According to a Centers for Disease Control and Prevention report detailing "Healthy Eating Index" scores among Americans 60 years and older, only 17% eat a diet good enough to be called, well, "good." A whopping 68% had a diet that "needed improvement" and for 14% their diet was outright "poor." Less than third of seniors met the guidelines for eating from the five recommended food groups.
Some of the best scores came in the categories measuring cholesterol and salt, which researchers say could be attributed to patients following medical guidelines limiting those nutrition busters. If that's the case, they need to be given information not just on what not to eat, but also on healthy substitutes to make. Unfortunately trying to adhere to doctor's orders is one of a number of factors creating the problem of malnutrition in the elderly.
Malnutrition: How It Happens
Studies have shown the malnutrition in the elderly can strike in places that you'd find surprising, like under the supposed watchful eye of doctors in hospital settings and of health practitioners in nursing homes. Seniors cared for in their own homes seem to fare better, but a variety of factors can lead to them neglecting themselves. For instance, if living alone, they might not want to bother cooking for one; if they are sick, they might lack the appetite or drive to eat, even though good food would help in the healing process.
A cycle of poor nutrition can easily turn into malnutrition in the elderly. If seniors don't eat enough they will get weak, lack the energy to go out, shop...or cook for themselves. Malnutrition in the elderly leads to more frailty and more illness—physical woes like a fracture that can lead to emotional woes like depression.
Malnutrition: Scratching the Surface
If you are aware of the less obvious underlying causes of malnutrition, you'll be in a better position to spot them and intervene:
- A diet that's too restrictive. Seniors might wisely cut back on red meat to lower cholesterol, but may not know how to get protein from other sources to make up for it. If they're lactose intolerant and are told to avoid dairy, they might not end up getting enough calcium, vitamin D and other nutrients.
- Excessive alcohol. Alcohol consumption can cut appetite and use up important nutrients.
- Dental and medical problems that lead to chewing and swallowing difficulties. Some conditions might make eating painful or simply impossible.
- Diminished ability to absorb vital nutrients. This can happen as part of the normal aging process or because of a specific illness like Crohn's, in which the disease itself prevents nutrients in food from being absorbed.
- Side effects of medications. These can range from just not having an appetite or food tasting differently, to full-fledged nausea and cramps.
- Debilitating chronic illness. Whether physical or mental, pain, fatigue and other symptoms can keep seniors from shopping for and preparing nutritious foods.
- Depression. A loss of appetite and subsequent weight loss are important signs of depression, which needs its own treatment without delay.
Malnutrition: Undercover Work Needed
People can be malnourished without being emaciated. Do some on-the-ground investigating to find out if your parent is at risk and, if so, take steps to reverse the situation.
- Eat a meal at home with your parent and pay attention to how much he or she really eats.
- Keep track of their weight; call their primary care physician if there is a loss of more than 5 to 10 pounds.
- Look for early signs of malnutrition: Ask their physician to run blood tests that look at protein levels.
- Make sure there are no physical problems that could be interfering with eating, like dental issues.
- Read over all the cautions that came with their prescriptions or look up the drug names online to see what effects they might have on appetite and taste buds; if you suspect any, ask doctors if substitutions can be made.
Malnutrition: Getting Appetite Back On Track
Get your parent excited about food again. Just because salt may be out doesn't mean herbs, black pepper and subtle spices are, too. Try simmering foods in chicken stock rather than boiling in plain water to add more flavor. And, if full meals are too much to eat at once, discuss rearranging the day's servings into 4 to 6 smaller meals. If your parent lives in a facility where institutional meals are served and is unhappy about their quality, your best option might be to supplement the offerings, with either nutritionals, like meal replacement and shakes, or non-perishable, healthy snacks that you know will be appealing—and eaten!
If you are still concerned about whether your parent is eating right, especially if the overall amount doesn't seem to be much, consider consulting with a registered dietitian. They may recommend adding vitamins and supplements to your parent's diet and can outline the best food choices, letting you know what combinations of servings from the various food groups will add up to a diet that is even better than just "good."