Strategies to Address

Age-related changes
Affecting Nutrition
Age-related change:
ABILITY TO CHEW

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 STRATEGIES:
 care for and retain own teeth and denture
 proper tooth brushing and use of special toothpaste for
sensitive tooth and gums
 chop, shred, or puree food that are difficult to chew
 select ground meat, fish, or poultry as protein sources
more easily chewed.
Age-related change:
LOSS OF SENSES
OF SMELL AND TASTE

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 STRATEGIES:
 serve food that is attractive and at proper temperature
 serve one food at a time rather than mixing foods
 serve food with different textures and aromas
Age-related change:
DECREASED
PERISTALSIS IN THE
ESOPHAGUS

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 STRATEGIES:
 avoid cold liquids.
 avoid emotional upsets and stress-
producing situations.
 take anticholinergic drugs as ordered by physician
Age-related change:
GASTROESOPHAGEA
L REFLUX

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 STRATEGIES:
 avoid overeating; juices, chocolate, and fat
 avoid alcohol and smoking
 elevate the head of the bed 30 to 40 degrees when
sleeping.
 lose weight if necessary.
 avoid bending over.
 take antacids or other medications as ordered by
physician
 avoid eating right before bed.
Age-related change:
DECREASED GASTRIC
SECRETIONS

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 STRATEGIES:
 chew food thoroughly.
 eat meals on a regular schedule
 use antacids or other medications as prescribed by
physician
 be alert for symptoms of deficiency of nutrients,
particularly iron, calcium, fat, protein, and vitamin
B12.
Age-related change:
SLOWED INTESTINAL
PERISTALSIS
✘ 

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 STRATEGIES:
 eat a high-fiber diet
 remain as active as possible
 increase fluid intake
 avoid laxative use
 eat meals at a regular time
 drink prune juice or eat prunes every morning
Age-related change:
LOWERED GLUCOSE
TOLERANCE

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STRATEGIES:
 eat more complex carbohydrates
 avoid sugar-rich food
Age-related change:
REDUCTION IN APPETITE
AND THIRST SENSATION

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 STRATEGIES:
 offer fluids at regular intervals and at preferred
temperature
 be alert for symptoms of dehydration and electrolyte
imbalance
 offer small meals at frequent intervals.
Age-related change:
NUTRITIONAL
DEFICIENCIES RELATED
TO ALCOHOL INTAKE

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 STRATEGIES:
 encourage diet high in protein and carbohydrates
 offer small, frequent meals to maintain calorie intake
 restrict sodium and fluids if edema is present
 take multivitamin supplements, as ordered by
physician
Age-related change:
LOSS OF APPETITE
ASSOCIATED WITH
DEPRESSION AND
LONELINESS
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 STRATEGIES:
 promote mealtime as a social event
 set an attractive table in a pleasant setting
 eat outdoors whenever possible
 invite guests as often as possible
 participate in special programs for senior citizens
Age-related change:
MALNUTRITION

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 STRATEGIES:
 eat essential foods first
 select nutrient-dense foods
 monitor for signs of nutritional deficiencies
 encourage eating by planning special events
Age-related change:
INCREASED RISK FOR
DRUG-NUTRIENT
INTERACTIONS

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 STRATEGIES:
 avoid unnecessary drugs; monitor for poly pharmacy
 be aware of drug actions and interactions
 check with pharmacist to determine if medication may
or may not be taken with food
 assess for confusion and inability to manage medication
regimen
Therapeutic Diets
OBESITY & WEIGHT CONTROL
NUTRITION/DIET THERAPY:
✘ Low-calorie diet
WOMEN – 1000-1500 calories
MEN – 1200-1800 calories
BED PATIENTS w/ heart disease- 800-100 calories
- should be attractive and palatable
- should not include alcoholic beverages, sweetened
carbonated beverages, candies etc.
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 DIABETES MELLITUS
NUTRITION/DIET THERAPY:
✘ Energy
- low-calorie diet for overweight diabetics
In bed: 11-12 cal/lb
Sedentary: 13-14 cal/lb
Moderately active: 15-16 cal/lb
✘ Protein
- About 1.5 g/kg body weight; 15-20% of daily caloric intake
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 DIABETES MELLITUS
NUTRITION/DIET THERAPY:
✘ Carbohydrate
50-55% of daily caloric intake
✘ Fat
30% of daily caloric intake

Caloric Requirements:
- basal metabolism, activity rate and physiological stress

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DISEASES OF THE GI TRACT
PEPTIC ULCER
NUTRITION/DIET THERAPY:
✘ Bland diet
- bland flavor, soft consistency and mechanically and
chemically non-stimulating
- eating three meals a day without snacks
- moderate meal size
- dietary fiber is encouraged, according to patient’s
tolerance
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DISEASES OF THE GI TRACT
Diverticular DISEASES
NUTRITION/DIET THERAPY:
✘ High-fiber diet
✘ Acute episodes may require liquids and low-residue food
MALABSORPTION SYNDROME
NUTRITION/DIET THERAPY:
✘ High-protein diet (100 g or more)

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DISEASES OF THE GI TRACT
Malabsorption syndrome
NUTRITION/DIET THERAPY:
✘ Low-fat fiber diet during the initial stages
Ulcerative colitis
NUTRITION/DIET THERAPY:
✘ High protein
✘ High Calories
✘ Increased Vitamins and Minerals
✘ Low-residue diet 32
DISEASES OF THE GI TRACT
LACTOSE INTOLERANCE
NUTRITION/DIET THERAPY:
✘ Lactose-restricted diet
DIARRHEA
NUTRITION/DIET THERAPY:
✘ NPO for 12 hours w/ IV fluid and electrolytes
✘ Liberal fluids
✘ Broths and electrolyte solutions
✘ Pectin & Oral rehydration 33
DISEASES OF THE GI TRACT
CONSTIPATION
NUTRITION/DIET THERAPY:
✘ Lactose-restricted diet
Intestinal gas
NUTRITION/DIET THERAPY:
✘ Exclude food that produce gas
✘ Small, frequent meals

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DISEASES OF THE GI TRACT
HEMORRHOIDS
NUTRITION/DIET THERAPY:
✘ High-fiber diet
✘ Liberal fluids
✘ Low-fiber diet during flare-ups
GASTROESOPHAGEAL REFLUX DISEASE
NUTRITION/DIET THERAPY:
✘ Limit food that relax the lower esophageal sphincter
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DISEASES OF THE GI TRACT
GASTROESOPHAGEAL REFLUX DISEASE
NUTRITION/DIET THERAPY:
✘ Avoid large meals and food high in fat
✘ Maintain ideal body weight
SHORT BOWEL SYNDROME
NUTRITION/DIET THERAPY:
✘ Dietary fat restriction
✘ Frequent fluid and electrolyte balance monitoring
✘ Parenteral nutrition support 36
 DISEASES OF THE LIVER
HEPATITIS
NUTRITION/DIET THERAPY:
✘ Protein – 2/3 of it from animal sources
✘ Energy
✘ Minerals and Vitamins
✘ Moderate Fat – 80 to 100 g
CIRRhosis
NUTRITION/DIET THERAPY:
✘ Diets restricted to 250 mg sodium
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 DISEASES OF THE LIVER
CIRRHOSIS
NUTRITION/DIET THERAPY:
✘ Protein intake of 100g for 250 mg of sodium
HEPATIC COMA
NUTRITION/DIET THERAPY:
✘ High calories- 1500-2000 calories

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DISEASES OF THE GALL BLADDER
Cholecystitis
NUTRITION/DIET THERAPY:
✘ Low-fat diet
✘ Plain and simple food
✘ Spices and high-residue food should be avoided
Food Preparation:
• Meat should be lean
• Vegetables cannot be dressed with butter, margarine or
sauces 39
DISEASES OF THE PANCREAS
PANCREAtitis
NUTRITION/DIET THERAPY:
✘ NPO for 48 hours for acute attacks
✘ Low-fat, low-elemental formulas
✘ Low to moderate fat, high CHO and moderate protein diet for
chronic cases
✘ Fluids and electrolytes given intravenously
✘ Vitamin and mineral supplementation
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DISEASES OF THE PANCREAS
CYSTIC FIBROSIS
NUTRITION/DIET THERAPY:
✘ Calories enough to supply demands for growth
✘ High-protein diet
✘ Liberal fat intake
✘ Vitamins and minerals
✘ Liberal fluid intake

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CARDIOVASCULAR DISEASES
ATHEROSCLEROSIS
NUTRITION/DIET THERAPY:
✘ Low-fat diet
✘ Increase in monounsaturated fatty acids
✘ Increase in polyunsaturated fats
✘ Increase in complex carbohydrate intake and restriction of
simple sugars
✘ Dietary fiber – 25-30 g/day
✘ Restriction of calories to 1200-1600 & 2000-2500 42
CARDIOVASCULAR DISEASES
CONGESTIVE HEART FAILURE
NUTRITION/DIET THERAPY:
✘ Sodium-restricted diet
✘ Calorie control
✘ Texture control
HYPERTENSION
NUTRITION/DIET THERAPY:
✘ Mild sodium restriction and weight reduction
✘ Low-fat diet 43
CARDIOVASCULAR DISEASES
MYOCARDIAL INFARCTION
NUTRITION/DIET THERAPY:
✘ Liquid diet on the initial stages
✘ Small, frequent meals
✘ Sodium, cholesterol, aft and calorie restriction
✘ Consumption of omega-3 fatty acid-rich food

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 DISEASES OF THE KIDNEYS
ACUTE GLOMERULONEPHRITIS
NUTRITION/DIET THERAPY:
✘ High-calorie diet chiefly from carbohydrates and fat
NEPHROTIC SYNDROME
NUTRITION/DIET THERAPY:
✘ High-protein diet, 100-150 mg daily
✘ High calorie intake
✘ Sodium restriction (500 mg)
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 DISEASES OF THE KIDNEYS
ACUTE RENAL FAILURE
NUTRITION/DIET THERAPY:
✘ Protein: 0.6-0.8 gm/kg
✘ Sodium: 1-2 gm/day
✘ Potassium: 2 gm/day
✘ Phosphorus and Calcium
✘ Fluid intake is regulated by output
✘ Fiber: 20-25 gm/day
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 DISEASES OF THE KIDNEYS
CHRONIC RENAL FAILURE
NUTRITION/DIET THERAPY:
✘ Protein: low to moderate according to tolerance
30-50 g
✘ Carbohydrates: 300-400 g
✘ Fat: 70-90 g
✘ Calories: 2000-2500 g daily
✘ Sodium control
✘ Potassium Control and water control 47
DISEASES OF THE KIDNEYS
RENAL CALCULI
NUTRITION/DIET THERAPY:
✘ Large fluid intake
✘ Stone Composition
✘ Urinary pH

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 MAINTENANCE OF HEALTHY
PERIDONTAL TISSUES
NUTRITION/DIET THERAPY:
✘ Lipids
✘ Protein
✘ Vitamins A, D, E, K, B-complex, C
✘ Calcium, Magnesium and Phosphorus
✘ Zinc
✘ Copper
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 CANCERS
NUTRITION/DIET THERAPY:
✘ Oral: high-calorie, high-protein beverages; lactaid
✘ Tube feedings:
Complete products
Chemically-defined products
Modular products
Specialty products
✘ Total Parenteral Nutrition: nutrients administered
intravascularly
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ACQUIRED IMMUNODEFICIENCY
SYNDROME
NUTRITION/DIET THERAPY:
✘ Energy: 35-45 kcal/kg BW
✘ Protein: 2-2.5 g/kg BW
✘ Fats: increase omega-3 sources
✘ Vitamins and Minerals

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Thank you!

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