CALCIUM: ANOTHER WEIGHT LOSS STRATEGY

CALCIUM AND VIT D SUPPLEMENTATION

CALCIUM CUTS BONE LOSS

VITAMIN C - THE WONDER CURE

PMS - PROPER MULTIPLE SUPPLEMENTATION

CATARACTS AND ANTIOXIDANTS

CALCIUM & MAGNESIUM

A CRAMP "SOLUTION"

CHOCOLATE CRAVINGS

CHELATION & MINERAL BIOAVAILABILITY

MALNUTRITION AND THE ELDERLY

MAGNESIUM: ARE YOU "MARGINALLY" DEFICIENT?

MAGNESIUM: THE MEDICINAL MINERAL

YOUR HEALTH CARE DEBATE

THE OTHER DEBATE

"TIS THE SEASON TO BE STRESSED"

VEGETARIANISM: A 90'S APPROACH TO A HEALTHIER LIFESTYLE

WINTER BLUES AND HOLIDAYS

ANTIOXIDANT PROTECTION

SHOULD YOU TAKE EXTRA VITAMINS

MACULAR DEGENERATION STUDY SUPPORTS SUPPLEMENTATION

WHAT DO HEART DISEASE, STROKES AND ALZHEIMER'S HAVE IN COMMON? 3 B VITAMINS

Today, over 11% of Americans are over age 65, and by the year 2030, that number is expected to increase to 25% of the population. For many reasons, the elderly face the toughest challenge to good nutrition.

Due to decreases in physical activity, muscle mass and basal metabolic rates, daily calorie needs drop about 10% each decade after age 50. But there does not appear to be any significant decrease in the need for nutrients. As a result, the elderly must chose nutrient-dense foods, since there is no room in a calorie-restricted diet for empty calories (i.e. junk food).

Not surprisingly, between 33 and 50% of the elderly's health problems are related to nutritional problems. Obesity, heart disease, hypertension, certain cancers and osteoporosis are representative of primary malnutrition - directly related to inadequate or excessive dietary intakes. Secondary malnutrition - malnutrition not directly related to diet - is also a common cause of nutrient deficiencies in the elderly (see "Medications" and "Alcohol").

CAUSES OF ELDERLY MALNUTRITION
A variety of physiological, social, economic and other reasons account for malnutrition among the elderly:

Changes in the mouth. According to the American Dental Association, approximately 50% of those aged 65 have lost their teeth. Of these 50% do not have dentures, have incomplete sets, have poorly fitted sets or do not use their dentures. Even those who have properly fitted dentures can only exert 25% of the chewing force provided by natural teeth. Add this to reduced salivary flow, periodontal disease, and the elderly find a severe limitation to the foods they can eat.

Diminished sense of taste and smell. With age, the number and sensitivity of taste buds decreases, leaving those that are responsible for sour and bitter tastes. As a result, the elderly easily lose interest in food.

Impaired hearing and vision. With age, hearing and sight diminish. This make sit harder to choose and prepare meals when trying to identify packages and read labels and recipes. Diminished hearing can make sharing meals with others difficult and cause embarrassment in restaurants lessening meal's enjoyment.

Gastrointestinal discomfort. As the body ages, gastric levels of hydrocholoric acid decrease; intestinal motility slows, and some develop lactose-intolerance. Avoiding gastrointestinal discomfort, the elderly restrict their own diets.

Chronic illness. Nearly 80% of the elderly have one or more chronic disease which can limit diets or cause loss of appetite which requires a limited diet.

Decreased sensitivity to thirst. Studies have shown that young and elderly bodies may fail to conserve water despite physiologic need for fluid. And, without the medium to transport minerals, the body suffers.

Limitation of activity. 50% of non-institutionalized elderly must limit their activity due to health problems. Without exercising, the elderly fail to obtain exercises' benefits such as increasing appetite, retaining muscle and joint functions, increasing lean body mass while decreasing fat, alleviating gastrointestinal problems and increasing sense of well-being.

Reduced muscular coordination. With age, frequently the elderly lose find muscle coordination. Consequently, the elderly may avoid foods which are difficult to prepare or eat, further limiting their diet.

Isolation or lack of social contact. People who are isolated are les likely to eat well. In a 1990 survey of non-institutional Americans over 65, 30% live alone and regularly skip meals.

Reduced income. The same survey found that 25% of the elderly have incomes less than $10,000, indicating that many may be unable to buy the nutritious foods they need.

Alcohol. For 2 to 10% of the elderly population, alcohol abuse can cause increased requirements for specific nutrients such as vitamin B-6, folic acid, thiamine, zinc and magnesium.

Medications. In the previously mentioned survey, 45% of the elderly take more than one prescription drug. And, certain medications and combinations of drugs can impair the body's absorption of nutrients as well as affect appetite. For example, phenobarbitol is known to cause folic acid deficiency anemia; corticosteroid depletes calcium reserves; and, diuretics deplete potassium.

Some Solutions?
The relationship between nutrition and health is compared to an elongating chain that represents the accumulation of problems over time. Each link that is added to the chain increases the risk that disease will develop. The good news is that the chain can be shortened if nutrition and other behaviors improve.

Government nutrition projects, churches and other volunteer organizations attempt to meet the elderly's social and nutritional needs. Unfortunately, together with the Food Stamp Program, home-delivered meals and congregate dining serve only 2 million elderly each year - less than 8% of the elderly population.

Vitamin and mineral supplementation is often recommended. However, a large proportion of the elderly population takes medication, and supplement regimens can weaken the benefits of an individual's medication. (For example, vitamin E may enhance warfarins' effects increasing the possibility of hemorrhage.) Therefore, a supplement program should never be started without the advice of a doctor, nurse or clinical nutritionist who is sensitive to nutrition.

Copyright © February - April, 1993