# Nursing Insight: Addressing healthy eating and promoting healthy elderly - Savonia AMK

> Both the quality and quantity of consumed food have an impact on the well-being and quality of life of elderly. Daily dietary intake significantly affects their…

## Introduction
The global population has been experiencing gradual growth, especially the number of people aged 60 and above. In 2022, the old population stands at 5.5 million and is expected to be 1.0 to 1.5 billion individuals aged 65 and older by 2031, with the majority of women in Finland (Statistics Finland 2022). Therefore, it is important to consume a healthy diet to promote wellbeing and healthy aging. 

This article aims to explain why it is important for nurses to understand healthy eating for the elderly and how they can apply this knowledge in caregiving.

## Promoting Healthy Eating Among the Elderly
A healthy diet supplies the necessary macronutrients (carbohydrates, proteins, and fats) and micronutrients (vitamins and minerals) to support physical activity and meet physiological needs. Macronutrients provide energy, support growth, and enhance the immune system. Vitamins and minerals are essential for body development, metabolism, and tissue function.

Aging causes changes in the digestive system, which often lead to digestive disorders such as dysphagia, irritable bowel syndrome (IBS), and constipation (WHO 2023).

### The Plate Model
The Finnish Nutrition Council (2014) suggests a plate model for the elderly divided into thirds:
*   **One-third:** Cooked or fresh vegetables.
*   **One-third:** High-protein sources.
*   **One-third:** Carbohydrate-rich foods.

Fat-free dairy products, cheese, yogurt, and fruit desserts are suitable snacks. A thin layer of soft vegetable spread on bread is recommended. Vegetable oil and margarine provide essential vitamins A, D, and E, as well as high calories.

### Nordic Nutritional Recommendations (NNR 2023)
The sixth edition of the NNR advises:
*   A shift towards a plant-based diet.
*   Higher fish consumption (at least twice weekly) and reduced meat intake.
*   Protein consumption of 1.2–1.5g/kg of body weight.
*   Fish provides vitamins A, B, D, and long-chain omega-3 fatty acids, which support healthy aging and prevent cardiovascular diseases.
*   Water intake: 2.0L/day for females and 2.5L/day for males.

## The Impact of Nutrition on Well-being
Nutrition plays a vital role in the well-being and quality of life of the elderly. Daily dietary intake affects physical and cognitive health, bone strength, and immune system resilience. A balanced diet can prevent gastrointestinal disorders, non-communicable diseases (e.g., diabetes mellitus, cardiovascular diseases), and malnutrition. It also supports mental health, helping to prevent depression and anxiety, and may reduce the risk of cognitive decline such as dementia and Alzheimer’s disease (Granic et al. 2020).

## The Role of Nurses in Nutritional Care
Nurses are the primary healthcare providers responsible for assessing the health of the elderly. They use standardized nutritional screening tools to identify individuals at risk of malnutrition or dietary concerns.

### Nutritional Screening Tools
*   Mini Nutrition Assessment (MNA)
*   Malnutrition Screening Tool (MST)
*   Malnutrition Universal Screening Tool (MUST)

### Steps of Nutritional Assessments
1.  **Height, Weight, and Body Mass Index (BMI):** Used to monitor nutritional status and identify significant weight changes.
2.  **Dietary History:** Gathering information on meal patterns, restrictions, allergies, and substance use (smoking/alcohol).
3.  **Clinical Evaluation:** Examining physical signs of malnutrition, muscle wasting, fat loss, dehydration, or edema, and reviewing medical history.
4.  **Functional Assessment:** Evaluating the individual’s ability to perform activities of daily living, such as shopping, cooking, and feeding themselves.

## Professional Requirements for Nurses
To effectively implement nutritional care, nurses require evidence-based knowledge and training:
*   **Nutrition Education:** Understanding how aging affects nutrient absorption and metabolism.
*   **Special Diets:** Knowledge of low-sodium, diabetic, or dysphagia diets and food safety protocols.
*   **Communication and Collaboration:** Working with dietitians, physicians, and specialists to ensure comprehensive nutritional care.

## Conclusion
Old age is a vulnerable stage of life, but nurses play a critical role in facilitating healthy dietary lifestyles to prevent disease and promote healthy aging.

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**Author:**
Saima Kamal Thakur, Registered Nurse, Bachelor of Health Care, Savonia University of Applied Sciences, Kuopio, Finland