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Position Paper of the American Dietetic Association



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from the association ADA REPORTS Position Paper of the American Dietetic Association Nutrition Across the Spectrum of Aging ABSTRACT It is the position of the American Dietetic Association that older Americans receive appropriate care have broadened access to coordinated comprehensive food and nutrition services and receive the benefits of ongoing research to identify the most effective food and nutrition programs interventions and therapies across the spectrum of aging Food and water and nutritional wellbeing are essential to the health selfsufficiency and quality of life for the fast growing heterogeneous multiracial and ethnic populations of older adults Many people as they age remain fully independent and actively engaged in their communities however others fare less well and need more support A broad array of appropriate culturally sensitive food and nutrition services physical activities and health and supportive care customized to the population of older adults are necessary National state and local policies that promote coordination and integration of food and nutrition services into health and supportive systems are needed to maintain independence functional ability chronic disease management and quality of life Dietetics professionals can take the lead by researching and developing national state and local collaborative networks to incorporate effectively the food and nutrition services across the spectrum of aging J Am Diet Assoc 2005 105 616 633 POSITION STATEMENT It is the position of the American Dietetic Association that older 0002 8223 05 10504 0019 30 00 0 doi 10 1016 j jada 2005 02 026 616 Americans receive appropriate care have broadened access to coordinated comprehensive food and nutrition services and receive the benefits of ongoing research to identify the most effective food and nutrition programs interventions and therapies across the spectrum of aging he enjoyment of food and nutritional well being along with other environmental factors has an impact on health related quality of life see Figure 1 which is defined as a personal sense of physical and mental health and the ability to react to factors in the physical and social environments Although difficult to measure self reported health status can be a reliable indicator of one s perceived health related quality of life 1 Approximately 42 of Americans 65 to 74 years of age and 33 of persons 75 years of age and older rated their health as very good to excellent in 2002 2 Nutrition is one of the major determinants of successful aging defined as the ability to maintain three key behaviors low risk of disease and disease related disability high mental and physical function and active engagement of life 3 Food is not only critical to one s physiological well being but also contributes to one s social cultural and psychological quality of life Research has shown that behaviors such as eating a healthful diet being physically active and not using tobacco are more influential than genetic factors in helping individuals avoid the deterioration associated with aging 4 T Older Americans refers to individuals 60 years of age and older The terms older adults and elders are used interchangeably in the text to refer to these individuals On occasion where defined older adults refers to people 50 years of age and older Journal of the AMERICAN DIETETIC ASSOCIATION Nutrition plays multiple roles in successful aging As a primary prevention strategy nutrition helps promote health and functionality As secondary and tertiary prevention medical nutrition therapy MNT is an effective disease management strategy that lessens chronic disease risk slows disease progression and reduces disease symptoms Thus the added years at the end of the life cycle can be healthful enjoyable and productive if chronic diseases and conditions can be prevented or effectively managed Dietetics professionals are uniquely qualified to provide a broad array of appropriate culturally sensitive food and nutrition services in addition to encouraging physical activity and other supportive care for older Americans Millions of older Americans would benefit from nutritional services if they were broadly available The United States ranks second among all countries in the number of people 80 years of age and older In 2001 the population aged 65 years or older in the United States numbered approximately 35 million people representing 12 4 of the population The population 85 years of age or older was estimated at 4 5 million people 5 Approximately 3 million older Americans are foreign born with approximately 39 of this population from Europe 31 from Latin America and 22 from Asia 6 The racial ethnic composition of older Americans aged 65 years and older is diverse 7 Currently whites represent the majority of older adults representing 84 of the older adult population The number of males per 100 females is 82 for adults 65 to 74 years 65 for adults 75 to 84 years and 41 for adults 85 years of age and older 8 The older US population will continue to grow significantly in the future The number of people 65 years of age or older is projected to increase to an estimated 71 million in 2030 with 2005 by the American Dietetic Association ADA REPORTS Figure 1 Factors that influence quality of life of adults 60 years and older aCommunity includes health and supportive services at local state and federal levels and health professionals and researchers the number of persons aged 80 years or older to increase from 9 3 million in 2000 to 19 5 million in 2030 9 Although the sex distribution of older residents is expected to change only moderately 59 women in 2000 vs 56 in 2030 larger changes in racial ethnic composition are expected 9 By 2050 whites are expected to represent 52 8 of the population Hispanics 24 3 blacks 13 2 Native Americans and Alaskan Natives 0 8 and Asians and Pacific Islanders 8 9 7 ENVIRONMENTAL IMPACTS ON HEALTHRELATED QUALITY OF LIFE Healthful lifestyles early detection of diseases immunizations injury prevention and self management tech niques have proven to be effective in promoting the health of older adults In 2001 American s life expectancy reached a new record high of 77 2 years increasing for men and women as well as whites and blacks 10 Older Americans can expect to live longer increasing the numbers who will reach their biological maximum age and to be healthier than ever before 11 Centenarians In 2001 there were 48 000 individuals in the United


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