The Academy of Nutrition and Dietetics, the largest organization of food and nutrition professionals in the U.S., came up with the recommendation as part of a position paper published in The Journal of the Academy of Nutrition and Dietetics.
"Registered Dietitian Nutritionists (RDNs) should evaluate each individual and assess the risks vs the benefits of a restrictive diet," wrote first author Becky Corner, a fellow of the Academy of Nutrition and Dietetics and a leading expert in elderly nutrition.
The experts also suggested that even if there are established dietary guidelines for certain medical conditions, restrictions should be loosened if a patient's oral intake is poor. In addition, care providers should evaluate the exchange between the consequences of malnutrition and unintended weight loss against certain disease-related health risks. Moreover, they advised that patients should also be involved in food choices.
“When considering a therapeutic diet prescription, the health care practitioner should ask: Is a restrictive therapeutic diet necessary? Will it offer enough benefits to justify its use?”
For most older adults in long-term care, the risks of less restrictive diets are outweighed by the benefits. Recommending the least restrictive diet will not only boost nutritional status but also improve the quality of life of patients, especially for the elderly in post-acute care settings. Nutrition interventions should be tailored to a patient's medication as well as preferred health care choices. (Related: Another reason to go Mediterranean: Research shows the diet helps protect older adults from becoming frail, prolonging health and independence.)
More choices usually translate to better health
Older adults may find restrictive diets unappetizing, which in turn leads to reduced pleasure in eating, decreased food intake, unintended weight loss, and malnutrition. On the contrary, more varied diets are linked to increased food and beverage intake. Food consumption should be maximized in order to prevent malnutrition and unintended weight loss, as these can result in additional health problems. Malnutrition and decreased appetite are also recognized as indicators of morbidity and mortality.
Malnutrition can lead to loss of strength and function, greater risks of falls, depression, lethargy, immune dysfunction, increased risk of infection, slowed down recovery, pressure injuries, poor wound healing, increased chances of hospital admission and readmission, increased treatment costs, and increased mortality.
Increasing the appetite
A loss of appetite in older people can be dangerous for their health. Although reduced appetite and changes in appetite are natural parts of aging, it is still important to make sure the right amount of nutrients are consumed. There are a few things you can do to help your elderly loved ones get enough nutrients from the food they eat.
- Increase nutrient density – Many older people are intimated with a large volume of food. Instead of increasing the portion sizes of food, increase the nutrient density of the foods. You can do this by adding healthy extra calories in the form of an avocado, olive oil, or a little peanut butter.
- Set a mealtime schedule – Having a regular eating schedule can prevent the body's hunger and thirst signals from straying from the usual patterns and appetite.
- Join the elder for meals – Eating alone can reduce appetite, for people of any age. Thus, encourage social meals by inviting family or friends to have a meal together.
- Observe medication side effects – The palate of older people can be affected by the medications they are taking. Some medications make meat taste metallic. If this happens, try other sources of protein like beans. If water tastes off for them, try adding herbs or sliced fruits or vegetables like lemon or cucumber.
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