September is Healthy Aging Month, and a great time to highlight nutrition needs of older adults. With advancing age, nutrient requirements change. Primarily, older adults need fewer calories but actually need more of many nutrients. Read on for a "Top 5" list of nutrition topics older adults need to focus on.

1. Hydrate

Older adults have a diminished sense of thirst, so many older adults may not be as aware of their need to drink fluids, making them more prone to dehydration. As well, medications used by older adults may result in fluid loss or increased fluid needs. In less mobile adults, not drinking enough fluids may come from a desire to not have to walk to a bathroom or to avoid potential incontinence.

However, not drinking enough fluids makes older adults more likely to develop urinary tract infections (UTI), pneumonia, and pressure ulcers and become confused or disoriented. A good sign of adequate hydration is to check urine color. It should be about the color of lemonade. A darker color indicates an individual is not hydrated enough.

How to: Older adults are encouraged to sip on liquids, primarily water and milk, at meals and between meals. Eating water-based foods, such as broth-based soups, watermelon, and citrus fruits can also contribute to fluid needs.

2. Eat Safe

Food safety is important for all age groups. However, older adults are at higher risk of food-borne illness since their immune systems are not as strong as they used to be. As such, they may become sicker from contaminated foods.

How to: The best way to prevent food-borne illness is to wash your hands! Wash hands with soap under warm water, scrubbing for at least 20 seconds. Do this before eating or preparing food, after using the bathroom, after taking out the trash, and in other situations where you dirty your hands.

To ensure safety in food preparation, thaw frozen foods in the refrigerator – not on the counter at room temperature – and cook to proper temperatures. Due to potential risk of listeria, hot dogs and deli meats should be heated before eating until steaming hot.

Refrigerate leftover cut produce and cooked foods within 2 hours. When using leftovers, reheat to boiling or to at least 165°F. Eat foods before the "use-by" date on the package. Once it passes, throw out those foods.

For other tips, visit Food Safety for Older Adults from the Food and Drug Administration.

3. Maximize Your Nutrients

Since older adults need fewer calories but more of some nutrients, their diets need to be full of nutritious foods. A focus on fruits, vegetables, whole grains, low-fat dairy, and lean protein will allow for a nutrient-rich diet.

However, due to changes with age, some nutrient needs are higher, nutrients may not be as well absorbed, or older adults have a harder time eating foods with these nutrients. As such, older adults need to ensure they get enough of all nutrients, but particularly calcium, vitamin D, vitamin B-12, potassium, fiber, and protein.

How to: If older adults find eating large meals too difficult or get full quickly, focus on eating smaller meals with snacks during the day. If some nutrient needs cannot be met through food, consider foods and drinks that have added vitamins, minerals, and other nutrients like fiber and protein to help meet needs. Some examples include fortified dry cereal, calcium-rich orange juice, liquid nutritional drinks, such as Ensure* or Boost*, and high fiber breads.

If food sources still do not meet needs, a multivitamin or specific vitamin or mineral supplement may be needed. Discuss supplement use with your doctor or medical care provider.

4. Adjust For Your Health

Chronic health conditions, such as heart disease, diabetes, kidney disease, osteoporosis, and cancer, become more common in older age. A nutritious diet throughout your life can minimize the risk of developing health conditions, but if one or more develops, adjust your food intake to manage your health.

How to: For many health conditions that impact diet, talk with a registered dietitian. He or she can help you determine how foods can help manage the disease.

For example:

• If you have heart disease, talk about how diet can improve your blood cholesterol and blood pressure numbers.
• If you have diabetes, discuss how to foods affect your blood sugar.
• If you have difficulty chewing or swallowing food, ask if dysphagia diets are appropriate.
• If you take medications, learn which foods you may need to avoid or consume more consistently to avoid drug-nutrient interactions.

5. Balance Eating In and Out

Foods prepared at home tend to be more nutritious that those eaten outside of the home. However, cooking may become more difficult with advancing age, such as holding onto knives or lifting heavy pots, so older adults may choose to dine out more frequently.

How to: When feasible, cook most of your meals at home using nutritious recipes. Larger recipes can be frozen for leftovers and eaten in a few weeks to minimize preparation. If frozen meals from your local stores are eaten, choose those that are lower in fat and sodium, are a good source of fiber, and contain vegetables, lean protein, and whole grains. For some older adults, senior meal sites and home deliver meals are options to have social interaction while eating a nutritious meal.

When dining out, read menu descriptions and pick options that also contain vegetables and lean protein while minimizing added fats, such as cheese and butter sauces. Consider sharing a plate or taking home half the meal to eat at a later time. (Remember food safety on this – within 2 hours of getting your meal, any leftovers need to be refrigerated.)

References:

• Academy of Nutrition & Dietetics, Food Safety Tips for Older Adults, NA. 2012.
• Academy of Nutrition & Dietetics, Healthy Weights for Healthy Older Adults, NA, 2014.
• Colorado State Extension, Nutrition and Aging, J.E. Anderson and S. Prior, 2007.
• Oklahoma State University Extension, Older Adults Are At Increased Risk For Dehydration, Mary Rhyne, 2008.
• University of Florida Extension, A Guide to Healthy Snacking for the Frail Older Adult, Paula Harris-Swiatko and Wendy Dahl, 2013.
• US Department of Agriculture, DRI Tables, 2010.

*University of Illinois does not support or endorse these products but provides the information as an example.

Today's post was written by Caitlin Huth. Caitlin Huth, MS, RD, is a registered dietitian and Nutrition & Wellness Educator serving DeWitt, Macon, and Piatt Counties. She teaches nutrition- and food-based lessons around heart health, food safety, diabetes, and others. In all classes, she encourages trying new foods, gaining confidence in healthy eating, and getting back into our kitchens.