Healthy Diet for the Older Adult
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Sirakarn Tejavanija and Sunil S. Jhangiani
Questions
1. Which of the following is an important body composition
change that occurs with aging?
A. Loss of fat mass
B. Progressive loss of muscle mass
C. Increase bone mass
D. None of the above
Answer: B
The major physiological changes in body composition
that occur with aging include:
• Increased fat mass and visceral fat.
• Progressive loss of lean muscle mass, termed “sarcopenia,”
which results in reduction of muscle strength and function.
Although sarcopenia is a part of normal aging, it is associated with impaired thermogenesis (resulting in metabolic
rate alteration), reduced immunocompetence, functional
limitation and disability, and increased fall and fracture
risk. Increasing physical activity or maintaining a physically active lifestyle among the elderly can help to minimize this loss and its adverse health consequences.
Progressive bone loss places the older individual at risk for
osteoporosis. The rate of bone loss accelerates in women
during menopause. These changes also serve as established
risk factors for many age-related diseases/disorders.
2. According to the Modified MyPyramid for Older Adults
recommendations, which are the micronutrients that some
older adults may need as supplements?
A. Calcium
B. Vitamin D
C. Vitamin B12
D. All of the above
Answer: D
With aging, the prevalence of lactose intolerance increases;
therefore, the older adult tends to become weary of milk
intake. This can result in a lower than recommended calcium
intake. The risk of vitamin D deficiency increases due to
inadequate exposure to the sun, decreased vitamin D production in the skin, sequestration of vitamin D in the excess
adipose tissue, and poor dietary intake. There may be a
reduction in gastric acid secretion which results in decreased
absorption of food-bound cobalamin, placing the older adult
at risk of vitamin B12 deficiency.
3. Which of the following is not true regarding general recommendations to relieve constipation in the elderly?
A.Increase fiber intake by consuming complex carbohydrates from whole grains, fruits, and vegetables rather
than refined carbohydrate
B. Drink enough fluids
C. Exercise regularly
D.Fiber supplements are preferred over fiber from whole
food
Answer: D
Constipation is common in the elderly due to a variety of
factors. Increasing fiber intake can help maintain good
bowel function. Dietary fiber must be derived preferably
from whole food and not fiber supplements. Overconsumption
of fiber can interfere with the absorption of essential micronutrients and certain medications. Along with the recommended fiber consumption, the older adults are encouraged
to have an adequate water intake to avoid the negative impact
of fiber (predisposes to constipation in the absence of fluid
intake), including intestinal obstruction. Regular exercise
also helps to stimulate peristalsis and thus lessen the
chances of constipation.
4. Which of the following is/are correct regarding recommendations for grain consumption in older adults?
A.At least 3 oz equivalents of total daily grain intake for both
elderly men and women should be from whole grains.
B. Both whole grains and refined grain are high in fiber.
C.Brown rice, oatmeal, and degermed cornmeal are
examples of whole grains.
D. All of the above.
C.S. Pitchumoni and T.S. Dharmarajan (eds.), Geriatric Gastroenterology,
DOI 10.1007/978-1-4419-1623-5_22, © Springer Science+Business Media, LLC 2012
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Answer: A
Recommended daily amount of total grain intake for men
and women aged greater than 50 years old are 6 and 5 oz
equivalents (servings), respectively. At least 3 oz equivalents should be from whole grains. Refined grains are whole
grains which have been milled to remove bran and germ.
Dietary fiber is also removed during milling process.
Therefore, refined grains are not a good source of fiber when
compared to whole grains. Brown rice and oatmeal are good
examples of whole grains, but degermed cornmeal, because
of the de-germing process becomes a refined grain.
5. Which of the following is not included in the basic four
food safety principles mentioned in the 2010 Dietary
Guidelines for Americans?
A. Clean
B. Separate
C. Overheat
D. Chill
Answer: C
The basic four food safety principles mentioned in the
2010 Dietary Guidelines for Americans are “clean,” “separate,” “cook,” and “chill.” These principles can help to
reduce the risk of food-borne illnesses. “Clean” refers to
proper cleaning of hands, food contact surfaces, and fruits
and vegetables. “Separate” refers to separating uncooked
S. Tejavanija and S.S. Jhangiani
from cooked and ready-to-eat foods in order to prevent
cross contamination. “Cook” refers to cooking to safe and
proper temperature. “Chill” refers to storage of leftovers
and takeout foods within 2 h in appropriate temperatures
and keeping the refrigerator at 40°F or below and the
refrigerator at 0°F or below. Overheating of food is not a
recommended food safety practice.
6. According to the 2010 Dietary Guidelines for Americans,
what is the daily recommended amount of sodium intake
for older adults?
A. 1,500 mg
B. 2,000 mg
C. 2,300 mg
D. 3,000 mg
Answer: A
The Tolerable Upper Intake Level (UL) for sodium intake
in adults set by the IOM is 2,300 mg/day. The 2010
Dietary Guidelines for Americans also recommends
reducing daily sodium intake to less than 2,300 mg and
further reducing intake to 1,500 mg among individuals
who are 51 and older. The latest guidelines also call for
reducing sodium intake to 1,500 mg for African Americans
of any age, and individuals with hypertension, diabetes, or
chronic kidney disease. A gram of sodium equals 2.5 g of
salt for purposes of conversion.