College of Science, Technology & Applied Arts of Trinidad & Tobago DEPARTMENT OF NATURAL & LIFE SCIENCES

GROUP ASSIGNMENT COVER PAGE

ASSIGNMENT TITLE: Nutrient Requirements for Adults

COURSE CODE: NURS 165

COURSE TITLE: Introduction to Nutrition

CRN:

26420 STUDENT I.D. 00026742

SEMESTER: 2012-2013 PROGRAMME Bsc. General Nursing Bsc. General Nursing Bsc. General Nursing Bsc. General Nursing Bsc. General Nursing

STUDENT NAME 1. 2. 3. 4. 5. Aaron Wallace Aneesha Ali Ghany Annette Basdeo Annisa Lalchan Celeste Mohammed

DATE OF SUBMISSION: Tuesday 05th Novenber, 2013

LECTURERS NAME: Mrs. Ruhee Mir Mohammed

TABLE OF CONTENTS INTRODUCTION Page PHYSIOLOGICAL CHANGES. Pages ECONOMICAL CHANGES Page

FACTORS AFFECTING DIET COMPOSITION Page MENU PLANNING PRINCIPLES Pages SOCIAL FACTORS Page

CONCLUSION..Page INDEX---------------------------------------------------------------------- Page REFERENCES

INTRODUCTION

PHYSIOLOGICAL CHANGES IN 60 +

Human being growth and decline extent over the entire life span. Everyone ages in different ways depending on individual make up and resources. During the middle and older adulthood, however a gradual loss of functioning cells occurs with reduced cell metabolism. As a result body organs system gradually loss some capacity to their jobs and maintain reserves. The rate of this decline accelerates in later life. Hormonal changes during the age process have many repercussions in general health. The common decline in insulin production or insulin sensitivity often results in elevated blood glucose levels and diabetes. Decrease in melatonin, the hormone responsible for regulating body rhythms, may interfere in the normal sleep cycle. Part of the normal changes in body composition is attributed to the decrease in growth and sex hormone. BODY COMPOSITION CHANGES Aging is marked by an approximate 2%to 3% loss of lean body mass per decade. There is a loss of skeletal muscle which contributes to decrease muscle strength, changes in gait and balance, loss of physical strength and function and increase risk for chronic diseases. SENSORY LOSS The senses of taste, smell, sight, hearing and touch often diminish at individual rates in the older adults. Less acute senses of taste and smell are common and may results from various factors including degenerative aging process such as decrease number in papilla on the tongue and olfactory nerve ending, uses of dentures, certain disease, medication, medical or surgical interventions and environmental exposures. A reduction in taste and smell acuity cause a reduced appetite. ORAL HEALTH STATUS Oral health can be affected by factors such as inadequate dental care, which can result in dental and periodontal problems which can cause difficulty with chewing and swallowing, which can

result in the avoidance of certain foods. A reduction in the number of taste buds can alter perception of certain foods. GASTROINTESTINAL FUNCTION There are numerous changes that can affect nutrients intakes, digestion, absorption and metabolism which occur in the gastrointestinal system during the aging process. The weakening of the gag reflex may cause swallowing difficulties; it can affect a persons ability to safely consume foods. Gastric atrophy cause alterations in gastric acidity which delays gastric emptying, changes in bowel motility rate and can affect the intake and availability of nutrients. CARDIOVASCULAR FUNCTION During the aging process, blood vessels become less elastic and total peripheral resistance increases, leading to an increase risk for and prevalence of hypertension. Also there is a high risk for cardiovascular diseases. RENAL FUNCTION Renal function and glomerular filtration rate can diminish as much as 60%, which cause a reduced blood flow. These anatomic changes produce a general decrease in the ability of the kidneys to concentrate urine. NEUROLOGIC FUNCTION Neurologic function in the older adults may be compromised for various reasons including alterations in cerebral functioning, decreased synthesis of neurotransmitters and less efficient nerve conduction. IMMUNOCOMPETENCE Immune function decreases with age. Although humoral and cell mediated immunities are affected. The primary defect seems to be in the T cells component. These changes results in a diminished ability to fight infections, leading to an increase prevalence of infections in older adults.

NUTRIENTS REQUIRED FOR THE OLDER ADULTS Nutrients are substances found in foods and drinks that we utilize by the body for growth, reproduction and maintenance of healthy tissues and energy. Nutrients fall into two main categories; these categories include macronutrients and micronutrients. Firstly, macronutrientsare needed in relatively large amounts; Macronutrients consist of proteins, carbohydrates, fats and water. Secondly, micronutrients are mostly needed in minute amounts. Micronutrients consist of vitamins and minerals.

In addition, nutrients that the body can make itself are considered nonessential nutrients. This type of nutrients can also beobtained from food. In addition, essential nutrientis one that we cant make for ourselves in sufficient quantities to meet our needs, so it must be obtained from food. These nutrients include minerals, most vitamins, some amino acids (from which proteins are made) and some fatty acids. Because our body cant make these, we must regularly choose foods that supply them.

PROTEIN

Protein is the main constituent of all body cells. It provides the material necessary for growth and the repair and maintenance of the body. Protein should account for 10% to 20% of the calories consumed each day. The daily recommended intake of protein in older adults is 40grams/day for females and 55-70grams/day or 0.8grams/kg body weight for males per day. This is the same amount of protein that is required for the young adult. The required intake of protein is subject to change if the individual suffers from chronic diseases. However, protein is an essential nutrient which means that the body cannot make this type of nutrients so it must be obtain from foods.

Protein can be obtained from both plant and animal sources.Animal protein contains the essential amino acids in the correct amounts; plant proteins however, do not contain all the essential amino acids except for soy. Examples of foods rich in protein includes; cereals and breads, milk and dairy products, lean meat and eggs, fish, legumes and beans. However, it is important to eat a variety of these foods as the body needs a variety of proteins to do its job.Additionally, protein is important to aid in the reduction of muscle and lean tissue loss, maintaining immunity and increasing wound healing.

CARBOHYDRATES Carbohydrates are the main source of energy for the body. Carbohydrates are macronutrients which are needed in fairly large quantities. The daily recommended value is 130g/day for the older adult; carbohydrate is important to maintain glycemic homeostasis and for gastrointestinal integrity and function. Additionally, carbohydrates are needed by the body for circulatory, immune, endocrine and other bodily functions as well as cell growth and tissue repairs. Secondly, it is primary source of energy of the brain, nervous tissue, retina, kidney and red blood cells. Approximately 55% of the energy that is coming from the diet should consist of carbohydrates.Carbohydrates can occur as either simple (sugar) or complex (starch). Simple carbohydrates can be found in fruits, vegetables, and milk. Complex carbohydrates can be found in whole grain breads, cereals, sweet corn, potatoes, nuts, oats, pasta, rice, legumes and starchy vegetables. Complex carbohydrates are a good source of fiber.

FIBER Fiber can be obtained from complex carbohydrates. Fiber is important in an older adult diet because as the body ages, changes in the gastrointestinal tract occur, reducing the absorption of nutrients and slowing down intestinal motility. As a result, malabsorption, nutrient deficiency and constipation are relatively common health problems that affect elderly people of both genders. A high-fiber diet helps to stimulate intestinal motility and prevent constipation. There is also evidence dietary fiber helps to lower cholesterol levels and regulate blood glucose levels. Additionally, dietary fiber is common in plant foods such as fruits, vegetable and legumes. Although dietary fiber cannot be digested or absorbed, it still contributes to health in a variety of ways. Dietary fiber comes in two types: soluble and insoluble fiber. Soluble fiber dissolves in water and becomes gel-like, causing it to stick to bile, toxins and other debris and drag them from your body. Insoluble fiber attracts water like a sponge and acts to clean your intestines, increase intestinal motility and stimulate regular bowel movements. Constipation is more common in the elderly due to reduced intestinal peristalsis or rhythmic contractions. It has been stated that the total fiber intake for older adults should be at least 30 grams per day for men and 21 grams for women. Because insoluble fiber absorbs water, you need to drink plenty of water, too, or a high-fiber diet can lead to constipation and compound existing problems with bowel movements. Elderly people sometimes have difficulty regulating fluid levels because their thirst mechanism may be suppressed, so it is important for older adults to drink a lot of fluids. Purified water, fresh juice, herbal tea and other non-caffeinated liquids are best.Most whole grains, vegetables, fruits and legumes are sources of insoluble and soluble fiber. For example, multi-grain bread, wheat germ, brown rice, broccoli, spinach, celery,

carrots,apples, pears, most berries, chickpeas, lentils and virtually all beans are especially good sources of dietary fiber.

FATS Fats are a concentrated form of energy for our bodies which help maintain body temperature and protect against injury and insulate body tissues and organs.Fat should account for 20% to 30% of the daily intake, with no more than 10% of the total intake coming from saturated fats because saturated fat tends to increase blood cholesterol levels. Most saturated fats are solid at room temperature such as margarine butter. The surplus fat we eat is converted into stored body fat, so it is important not to eat too much fat. Additionally, there are polyunsaturated fat which tends to lower blood cholesterol levels and this is found in mostly plant sources such as sunflower, soybeans and corn. Then there is monounsaturated fat which tends to lower LDL cholesterol (the bad cholesterol). Finally, there isTrans fat which should be kept at a minimum. This helps to reduce the risk of developing

chronic diseases. In order to have minimal fat consumption in the older adult, meats should be trimmed and lean, dairy products should be low fat, and food should be boiled, steamed, baked, grilled or barbequed.

WATER Water is essential to life. Between 45% and 50% of an older adults weight consist of water. In order to stay hydrated and to prevent constipation, the daily recommended intake of water is 6-8 glasses per day. The older adults are more susceptibleof becoming dehydrated quickly because their body's ability to conserve water is reduced, their thirst sense becomes less acute and they less able to respond to changes in temperature. In addition, if they have any chronic illnesses such as uncontrolled or untreated diabetes this puts them at a high risk for dehydration, but other chronic illnesses also make them more likely to become dehydrated. These include kidney disease, alcoholism and adrenal gland disorders. Even having a cold or sore throat makes them more susceptible to dehydration because they are less likely to feel like eating or drinking when they are sick. A fever increases dehydration even more. They should aim at consuming the

required amount to avoid dehydration. The older adult should also drink coffee, juice, milk or other beverages in order to stay hydrated.

VITAMINS

Nutritional needs change throughout the various stages of life. While overall caloric needs tend to decrease with age, the requirements for individual micronutrients (vitamins and nutritionallyessential minerals) do not decrease. In fact, the needs for some micronutrients, such as calcium and vitamin D, actually increase with age; older adults require higher intakes of these two micronutrients. Older adults may also need more dietary antioxidants, such as vitamins C and E, as well as certain B vitamins, including vitamin B6, folate, and vitamin B12. Since physical activity levels generally decline with increasing age, older adults have lower energy requirements than younger adults.Therefore, it is particularly important for older adults to choose nutrient-rich foods and take a daily multivitamin-mineral supplement. Adequate intake of micronutrients not only ensures that current metabolic needs are met but also may reduce one's risk for chronic diseases, including heart disease, cancer, and osteoporosis, that are more common in older adults.

Additionally, older adults tend to suffer from vitamin deficiencies since they try to eat less to reduce the amount of calories being consumed. Also vitamin deficiencies can result from the inability of the body to absorb the vitamins due to reduction in the production of stomach acids secretion. The economic status of the older adult also contributes to the deficiency of vitamins because the cost of buying food and fruits rich in vitamins is very high.

VITAMIN A Vitamin A, also called beta-carotene, is a fat-soluble vitamin and it is essential for good vision, maintaining healthy skin, hair, and mucous membranes and for proper functioning of the immune system. Persons, who consume Vitamin A often, are less likely to develop cancer. Sources of Vitamin A are meat, eggs, fish, poultry dairy products, carrots and spinach. The daily recommended intake for the older adult is 900ug/ day for men and 700ug/day for women.

VITAMIN D

Vitamin D is a fat-soluble vitamin. Vitamin D is required for optimal calcium and magnesium absorption for normal development of healthy bones and teeth and for the maintenance of bone

density. Vitamin D is also important because it plays a role in immunity and blood cell formation and it also helps cells differentiate which lower the risk of developing cancer.Vitamin D plays an important role in maintaining muscle strength. Thus, inadequate vitamin D status results in loss of bone integrity and muscle weakness; both can potentially increase the likelihood of falls and bone fractures in older adults. A deficiency of Vitamin D can lead to osteoporosis. Vitamin D is obtained mainly from sunlight, but can also be obtained from supplements and oily fish, eggs, and breakfast cereals. The daily recommended intake is 10ug/day for the older adult.

VITAMIN E Vitamin E is a fat-soluble vitamin and it is similar to Vitamin C, in that it is a powerful antioxidant that protects the cell membrane, polyunsaturated fatty acids and vitamin A from being oxidized. Vitamin E helps to protect cells from the damage caused by free radicals. Free radicals are compounds formed when our bodies convert the food we eat into energy. People are also exposed to free radicals in the environment from cigarette smoke, air pollution, and ultraviolet light from the sun. In addition vitamin E helps to protect the white blood cells and helps to improve the absorption of vitamin A. The body also needs vitamin E to boost its immune system so that it can fight off invading bacteria and viruses. It helps to widen blood vessels and keep blood from clotting within them and is important for the formation of red blood cells. In addition, cells use vitamin E to interact with each other and to carry out many important functions.The recommended daily intake is 15 mg/day for the older adult. Vitamin E can be obtained from vegetable oils, nuts, sunflower seeds, green leafy vegetables and fortified cereals. A deficiency in Vitamin E could result in hemolytic anemia, and an impaired immune system.

VITAMIN K Vitamin K is a fat soluble vitamin and is important for the clotting of blood, bone metabolism and the regulation of blood calcium levels. The required daily intake for the older adult is 120ug/day for men and 90ug/day for women. Sources of vitamin k are spinach, turnip greens, collard greens, mustard greens, vegetable oils and Brussels sprouts. A deficiency in this vitamin can cause chronic diseases, and impaired blood clotting. VITAMIN C Vitamin C, also known as ascorbic acid is an essential water soluble vitamin. It is essential in fighting infections, enhances iron absorption and regenerates oxidized vitamin E. Vitamin C aids in the formation of liver bile which helps to detoxify alcohol and other substances. Evidence indicated that Vitamin C levels in the eye in older adult decrease and this can be a cause of cataracts. In addition, vitamin C has been reported to reduce activity of the enzyme, aldose and reductase, which helps protect people with diabetes and the recommended daily intake for the older adult is 90mg/day for men and 75mg/day for women. A deficiency in vitamin C can lead to bone pain and anemia. VITAMIN B Vitamin B is a group of water soluble vitamins that are important for cell metabolism. Vitamin B1, Thiamine, is important for the conversion of energy from carbohydrates, to boost the immune system. It also helps to break down fat and protein. This vitamin can be found in both plant and animal food sources, for example, pork, fortified cereals, enriched rice and pasta, peas, tuna, and legumes. Deficiencies in vitamin B1 can result in memory loss, confusion and muscle weakness in the older adults. The recommended daily intake for the older adult of Vitamin B1 is 1.2mg/day for men and 1.1mg/day for women.

Vitamin B2, Riboflavin, is essential for body growth, reproduction and red cell production. It also aids in the metabolism of fat and carbohydrates. Eating a well balanced meal will supply the required amount of vitamin B2, but older adults are at a risk of developing a deficiency if their diet is poor. Vitamin B2 can be obtained from beef, liver, soybean, yeast, almond, milk and dairy foods, fortified cereals, enriched breads and grains. A deficiency in this vitamin can result in the swelling of the mouth and throat, anemia and dementia. The required daily intake for the older adult is 1.3mg/day for men and 1.1mg/day for women. VitaminB3, Niacin, isessential for cell respiration and to help release energy from carbohydrates, fat and protein. It helps maintain healthy skin and supports the nervous and digestive systems. Unlike other B-group vitamins, niacin is very heat stable and little is lost in cooking. Niacin can be found in beets, yeast, beef liver, pork, turkey, chicken, fish, sunflower seeds, peanuts and all protein-containing foods. The required amount of niacin for older adults is 16mg/day for female and 14mg/day for males.

Vitamin B6, Pyridoxine, is not synthesized by the body, and therefore it is obtained from the diet.VitaminB6has several different functions in the body, participating as a cofactor for more than 100 enzymes. This vitamin is important in neurotransmitter synthesis, red blood cell formation and function, niacin formation from the amino acid tryptophan, steroid hormone function, and nucleic acid synthesis. It is also very rare for an individual to develop a deficiency for this vitamin. A deficiency would result in anemia, depression, confusion, and convulsions. Vitamin B6 can be obtained from chickpeas, yeast, liver, most cuts of meat/fish/poultry and fortified cereals. The required daily intake for the older adult is 1.7mg/day for men and 1.5mg/day for women.

Vitamin B9, Folate, is essential for the metabolism of amino acids, and the synthesis of DNA.Folate and folic acid are two terms often used interchangeably; the former refers to folates found naturally in foods, while the latter refers to the more bioavailable, synthetic form that is used in vitamin supplements and fortified foods. Dietary intake recommendations for folate are not higher in older adults compared to younger people. However, there is some concern that intake recommendations are not being met in some older adults, especially the elderly, presumably due to low intake of fruits and vegetables. Even marginal deficiencies can elevate blood homocysteine levels, possibly increasing risk for cardiovascular diseases, as well as Alzheimer's disease, anemia and other types of dementia.This vitamin can be obtained from foods such as Fortified cereals, enriched breads and grains, spinach, legumes, fruits and vegetables and liver. The daily recommended intake for the older adult is 400mg/day.

Vitamin B12, Cobalamin, aids with the formation of blood. It is also required for a healthy nervous system, and for the synthesis of homocysteine. The prevalence of vitamin B12 inadequacy increases with age, making older adults more susceptible to deficiency. If the deficiency is not corrected, anemia, memory loss, disorientation, dementia as well as neurological and gastrointestinal symptoms can result. Deficiency symptoms may take years to manifest because the vitamin can be stored in the body. Older adults are more vulnerable to vitamin B12 deficiency because they are more likely to be affected by atrophic gastritis, a chronic inflammation of the lining of the stomach, which ultimately results in stomach atrophy and decreased stomach acid production. Reductions in stomach acid impair the release of vitamin B12from proteins in food. Thus, food-bound vitamin B12malabsorption results in individuals with atrophic gastritis. It has been estimated that 10-30% of older adults are affected by this condition.

Vitamin B12 can be obtained from shellfish, dairy products, meat, fish and fortified cereals. The required daily intake for the older adult is 2.4ug/day.

TABLE SHOWING: DIETARY REFERENCE INTAKES(DRIs) OF VITAMINS AND ELEMENTS FOR THE OLDER ADULTS

SOCIAL FACTORS THAT INFLUENCE NUTRITION IN OLDER ADULTS

Nutrition is an important determinant of health in persons over the age of 65. However social issues influence an older person's risk of being malnourished. Depression/isolation is directly related to negatively affecting an older adults nutrition. Older adults who live alone can be vulnerable to social isolation, if many of their life-long friends have died, thus eating alone also can affect nutrition by leading to depression and a poor appetite. Then there are older adults, who suffer from or are developing health problems or sensory deficits. The prescribed treatment regime poses a problem for individuals in this age group. They have physical limitations and because eating is a social activity, some older persons who live alone are unable to prepare full, balanced meals, making under-nutrition a concern. Retirement is often the first major transition the older adult faces. The effect it has on the physical and mental status of the individual varies from person to person, because of the reason and attitude towards retiring. Some of the retirees have difficulty adjusting to certain aspects of retirement, for example, boredom from retirement, lack of routine social activities and reduction in income. However, some persons choose to retire, having looked forward to quitting unpleasant work; while others are forced to retire (e.g., because of health problems or job loss). Appropriate preparation for retirement and counseling for retirees and families who experience difficulties may help. Relocation may occur several times during old age. Although relocation is often indicated as a necessary therapeutic intervention, the stress of relocation on elderly persons can prove detrimental to their life satisfaction and longevity. If a move is involuntary for example, a move from a private home to an institution; the loss of environment control and likelihood can pose a threat to the person's well-being. However there are cases in which the outcome is good, for example, a voluntary move from one private home to another. Older adults who respond poorly to relocation are more likely to be living alone, socially isolated, poor, and depressed. Studies have shown that men are more affected than women. Older adults should become acquainted with the new setting well in advance. For the cognitively impaired, a move away from familiar surroundings may worsen functional dependence and disruptive behavior. Bereavement affects many aspects of an older person's life. For example, social interaction and companionship decrease, and social status may change. The death of a spouse affects men and women differently. In the 2 year after the death of a wife, the mortality rate in men tends to increase, especially if the wife's death was unexpected. For women who lose a husband, data are less clear but generally do not indicate an increased mortality rate. Loss is painful whether its a loss of independence, mobility, health, your long-time career, or someone you love. In the elderly, bereavement can present in many different ways such as: Increased physical pain Trouble sleeping

Increase in drinking and/or smoking Loss of interest in Reduced desire to life, in social activities tend to personal care

Feelings of guilt about things not directly related to the loss Hallucinations other than hearing and seeing the decedent

It is important to understand that bereaving is a necessary and healthy process to go through in order to heal and cope. The experience of bereavement is unavoidable. It can be very difficult to take control of responsibilities previously performed by the loved one. Feelings of loneliness and the emotional gap such a loss creates can be immensely painful. Family and friends can encourage acceptance by facilitating dialogue about the loss, by getting the older adult to open up and by the sharing of stories and happy memories. Abuse and neglect of the older adult also affects their nutrition. Abuse and neglect of the older adult by relatives is a common occurrence in the society. The abuse can be emotional, physical, sexual, and financial, all of which will have an impact on the type and amount of food the older adult consumes. Some relatives may use food as a means of abuse, by withholding food or providing unhealthy meals for the older adult.

SERVICES AVAILABLE IN TRINIDAD AND TOBAGO Senior citizens aged 65 years who are citizens or legally resident in Trinidad and Tobago and whose income does not exceed $3000.00 per month is applicable for the Senior Citizen Pension. Payment Schedule Income Band New Rate

0-500 >500-1450 >1450-1650 >1650-1800 >1800-2000 >2000-2200 >2200-2400 >2400-2600 >2600-2800 >2800-3000

3000 2550 2350 2200 2000 1800 1600 1400 1200 1000

National Poverty Reduction Programme and Social Welfare grants to persons 60 years and over provide for: Free eye glasses. Free hearing aids. Free transportation on buses. House repairs to the value of 30 000.00 Burial of a pensioner to the value of $3000.00

There are 8 Senior Activity Centers located in the areas of Port of Spain, Mayaro/Rio Claro, San Juan/Laventille, Chaguanas, Tunapuna/Piarco, Princes Town, Point-e-Pierre, and Point Fortin.

These centers target persons age 55 and over, and who are in good health and physically active. The activities offered are: Aerobics, Yoga, Tai Chi, Home Gardening, Field Trips, Art and Craft, Computer Literacy, Swimming, Dance, and Reading/Adult Literacy. Chronic Disease Assistance Programme (CDAP): Universal access to free health services at the nations health clinics and hospitals, free prescription drugs and other pharmaceutical items to combat the following health conditions: Diabetes Asthma Cardiac Diseases Arthritis Glaucoma Mental Depression High Blood Pressure

Benign Prostatic Hyperplasia (BPH) Epilepsy Hperchlolesterolemia Parkinsons Disease Thyroid Disease Cadiac Disease Arthritis Glaucoma Mental Depression Free Transportation: Older persons 60 years and over enjoy free bus rides, free Ferry trips to Tobago and free trips on Water taxis during non-peak hours. Reduced Annual Water and Electricity Rates By the Ministry of Public Utilities: The Ministry of Public Utilities established a Public Assistance Programme for Older Persons which granted those discounts on their annual water and electricity rates. Home Improvement Grant: The Home Improvement Grant Programme is provided by the Ministry of Housing and Environment and is geared towards providing assistance for needy citizens whose houses were substandard, dilapidated, or in need of repair. A maximum of US 3300.00 is available to eligible participants. The Division of Ageing

The Division of Ageing was established under the former Ministry of Social Development in August 2003, in accordance with the tenets of the Madrid International Plan of Action on Ageing (MIPAA). The Division serves as an umbrella agency to focus ageing initiatives, and acts as an advocate for older persons in Trinidad and Tobago. Functions of the Division of Ageing: Develop standards of care for older persons Monitor and coordinate the implementation of the National Policy on Ageing

Organize and coordinate training programmes, seminars and workshops for care providers of older persons Develop and implement programmes and projects for the benefit of the older persons Conduct research on matters pertaining to ageing and older persons Conduct public sensitization programmes nationwide on issues regarding ageing and older persons Network with social-sector Ministries, the private sector, and civil society in the interest of older persons Control, monitor and regulate Homes for Older Persons Types I & II

WORLD ELDER ABUSE AWARENESS DAY 15TH JUNE INTERNATIONAL DAY OF OLDER PERSONS OCTOBER 1ST

Conclusion

24 HOUR MEAL PLAN FOR THE OLDER ADULT

BREAKFAST 2 slices whole wheat bread 1 small boiled egg 8 oz low fat milk, skimmed milk 10 medium grapes

MID MORNING SNACK 2 whole wheat crackers 8oz glass of water

LUNCH Bake fish with vegetables (90 g fish, 6 oz potatoes, 4 oz grated carrots) cup cooked brown rice 4 oz fresh salad 8 oz unsweetened orange juice 4 oz water

MID AFTERNOON SNACK Cup Granola 8 oz water DINNER whole wheat roti with Tomato Choka 8 oz water

LATE NIGH SNACK 4 Whole Wheat Crix 8 oz of tea ( spoon of sugar)

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