Food choice of older adults

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Research into food preferences in older adults and seniors considers how people's dietary experiences change with ageing, and helps people understand how taste, nutrition, and food choices can change throughout one's lifetime; particularly when people approach the age of 70, or beyond. Influencing variables can include: social and cultural environment, gender and/or personal habits, and also physical and mental health. Scientific studies have been performed to explain why people like or dislike certain foods and what factors may affect these preferences.

Contents

The science of food preferences

The Food Guide Pyramid Food Guide Pyramid- A Guide to Daily Food Choices - NARA - 5710010.jpg
The Food Guide Pyramid

Research in this area is usually done in order to examine the variables that cause the elderly to change their food preferences; an example is the Elderly Nutrition Program (ENP). The ENP was implemented in 1972 to explore how food preferences varied depending on biological sex and ethnic groups, the goal being to improve the quality of meal programs.

Meals and preferences for 13 food groups, including fresh fruit, chicken, soup, salad, vegetables, potatoes, meat, sandwiches, pasta, canned fruit, legumes, deli meats, and ethnic foods, are being assessed in order to gain a general impression of people's dietary habits and food preferences. After adjusting for variables, older male subjects were found to be significantly more likely to prefer deli meats, meat, legumes, canned fruit, and ethnic foods compared to females. In addition, compared with African Americans, the study found that "... Caucasians demonstrated higher percentages of preference for 9 of 13 food groups including pasta, meat, and fresh fruit", and recommended that "... To improve the quality of the ENP, and to increase dietary compliance of the older adults to the programs, the nutritional services require a strategic meal plan that solicits and incorporates older adults' food preferences". [2]

Influences on food preference

There are multiple factors in an elderly person's life that can affect food preferences. Aspects like their environment, mental and physical health, and lifestyle choices can all contribute to the individual taste and/or habits of elderly people.

An article about Influences on Cognitive Function in Older Adults (Neuropsychology, November 2014) states that "the nutritional status of older adults relates to their quality of life, ability to live independently, and their risk for developing costly chronic illnesses. An aging adult’s nutritional well-being can be affected by multiple socio-environmental factors, including access to healthy and affordable foods, congregate meal sites, and nutritious selections at restaurants. The Academy of Nutrition and Dietetics, American Society for Nutrition, and the Society for Nutrition Education have identified an older adult's access to a balanced diet to be critical for the prevention of disease and promotion of nutritional wellness so that quality of life and independence can be maintained throughout the aging process and excessive health care costs can be reduced". [3]

Younger vs. older adults

Taste buds, a person's needs for certain vitamins and other nutrients, and their desire for different types of food can change throughout a person's life. 50 young adults and 48 elderly adults participated in a study by the Monell Chemical Senses Center. [4] "Young" subjects ranged from 18 to 35 years of age, and "elderly" subjects were defined as 65 years of age or older. There were more females than males in the study, but there were approximately equal proportions of males and females in the two age groups.

The study observed that younger females had stronger cravings for sweets than elderly females. Possible causes considered for this difference were the younger female test subjects' menstrual cycles and the fact that elderly women no longer go through menopause. The study also postulated that "... Ninety-one percent (91%) of the cycle-associated cravings were said to occur in the second half of the cycle (between ovulation and the start of menstruation)". [4]

These physical changes can be considered when assessing why an older person might not be getting the nutrition they need. As taste buds change with age, certain foods might not be seen as appetizing. For example, a study done by Dr. Phyllis B. Grzegorczyk concluded that as people age, their sense for tasting salty foods slowly goes away. [5]

Male vs. female

Elderly couple eating lunch together Couple eating lunch.jpg
Elderly couple eating lunch together

There are differences in food preferences between the sexes. In a study conducted by the ENP, preferences of male and female subjects were identified in the following 13 individual food groups: fresh fruit, chicken, soup, salad, vegetables, potatoes, meat, sandwiches, pasta, canned fruit, legumes, deli meats, and ethnic groups.

Through this study, it was apparent that older males were "significantly more likely to prefer deli meats, meat, legumes, canned fruit, and ethnic foods compared to females". [2]

Another study by the Monell Chemical Senses Center concluded that females had significantly more cravings for sweets and for chocolate than males; and the study results suggested that males had more cravings or preferences for entrées than sweets. [4]

Personal Health

Physical health

Some older people avoid certain foods or are unwilling to modify their diets due to oral health problems. These issues, such as ill-fitting dentures (false teeth) or gum disease, are correlated with significant differences in dietary quality, which is a measure of the quality of the diet using a total of eight recommendations regarding the consumption of foods and nutrients from the National Academy of Sciences (NAS). Approaches to minimize food avoidance and promote changes to the diets of people with eating difficulties due to oral health conditions are needed desperately, because without being able to chew or take in food properly, their health is affected dramatically, and their food preferences are limited greatly (too soft or liquids only). [6]

Due to varying factors in older adults' physical and mental well-being, eating choices can become more restricted. Many elderly people are forced into eating softer foods, foods that incorporate fiber and protein, drinking calcium-packed liquids, and so on. Six of the leading causes of death for older adults, including cardiovascular disease, cancer, chronic lower respiratory disease, stroke, Alzheimer's disease, and diabetes mellitus, have nutrition-related causes and/or respond favorably to nutrition interventions. [7] These six illnesses can implement certain restrictions and heavily influence the diet of elderly persons.

Declines in physical health, such as conditions like arthritis, can also cause deterioration in diet due to difficulties in preparing and eating food. [8]

At the 2010 "Providing Healthy and Safe Foods As We Age" conference sponsored by the Institute of Medicine, Dr. Katherine Tucker noted that the elderly are less active and have lower metabolic rates, with a consequent reduced need to eat. [9] In addition, they tend to have existing diseases and/or take medications that interfere with nutrient absorption. Based on their research dietary requirements, one study developed a modified food pyramid for adults over 70. [10]

There is not enough evidence to confidently recommend the use of any form of carbohydrate in preventing or reducing cognitive decline in older adults with normal cognition or mild cognitive impairment. [11] More evidence is needed to evaluate memory improvement and find nutritional issues due to carbohydrates.

Mental health

The impact of certain diseases can also impact the quality of the food in the elderly population, especially those that are in care facilities. Certain risk factors include conditions that impair cognitive function, such as dementia. When a person falls victim to a condition that limits mental capacity, mortality risk can rise if due care is not implemented. [12]

As a result of certain mental health conditions and/or diseases—like Alzheimer's disease—a person's food preferences might become affected. With certain diseases, individuals can develop specific preferences or distaste for various types of food that were not present before onset. For example, people with Alzheimer's disease may experience many big and small changes as a result of their symptoms. [13] One change identified by Suszynski in "How Dementia Tampers with Taste Buds" is within the taste buds of a patient with dementia, which contain the receptors for taste. Since the experience of flavor is significantly altered, people with dementia can often change their eating habits and take on entirely new food preferences. In this study, the researchers found that these dementia patients had trouble identifying flavors and appeared to have lost the ability to remember tastes, therefore leading to a theory that dementia caused the patients to lose their knowledge of flavors. [13]

Psychological conditions can also affect elderly eating habits. For instance, the length of widowhood may affect nutrition. [14] Depression in elderly people is also associated with a risk of malnutrition. [15]

Lifestyle choices

Elderly people, like all people, have different lifestyle choices involved in their eating habits. Dietary choices are often a result of personal beliefs and preferences. [8]

A survey based on self-reporting found that many rural elderly Iowans adopted eating habits that provided inadequate levels of some key nutrients, and most did not take supplements to correct the deficiencies. [16] In contrast, a restaurant study found that the impact of a lifestyle of health and sustainability on healthy food choices is much stronger for senior diners than for non-senior diners. [17]

Other research has found that adults, regardless of age, will tend to increase fruit and vegetable consumption following a diagnosis of breast, prostate, or colorectal cancer. [8]

Social environment and conditioning

The environment can greatly impact the food preferences of older adults. Those around 75 years old and older are more likely to suffer from limited mobility due to health conditions, [18] and often rely on others for food shopping and preparation. [19]

In some areas, homebound seniors receive one meal per day (several fresh and frozen meals may be included in a single delivery) from communities[ clarification needed ] that offer congregate[ clarification needed ] meals, or meals served in community settings such as senior centers, churches, or senior housing communities. [20] These congregate meal programs are encouraged[ by whom? ] to offer these elderly people a meal at least five times per week.

Impeded access to transportation may also be an issue for elderly persons, especially in rural areas where there is less public transportation. This can vary greatly with geographic location; for instance, an Iowa-based study failed to find problems in purchasing food among the elderly in rural open country and towns, as those without their own transportation relied on family, friends, and senior services. [19] A separate study found a slight difference in urban areas with[ clarification needed ] elderly who did not own a car. [21] Aside from transportation, the kind and quality of available food can also shape food choices if a person lives in a so-called "food desert".

Social network type can also affect individuals' food choices in our elderly population. For example, one study showed that someone with a larger social network and lower economic status is more likely to have proper nutrition than someone who has a smaller social network and higher economic status. [22] Health and social aid can be instrumental in introducing positive change for those at risk.

See also

Related Research Articles

<span class="mw-page-title-main">Food pyramid (nutrition)</span> Visual representation of optimal servings from basic groups

A food pyramid is a representation of the optimal number of servings to be eaten each day from each of the basic food groups. The first pyramid was published in Sweden in 1974. The 1992 pyramid introduced by the United States Department of Agriculture (USDA) was called the "Food Guide Pyramid" or "Eating Right Pyramid". It was updated in 2005 to "MyPyramid", and then it was replaced by "MyPlate" in 2011.

<span class="mw-page-title-main">Fad diet</span> Popular diet with claims not supported by science

A fad diet is a diet that is popular, generally only for a short time, similar to fads in fashion, without being a standard scientific dietary recommendation, and often making unreasonable claims for fast weight loss or health improvements; as such it is often considered a type of pseudoscientific diet. Fad diets are usually not supported by clinical research and their health recommendations are not peer-reviewed, thus they often make unsubstantiated statements about health and disease.

<span class="mw-page-title-main">Mediterranean diet</span> Diet inspired by the Mediterranean region

The Mediterranean diet is a diet inspired by the eating habits and traditional food typical of southern Spain, southern Italy, and Crete, and formulated in the early 1960s. It is distinct from Mediterranean cuisine, which covers the actual cuisines of the Mediterranean countries. While inspired by a specific time and place, the "Mediterranean diet" was later refined based on the results of multiple scientific studies.

<span class="mw-page-title-main">Diet (nutrition)</span> Sum of food consumed by an organism

In nutrition, diet is the sum of food consumed by a person or other organism. The word diet often implies the use of specific intake of nutrition for health or weight-management reasons. Although humans are omnivores, each culture and each person holds some food preferences or some food taboos. This may be due to personal tastes or ethical reasons. Individual dietary choices may be more or less healthy.

<span class="mw-page-title-main">Plant-based diet</span> Diet consisting mostly or entirely of plant-based foods

A plant-based diet is a diet consisting mostly or entirely of plant-based foods. Plant-based diets encompass a wide range of dietary patterns that contain low amounts of animal products and high amounts of fiber-rich plant products such as vegetables, fruits, whole grains, legumes, nuts and seeds. They do not need to be vegan or vegetarian but are defined in terms of low frequency of animal food consumption.

<span class="mw-page-title-main">Baby food</span> Food made especially for infants

Baby food is any soft, easily consumed food other than breastmilk or infant formula that is made specifically for human babies between six months and two years old. The food comes in many varieties and flavors that are purchased ready-made from producers, or it may be table food eaten by the family that has been mashed or otherwise broken down.

<span class="mw-page-title-main">Cat food</span> Food for consumption by cats

Cat food is food specifically designed for consumption by cats. As obligate carnivores, cats have specific requirements for their dietary nutrients, namely nutrients found only in meat, such as taurine, arginine, and Vitamin B6. Certain nutrients, including many vitamins and amino acids, are degraded by the temperatures, pressures and chemical treatments used during manufacture, and hence must be added after manufacture to avoid nutritional deficiency.

<span class="mw-page-title-main">Healthy diet</span> Type of diet

A healthy diet is a diet that maintains or improves overall health. A healthy diet provides the body with essential nutrition: fluid, macronutrients such as protein, micronutrients such as vitamins, and adequate fibre and food energy.

<span class="mw-page-title-main">Protein (nutrient)</span> Nutrient for the human body

Proteins are essential nutrients for the human body. They are one of the building blocks of body tissue and can also serve as a fuel source. As a fuel, proteins provide as much energy density as carbohydrates: 4 kcal per gram; in contrast, lipids provide 9 kcal per gram. The most important aspect and defining characteristic of protein from a nutritional standpoint is its amino acid composition.

<span class="mw-page-title-main">Western pattern diet</span> Modern dietary pattern

The Western pattern diet is a modern dietary pattern that is generally characterized by high intakes of pre-packaged foods, refined grains, red meat, processed meat, high-sugar drinks, candy and sweets, fried foods, industrially produced animal products, butter and other high-fat dairy products, eggs, potatoes, corn, and low intakes of fruits, vegetables, whole grains, pasture-raised animal products, fish, nuts, and seeds.

The Dietary Guidelines for Americans (DGA) provide nutritional advice for Americans who are healthy or who are at risk for chronic disease but do not currently have chronic disease. The Guidelines are published every five years by the US Department of Agriculture, together with the US Department of Health and Human Services. Notably, the most recent ninth edition for 2020–25 includes dietary guidelines for children from birth to 23 months. In addition to the Dietary Guidelines per se, there are additional tools for assessing diet and nutrition, including the Healthy Eating Index (HEI), which can be used to assess the quality of a given selection of foods in the context of the Dietary Guidelines. Also provided are additional explanations regarding customization of the Guidelines to individual eating preferences, application of the Guidelines during pregnancy and infancy, the USDA Nutrition Evidence Systematic Review, information about the Nutrition Communicators Network and the MyPlate initiative, information from the National Academies about redesigning the process by which the Dietary Guidelines for Americans are created, and information about dietary guidelines from other nations.

<span class="mw-page-title-main">Sustainable diet</span> Diet that contributes to the broader environmental and social sustainability

Sustainable diets are "dietary patterns that promote all dimensions of individuals’ health and wellbeing; have low environmental pressure and impact; are accessible, affordable, safe and equitable; and are culturally acceptable". These diets are nutritious, eco-friendly, economically sustainable, and accessible to people of various socioeconomic backgrounds. Sustainable diets attempt to address nutrient deficiencies and excesses, while accounting for ecological phenomena such as climate change, loss of biodiversity and land degradation. These diets are comparable to the climatarian diet, with the added domains of economic sustainability and accessiblity.

<span class="mw-page-title-main">Military nutrition</span> Food and nutrition in the military

Military nutrition is the field and study of food, diet, and nutrition in the military. It generally covers and refers to military rations and nutrition in military organizations and environments.

Research into food choice investigates how people select the food they eat. An interdisciplinary topic, food choice comprises psychological and sociological aspects, economic issues and sensory aspects.

Nutrition psychology (NP) is the psychological study of the relationship between dietary intake and different aspects of psychological health. It is an applied field that uses an interdisciplinary approach to examine the influence of diet on mental health. Nutrition psychology seeks to understand the relationship between nutritional behavior and mental health/well-being NP is a sub-field of psychology and more specifically of health psychology. It may be applied to numerous different fields including: psychology, dietetics, nutrition, and marketing. NP is a fairly new field with a brief history that has already started to contribute information and knowledge to psychology. There are two main areas of controversy within nutrition psychology. The first area of controversy is that the topic can be viewed in two different ways. It can be viewed as nutrition affecting psychological functions, or psychological choices and behavior influencing nutrition and health. The second controversy is the defining of what is "healthy" or "normal" as related to nutrition.

The psychology of eating meat is an area of study seeking to illuminate the confluence of morality, emotions, cognition, and personality characteristics in the phenomenon of the consumption of meat. Research into the psychological and cultural factors of meat-eating suggests correlations with masculinity, support for hierarchical values, and reduced openness to experience. Because meat eating is widely practiced but is sometimes associated with ambivalence, it has been used as a case study in moral psychology to illustrate theories of cognitive dissonance and moral disengagement. Research into the consumer psychology of meat is relevant both to meat industry marketing and to advocates of reduced meat consumption.

Nutrition is the intake of food, considered in relation to the body's dietary needs. Well-maintained nutrition includes a balanced diet as well as a regular exercise routine. Nutrition is an essential aspect of everyday life as it aids in supporting mental as well as physical body functioning. The National Health and Medical Research Council determines the Dietary Guidelines within Australia and it requires children to consume an adequate amount of food from each of the five food groups, which includes fruit, vegetables, meat and poultry, whole grains as well as dairy products. Nutrition is especially important for developing children as it influences every aspect of their growth and development. Nutrition allows children to maintain a stable BMI, reduces the risks of developing obesity, anemia and diabetes as well as minimises child susceptibility to mineral and vitamin deficiencies.

Tea and toast syndrome is a form of malnutrition commonly experienced by elderly people who are unable to prepare meals and tend to themselves. The term is not intrinsic to tea or bread products only; rather, it describes limited dietary patterns which lead to reduced calories resulting in a deficiency of vitamins and other nutrients. This can contribute to a gradual loss of wellness and muscle due to poor protein intake. In elderly individuals with a low GFR, the syndrome may manifest itself as hyponatremia, a low concentration of the electrolyte sodium in the bloodstream. This is attributed to drinking a large amount of water while consuming a diet poor in salt and protein. Hyponatremia can lead to various neurological problems ranging from headaches and a decreased ability to think, to seizures and coma in the most severe cases.

The Mediterranean-DASH Intervention for Neurodegenerative Delay diet, or more commonly, the MIND diet, combines portions of the DASH diet and the Mediterranean diet. Both the DASH diet and the Mediterranean diet have been shown to improve cognition; however, neither was developed to slow neurodegeneration. Therefore, a team at Rush University Medical Center, headed by Martha Clare Morris, worked to create the MIND diet. Like the DASH and Mediterranean diets, the MIND diet emphasizes the intake of fresh fruit, vegetables, and legumes. The MIND diet also includes recommendations for specific foods, like leafy greens and berries, that have been scientifically shown to slow cognitive decline. Recent research has shown that the MIND diet may be more effective at reducing cognitive decline than either the Mediterranean or the DASH diet alone, though a cause and effect relationship has yet to be determined. Additional testing has shown that the level of adherence to the MIND diet also impacts the diet's neuro-protective effects.

Food psychology is the psychological study of how people choose the food they eat, along with food and eating behaviors. Food psychology is an applied psychology, using existing psychological methods and findings to understand food choice and eating behaviors. Factors studied by food psychology include food cravings, sensory experiences of food, perceptions of food security and food safety, price, available product information such as nutrition labeling and the purchasing environment. Food psychology also encompasses broader sociocultural factors such as cultural perspectives on food, public awareness of "what constitutes a sustainable diet", and food marketing including "food fraud" where ingredients are intentionally motivated for economic gain as opposed to nutritional value. These factors are considered to interact with each other along with an individual's history of food choices to form new food choices and eating behaviors.

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