and overall US health-care costs are expected to increase by 25% (1). Our growing diversity is accentuated by an increased prevalence of obesity, hypertension, and diabetes, as well as the desperate need for lifestyle intervention in vulnerable race and ethnic groups which make up our graying populations. Optimal nutrition and physical activity represent a golden key to good health in a patient’s later years.
PHYSIOLOGIC AGING AND NUTRITION
The aging process leads to changes in physical vigor and strength that may be minor between ages 50 and 60, but become more pronounced at ages 70–80. Age-related changes in body composition, gastrointestinal function, and renal function follow the same progression across the population but occur at different rates such that older persons differ markedly from one another, and these changes influence nutrient needs.
NUTRIENT REQUIREMENTS OF THE OLDER ADULT
The aging process coupled with chronic disease and rising use of medications brings uncertainty to the nutrient recommendations for older adults. The dietary reference intakes (DRI) defines two age categories for older adults (51–70 and 71 and over). This is a recognition of the cumulative physiologic and functional changes that occur as a result of the aging process and development of chronic diseases.
BODY WEIGHT IN THE OLDER ADULT
Body weight management poses particular problems for older people. Involuntary weight loss and decreasing muscle mass lower functional capacity whereas ill-advised weight gain aggravates any existing disability and worsens chronic disease. Changes in food intake regulation prevent appropriate responses to short-term changes in food intake that would bring about a return to the former weight.
Positive changes in the quality or amount of food consumed are never without benefit, regardless of age or physical status. Increased intakes of fruits, vegetables, whole grains, and good sources of calcium and protein add important nutrients and phytochemicals for resisting chronic disease and enhancing immune response