Executive Summary of Recommendations (2012)
Executive Summary of Recommendations
Below are the major recommendations and ratings for the Academy of Nutrition and Dietetics Food and Nutrition for Older Adults Promoting Health and Wellness Recommendations. More detail (including the evidence analysis supporting these recommendations) is available on this website to Academy members and EAL subscribers under Major Recommendations.
To see a description of the Academy Recommendation Rating Scheme (Strong, Fair, Weak, Consensus, Insufficient Evidence), click here.
The Food and Nutrition for Older Adults Promoting Health and Wellness Recommendations are listed below. (Note: If you mouseover underlined acronyms and terms, a definition will pop-up.)
FNOA: Considerations for Weight Management in the Older AdultRegardless of age, the registered dietitian (RD) should consider the following when assessing the need for weight management through modifications in dietary intake and physical activity in older adults:
FairImperativeFNOA: Use Multiple Assessment Indicators for Classification of Overweight/ObesityRegardless of age, the RD should use more than one of the following assessment indicators when classifying overweight or obesity:
- Classification of overweight or obesity
- Presence of comorbidities
- Physical function
- Cognitive function
- Attitude toward longevity
- Personal choice
- Quality of life.
- Weight change (and weight history)
- Current (and past) weight, height and BMI
- Waist circumference
- Body composition.
FNOA: Encourage DRI for All Older AdultsFor all older adults, the registered dietitian (RD) should encourage food intake meeting the Dietary Reference Intakes (or other recommended levels) for antioxidant vitamins and minerals and recommend a multi-vitamin if food intake is low. Studies regarding antioxidant intakes below recommended levels reported an association with cognitive decline, however research regarding age-related macular degeneration was inconclusive.StrongImperativeFNOA: Collaborate with Others Regarding Treatment of Diagnosed Age-Related Macular Degeneration
StrongConditionalFNOA: Advise Against Antioxidants for Treatment of Diagnosed Cognitive Impairment/Alzheimer's Disease
- For older adults with diagnosed age-related macular degeneration, the RD should collaborate with others on the inter-professional team (such as physicians, ophthalmologists, pharmacists and other healthcare professionals) to determine whether an older adult would benefit from high-dose supplementation of antioxidants, as some formulations have side-effects and contraindications.
- Studies have found a beneficial effect of antioxidant (beta-carotene, vitamin C and vitamin E), lutein/zeaxanthin and zinc and copper from diet or supplementation on delaying progression of advanced age-related macular degeneration. However, other studies report inconclusive findings.
StrongConditionalFNOA: Screen for USDA and OAA Program EligibilityThe registered dietitian (RD) should screen all older adults for eligibility (or refer for screening) in United States Department of Agriculture (USDA) programs and the Older Americans Act Nutrition Service Program and identify potential barriers to participation, such as disability, functional impairment, attitude toward program utilization and income level. Research reported racial and ethnic differences in program participation, as well as in subjects with vision or hearing difficulties, special dietary needs, functional limitations or disabilities.FairImperativeFNOA: Encourage Participation in USDA and OAA ProgramsThe RD should encourage eligible older adults to apply for and participate in the following United States Department of Agriculture (USDA) and Older Americans Act (OAA) programs:
- For older adults with diagnosed cognitive impairment or Alzheimer's Disease, the RD should advise against antioxidant supplementation, as it has not been shown to have an effect and some formulations have side effects and contraindications
- Findings from studies of antioxidant intake above recommended dietary allowance (RDA) levels in subjects with diagnosed cognitive impairment or Alzheimer's Disease demonstrated no difference in the delay of cognitive decline. These findings were substantiated by one systematic Cochrane review.
- United States Department of Agriculture (USDA)
- Supplemental Nutrition Assistance Program (SNAP)
- Senior Farmer's Market Nutrition Program (SFMNP)
- Child and Adult Care Food Program (CACFP)
- Emergency Food Assistance Program
- Commodity Supplemental Food Program (CSFP).
- Older Americans Act (OAA) programs
- OAA Congregate Nutrition Program
- OAA Home Delivered Nutrition Program.