community nutrition update: older adults anne hoisington osu extension, multnomah co. may 23, 2002

Community Nutrition Update:Community Nutrition Update:Older AdultsOlder Adults

Anne Hoisington

OSU Extension, Multnomah Co.

May 23, 2002

OutlineOutline

Background: population trends, characteristicsHealth problems with nutritional implicationsFood Insecurity: definitions, prevalence, risksWhat should the educator know? What can the educator do?

Population Trends Population Trends

Number of older Americans increasing

1 in 8 >65; 1 in 4 by 2030

Fastest growing segment: 85+

Characteristics of Adults 65+Characteristics of Adults 65+

95% live within community5% live in LTC

Oregon: 2/3 live with others (1/3 alone) Oregon: 4x as many women live alone

(Oregon Gerontological Association, 1993)

Health Problems with Nutritional Health Problems with Nutritional Implications Implications

Medical: cancer, diabetes, heart disease

Physical: sensory: sight, smell, taste; pain, dentition

Polypharmacy: absorption, metabolism, excretion, side effects (anorexia, nausea, drowsiness)

Emotional: depression, boredom, anger, dementia

Nutrition problems, continuedNutrition problems, continued

Health consequences of aging: Muscle mass, metabolism: weight,

energy/caloric needs down, physical activity, need for nutrient density

Bone mass, functional digestive system, changes in cholesterol, BP, salt sensitivity, changes in glucose metabolism

At Risk for Poor Nutrition At Risk for Poor Nutrition Lower education levelWomen Black, Hispanic elderlyThose living alone>85

1 in 5 older adults at or below 130% of poverty

(Guthrie, 2002)

Food Security Food Security

Having assured access at all times to enough food for an active, healthy life

Food InsecurityThe inability to acquire or consume an adequate

quality or sufficient quantity of food in socially acceptable ways, or the uncertainty that one will be able to do so

(Anderson, 1990)

Food Insecurity Among Older Adults Food Insecurity Among Older Adults

~6% elderly households report some degree of food insecurity

Compared to ~10% of all households (Current Population Survey 1999, Andrews et al.)

(Adapted from model by Wolfe et al., 1996)

Factors Affecting Food Security in Older Adults

Food Insecurity Experience

Availability of Family

Savings

Unexpected Expenses

Fixed Income

Medical Costs

Poor Health, Physical Disabilities

Food Management Strategies

Community Characteristics

Lower IncomeLower Income

Fewer servings of fruitLower caloric intakeLower intake of vitamin C, B vitaminsLess likely to eat breakfastSkip lunch and dinner, fewer snacks

(Guthrie et al., 2002)

Higher IncomeHigher Income

More reported use of dietary supplementsMore likely to have all key nutrients More total fat/saturated fatMore foods prepared outside the homeMore sodium than recommended

(Guthrie et al., 2002)

Food Insecure Food Insecure

Lower mean intakes: protein, folate, iron, zinc

Fewer servings of vegetables, meatLess dietary varietyHigher risk of underweight

(NHANES III, 2000)

What should the educator know? What should the educator know?

Nutrition Programs

USDA: Meals-on Wheels, Congregate Meals

Food StampsSupplemental Foods

How do older adults learn?

Written materials most helpful; food labels (Krinke, 1990)

Personalize the learning, multi-sensory education (Sharpe et al., 1996)

Younger old more likely to believe in positive outcomes of behavior change

(Contento et al., 1995)

Train the Trainer

North Carolina Congregate Meals sites “Meals on a Budget”—8 weeks, ½ hr lessons Cutting food costs, eating healthfully, improving

nutritional status Increased meal site managers’ confidence

(McClelland et al., 2002)

What can the educator do? What can the educator do?

Senior Nutrition Awareness Program (SNAP)

Connecticut, RI Congregate Meal sites Group nutrition education workshops Healthy cooking classes Handouts/fact sheets, website, cable TV

Summary Summary

Provide nutrition education within context:

– Physical limitations– Psychological issues– Environmental factors– Socioeconomic

Community Nutrition Update—Community Nutrition Update—Conclusion Conclusion

Eating together is a critical component

Environment influences eating patterns

Learn the learning style

Eating habits are established early

But….changes may be made throughout lifecycle

Education programs need evaluation App 102402