Chapter 18 Life Cycle Nutrition: Adulthood and the...

Enriched Instructor’s Manual to Accompany Understanding Nutrition, First Canadian Edition 18-1

Chapter 18Life Cycle Nutrition: Adulthood and the Later Years

I F N O T H I N G E L S E , M Y S T U D E N T S S H O U L D L E A R N …

1. That during the course of natural aging, numerous physiological changes take place and that dietary patterns become an everimportant factor in maintaining adequate health.

2. That a variety of effective dietary and lifestyle strategies exist for aging adults to maintain independence, health, and overall wellbeing.

3. The factors involved with the potential for malnutrition in the aging adult, as well as the potential for nutrientdrug interactions.

4. The common condition and ailments that occur during the course of natural aging, such as vision problems, arthritis, and changes to nervous system/ brain function.

L E A R N I N G O B J E C T I V E S

Students should be able to:

• LO 18.1: Discuss the lifestyle and nutritional behaviours that can have a positive impact on healthy aging. [Understand/Apply]

• LO 18.2: Describe the impact of energy restriction on health as people age, in addition to the role of physical activity. [Understand/Apply]

• LO 18.3: Describe the various changes that occur with aging, with specific reference to body weight, body composition, immunity, the GI tract, tooth losses, and sensory changes, as well as psychological, economic, and social changes. [Understand/Remember]

• LO 18.4: Describe the energy and nutritional needs of older adults, with specific reference to protein, carbohydrates/fibre, fat, and vitamins/ minerals. [Understand/Remember]

• LO 18.5: Discuss the nutrition recommendations for vision changes that occur with aging. [Understand/Apply]

Copyright © 2013 by Nelson Education Ltd.


• LO 18.6: Discuss the role of nutrition in the prevention and treatment of arthritic conditions. [Understand/Apply]

• LO 18.7: Describe diseases of the aging brain and the role of nutrition in brain function. [Understand/Apply]

• LO 18.8: Outline and describe various strategies, to include nutritional factors, to maintain health during natural aging. [Understand/Remember]

• LO 18.9: Describe meal planning for single, older adults and the risk factors for potential malnutrition. [Understand/Apply]

• LO 18.10: Describe the medications that increase excretion of, alter requirements of, or interact with nutrients and the dietary changes recommended. [Understand/Remember]

W H Y I S T H I S C H A P T E R I M P O R T A N T T O S C I E N T I S T S A N D H E A L T H C A R E P R A C T I T I O N E R S ?

“Of special interest to...” symbol key:

= HealthCare Practitioners = Science Majors

• Life expectancy for Canadian adults increased in the twentieth century. Life choices can greatly affect how long a person lives and the quality of life in the later years. No diet or supplement can extend life. Scientists are studying ways to increase longevity through diet and exercise interventions.

• Lifestyle factors can make a difference in aging. Studies involving rats and other species have demonstrated that food energy restriction may lengthen the lives of individuals. Claims for life extension through use of antioxidants or other supplements have not been proven scientifically; however, dietary sources of antioxidants are known to improve the quality of life by neutralizing the action of free radicals which increase during aging

• Scientists are exploring the links between nutrition and Alzheimer’s Disease. Elevated levels of certain minerals such as aluminum, copper, iron, and zinc have been observed in the brains of patients with Alzheimer’s disease. In addition, a low antioxidant nutrient intake and low fishoil and fish intakes have been linked to Alzheimer’s disease.

• Nutrition and drugs can sometimes interact. Scientists continue to study nutrient–drug interactions, while healthcare practitioners should be aware of the medications their patients take so as to minimize the possibility of such interactions (See Highlight 18 in the textbook).



W H Y S H O U L D S T U D E N T S C A R E ?

• Students should have an understanding of the aging process and the nutritional requirements of the elderly, as vitamin and mineral needs will change. Some of the challenges are listed below:

– Food choices of the elderly are affected by aging, altered health status, and changed life circumstances. Assistance programs can help by providing nutritious meals, offering opportunities for social interactions, and easing financial problems.

– Energy needs decrease with age, but exercise burns off excess fuel, maintains lean tissue, and brings health benefits.

– Protein needs remain about the same through adult life, but choosing lowfat fibrerich protein foods may help control other health problems.

– Generous carbohydrate intakes are recommended for older adults. Including fibre in the diet is important to avoid constipation.

– A diet high in fruits and vegetables and low in fats of meats and dairy products may improve some symptoms of arthritis. Omega3 fatty acids may also have a positive effect.

– Vitamin A absorption increases with aging. Older people suffer more from deficiencies of vitamin D and vitamin B12 than young people do. Cataracts and macular degeneration often occur among those with low fruit and vegetable intakes.

– Alzheimer’s disease causes some degree of brain deterioration in many people past age 65. Current treatment helps only marginally; dietary aluminum is probably unrelated. The importance of nutrition care increases as the disease progresses.

W H A T A R E C O M M O N S T U D E N T M I S C O N C E P T I O N S / S T U M B L I N G B L O C K S ?

1. Many students are not aware of the physical changes of aging that can be affected by nutrition. By understanding the physiological basis of these agingrelated changes, students will be able to better understand how the action of various nutrients can positively affect such changes.

2. Students are not aware that older adults suffer more from deficiencies of vitamin D and B12 than young adults, and that dehydration is a major risk for older adults.

3. Many students, and hence, young adults, often do not pay sufficient attention to the numerous factors, other than nutrition, that can affect the quality of life of an adult during the course of natural aging. Table 183 provides an overview of these



factors and how they can be used to promote healthy aging.

4. Many students believe that nutritional needs during natural aging is the same as young adults. However, nutritional requirements change considerably as energy needs decrease, but the provision of certain micronutrients increase due to agerelated deteriorations in various functions.

W H A T C A N I D O I N C L A S S ?

There are a variety of activities that can be done in class. Listed below are some activities that will help introduce the topic of nutrition, and the students to each other.

Classroom Activity 181: ChapterOpening QuizObjective: Introduction to chapter Class size: Any

Instructions: As a way of introducing any new chapter, give a quiz to the class. This is a quiz designed to be projected overhead. For details, please see Chapter 1, Classroom Activity 14.

Classroom Activity 182: Simulation of Aging ProcessesKey concept: Physiological changes during aging Class size: Small to medium

Materials needed: Knee wraps, needles, thread, fabric (several small pieces), scissors (2 pairs), reading glasses (2 pairs), petroleum jelly, plastic/rubber gloves (2 pairs), newspaper, cotton balls

Instructions: Prior to class, collect several items and set up stations in the classroom:

• Station 1—knee wraps• Station 2—sewing needles, thread, fabric, scissors, reading glasses with Vaseline

on lenses, plastic or rubber gloves• Station 3—newspaper, scissors, plastic or rubber gloves, reading glasses with

Vaseline on lenses, cotton balls

Assign the following tasks to each student:

• Wrap the knee wraps around one knee to simulate joint stiffness and walk around for 3 to 5 minutes; walk up and down stairs if available.

• Wearing the reading glasses, and plastic or rubber gloves, thread a needle and sew a row of stitches.

• Wearing the reading glasses and plastic or rubber gloves, with cotton balls placed in the ears, cut an article out of the paper and talk about it to another student.

After the activity is complete, discuss the challenges of the aging process.

Critical Thinking Questions1

These questions will also be posted to the book’s website so that students can complete

1 Contributed by Kathleen Rourke.



them online and email their answers to you.

1. Chapter 18 points out that 70–80 percent of an individual’s life expectancy depends on the individual’s health and lifestyle behaviours and the other 20–30 percent depend on the individual’s genetic background. This chapter also differentiates between physiologic age and chronologic age, the former being based on your health and exercise activities as well as lifestyle, and the latter, on birth date. One can be younger physiologically because one eats well and exercises even if one is chronologically older (or vice versa). Given this information, assess the difference between your physiologic and chronological age. In this assessment, outline how you are meeting each of the principles of dietary planning based on Canada’s Food Guide.

Once you have determined your physiologic age, discuss this age and your overall life expectancy, given your diet, exercise, health status, and lifestyle behaviours in relation to your individual genetic background. In looking at your personal and family health history, what role do you think genetics will play in your overall life expectancy? Does your lifestyle contribute more to your life expectancy than it would to that of others in your family? Barring no unforeseen circumstances, what are you estimating to be your overall life expectancy?

2. Chapter 18 outlines some of the physiologic changes that can occur in the aging or older adult. However, many older adults have had the benefit of wonderful health care and now remain active well into their 80s. What advice could you give to these individuals and what precautions might you offer?

3. Many older Canadians lose their friends of many years because of death. What impact does this have on mind and body?

4. The elderly are challenged by several chronic health problems and may also experience some nutritional issues as a result of physiologic challenges. They may also suffer from mental health issues as a consequence of aging. Discuss the many challenges you as an RD might work around to enhance the nutritional status of an elderly patient. Make the list as exhaustive a desired.

5. What other health challenges do older Canadians face in an often volatile economy? How can they protect themselves nutritionally and with regard to their health status?

6. Nutrient–drug interactions can negatively influence the overall effect of a drug and in some cases they can be fatal. After reading Highlight 18, select a member of your family who is in the older adult category and takes more than 4–5 medications. Thinking about what you know of this person’s overall health and nutritional status, assess the nutrient–drug interactions that may occur with these drugs. Your family member will remain confidential. Make dietary recommendations given your family member’s medical history, rationale for taking medications, and potential or nutrient–drug interactions.



W H A T O T H E R R E S O U R C E S A R E A V A I L A B L E ?

You can look up information about government policy as well as any health condition that you are interested in learning more about. Consult the following websites to get reliable information on the following:

• The Government of Canada has a website, Seniors Canada, which outlines the government’s actions on seniors’ issues: http://www.seniors.gc.ca. A range of issues is covered, including Food and Nutrition under the Health and Wellness menu option.

• The Canadian Association on Gerontology (http://www.cagacg.ca) is a national, multidisciplinary scientific and educational association that provides leadership in matters related to the aging population, and seeks to improve the lives of older Canadians by creating and disseminating knowledge in gerontological policy, practice, research, and education.

• The Canadian Centre for Activity and Aging (http://www.uwo.ca/actage) conducts research and provides education and program development for healthy aging and improving physical ability in older adults. This website has an extensive list of online resources, many of which are associated with active living in the senior years. The Centre is based in the Faculty of Health Sciences at the University of Western Ontario.

• The Canadian Guide for Physical Activity for Seniors can be found at http://www.phacaspc.gc.ca/pauuap/paguide/older/index.html

• Learn more about arthritis from the Arthritis Foundation and the National Institute of Arthritis and Musculoskeletal and Skin Diseases: http://www.arthritis.org and http://www.niams.nih.gov

• Learn more about Alzheimer’s disease from the Alzheimer’s Society of Canada: http://www.alzheimer.ca


http://www.alzheimer.ca/

http://www.niams.nih.gov/

http://www.arthritis.org/

http://www.phac-aspc.gc.ca/pau-uap/paguide/older/index.html

http://www.uwo.ca/actage

http://www.cagacg.ca/

http://www.seniors.gc.ca/


A N S W E R K E Y F O R A L L I N S T R U C T O R ’ S M A N U A L A C T I V I T I E S

Critical Thinking Questions2

These questions will also be posted to the book’s website so that students can complete them online and email their answers to you.

1. Answer: This question is individualized for students and allows them to focus, for a moment, on how they are taking care of themselves and where they need to improve. It is important to point out to students that they serve as role models to their patients, and therefore they must find a way to carry out the same habits that they are asking their patients to pursue. As busy students, some probably with families and jobs, they may find this a difficult task. Having the class share their diverse backgrounds will prepare the students for their internships and work with patients.

For now, students are being asked to personalize the role of genetics and health behaviours in overall health status and longevity. Some students may be young and have a difficult time grasping the thought that they will become old. However, it is a good time for them to acquaint themselves with both their chronologic and physical age and the differences, given the stresses of school. The experiences of older students can provide teaching points for other students on how things can change quickly, even when one is a health professions student.

Use this assignment to allow all students to learn from the different age groups and how different lifestyles can drastically change one’s physiologic age versus chronologic age. If your students are mostly the same age, experiment with some students doing their own investigation, while others do a family member’s life expectancy investigation. In this manner, students are able to see the impact of diet, exercise, genetics, and overall lifestyle on life expectancy.

2. Answer: Many older adults are far from the norm in that they are living longer, exercising, eating a healthy diet, and following up with their doctor on a regular basis. These individuals are the reason that the longevity of older adults has increased. When I was teaching at a medical school, one of the gerontology physicians indicated that if he did not know all the information about diet and dietary supplements, he would look “stupid” to his patients, as they knew everything about diet and supplementation. Healthcare professionals must keep up to date on all supplements and diet trends as the older adults are often prone to changing their diet and being involved in the latest health and diet trends. While there are many positive aspects of this trend there are also issues, depending on the patient.

Active older adults optimize their health status but can also injure themselves easily because of their genetic health. Many older adults become involved in all sorts of activities, which is great, but depending on their health status and genetics, some can become prone to hip fractures and many other types of bone fractures, which can take

2 Contributed by Kathleen Rourke.



a long time to heal.

While active individual may be happy, they may be over their BMI and ideal % body fat for height and weight. This situation requires weight loss, which is not easy in the older years. Working with an RD who is skilled in geriatric nutrition is the best course, as there are many nutrients that need to be watched, such as calcium, vitamin D, and vitamin B12. Zinc and all nutrients required for immunity are also important to the older adult.

While these adults are generally healthy, many adults suffer from problems such as poor dentition, bone disease, compromised immune function, compromised GI function, and sensory losses as well as economic and social changes.

Older individuals who enjoy good nutrition and exercise may still suffer from depression from losing many friends. People who are in great health live much longer than their friends, relatives, etc., and often find themselves alone at the end of their lives. A health professional who is acutely aware of this and can continue to provide support to the patient, friends from classes that the patient has participated in, and, of course, a nutrientrich diet with exercise and stress management are most important to help this individual to continue on and feel part of the community.

Activity is clearly important as is consumption of favourite foods in slimtomoderate amounts, depending on the foods. Many active adults eat a healthy diet that is based on recommendations and supports activity and health status. Despite the fact that many active adults eat a balanced diet, it is still recommended that a multivitamin supplement be consumed for those changes in diet plans and dietary allowances.

3. Answer: Individuals who consume a diet rich in nutrients and maintain an active lifestyle often find themselves without their friends at the end of their lives. Unfortunately, one consequence of health is loss of less healthy friends as one ages; however one benefits from being with family, children, and grandchildren. Depression is a major problem for older adults who lose many of their friends and family and are faced with being alone because they choose to live a healthy lifestyle. At this point, they face the question of whether it was worth it or not, as they are all alone. This is clearly a difficult time that requires the other family members to support the elderly member and his or her quest to move forward. Family must assure the individual that he or she is needed and wanted and that there is a place for the individual in the family.

Losses of friends and family are very hard for the older adult and can often result in a significant depression. Family members must be watchful of depression, loneliness, and the like with older adults in this situation. It is not unthinkable for the older adult to commit suicide under these circumstances.

Older adults who are healthy and active can meet with others who are equally active and healthy in many formats, including senior citizens groups, etc. Seniors should be encouraged to become involved in group activities they are interested in. There are many options for walking, crafts, and the like that allow seniors to be engaged, remain active, and continue to meet likeaged members of the opposite sex. As long



as adults are involved in the activities that they love and they continue to eat healthy and remain active, their health status is believed to benefit from their activities!

4. Answer: The major chronic diseases faced not only by the elderly but many younger Canadians due to the increasing prevalence of obesity are cardiovascular disease and type 2 diabetes and its comorbidities of renal disease, skin breakdown, and visual problems. Other chronic diseases of the elderly include arthritis and dementia (several varieties including Alzheimer’s). Each of these chronic problems has its own sets of dietary and medical issues that must be solved. As patients advance in age, so too do the number of chronic issues and the medications the patients take, which also affects their risk for drug–nutrient interactions and senses of taste and smell.

With cardiovascular disease and diabetes, patients are often put on dietary restrictions and placed on medications. Depending on the patient, compliance can be an issue with both diet and medication. Of course, better compliance does equate to better outcome, but such equations are seldom that simple when working with people that face economic issues and loneliness and are creatures of habit. Therefore, the RD working with an older population must be patient as well as understand the complexity of their medical care and their social, economic, cultural, and religious beliefs.

When any chronic disease progresses, it can be difficult on both the patient and the family. Individuals blame themselves and find it difficult to move beyond the blame game. In cases of renal disease, major bedsores, visual issues, or Alzheimer’s, many changes in lifestyle must take place, requiring an integrated healthcare system and seamless communication. The RD and other healthcare professionals do best by their patients to communicate clearly with the patient and the family, and work to provide seamless communication, to the best of their ability. Patients and their families are scared, frustrated, and trying to understand what to do with “mom or dad” in a short period of time. Adding dialysis or other major medical care to their parent’s schedule is a new “ballgame,” and working out the schedule is difficult—not to mention that mom and dad think they can just go back home and do what they have always done.

In this regard, the elderly lose many of their freedoms, routines, and independence over time, which becomes very difficult for most. Individuals who were once the providers for their children are now having their children provide for them, if they are lucky.

Imagine if you were independent for 80 years and all of the sudden you had problems seeing or remembering or your skin was breaking down to the point that you were infected all the time? This is a major change in life for the individuals who have provided so much to our country, etc. When working with elderly patients, it is important to respect their contributions and understand their losses in the aging processes while keeping an eye on their complex medical, physiological, and nutritional needs as well as those of the family caring for them. If there is no family available, the RD must be very cognizant of all provincial and federal programs of assistance for the patient to optimize the care process. The social worker can help in this process.



As noted in Chapter 18, changes in the body that are associated with aging can result in nutritional compromise. For instance, the thirst sensation is less acute, and constipation becomes more frequent (especially when patients are less active and do not eat a highfibre diet, and depending on medications). Some physiological changes in the body can result in vitamin or mineral deficiencies, and elderly who stay inside exclusively can develop vitamin D deficiency. Changes in the body resulting from aging and perhaps from a chronic disease or chronic medical problem can present longterm nutritional problems for patients. The RD must pay particular attention in assessing all systems of the patient prior to making nutritional recommendations. It is also important to know the medications that the patient is taking to prevent drug–nutrient interactions.

As noted throughout your textbook, it is very important to optimize hydration status. Therefore, the RD must always check the patient’s hydration status, as many elderly patients lose their thirst sensation. Checking the patient’s medical exams, medications, and blood work will also guide the RD as to any changes that need to be made with diet.

Ask the patient about their past weeks with the present diet and any problems. Also ask the family members to correlate the information. Never assume anything, as changes can happen quickly in the elderly population. Therefore, a thorough and complete assessment is required for each patient and their family to be most effective.

The elderly patient suffers many losses. Not only do they lose friends but they lose their independence, and they may lose their ability to walk, feel, and remember people. Consider one of your family members or a friend. Aging is not for the weak! Those that have taken the best care of themselves may live longer but are often left alone with no one their age to talk to and many aliments to deal with as well as isolation, etc.

As a result of this as well as medications, health problems, etc. many elderly lose interest in eating and may prepare themselves toast for dinner and nothing else. Meals that were once fun now mean loneliness and remembering the losses. Preparation can be difficult. Therefore, it is very important to assist with prepared meals and join the patient for the meal or have someone join them.

We learn from childhood that meals are social and that does not turn off in the elderly. The RD must work with the family, social worker, or any contacts to make meals fun and interactive and to work with the culture and ethnicity of the patient, as much as possible, to encourage him or her to eat. Aging is not easy, but because food is universal, when the elderly feel connected with food and culture they can feel connected with the rest of the world!

5. Answer: While older Canadians face many challenges, all Canadians face incredible challenges. Many older adults are living with their younger children and facing the challenges of trying to survive and provide for their children, given this poor economy.

This can be difficult for older Canadians who have already lived their lives and are ready to move on into the twilight. Many older adults face the challenges of chronic



illness, such as diabetes, cardiovascular disease, lung or renal disease, or autoimmune disease. Some move in with their children, which can create an impossible situation. Others must move in with other relatives or to assisted living/nursing facilities, and the circumstances are not always optimal. Older adults may have to adjust to a situation that seems unworkable or disrespectful of their wishes.

The older adult will be more successful in their aging process with a family that supports her or him. Obviously, aging is part of growing older. So too, is learning new things. Body composition, genetics, and other nutritional and exercise components all influence lifelong health status.

It is important to help older adults to “feel young” appropriately in any way. Allowing older adults to understand that they are still vital to the family and are valued and helping them maintain an exercise and health regime are all part of the picture that the older people want to see themselves within.

6. Answer: This is a great opportunity for students to observe drug–nutrient interactions, plus observe all the complex interactions that are required to be assessed and counselled in the elderly patient. Students often love this assignment as they can connect with family in a helping manner and it allows them to understand their studies in reallife terms.

Help students to understand elderly patients has complex needs, yet should not be feared but cared for and enjoyed as they have much to offer. Given that they are complex patients, they can be more challenging and much more rewarding!!

Worksheet Answer KeyWorksheet 181: Chapter 18 Crossword Puzzle1. osteoarthritis 2. rheumatoid 3. arthritis

4. Alzheimer’s 5. Meals On Wheels 6. life span

7. quality of life 8. cataracts 9. senile dementia

10. pressure ulcers

Worksheet 182: Eating for Healthy Aging Review (Internet Exercise)

1. True2. False

3. True4. False

5. True6. False



W O R K S H E E T A C T I V I T I E S

Worksheet 181: Chapter 18 Crossword Puzzle

Across Down

2. Arthritic disease of the immune system involving painful inflammation of the joints and related structures

7. A person’s perceived physical and mental wellbeing

8. Thickenings of the eye lenses that impair vision and can lead to blindness

9. The loss of brain function beyond the normal loss of physical adeptness and memory that occurs with aging

10. Damage to the skin and underlying tissues as a result of compression and poor circulation

1. A painful, chronic disease of the joints that occurs when the cushioning cartilage in a joint breaks down

3. Inflammation of a joint usually accompanied by pain, swelling, and structural changes

4. A degenerative disease of the brain involving memory loss and major structural changes in neuron networks

5. A nutrition program that delivers food for the elderly to their homes

6. The maximum number of years of life attainable by a member of a species


1 2 3

4

5

6

7

8

9

10


Worksheet 182: Eating for Healthy Aging Review(Internet Exercise)

Go to this website to answer questions 1–6: http://nihseniorhealth.gov/eatingwellasyougetolder/toc.html. Click on Benefits of Eating Well and proceed through all of the information provided. Click on the topics on the left menu to proceed through the content. Take the quizzes as you go through the content areas to make sure that you understand the presented information. Do not close the window until you have answered all of the questions.

1. Eating well can reduce the risk of developing type 2 diabetes.a. Trueb. False

2. The number of calories you need each day only depends on your age.a. Trueb. False

3. Including nutrientdense foods in your diet can provide you with needed nutrients while limiting caloric intake.a. Trueb. False

4. Refined grain food sources are equivalent in nutritional content to wholegrain food sources.a. Trueb. False

5. Walnuts are an example of a food that contains polyunsaturated fat.a. Trueb. False

6. Women over age 50 should consume 2000 calories (kcal) per day if they are moderately active in terms of physical activity.a. Trueb. False


http://nihseniorhealth.gov/eatingwellasyougetolder/toc.html


Handout 181: MealsOnWheels—Ensuring Adequate Nutrition for the Elderly

Do you know of an elderly neighbour who does not get out of the house much?

• Do they have enough food to eat?• Can they prepare their own food?• Do they have the money to afford good quality food?

MealsOnWheels is a nationwide organization of volunteers who work to bring highquality, nutritional meals to their neighbours in need. There are millions of elderly and disabled people who receive nutritious meals from neighbors who work together to prepare and deliver meals to homes.

How can you learn more about the MealsOnWheels Program?

Website: http://www.mowaa.org

The March for Meals program is a campaign that hopes to expand the reach of the MealsOnWheels Program by:

• Recruiting more volunteers• Raising money for service to more seniors in need• Raising awareness of the problem of malnourishment in the elderly and disabled

Any community group such as church groups or community groups can contact the MealsOnWheels program to find out how to set up a program in their area. The MealsOnWheels organization can advise a community group on how to identify people in need, how to raise money, and how to recruit volunteers to develop a MealsOnWheels program in their community!

Although there are no Canadian national programs focused on nutrition, many provinces and municipalities offer mealsonwheels and congregate dining programs, as well as other activities and services to support the aging population. Information from Health Canada about healthy aging and nutrition can be found through the Public Health Agency of Canada website, http://www.phacaspc.gc.ca/hpps/index.html.

One example of a communitybased nutrition education program is Evergreen Action Nutrition, provided by the Guelph/Wellington Seniors Association at the Evergreen Seniors Centre. This program includes cooking workshops, men’s cooking groups, monthly displays with recipes and pamphlets, individual counselling by a registered dietitian, based on suggestions from community seniors. Check in your community for nutrition programs for seniors. Seniors who are involved with nutrition education programs enjoy talking about food and make excellent guest speakers for lectures.

The Physical Activity Guide to Healthy Active Living for Older Adults includes a tearsheet and a handbook. This resource is available from Canada’s Physical Activity Guide website: http://www.phacaspc.gc.ca/pauuap/paguide/older/index.html.

Contributed by Mary Ellen Clark.


http://www.phac-aspc.gc.ca/pau-uap/paguide/older/index.html

http://www.phac-aspc.gc.ca/hp-ps/index.html

http://www.mowaa.org/

Chapter 18 Life Cycle Nutrition: Adulthood and the...

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