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Chapter: Nutrition and Diet Therapy: Diet During Late Adulthood

The Effects of Aging

As people age, physiological, psychosocial, and economic changes occur that affect nutrition.



As people age, physiological, psychosocial, and economic changes occur that affect nutrition.

Physiological Changes


The body’s functions slow with age, and the ability of the body to replace worn cells is reduced. The metabolic rate slows; bones become less dense; lean muscle mass is reduced; eyes do not focus on nearby objects as they once did, and some grow cloudy from cataracts; poor dentition is common; the heart and kidneys become less efficient; and hearing, taste, and smell are less acute. If poor nutri-tion has been chronic, the immune system may be compromised.


Osteoarthritis and its debilitating effects are of great concern to the elderly. Arthritis can limit the ability to perform activities of daily living (ADLs). The role that diet plays in arthritis has been of increasing interest to researchers. Exces-sive weight, certain vitamin deficiencies, and the type of diet being followed may influence some types of arthritis. Eating a healthy, well-balanced diet that includes the “5 a day” fruits and vegetables, along with grain products, and sugar and salt in moderation, may be beneficial for arthritis sufferers. Your physician or dietitian may also recommend taking a multiple vitamin daily.


There appears to be no direct connection between a specific kind of food and a specific symptom of arthritis. Neither is there a special diet that is consistently beneficial for arthritis sufferers; however, the best advice is to eat a healthy diet that includes a variety of foods and to exercise.


Digestion is affected because the secretion of hydrochloric acid and enzymes is diminished. This in turn decreases the intrinsic factor synthesis, which leads to a deficiency of vitamin B12. The tone of the intestines is reduced, and the result may be constipation or, in some cases, diarrhea.

Psychosocial Changes 

Feelings do not decrease with age. In fact, psychosocial problems can increase as one grows older. Age does not diminish the desire to feel useful and appreci-ated and loved by family and friends. Retirement years may not be “golden” if one suffers a loss of self-esteem from feelings of uselessness. Grief over the loss of a spouse or close friend, combined with the resulting loneliness, can be devastating. Physical disabilities that develop in the senior years and prevent one from going out independently can destroy a social life. Becoming a fifth wheel in a grown child’s home or a resident of a nursing home can lead to severe depression. Problems such as these can diminish a person’s appetite and ability to shop and cook.

Economic Changes

Retirement typically results in decreased income. Unless one has carefully prepared for it, this can affect one’s quality of life by reducing social activities, adding worry about meeting bills, and causing one to select a less than healthy diet by choosing foods on the basis of cost rather than nutrient content.

Sidestepping Potential Problems

Healthy eating habits throughout life, an exercise program suited to one’s age, and social activities that please can prevent or delay physical deterioration and psychological depression during the senior years. The benefits can be said to be circular. The first two contribute largely to one’s physical condition, and social activities can prevent or diminish depression, which, if unchecked, can also depress appetite. They give purpose to the day, joy to the heart, and zest to the appetite. Whenever an elderly person is depressed, the patient’s nutrition and lifestyle should be carefully reviewed.


Food–drug interactions must be monitored closely in the elderly. Frequently, specific foods will prevent, decrease, or enhance the absorption of a particular drug. Dairy products should not be consumed within 2 hours of taking the antibiotic tetracycline, or it will not be absorbed. A person taking a blood clot–reducing drug such as coumadin or warfarin (often called blood thinners) needs to consume vitamin K–rich food in moderation since vitamin K counteracts blood thinners. Even vitamin supplements can cause interactions. The antioxidant vitamins are not to be taken with blood clot–reducing medica-tions because they also have a tendency to thin the blood.


Drug–drug interactions as well as food–drug interactions can contribute to decreased nutritional status. These interactions could affect appetite as well as absorption of nutrients from the food eaten. Careful monitoring is recom-mended. 

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