Clinical Nutrition

1. Geriatric Nutrition
-Mangesh G Jadhav
-Roll no. 08 Msc-2 Biochem.
-Fergusson college ,pune
-Clinical Nutrition & Food
Technology

2.  Geriatric Nutrition deals with nutritional
requirements of old people.
 Why is the need specialized nutrition for
geriatrics?
◦ Process of ageing brings physiological
change.
◦ It influences appreciably the nutritional
requirements.

4. Physiological changes:
 Reduced cellular metabolism:
◦ Decrease in the metabolism.
 Nervous system:
◦ Decrease in reaction time;
◦ Decrease in memory power & rate of learning;
◦ Changes in behaviour;
◦ Dimness in vision.
 Skeletal system and teeth:
◦ Osteoporosis.
◦ Increased calcium requirement.
◦ Loss of teeth due to decay of teeth and gum.

5.  Gastrointestinal track:
◦ Decreased secretion of saliva.
◦ Decreased ability to digest starch.
◦ Gastric acidity decreases.
◦ Peptic, tryptic, amylolytic and lipolytic
enzyme activities are decreased.
◦ Change in intestinal mucosa.
 Cardiovascular system:
◦ Increase in incidence of atherosclerosis.
◦ Change of heart muscle and coronary
arteries.

6.  Renal system:
◦ Decreased functioning of the kidney.
 Endocrine system:
◦ Marked changes in endocrine glands take
place.
◦ Activities of several endocrine glands such
as thyroid, adrenal cortex and Islets of
Langerhans are diminished.
 Integumental system:
◦ Change in the appearance of the skin, hair
and nails.
◦ Decreased elasticity of the skin.

7. Nutritional requirements

8. Male Female
Age (years) (65-75) (55-75)
Body wt. (kg) 55 45
Calories (Kcal) 2100 1700
Protein (g) 55 45
Calcium (g) 0.5 0.5
Iron (mg) 20 30
Vitamin A (µg) 750 750
Thiamine (mg) 1.2 1.0
Riboflavin (mg) 1.3 1.0
Nicotinic acid (mg) 16.0 13.0
Ascorbic acid (mg) 50 50
Vitamin D (I.U) 200 200
Folic acid (µg) 100 100
Vitamin B12 (µg) 1.0 1.0
I.C.M.R.- Calorie requirements assumed to be 10% less than that of sedentary
workers.

9.  Calories:
◦ Reduced by about 25%.
◦ Calorie intake to be adjusted to maintain the
body weight constant.
 Proteins:
◦ Protein deficiency is observed.
◦ Diet should include protein rich foods such as
eggs, milk fish, meat, pulses and nuts.
◦ Daily protein intake should be 1.5 g/kg body
weight.

10.  Fat:
◦ Diet should contain about 50-70g fat.
◦ Half this quantity should be in the form of
vegetable oils rich in essential fatty acids.
 Minerals:
◦ Intake of Calcium and Iron is reduced.
◦ Daily intake of calcium= 0.8-1.0g and iron=
30-40mg.

11.  Vitamins:
◦ Deficiency signs and symptoms of several
vitamins are frequently seen.
◦ Thus prescribed to take daily one multivitamin
tablet.
 Water:
◦ To ensure urine excretion volume should not
be less than 1.5 litres/day.
 Roughage:
◦ Should contain tender vegetables and fruits
(constipation prevention).
◦ Avoid excessive consumption of mature
vegetables and whole cereals and pulses
(may cause intestinal mucosa irritation and
cause digestive upsets).

12. Balanced diet for old people:

13. Food stuff Veg (male) N.veg(male) Veg (female) N.veg(female)
Cereals 320 320 320 320
Pulses 70 50 70 50
Green leafy
vegetables
100 100 125 125
Other
vegetables
75 75 75 75
Roots and
tubers
75 75 75 75
Fruits 150 150 150 150
Fats and oils 30 30 30 30
Cheese 50 - 50 -
Milk 800 600 800 600
Eggs - 40 - 40
Sugar and
jaggery
30 30 30 30
Table 1: Balanced diets (g) at high cost for above 60 years (sedentary
work)

14. Foodstuff
Veg
(male)
N. Veg
(male)
Veg
(female)
N.Veg
(female)
Cereals 320 320 220 220
Pulses 70 55 60 45
Green leafy
vegetables
100 100 123 125
Other vegetables 75 75 75 75
Roots and tubers 75 75 50 50
Fruits 75 75 75 75
Milk 600 400 600 400
Fats and oils 30 30 30 30
Meat and fish - 60 - 60
Eggs - 30 - 30
Sugar & jaggery 30 30 30 30
m.vit.-min tablet 1 1 1 1
Table 2: Balanced diets (g) at moderate cost for above 60 years (sedentary work)

15. Foodstuff Veg (male)
N.Veg
(female)
Veg (male)
N.Veg
(female)
Cereals 350 350 250 250
Pulses green
leafy vegetables
70 55 70 55
Other
vegetables
100 100 125 125
Roots and
tubers
75 75 75 75
Fruits 30 20 30 20
Milk 300 200 300 200
Fats and oils 35 40 30 35
Meat and eggs - 30 - 30
Sugar and
jaggery
30 30 30 30
m.vit-min tablet 1 1 1 1
Table 3: Balanced diets (g) at low cost for above 60 years (sedentary
work)

16.  Balanced diets at high cost: these diet
contains liberal amounts of milk &/or other
foods of animal origin.
 Balanced diets at moderate cost: these
diets include only moderate quantities of milk
and other animal foods.
 Balanced diets at low cost: these diets
contain only small quantities of milk and
other animal foods. One multivitamin-mineral
tablet is included to provide the essential
vitamins and minerals.