**Native Americans, Alaska Natives and Native Hawaiiansfrom the associationADA REPORTSPosition Paper of the American Dietetic Association:Nutrition Across the Spectrum of AgingABSTRACTIt is the position of the American Die-tetic Association that older Americansreceive appropriate care; have broad-ened access to coordinated, comprehen-sive food and nutrition services; andreceive the benefits of ongoing researchto identify the most effective food andnutrition programs, interventions, andtherapies across the spectrum of aging.Food and water and nutritional well-being are essential to the health, self-sufficiency, and quality of life for thefast growing, heterogeneous, multira-cial, and ethnic populations of olderadults. Many people, as they age, re-main fully independent and activelyengaged in their communities; how-ever, others fare less well and needmore support. A broad array of appro-priate, culturally sensitivefood and nu-trition services, physical activities, andhealth and supportive care customizedto the population of older adults arenecessary. National, state, and localpolicies that promote coordination andintegration of food and nutrition ser-vices into health and supportive sys-tems are needed to maintain indepen-dence, functional ability, chronicdisease management, and quality oflife. Dietetics professionals can takethe lead by researching and developingnational, state, and local collaborativenetworks to incorporate effectively thefood and nutrition services across thespectrum of aging.J Am Diet Assoc. 2005;105:616-633.POSITION STATEMENTIt is the position of the AmericanDietetic Association that olderAmericans* receive appropriate care;have broadened access to coordinated,comprehensive food and nutrition ser-vices; and receive the benefits of ongo-ing research to identify the most effec-tive food and nutrition programs,interventions, and therapies acrossthe spectrum of aging.The enjoyment of food and nutri-tional well-being, along withother environmental factors, hasan impact on health-related quality oflife (see Figure 1), which is defined asa personal sense of physical and men-tal health and the ability to react tofactors in the physical and social en-vironments. Although difficult tomeasure, self-reported health statuscan be a reliable indicator of one’sperceived health-related quality oflife (1). Approximately 42% of Ameri-cans 65 to 74 years of age and 33% ofpersons 75 years of age and olderrated their health as very good to ex-cellent in 2002 (2).Nutrition is one of the major deter-minants of successful aging, definedas the ability to maintain three keybehaviors: low risk of disease and dis-ease-related disability, high mentaland physical function, and active en-gagement of life (3). Food is not onlycritical to one’s physiological well-be-ing but also contributes to one’s so-cial, cultural, and psychological qual-ity of life. Research has shown thatbehaviors such as eating a healthfuldiet, being physically active, and notusing tobacco are more influentialthan genetic factors in helping indi-viduals avoid the deterioration asso-ciated with aging (4).Nutrition plays multiple roles in suc-cessful aging. As a primary preventionstrategy, nutrition helps promotehealth and functionality. As secondaryand tertiary prevention, medical nutri-tion therapy (MNT) is an effective dis-easemanagementstrategythatlessenschronic disease risk, slows disease pro-gression, and reduces disease symp-toms. Thus, the added years at the endof the life cycle can be healthful, enjoy-able, and productive if chronic diseasesand conditions can be prevented or ef-fectively managed. Dietetics profes-sionals are uniquely qualified to pro-vide a broad array of appropriate,culturally sensitive food and nutritionservices in addition to encouragingphysical activity and other supportivecare for older Americans.Millions of older Americans wouldbenefit from nutritional services if theywere broadly available. The UnitedStates ranks second among all coun-tries in the number of people 80 yearsof age and older. In 2001, the popula-tion aged 65 years or older in theUnited States numbered approxi-mately 35 million people, representing12.4% of the population. The popula-tion 85 years of age or older was esti-mated at 4.5 million people (5). Approx-imately 3 million older Americans areforeign-born, with approximately 39%of this population from Europe, 31%from Latin America, and 22% fromAsia (6).The racial/ethnic composition ofolder Americans, aged 65 years andolder, is diverse (7). Currently, whitesrepresent the majority of older adults,representing 84% of the older adultpopulation. The number of males per100 females is 82 for adults 65 to 74years, 65 for adults 75 to 84 years,and 41 for adults 85 years of age andolder (8).The older US population will con-tinue to grow significantly in the fu-ture. The number of people 65 years ofage or older is projected to increase toan estimated 71 million in 2030, with0002-8223/05/10504-0019$30.00/0doi: 10.1016/j.jada.2005.02.026*Older Americans refers to individu-als 60 years of age and older. Theterms older adults and elders areused interchangeably in the text torefer to these individuals. On occa-sion, where defined, older adults re-fers to people 50 years of age andolder.616 Journal of the AMERICAN DIETETIC ASSOCIATION © 2005 by the American Dietetic Associationthe number of persons aged 80 years orolder to increase from 9.3 million in2000 to 19.5 million in 2030 (9). Al-though the sex distribution of older res-idents is expected to change only mod-erately (59% women in 2000 vs 56% in2030), larger changes in racial/ethniccomposition are expected (9). By 2050,whites are expected to represent 52.8%of the population; Hispanics, 24.3%;blacks, 13.2%; Native Americans andAlaskan Natives, 0.8%; and Asians andPacific Islanders, 8.9% (7).ENVIRONMENTAL IMPACTS ON HEALTH-RELATED QUALITY OF LIFEHealthful lifestyles, early detection ofdiseases, immunizations, injury pre-vention, and self-management tech-niques have proven to be effective inpromoting the health of older adults. In2001, American’s life expectancyreached a new record high of 77.2years, increasing for men and women,as well as whites and blacks (10). OlderAmericans can expect to live longer, in-creasing the numbers who will reachtheir biological maximum age, and tobe healthier than ever before (11).CentenariansIn 2001, there were 48,000 individu-als in the United States who were 100years of age or older (5).