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ADA Nutrition Guidelines Modified for Older Adults

A Modified MyPyramid for Older Adults has been developed to serve older adults, who have unique dietary needs and less familiarity with computer use vs younger persons.

Special considerations regarding nutritional needs of the elderly population are that food intake tends to decrease with advancing age because of reduced energy needs associated with lower energy expenditure in physical activity and basal metabolic rate. However, requirements for vitamins and minerals either remain stable or increase.

The Modified MyPyramid for Older Adults specifically emphasizes whole grains; variety within the grains group; variety and nutrient density; vegetables and fruits particularly suited to older adults’ needs, such as frozen foods; low-fat and nonfat dairy products including reduced lactose alternatives in the milk group; low saturated fat and trans fat choices in the oils group; and low saturated fat and vegetable options in the meat and beans group.

The underlying principles of the Modified MyPyramid for Older Adults include focus on nutrient- and fiber-rich foods within each group, recommending food sources of nutrients rather than supplements, and use of fluid and physical activity icons. The base of the pyramid has a row of glasses to remind older adults that it is crucial to remain well hydrated. In the second row, pictures of various physical activities emphasize the need for regular physical activity, which is of vital importance given the high prevalence of physical inactivity in older adults.

To highlight the possible need for supplemental forms of calcium, and vitamins D and B12 because of increased requirements for these nutrients associated with aging, a flag was placed at the top of the pyramid. More recent concerns about potential overnutrition in older adults are also addressed.

"It is important to communicate to older adults that eating should remain an enjoyable experience," the authors write. "Drawing public attention to this issue provides an opportunity for those educating the public regarding optimal nutrition, not just for those >70 y. The guidance provided can be used as a road map and should be adaptable so it can accommodate many different dietary preferences, patterns, and lifestyles."

Practice Pearls

  • The Modified MyPyramid for Older Adults specifically emphasizes nutrient-rich and fiber-rich foods within each group and recommends food sources of nutrients rather than supplements. These include whole grains; variety within the grains group; variety and nutrient density; vegetables and fruits that are easy to prepare (eg, frozen foods); low-fat and nonfat dairy products including reduced lactose alternatives in the milk group; low saturated fat and trans fat choices in the oils group; and low saturated fat and vegetable options in the meat and beans group.
  • The Modified MyPyramid for Older Adults is a graphic intended to improve understanding and use of MyPyramid by the elderly population, who may be less comfortable with obtaining Web-based information.

J Nutrition. 2008;138:5-11.