Nutrition is essential to a healthy lifestyle, especially for the elderly. As aging occurs, individuals tend to become more prone to malnutrition due to decreased appetite, decreased metabolism, and decreased absorption and utilization of nutrients. As such, it is essential to assess the nutrition status of elderly individuals to ensure that they get the nutrients they need for a healthy life. Nutrition assessment evaluates an individual’s nutritional status by assessing their dietary intake, physical examination, and anthropometric measurements.
Background
The client is a 70-year-old male with a height of 5’10” and a weight of 175 lbs. His body mass index (BMI) is 25.7, which is classified as being in the normal range ( Azzolino et al.,2020). He is not currently participating in regular physical activity but can perform light to moderate activities as needed. He has no known past or current medical history.
A 24 Hours Diet Recall
A 24-hour diet recall was conducted on a 70-year-old male client, and the results were recorded. This was followed by an in-depth interview, during which the client was asked about any special considerations that may affect their nutritional status. Questions related to environmental factors such as living alone, inability to prepare food, inadequate income, or lack of transportation were asked. Cultural traditions that may impact food preferences were also discussed. Food allergies, such as dairy products or fatty foods, seafood, etc., were discussed, and any weight loss or gain over the past six months was noted (Azzolino et al.,2020). Recent events that may have altered usual nutritional intakes, such as illness, surgery, or emotional stress, were noted. The client was also asked about any aspects of their therapeutic regimen that may affect food intake medications. Questions related to their interest in food, difficulties in ingesting, chewing, swallowing, regurgitation, stomach fullness, bloating, impaired fine motor coordination, manual dexterity, or fatigue were asked. Hydration levels were assessed to ensure the client consumed at least 2-3 liters daily. Overeating in response to stress was discussed, and the types of snack foods usually consumed were noted. If the client is hospitalized, their prescribed diet is discussed compared to their typical diet.
Results:
The results of the 24-hour diet recall revealed that the client had consumed a total of 2550 calories, which was within the recommended daily intake for an individual of their age and gender (Azzolino et al.,2020). The breakdown of the macronutrient intake was as follows:
Carbohydrates: 500 calories (25%)
Protein: 400 calories (20%)
Fats: 1100 calories (55%)
The interview further revealed that the client had no environmental factors, such as living alone or lack of transportation, that may affect their food intake. The client also reported no cultural traditions that impact their food preferences. The client takes no medications or other therapeutic regimens that may affect their food intake (Azzolino et al.,2020). The client could easily consume various food items, such as fruits, vegetables, grains, dairy products, and fats. They reported no food allergies, no changes in their weight in the past six months, and no recent events such as illness, surgery, or emotional stress that altered their usual nutritional intake.
The client reported no difficulties with chewing, swallowing, regurgitation, stomach fullness, bloating, or impaired fine motor coordination and manual dexterity. The client reported some fatigue and a lack of interest in food, but these did not affect their food intake or reduce overall intake. The client also reported an adequate fluid intake, of 2-3 liters daily, within the recommended range for an older adult (Azzolino et al.,2020). The client also reported no overeating in response to stress and did not report any snack food used. The client’s nutritional status was adequate, with no significant deficiencies or allowances. The client could consume various foods without difficulty and reported an adequate fluid intake. The only areas of concern were fatigue and lack of interest in food, but these did not appear to impact the client’s overall nutritional status.
Nutritional Assessment
The first step in assessing the 24-hour diet recall for an adult 70 years of age or older is to use a senior primary care screening assessment tool. The Comprehensive Geriatric Assessment Kit Nutrition Assessment was used for this assessment, which consists of three tools: the Body mass index calculator, the Mini Nutritional Assessment, and the Malnutrition Universal Screening Tool. The Body mass index calculator was used to assess the client’s body mass index, which measures body fat based on height and weight. The Mini Nutritional Assessment was used to assess the overall nutritional status of the individual and identify any risk factors related to malnutrition (Baranowski et al.,2019). Lastly, the Malnutrition Universal Screening Tool was used to identify risk factors that may lead to malnourishment. All three tools evaluated the person’s nutritional state and thoroughly explained their present health.
The client had consumed 2550 calories overall, .which was within the daily allowance for someone of their age and gender, according to the findings of the 24-hour diet recall. Following is a summary of the macronutrient intake::
Carbohydrates: 500 calories (25%)
Protein: 400 calories (20%)
Fats: 1100 calories (55%)
The Chronometer program also revealed that the individual had consumed 67 grams of fiber, slightly lower than the recommended daily intake of 25-38 grams for someone of this age and gender. The sodium intake was 5,217 mg, slightly higher than the recommended daily intake of 2,300 mg(Baranowski et al.,2019). The amount of total fat consumed by the person exceeded the 20–35% daily recommendation, with saturated fats (13%), polyunsaturated fats (6%), and monounsaturated fats (3%) accounting for the bulk of this fat. The daily recommended intake of 300 mg of cholesterol was marginally exceeded by the dietary cholesterol intake of 145 mg. It was discovered that the person had consumed an adequate quantity of vitamin A, vitamin C, vitamin D, vitamin e, vitamin k, thiamin, riboflavin, niacin, folate, vitamin b6, vitamin b12, magnesium, phosphorus, and potassium. The individual’s vitamin and mineral intake was also examined. The person’s diet was primarily made up of foods high in nutrients, and their intake of macro- and micronutrients was generally within the suggested ranges.
Intake Requirement
For a 70-year-old client, it is essential to ensure their dietary intake provides the necessary nutrients to keep them healthy and active. A 24-hour dietary intake recommendation for a 70-year-old client should provide adequate nutrients: carbohydrates, proteins, fats, vitamins, minerals, and water. Carbohydrates should make up the majority of a 70-year-old’s daily caloric intake, with about 45-65% coming from carbohydrates such as whole grains, fruits, vegetables, and legumes (Baranowski et al.,2019). A minimum of 130 grams of carbohydrates should be consumed daily, as this helps to provide the energy needed for daily activities. Protein is essential for tissue repair and maintenance and should come from lean meats, poultry, fish, eggs, beans, nuts, and seeds. Fats should make up 20-35% of a 70-year-old’s daily caloric intake, with a focus on healthy fats. These include olive oil, avocados, nuts, and seeds. Vitamins and minerals are also crucial for the 70-year-old to remain healthy. Vitamins and minerals are found in fruits, vegetables, dairy products, and fortified cereals. Vitamin D and calcium are essential for bone health, while B vitamins are important for energy production. Water is essential to keep the body hydrated and functioning properly. It is recommended that the 70-year-old drink at least eight glasses of water per day.
The Normal Intake to the Ideal Intake
The results of the 24-hour diet recall for the client showed that the total caloric intake was within the recommended daily intake for an individual of their age and gender. The macronutrient breakdown of the client’s diet showed that they had consumed 500 calories from carbohydrates, 400 calories from protein, and 1100 calories from fats. Although the caloric intake was within the recommended range, the macronutrient intake could have been better. The ideal macronutrient ratio for an individual of the client’s age and gender is 45-65% carbohydrates, 10-35% protein, and 20-35% fats. This means the client should consume 900-1200 calories from carbohydrates, 350-700 calories from protein, and 400-800 calories from fats(Baranowski et al.,2019). The client was overeating fats and under-consuming carbohydrates compared to the ideal ratio. The client should focus on increasing the intake of carbohydrates and reducing the intake of fats. To do this, the client should replace unhealthy fats, such as those found in processed foods, with healthier fats, such as those found in nuts, seeds, and avocados. The client should also focus on consuming more complex carbohydrates like whole grains, starchy vegetables, and legumes.
Meal Plan
Breakfast:
- Bowl of oatmeal with diced apples, walnuts, and cinnamon
- 8 ounces of lo• 2 scrambled eggs w-fat milk
Lunch:
- 2 ounces of grilled salmon
- 2 cups of steamed broccoli
- 1 cup of cooked quinoa
- 8 ounces of low-fat yogurt
Dinner:
- 3 ounces of grilled chicken
- 1 cup of mashed sweet potatoes
- 2 cups of steamed spinach
Snacks:
- 2 ounces of hummus with 1 cup of raw vegetables
- ½ cup of trail mix
- 8 ounces of low-fat yogurt
How to Incorporate the Recommended Changes into the Client dietary habits
The client should be encouraged to change his diet to ensure it is balanced and meets his nutritional needs. This can be done by increasing the intake of fruits, vegetables, and whole grains while reducing the consumption of processed, high-fat and high-sugar foods. The client should also be encouraged to increase his physical activity level to help maintain a healthy weight(Baranowski et al.,2019). To reassess the client’s nutritional status in the future, the 24-hour diet recall can be repeated at regular intervals to assess progress. Assessing the client’s willingness and motivation to make the recommended dietary changes is essential. Questions such as whether he feels he could make the changes, his perceived barriers, and strategies he could use to overcome those barriers should be asked. The client should also be encouraged to set realistic goals and to be provided with support and resources to help him achieve those goals.
The 24-hour diet recall revealed that the client had consumed 2,550 calories, within the recommended daily intake for an individual of their age and gender. The macronutrient breakdown of the client’s diet showed that they had consumed 25% carbohydrates, 20% protein, and 55% fats, which could have been better. The client should focus on increasing their carbohydrate intake and reducing their fat intake. The client should also focus on consuming more complex carbohydrates like whole grains, starchy vegetables, and legumes. Lastly, the client should increase their protein intake, essential for maintaining muscle mass and promoting satiety. With these dietary changes, the client can optimize their overall nutritional status and ensure they get the necessary nutrients for health.
References
Azzolino, D., Arosio, B., Marzetti, E., Calvani, R., & Cesari, M. (2020). Nutritional status mediates fatigue and its underlying mechanisms in older people. Nutrients, 12(2), 444.
Baranowski, T., Ryan, C., Hoyos-Cespedes, A., & Lu, A. S. (2019). Nutrition education and dietary behavior change games: A scoping review. Games for health journal, 8(3), 153-176.
Cowan, A. E., Jun, S., Tooze, J. A., Dodd, K. W., Gahche, J. J., Eicher-Miller, H. A., … & Bailey, R. L. (2020). Comparison of 4 methods to assess the prevalence of use and estimates of nutrient intakes from dietary supplements among US adults. The Journal of Nutrition, 150(4), 884-893.
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