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Factors that affect nutrition

There are many factors that influence nutritional status in older adults, and they can be broadly grouped into four main areas:

• Those that naturally occur during the ageing process, such as a reduced ability to absorb nutrients efficiently, or a sore mouth due to dentures
• Disease-specific conditions such as cancer, which place greater nutritional demands on people
• Some drugs that interact with nutrients and prevent absorption, for example aspirin, which can interfere with the absorption of vitamin C
• Social influences, such as not being able to get to shops, or social isolation

Continuing to enjoy food and to eat a diet that maintains nutritional status is key to coping with illness. Poor nutrition has been shown to increase the risk of infections, bed sores, chest infections and poor wound healing. Good nutritional status will help ensure a quicker recovery.
Other common problems:

Loss of taste

The ability to taste flavours declines as we age. Food can often taste bland to older people so try:

• Using herbs and spices, tomatoes and other flavouring such as lemon juice to flavour food, but avoid using too much salt
• Choosing foods with a strong taste - go for strong-flavoured meats, sauces, dressings, mustards and pickles

Loss of interest in food

Older people can lose interest in food for a variety of reasons. Depression due to loss of independence or bereavement, or simply eating alone can reduce appetite.

• Explore the possibility of lunch clubs in your area
• Eat with company when you can
• Make meal times special by laying the table and presenting food in an attractive way
• Choose a variety of foods where possible to keep the experience interesting

Poor appetite

If you're unable to eat much, try small appetising meals and calorie-rich snacks in between meals to boost nutrient intake. To increase your calorie intake, try the following tips:

• Fats and sugars provide energy and help food to taste good, so use these generously. Add extra cheese to sauces or grate on potatoes, add butter or margarine to vegetables, or enrich full-fat milk by adding dried milk powder. Try using sugar or honey on breakfast cereals.
• Eat pudding once or twice a day, such as yoghurt, milky puddings, ice cream, trifle, cake, fruit pie, sponge puddings with custard and ready prepared desserts. Cakes, biscuits, chocolate and crisps provide extra energy when eaten with meals, but ensure they don't spoil the appetite for more nourishing foods.
• Enriched-nourishment drinks, available from pharmacies and supermarkets, may be taken between meals to increase calorie intake, but shouldn't replace meals.
• Alcohol in small amounts can actually stimulate the appetite, but check with your GP first, especially if you're taking medication.

Difficulty in chewing

• Keep your teeth healthy and/or make sure your dentures fit properly
• A sore mouth or lack of saliva also makes chewing difficult - if this is the case, check with your GP

Constipation

Constipation can lead to poor eating, so:

• eat plenty of fruit and vegetables, wholemeal bread, cereals and pasta. Avoid raw bran and excessive amounts of very high-fibre foods, as they're too bulky and may interfere with the absorption of certain nutrients.
• drink plenty of fluids. Aim for up to eight cups of fluid a day. Tea and coffee can count towards this, as can sauces such as gravy, custard and ice cream.

Older people needing extra care

If you're responsible for looking after an older relative or friend who needs a lot of assistance, here are some common problems and suggestions that might be useful to ensure they eat well.

• Offer to do some shopping for them
• Shop online for them or, if they have a computer with internet access, offer to help them learn how to do it
• Make a batch of stew, pasta sauce or other dishes and freeze them in individual portions so they're ready to heat and eat
• Make sure they have plenty of store cupboard items that are easy to prepare, such as tinned vegetables and fish, pasta and rice, dried fruit and nuts, frozen foods, etc.

Swallowing difficulties

If you suspect an older relative is experiencing problems with swallowing, contact your doctor. Such difficulties can arise from neurological disorders, Parkinson's disease, or following head injury or stroke.
A speech and language therapist can diagnose the severity of the problem, and will offer advice on which types of food texture will be appropriate. The texture of foods can be modified to help with swallowing problems - for example, soft foods through to thick fluids or a thin purée.
A dietician should be involved in the care process to ensure the texture-modified diet is high in energy and essential nutrients.

many thanks to bbchealth  for the art above.