• Hypertension, coronary heart disease and diabetes are all preventable, in part, by a lifelong healthy diet. ⁽²⁾

• A 2004 study of older Canadian adults found that the seniors with a poor diet had fewer good physical health days and reported lower satisfaction with their overall life. ⁽³⁾

• Poor health and other barriers may prevent older adults from accessing food even when they have money to purchase it, according to a 2001 Journal of Gerontology study. ⁽⁴⁾

• Some medication side effects can blunt appetite and impair digestion in older adults, according to an Archives of Internal Medicine study. ⁽⁵⁾

• Persistent oral health problems are linked with lower consumption of some foods and nutrients, and dental health is closely linked with nutrition status according to two Journal of American Dietetic Association studies. ^{(6, 7)}

• Frequency of social contact is among the factors that can affect diet in older adults, according to a 2005 Journal of Nutrition Health and Aging study. ⁽⁸⁾

• A small 2001 study of healthy older people found that protein, carbohydrate and fat -- each macronutrient working alone -- enhanced the seniors' performance on memory tests. ⁽⁹⁾

• Older women who followed a low-fat diet were generally able to avoid weight gain over seven years, according to January 2006 Women's Health Initiative results. ⁽¹⁰⁾

• Older women who switched to a low-fat diet and ate more fruits and vegetables did not have a significantly reduced risk for breast or colon cancer, according results of he 2006 Women's Health Initiative results. ^(11,12)

• Postmenopausal women who participated in intensive education sessions that encouraged them to follow a low-fat, fruit-and-vegetable rich diet achieved only modest reductions in cardiovascular disease risks over eight years. ⁽¹³⁾

• A study of nutrition education strategies for older adults found few successful ways to change behavior but suggests that the most effective approaches are conducted in a social setting, while providing hands-on activities, incentives and access to health professionals. ⁽¹⁴⁾

"If you are really going to help someone with their diet, you can't just give them a tear-off sheet, or tell them to eat more," says Nancy Wellman, director of the National Policy and Resource Center on Nutrition and Aging. "One needs to know where the gaps are in one's eating."

Some experts call for nutritional risk assessment for anyone over age 65, but Wellman says an analysis is especially important for older people who have a chronic illness or multiple chronic diseases. "The more complicated a person's health profile is, the more appropriate it is to make a referral to a dietitian," she says.

Wellman says physicians rarely have the training or time to suss out nutrition problems, but dietitians regularly "translate the science of nutrition into the art of making healthier food choices."

A nutritional assessment usually begins with a simple questionnaire that can lead to a longer discussion about lifestyle and food habits. That conversation can often uncover motivation for change. "Sometimes they are willing to do almost anything to stay out of nursing homes. If that means eating better and moving more, it's an easy sell," Wellman says.

Wellman's team recently completed a ten-site study designed to pinpoint simple steps to improve older Americans' health. Results aren't published yet, but Wellman said, "We found that when we offered mini-talks on nutrition and exercise, and used pedometers and little food check-offs, it improved people's self-reported health status, and increased servings of fruits and vegetables, calcium-rich foods and fiber."

Susan Moores, a spokeswoman for the American Dietetic Association, says crafting a successful meal strategy with seniors requires both cheerleading and a velvet-glove approach.

"You will find that people in their 60s really do not want necessarily to be grouped in with people in their 70s and older," she says. "And people in their 50s, certainly aren't real comfortable with the word 'senior.' So we have to be real careful with how we talk with folks."

Diet and nutrition needs can be very different depending on a person's age and level of independence, she adds. People age 50 to 65 -- even up to age 75 -- may be primarily fighting obesity, Moores says. The "young old" can be overweight and still undernourished because they are not eating the right foods, she says. By contrast, people over 75 have a greater risk for under-nutrition and for not getting enough calories, Moores says.

In the United States, the largest healthy eating program for seniors is the Older Americans Act Program, which provides group dining and Meals on Wheels. But Wellman says some older adults hesitate to ask for help. Family members and health practitioners have to take cues from older adults to know how much intervention is needed and welcomed, Moores says.

References

1. U.S. Department of Health and Human Services, CDC, Coordinating Center for Health Promotion. (2006) "Healthy Aging, Preventing Disease and Improving Quality of Life Among Older Americans."
2. Centers for Disease Control and Prevention, Merck Institute on Aging and Health. The State of Aging and Health in America 2004.
3. HH Keller et al. (2004) Nutritional risk predicts quality of life in elderly community-living Canadians. J Gerontol A Biol Sci Med Sci, Jan;59(1):68-74.
4. JS Lee et al. (2001) Factors Associated with Food Insecurity Among U.S. Elderly Persons: Importance of Functional Impairments. Journal of Gerontology: Social Sciences 56B(2): S94-S99.
5. DM Fick et al. (2003) Updating the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Archives of Internal Medicine 163: 2716-24.
6. RL Bailey et al. (2004) Persistent Oral Health Problems Associated With Comorbidity and Impaired Diet Quality in Older Adults. Journal of the American Dietetic Association Oct.;104(10):1548.
7. NR Sahyoun et al. (2003) Nutritional status of the older adult is associated with dentition status. Journal of the American Dietetic Association. Jan;103(1):61-6.
8. NR Sahyoun et al. (2005) Dietary Quality and Social Contact Among a Nationally Representative Sample of the Older Adult Population in the United States. J Nutr Health Aging. 9(3):177-83.
9. RJ Kaplan et al. (2001) Dietary protein, carbohydrate, and fat enhance memory performance in the healthy elderly. Am J Clin Nutr, Nov;74(5):687-93.
10. BV Howard et al. (2006) Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial. Journal of the American Medical Association, Jan 4:295(1):39-49
11. RL Prentice et al. (2006) Low-fat dietary pattern and risk of invasive breast cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. Journal of the American Medical Association, Feb 8:295(6):629-42.
12. SA Beresford et al. (2006) Low-fat dietary pattern and risk of colorectal cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. Journal of the American Medical Association, Feb 8:295(6):643-54.
13. BV Howard et al. (2006) Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. Journal of the American Medical Association, Feb 8:295(6):655-66.
14. NR Sahyoun et al. (2004) Evaluation of nutrition education interventions for older adults: a proposed framework. Journal of the American Dietetic Association, Jan;104(1): 58-69.