Food choice of older adults

As people age, their bodies change. This can include their taste buds, their needs of certain vitamins and nutrients, and their desire for different types of food. In a study by the Monell Chemical Senses Center,[4] fifty young adults and forty-eight elderly adults participated in the study. "Young" subjects ranged from eighteen to thirty-five years of age and "elderly" subjects were defined as sixty-five 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. Causation theories included accounting this difference in preference with the younger female test subject's menstrual cycles and the fact that elderly women no longer go through menopause. The study also postulated that "... Ninety-one percent 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 someone of an older age 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. Grzegorcyzk says that as we age, our sense for tasting salty foods goes away slowly. [5] Therefore, when elderly people in care homes eat (often frozen, mass produced) meals that contain large amounts of salt, they may not enjoy it. This could lead to depression, anxiety, or thoughts of suicide.

Elderly couple eating lunch together

Not only are there differences in food preferences between ages, but between biological sexes also. In a study conducted by the ENP, preferences of male and female subjects throughout 13 individual food groups (fresh fruit, chicken, soup, salad, vegetables, potatoes, meat, sandwiches, pasta, canned fruit, legumes, deli meats, and ethnic groups) were identified.

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 entrees than sweets.[4]

With age, some people tend to avoid food 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 associated 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 that have eating difficulties due to oral health conditions are needed desperately because without being able to chew or take in food properly, their health is effected drastically and their food preferences are limited greatly (to soft or liquids only).[6]

Due to varying factors of older adults' physical and mental wellbeing, eating choices can become more and 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, 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 can also cause deterioration in diet due to difficulties in preparing and eating food as a result of conditions like arthritis.[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 metabolism with a consequent lower 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]

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.[11]

As a result of certain mental health conditions and/or diseases—like Alzheimer's—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 may experience many big and small changes as a result of their symptoms.[12] 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.[12]

Psychological conditions can also affect elderly eating habits. For instance, length of widowhood may affect nutrition.[13] Depression in elderly people is also associated with a risk of malnutrition.[14]

Elderly people, as 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 community-dwelling elderly Iowans adopted eating habits that provided inadequate levels of some key nutrients and most did not take supplements to correct the deficiencies.[15] 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.[16]

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]

The environment can greatly impact food preferences of older adults. Those around 75 years old and older are more likely to suffer with limited mobility due to health conditions[17] and often rely on others for food shopping and preparation.[18]

In some areas, homebound seniors receive one meal per day (several fresh and frozen meals may be included in a single delivery) by communities that offer congregate meals, or meals served in community settings such as senior centers, churches or senior housing communities.[19] These congregate meal programs are encouraged 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 due to geographic location; for instance, a study based in Iowa study failed to find problems in purchasing food among elderly in rural open country and towns, as those without their own transportation relied on family, friends and senior services.[20] A separate study found a slight difference in urban areas with elderly who did not own a car.[21] Aside from transportation, the kind and quality of available food can also shape food choice 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 a person that has a larger social network and lower economic status is more likely to have proper nutrition that someone who has a smaller social network and higher economic status. [22] Health and social aid can be instrumental into introducing positive change for those at risk.