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Promoting Adequate Nutrition

among African-American
Older Adults
Angeline Motari
RN BSN FNP Student
Coppin State University
NURS 513: Clinical Project

Objectives
At the end of the presentation, participants
should be able to:
Describe the benefits of adequate nutrition for older
adults
State their role in promoting adequate nutrition
among older adults
State some tools that are useful for assessing
nutrition
Describe available resources for promoting
adequate nutrition

Introduction
Adequate nutrition
Sufficient amount of nutrients from all food
groups to sustain life and health (US National
Library of Medicine, 2013)

Benefits of adequate nutrition based on CDC


2013:
Lower risk of overweight and obesity
Lower risk of chronic diseases and cancers
Lower risk of micronutrient deficiencies

Significance
Obesity among older adults nationally
AA 45%
Hispanics 36.8%
Caucasians 30% (Seeman, Merkin, Crimmins, &
Karlamangala, 2010)

Maryland ranks eighth nationally in terms of


food insecurity
1 in 5 low-income older adults struggle with
hunger in Maryland (Wilson, 2014)

Significance
AA older adults in Baltimore city are at a
greater risk of poor nutrition due to:
Low-income
Availability and convenience (Lucan, Barg, &
Long, 2010)

Consumption of five or more fruits and


vegetables in Baltimore city
AAs 23% ; Caucasians 31%

Purpose
Create awareness of the existing nutrition
problem in older adults
Empower healthcare workers with knowledge
about adequate nutrition for older adults
Influence the dietary habits of older adults
through healthcare workers

Conceptual Framework
Health Promotion Model (HPM) by Nora J. Pender
The model emphasizes better health habits that
promote health and wellness
Knowledge is vital in health promotion
Studies among older adults, working adults,
cardiac rehabilitation patients, and cancer
patients
ascertain the ability of the model to promote
health (Alligood & Tomey, 2010).

Review of Literature
Adult nutritional status in the US
The rate of obesity is on the rise in the US at 35.3%
in 2012 (Healthy People 2020, 2014).
Many American adults consume foods that have
poor nutrition quality (USDA, 2013)
Only 1 in 10 Americans consume the recommended
amount of fruits and vegetables (CDC, 2013).
Nutrition information labels are underutilized
(Stastnya, Evensonb, Mozumdarc, 2011).

Review of Literature contd


Adequate nutrition among low-income
Americans
Cost, availability, and accessibility affect healthy
dietary choices (Haynes-Maslow, Wheeler, Leone,
2013)
Low-income communities have fewer fresh
produce stores (Jaskiewicz et al., 2013).
A higher number of fast-food restaurants promote
fast-food consumption (Lucan et al., 2010).

Review of literature contd


Adequate nutrition among low-income AAs in
the urban setting
Culture is an important aspect in food
consumption (Lee-Kwan et al., 2013)
Low-income affects fresh produce purchase
(Young et al., 2013)
Nutrition labels at the point of purchase have
no effect on purchase among low-income
populations (Noormohamed et al., 2012)

Review of literature contd


Adequate nutrition among low-income AA
older adults in the urban setting
An integrated approach in nutrition education
for older adults
Eat Smart Live Strong a project by the United
States Department of Agriculture (USDA, 2013)

Culturally-sensitive and age sensitive programs


for older adults (NBNA, 2012)

Role of Healthcare worker


Assess the nutrition status of the older adult
Intervene based on assessment findings
Nutrition consult
Provide individualized nutrition education
Evaluate and reinforce appropriately

Advocate for the older adults


Refer to social work
Financial assistance and community resources

Nutrition assessment
Tools for assessing nutrition adequacy
Mini Nutritional Assessment MNA by the Nestle
Nutrition Institute
Algorithm for intervention based on MNA score

Nutrition Checklist by the Nutrition Screening


Initiative
Based on the word DETERMINE which reminds
the clinician of warning signs

Resources
My Plate food icon introduced by the USDA in
2011
A great visual to encourage adequate nutrition

My Plate for older adults


http://www.nutrition.tufts.edu/documents/MyPlatefo
rOlderAdults.pdf

Online recipes and menu ideas by the USDA


Age appropriate and culturally sensitive

Nutrition supplement programs

MyPlate

Conclusion
Benefits of adequate nutrition among older
adults
Role of the healthcare provider
Tools for assessing nutrition status
Resources for promoting adequate nutrition
for older adults

Post-presentation Quiz

References

Alligood,M.R., & Marriner-Tomey,A. (2010). Health Promotion Model. InNursing theorists and
their work, seventh edition(7thed., pp.434-445). Maryland Heights, MO: Mosby-Elsevier.
Center for Disease Control and Prevention (2013, September 12). Nutrition for Everyone: Fruits
and Vegetables | DNPAO | CDC. Retrieved October 23, 2013, from
http://www.cdc.gov/nutrition/everyone/fruitsvegetables/index.html
Haynes-Maslow, L., Parsons, S. E., Wheeler, S. B., & Leone, L. A. (2013, March 14). A qualitative
study of perceived barriers to fruit and vegetable consumption among low-income populations,
North Carolina, 2011. Prevent Chronic Disease, 10. doi: 10.5888/pcd10.120206
Healthy People 2020 (2014). Healthy People 2020 leading health indicators: Nutrition, physical
activity, and obesity. Retrieved October 10, 2014, from
http://www.healthypeople.gov/sites/default/files/HP2020_LHI_Nut_PhysActiv.pdf
Jaskiewicz, L., Dombrowski, R. D., Drummond, H. M., Barnett, G. M., Mason, M., & Welter, C.
(2013, October 3). Preventing chronic disease: Partnering with community institutions to
increase access to healthful foods across municipalities. Retrieved from
http://www.cdc.gov/pcd/issues/2013/13_0011.htm
Lee-Kwan,S.H., Goedkoop,S., Yong,R., Batorsky,B., Hoffman,V., Jeffries,J., . . . Gittelsohn,J.
(2013). Development and implementation of the Baltimore healthy carry-outs feasibility trial:
Process evaluation results.Public Health,13(638). doi:10.1186/1471-2458-13-638

References

Lucan, S. C., Barg, F. K., & Long, J. A. (2010). Promoters and barriers to fruit, vegetable, and fast-food
consumption among urban, low-income African Americans--A qualitative approach. American Journal of
Public Health, 100(4), 631-635.
National Black Nurses Association Inc. (2012, July 26).Malnutrition resolution. Retrieved from
http://www.nbna.org/pdf/position_paper/Malnutrition_Resolution.pdf
Noormohamed,A., Lee,S.H., Batorsky,B., Jackson,A., Newman,S., & Gittelsohn,J. (2012). Factors
influencing ordering practices at Baltimore City carry-outs: Qualitative research to inform an obesity
prevention intervention.Ecology of Food and Nutrition,51, 481-491. doi:
10.1080/03670244.2012.705732
Stastnya,S.N., Evensonb,A., & Mozumdarc,A. (2011). Effect of nutrition facts panel and ingredient
declaration on customer satisfaction and nutrition perceptions in a table-service restaurant at midday
meal.Journal of Foodservice Business Research, 14(4), 310-333. doi:10.1080/15378020.2011.624051
United States Department of Agriculture Food Nutrition Service (2013). Eat smart live strong: nutrition
education for older adults. Retrieved from http://snap.nal.usda.gov/snap/ESLS/ProjectOverview.pdf
Young,C.R., Aquilante,J.L., Solomon,S., Colby,L., Kawinzi,M.A., Uy,N., & Mallya,G. (2013). Improving
fruit and vegetable consumption among low-income customers at farmers markets: Philly Food Bucks,
Philadelphia, Pennsylvania, 2011. Preventing Chronic Disease, 10(166). doi: 10.5888/pcd10.120356