Nutrition Education for the Elderly in the US

  • Reicks, Marla (University of Minnesota)
  • Published : 2002.03.01

Abstract

Eating behavior change as a result of nutrition education interventions as secondary prevention strategies can contribute to an increase in life expectancy and better health for older adults in the United States (U.S.). Many of the chronic conditions prevalent in older adults are modifiable by dietary changes, including heart disease, diabetes mellitus, hypertension, obesity and osteoporosis. Important demographic observations in the U.S. including the projected large increase in number of older adults by 2030 have implications for nutrition education focus and services. A comprehensive review of nutrition education interventions for older adults in the U.S. published in 1995 identified elements from adult education theories that contribute to the effectiveness of nutrition education. These elements have been the focus of more recent studies with older adults providing additional evidence for relationships between concepts from commonly used behavior change theories and dietary patterns or change. In the U.S, an important program contributing to nutritional adequacy of the diet for older adults is the Elderly Nutrition Program which provides resources for congregate dining and includes a mandatory nutrition education component. Nutrition education is also provided through clinic based programs, and print and broadcast media. Application of the Transtheoretical Model has shown that the level of interest or motivation to comply with dietary guidance may be greater for some older adults due to an increasing burden of chronic disease and poorer quality of life, while others may not feel a need to change lifestyle habits.

References

  1. Abusabha R, Hsieh KH, Achterberg C(2001) : Dietary fat reduction strategies used by a group of adults aged 50 years and older. J Am Diet Assoc 101 : 1024-1030 https://doi.org/10.1016/S0002-8223(01)00252-8
  2. Administration on Aging(AoA)-A Profile of Older Americans : 2001 http://www.aoa.dhhs.gov/aoa/STATS/profile/default.htm
  3. Amarantos E, Martinez A, Dwyer J (2001) : Nutrition and quality of life in older adults. J Gerontol A Bioi Sci Med Sci 56 Spec No 2: 54-64
  4. American Dietetic Association (ADA) (2000) : Position of the American Dietetic Association : Nutrition, aging, and the continuum of care. J Am Diet Assoc 100 : 580-595 https://doi.org/10.1016/S0002-8223(00)00177-2
  5. Auld GW, Nitzke SA, McNulty J, Bock MA, Brulm CM, Gabel K, Lauritzen G, Lee YF, Medeiros D, Newman R, Ortiz M, Read M. Schutz H, Sheehan E(1998) : A stage-of-change classification systembased on actionsand beliefs regarding dietaryfat and fiber. Am J Health Promotion 12 : 192-201 https://doi.org/10.4278/0890-1171-12.3.192
  6. Bermudez OI, Falcon LM, Tucker KL(2000) : Intake and food sources of macronutrients among older Hispanic adults ; association with ethnicity, acculturation, and length of residence in the United States. J Am Diet Assoc 100 : 665-673 https://doi.org/10.1016/S0002-8223(00)00195-4
  7. Bidlack WR (1996) : Interrelationships of food, nutrition, diet and health: the National Association of State Universities and Land Grant Colleges White Paper. Am Coli Nutr 15 : 422-433 https://doi.org/10.1080/07315724.1996.10718620
  8. Brunt AR, Schafer E, Oakland MJ (1999) : Ability of social support to predict at-risk dietary intake and anthropometric measures in white, rural, community-dwelling elderly women. J Nutr Elderly 19 : 49-69
  9. Chernoff R (2001) : Nutrition and health promotion in older adults. J GerontolA Bioi Sci Med Sci 56 Spec No 2 : 47-53
  10. Conn VS (1997) : Older women: social cognitive theory correlates of health behavior. Women Health 26 : 71-85
  11. Contento I, Contento I, Balch GI, Bronner YL, Lytle LA, Maloney SK, White SL, Olson CM, Swadener SS (1995) : Chapter 7. Nutrition Education for Older Adults. J Nutr Edue 27 : 339-346 https://doi.org/10.1016/S0022-3182(12)80093-8
  12. Davis MA, Murphy SP, Neuhaus JM, Gee L, Szkupinski Quiroga S (2000) : Living arrangements affect dietary quality for U.S. adults aged 50 years and older: NHANES III 1988-1994. J Nutr 130 : 2256-2265 https://doi.org/10.1093/jn/130.9.2256
  13. Dornelas EA, Wylie-Rosett J, Swencionis C (1998) : The DIET study: long-term outcomes of a cognitive-behavioral weight-control intervention in independent-living elders. J Am Diet Assoc 98 : 1276-1281 https://doi.org/10.1016/S0002-8223(98)00287-9
  14. Drewnowski A, Evans WJ (2001) : Nutrition, physical activity, and quality of life in older adults : summary. J Gerontol A Bioi Sci Med Sci 56 Spec No 2 : 89-94 https://doi.org/10.1093/gerona/56.suppl_2.89
  15. Elbon SM, Johnson JA, Fischer JG(1996) : Developing an instrument to measure the influence of knowledge, behaviors, and attitudes on milk consumption patterns in older participants of a community wellness group: a pilot study. J Nutr Elderly 15 : 21-37 https://doi.org/10.1300/J052v15n04_03
  16. Falk LW, Bisogni CA, Sobal J (1996) : Food choice processes of older adults: a qualitative investigation. J Nutr Educ 28 : 257-265 https://doi.org/10.1016/S0022-3182(96)70098-5
  17. Federal Interagency Forum on Aging-Related Statistics. Report on Older Americans 2000 : Key Indicators of Well-Being. [accessed 11/10/00]
  18. Fedder DO, Koro CE, L'Italien GJ (2002) : New National Cholesterol Education Program III Guidelines for Primary Prevention Lipid-Lowering Drug Therapy : Projected Impact on the Size, Sex, and Age Distribution of the Treatment-Eligible Population. Circulation 105 : 152-156 https://doi.org/10.1161/hc0202.101971
  19. Ferrini R, Edelstein S, Barrett-Connor E(1994) : The association between health beliefs and health behavior change in older adults. Prey Med 23 : 1-5 https://doi.org/10.1006/pmed.1994.1001
  20. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL (1998) : Overweight and obesity in the United States : prevalence and trends, 1960-1994. Int J Obes 22 : 39-47 https://doi.org/10.1038/sj.ijo.0800541
  21. Food Security Supplement to the Current Population Survey, U.S. (1998) : Bureau of the Census. Washington, DC, August
  22. Gaston NW, Mardis A, Gerrior S, Sahyoun N, Anand RS (1999) : A focus on nutrition for the elderly : It's time to take a closer look. Nutrition Insights No. 14, USDA Center for Health Policy and Promotion, Washington, DC
  23. Harris TB, Savage PJ, Tell GS, Haan M, Kumanyika S, Lynch JC (1997) : Carrying the burden of cardiovascular risk in old age : associations of weight and weight change with prevalent cardiovascular disease, risk factors, and health status in the Cardiovascular Health Study. Am J Clin Nutr 66 : 837-844
  24. Jensen GL, Rogers J (1998) : Obesity in older persons. J Am Diet Assoc 98 : 1308-1311 https://doi.org/10.1016/S0002-8223(98)00293-4
  25. Kaempfer D, Wellman NS, Himburg SP (2002) : Dietetics student's low knowledge, attitudes, and work preferences toward older adults indicate need for improved education about aging. J Am Diet Assoc 102 : 197-202 https://doi.org/10.1016/S0002-8223(02)90048-9
  26. Kannel WB, D'Agostino RB, Cobb JL (1996) : Effect of weight on cardiovascular disease. Am J Clin Nutr 63 (3 Suppl) : 419S-422S https://doi.org/10.1093/ajcn/63.3.419
  27. Keith PM, Schafer RB (1997) : Correlates of dietary change among younger and older men. J Nutr Elderly 16 : 33-46
  28. Matheson DM, Woolcott DM, Matthews AM, Roth V (1991) : Evaluation of a theoretical model predicting self-efficacy toward nutrition behaviors in the elderly. J Nutr Educ 23 : 3-9 https://doi.org/10.1016/S0022-3182(12)80447-X
  29. McCarron DA, Reusser ME(1996) : Body weight and blood pressure regulation. Am J Clin Nutr 63 (3 Suppl) : 423S-425S https://doi.org/10.1093/ajcn/63.3.423
  30. Millen BE, Silliman RA, Cantey-Kiser J, Copenhafer DL, Ewart CV, Ritchie CS, Quatromoni PA, Kirkland JL, Chipkin SR, Fearon NA, Lund ME, Garcia PI, Barry PP(2001) : Nutritional risk in an urban homebound older population. The nutrition and healthy aging project. J Nutr Health Aging 5 : 269-277
  31. Millen BE, Ohls JC, Ponza M, McCool AC (2002) : The Elderly Nutrition Program: an effective national framework for preventive nutrition interventions. J Am Diet Assoe 102 : 234-240 https://doi.org/10.1016/S0002-8223(02)90055-6
  32. Murphy PA, Prewitt TE, Bote E, West B, Iber FL(2001) : Internal locus of control and social support associated with some dietary changes by elderly participants in a diet intervention trial. J Am Diet Assoc 101 : 203-208 https://doi.org/10.1016/S0002-8223(01)00053-0
  33. Nigg CR, Burbank PM, Padula C, Dufresne R, Rossi JS, Velicer WF, Laforge RG, Prochaska JO (1999) : Stages of change across ten health risk behaviors for older adults. Gerontologist 39 (4) : 473-482 https://doi.org/10.1093/geront/39.4.473
  34. Nutrition Screening Initiative (1992) : Nutrition education and counseling interventions to improve the nutritional status of older Americans. In : Nutrition Interventions Manual for Professionals Caring for Older Americans. Prepared by Greer, Margolis, Mitchell, Grunwald & Associates for the National Screening Initiative, pp.86-103
  35. Pi-Sunyer FX (1996) : Weight and non-insulin-dependent diabetes mellitus. Am J Clin Nutr 63 (3 Suppl) : 426S-429S https://doi.org/10.1093/ajcn/63.3.426
  36. Rainey CJ, Cason KL(2001) : Nutrition interventions for low-income, elderly women. Am J Health Behav, May-Jun 25 (3) : 245-251 https://doi.org/10.5993/AJHB.25.3.11
  37. Saluter AF, Lugaila TA. Marital status and living arrangemsnts : march 1996. Current Population Reports, Population Characteristics, Series P-20, no. 496. U.S. Departmetn of Commerce, Washington, DC
  38. Seeman TE, Crimmins E (2001) : Social environment effects on health and aging : integrating epidemiologic and demographic approaches and perspectives. Ann N Y Acad Sci 954 : 88-117
  39. Stevens J, Cai J, Pamuk ER, Williamson DF, Thun MJ, Wood JL (1998) : The effect of age on the association between body-mass index and mortality. N Engl J Med 338 : 1-7 https://doi.org/10.1056/NEJM199801013380101
  40. Stewart PL, Brochetti D, Cox RH, Clarke MP(1998) : Low-income elderly adults' needs and preferences for nutrition education. J Nutr Elderly 18 : 1-20
  41. Taylor-Davis S, Smiciklas-Wright H, Warland R, Achterberg C, Jensen GL, Sayer A, Shannon B (2000) : Responses of older adults to theory-based nutrition newsletters. J Am Diet Assoc 100 : 656-664 https://doi.org/10.1016/S0002-8223(00)00193-0
  42. Tucker M, Reicks M(2002) : Exercise as a gateway behavior for healthy eating among older adults : An exploratory study. In press in J Nutr Educ March/April
  43. U.S. Department of Health and Human Services and Centers for Disease Control and Prevention(1999) : Chronic diseases and their risk factors : The Nation's Leading Causes of Death
  44. Wakimoto P, Block G(2001) : Dietary intake, dietary patterns, and changes with age : an epidemiological perspective. J Gerontal A Bioi Sci Med Sci 56 Spec No 2 : 65-80