Technical Assistance Forum

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Technical Assistance Forum and
30th Anniversary Celebration
of the Title VI Program
 
April 28 to May 1, 2008
Minneapolis, Minnesota
2400 Mystic Lake Blvd.
Prior Lake, MN
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Meeting the Nutritional Needs of Tribal Elders
April 30, 2008

• Floristene Johnson, MS, RD\LD
• Desoto, Texas

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Objectives

• Learn about the nutritional needs of older adults
  and how to meet those needs.
• Know how to identify and address some special
  nutritional needs of older adults. Weight
  control ( or -)
• Sensory Changes in Older Adults

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What are the nutritional needs of Tribal Elders?
Dietary Reference Intakes Age 51-70 Male
Vitamin A Thiamin Vitamin B 12 Vitamin
D Riboflavin Potassium Vitamin E
Calcium Sodium Vitamin K
Folate Magnesium Vitamin C Vitamin
B6 Protein Fat Carbohydrates Zinc
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What Happens as We Age

• Basal Metabolism ( or -_
• Height
• Weight
• Hair
• Skin
• Eyes
• Nose
• Teeth
• Ears

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Title III and VI of the Older Americans Act, as
Amended (OAA)

• statesa nutrition program
• which, 5 or more days a week provides at least
  one hot or other appropriate meal per day
• which shall be provided in congregate setting
• which may include nutrition education and other
  appropriate nutrition services

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...a nutrition project shall____

• provide meals that
• Comply with the Dietary Guidelines for Americans,
  published by the Secretary and the Secretary of
  Agriculture.
• ...a nutrition project provides meals that
  provide to each participating older individual
• a minimum of 33 1/3 percent of the Dietary
  Reference Intakes, if the project provides one
  meal per day.

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• a minimum of 66 2/3 percent of the daily
• recommended dietary allowances if
  the
• project provides two meals per day, and
  
• 100 percent of the allowances if the project
• provides three meals per day, and
• to the maximum extent practicable, are adjusted
  to
• meet any special dietary needs of program
  participants,

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Using the Dietary Guidelines (2005)To Meet the
Nutritional Needs

• Developed by the
• United States Department of Health and Human
  Services (HHS)
• United States Department of Agriculture (USDA)

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Dietary Guidelines For Americans

• 41 Total Key Recommendations
• 23-General Population
• 18- Specific Populations

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DG Basics

• Meet nutrient needs by consuming foods
• Use fortified foods and dietary supplements only
  in certain cases
• Dietary supplements cannot replace a healthful
  diet.
• The DGAs are for Americans 2 years and above.

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DGA- Nine Focus Areas

• Adequate Nutrients Within calorie Needs
• Weight Management
• Physical Activity
• Food Groups To Encourage
• Fats
• Carbohydrates
• Sodium and Potassium
• Alcoholic Beverages
• Food Safety

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• ADEQUATE NUTRIENTS WITHIN CALORIE NEEDS
• Consume a variety of nutrient-dense foods and
  beverages
• Choose foods that limit the intake of saturated
  and trans fats, cholesterol, added sugars, salt,
  and alcohol.
• Meet recommended intakes within energy needs
• Over 50 Consume Vitamin B12 in its
  crystalline form.
• Older Adults, people with dark skin should
  consume extra Vitamin D

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WEIGHT MANAGEMENT

• To maintain body weight in a healthy range,
• To prevent gradual weight gain over time, make
  small decreases in calories and increase physical
  activity.

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Weight Management For Special Populations

• Those Who Need to Lose Weight Aim for a slow and
  steady weight loss
• Overweight with chronic diseases/medication
  Consult doctor
• Older adults. Participate in regular physical
  activity to reduce functional declines associated
  with aging and to achieve the other benefits of
  physical activity identified for
• all adults.

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Risks Associate with Excess Weight

• Excess body fat leads to a higher risk for
• premature death
• type 2 diabetes,
• high blood pressure
• high blood cholesterol and triglycerides
• heart disease,
• Stroke
• gall bladder disease
• respiratory dysfunction,
• gout, arthritis, and certain kinds of cancers.

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Body Mass Index (BMI)

• Locate your height in the left-most column and
  read across the row for your height to your
  weight.
• Follow the column of the weight up to the top
  row that lists the BMI.
• A BMI under 19 is underweight,
• 19 through 24 is the healthy weight range,
• 25 through 29 is in the overweight range,
• and a BMI of 30 and above is the obese range.

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PHYSICAL ACTIVITY

• Engage in regular physical activity and reduce
  sedentary activities
• Engage in at least 30 minutes of
  moderate-intensity physical activity, above usual
  activity, at work or home on most days of the
  week.
• Achieve physical fitness by including
  cardiovascular conditioning, stretching exercises
  for flexibility, and resistance exercises or
  calisthenics for muscle strength and endurance.

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FOOD GROUPS TO ENCOURAGE

• Consume a sufficient amount of fruits and
  vegetables while staying within energy needs.
• Choose a variety of fruits and vegetables each
  day. In particular, select from all five
  vegetable subgroups (dark green, orange, legumes,
  starchy vegetables, and other vegetables) several
  times a week.

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FOOD GROUPS TO ENCOURAGE
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FOOD GROUPS TO ENCOURAGE

• Consume 3 or more ounce-equivalents of
  whole-grain products per day, with the rest of
  the recommended grains coming from enriched or
  whole-grain products. In general, at least half
  the grains should come from whole grains.

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(No Transcript)
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FOOD GROUPS TO ENCOURAGE
Consume 3 cups per day of fat-free or low-fat
milk or equivalent milk products.
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FATS

• Plan meals with less than 10 percent of calories
  from saturated fatty acids and less than 300
  mg/day of cholesterol, and keep trans fatty acid
  consumption as low as possible.
• Plan for the total fat intake to be between 20 to
  35 percent of calories, with most fats coming
  from sources of polyunsaturated and
  monounsaturated fatty acids
• When selecting and preparing meat, poultry, dry
  beans, and milk or milk products, make choices
  that are lean, low-fat, or fat-free.
• Choose products low in fats and oils.

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CARBOHYDRATES

• Choose fiber-rich fruits, vegetables, and whole
  grains often.
• Choose and prepare foods and beverages with
  little added sugars or caloric sweeteners
• Reduce the incidence of dental caries by
  practicing good oral hygiene and consuming sugar-
  and starch-containing foods and beverages less
  frequently.

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SODIUM AND POTASSIUM

• Consume less than 2,300 mg (approximately 1
  teaspoon of salt) of sodium per day.
• Choose and prepare foods with little salt. At the
  same time, consume potassium-rich foods, such as
  fruits and vegetables
• Individuals with hypertension, older adults.
  Aim to consume
• no more than 1,500 mg of sodium per day, and meet
  the potassium recommendation
• (4,700 mg/day) with food.

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• older adults, and those who are
  immunocompromised.
• Do not eat or drink raw (unpasteurized) milk or
  any products made from unpasteurized milk,
• raw or partially cooked eggs or
• foods containing raw eggs, raw or undercooked
  meat and poultry, raw or undercooked fish or
  shellfish,

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ALCOHOLIC BEVERAGES

• Those who choose to drink alcoholic beverages
  should do so sensibly and in moderation
• Alcoholic beverages should not be consumed by
  some individuals, including individuals taking
  medications that can interact with alcohol, and
  those with specific medical conditions.
• Alcoholic beverages should be avoided by
  individuals engaging in activities that require
  attention, skill, or coordination, such as
  driving or operating machinery.

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• Thanks for your particpation.