1. Rista Fauziningtyas, S.Kep.Ns., M.Kep.

, PhD
Short CV
2. Email: ristafauzinigtyas@fkp.unair.ac.id

3. Organization: FKp Unair, CoE PSQ, dan IPEGERI

4. Education: S1- FKp Unair, S2-FKp Unair, PhD – Faculty

Medicine, Universiti Malaya

5. H-index scopus: 5

1
UNIVERSITAS AIRLANGGA
Excellence With Morality
SURABAYA
Capital of the East Java Province, Surabaya
is a port city and a hub to the beauty of
Eastern Indonesia. The city offers a vibrant,
sprawling metropolis that combines modern ● Heroes Monument
skyscrapers with canals and buildings from ● Suroboyo Statue
its Dutch colonial. Moreover, Surabaya is ● Bungkul Park
also known as the second-largest city in
Indonesia after Jakarta.

Today, Surabaya is a home to

3 million population from
diverse backgrounds

The average
temperature of
Surabaya is
27.4 °C - 35 °C
 CITY OF
SURABAYA

TARI
REMO
TRADITIONAL FOOD
NUTRITION
FOR OLDER
PEOPLE
Rista Fauziningtyas, S.Kep., Ns., M.Kep., PhD.

Lecturer of FoN Universitas Airlangga

 Agenda
1. Introduction

2. Review the biology/physiology/social of aging

related to nutrition

3. Factor related the food preferences in Thailand

4. Malnutrition

5. Healthy nutrition for older adult

6. Conclusion

11/29/2023 7
Introduction

Increasing Older adult Population Morbidity

• Who is older adult? • Noncommunicable diseases have become

• Person who reach >= 60 years olds more prominent than infectious disease

• In 2019 > 1 billion people aged > 60 years (Alzheimer’s disease and diabetes mellitus)

• Predict: increase to 2.1 billion by 2050 • Dementia : 55.2 million (7th top causes of
death)

8
 POPULATION &
POPULATION & Morbidity: > 60 years in
Morbidity: > 60 years in Thailand
Indonesia
THAILAND OLDER
POPULATION 2023
20.17%
(1.5 M)

INDONESIA OLDER
POPULATION 2021
10.82%
(29.3 M)

DISABILITY STATUS
Dis-
ability
12%

Non-
Dis-
ability Source: https://www.statista.com/statistics/713667/thailand-forecast-aging-population/
88%

9
 Source: https://thegeriatricdietitian.com/

Source: https://www.todaysgeriatricmedicine.com/archive/SO20p28.shtml

2023 10
Changes in body
• Decline of body’s metabolism
composition and
physiology of Older • Neurodegeneration of the aging gut nervous system
Adult
(dysphagia, reflux, constipation)

• Decreased gastric secretions with aging

• Appetit and food consumption declines-less hungry, fuller

between meals, eat more slowly, consume smaller meals

• Anorexia of aging

• Body weight loss

11/29/2023 11
 Changes in GI tract Older Adult (An R, Wilms E, Masclee AAM, et al: 2018)

GI tract function: ensures adequate digestion and absorption of nutrients, involving a sequence of
events from the mouth until the anus
11/29/2023 12
 • With age, loss of up to 3 kg of lean body mass per body
mass decade after age 50.
Older Adult
Changes in Body • Sarcopenia: an inevitable loss in lean body mass (skeletal
Weight/Composition muscle and bone) and a relative increase in fat mass over time

• A loss of bone and total body calcium

11/29/2023 13
 Psychological & Social
Issues in Older Adult
Psychological
Nutrition
• Delirium
• Dementia
• Depression/anxiety/bereavement
• Alcoholism

Social
• Poverty
• Isolation/loneliness
• Inability to shop/prepare and cook
food
11/29/2023 14
 Older Adult Food Choices (Chalermsri, C. et al: 2020)

Elderly people’s food choices and dietary practices in

Thailand
11/29/2023 15
 When does an older adult’s Malnutrition
nutritional status become A deficiency, excess or imbalance of energy, protein and
problematic? other nutrients causes adverse effects on body form,
function and clinical outcome

Types of Malnutrition
1. Undernutrition: OA does not consume enough nutrients
1. Protein-energy malnutrition: lacks both protein and
calories in their diet
2. Micronutrient deficiencies: lack of specific vitamins and
minerals
3. Marasmus: a severe undernutrition characteristic by
chronic energy deficiency leading to muscle loss and
weakened immune system
2. Overnutrition: overeating or diet-related obesity leading to
excessive weight gain

11/29/2023 16
Health Disruption Due to
Malnutrition
 Decline in functional status
 Impaired muscle function
 Decreased bone mass
 Anemia
 Immune dysfunction
 Reduced cognitive function
 Poor wound healing/delayed recovery from surgery

 Higher hospital admission rate and mortality

17
 Nutritional Assessment for older adult
• Dietary assessment
• 24 hour recall

• Food records for 7 days

• Clinical assessment
• Wasted, thin, skin, hair, nails, wound healing

• Test: albumin serum (3,4-5,4 g / dL) ,

haemoglobin (F = 12-15 g/dl, M =13-17 g/dl)

• Screening tools
• MUST-Malnutrition Universal Screening tool

• MNA-SF- Mini-nutritional Assessment short

form

20XX 18
Mini Nutritional Assessment –
Short Form (MNA-SF)

The MNA-SF focusses on BMI,

weight loss, mobility, stress or
illness, poor appetite,
dementia/depression. If BMI can’t
be obtained, calf circumference
can be used instead.

Source: https://www.researchgate.net/figure/Short-form-Nestle-Mini-Nutritional-
Assessment-MNAC-Nestle-1994-Revision-2009-N67200_fig2_262681755

19
 Nutrition for older adult:
Source: https://medlineplus.gov/nutritionforolderadults.html

• Eat foods that give you lots of nutrients without a

lot of extra calories, such as
• Fruits and vegetables (choose different types with
bright colors)
• Whole grains, like oatmeal, whole-wheat bread, and
brown rice
• Fat-free or low-fat milk and cheese, or soy or rice
milk that has added vitamin D and calcium
• Seafood, lean meats, poultry, and eggs
• Beans, nuts, and seeds
• Pick food that have balance micronutrients such as
B12, iron, folate, potassium, and magnesium

20XX 20
 Nutrition for older adult: (2)
Source: https://medlineplus.gov/nutritionforolderadults.html

• Avoid empty nutrition. Such as chips, candy,

baked goods, soda, and alcohol.
• Choose foods that are low in cholesterol, fat,
sugar and salt.
• Drink enough liquids (30 ml/kg body weight).
Some people lose their sense of thirst as they
age.
• Be physically active. If you have started losing
your appetite, exercising may help you to feel
hungrier.

IMPORTANT!!!
• A sedentary male > 70 years old requires 2,000 calories. An active male requires
2,600 calories a day.
• A sedentary & Active female > 70 years old requires 1600 to 2,000 calories.
20XX 21
 Protein Needs for Older
Adults

• RDA minimum for protein

regardless older adult is 0.8
gram/kg per day

• RDA optimum for protein

regardless older adult is 1.8
gram/kg per day to improve
health function

20XX 22
 Conclusion
• Nutrition balance become important need to maintain
the health of older adult

• Emphasize the importance of sufficient protein intake

to combat age-related muscle loss and maintain
overall physical function.

• Focus on Bone Health with Calcium and Vitamin D

intake

• Highlight the role of essential micronutrients like B12,

iron, folate, potassium, and magnesium in supporting
various bodily functions crucial for overall vitality.

• Adapt Nutritional Intake to Individual Needs

20XX 23
 QUIZ

• Please discuss with your group, these questions below:

• What nurse can do if the older adult having difficulties in chewing and swallowing
food? (Group 1)
• What nurse can do if the older adult easily feel full, while they have undernutrition
condition? (Group 2)
• What nurse can do if the older adult lost their appetite and decrease sensing the taste?
(Group 3)

• Write you answer in the paper with 3 words for each intervention. Then,

20XX
showed and explain to your friend!! 24
 Q&A SESSION

20XX 25
 References
1. An R, Wilms E, Masclee AAM, et al. Age-dependent changes in GI
physiology and microbiota: time to reconsider? Gut 2018;67:2213-2222.

2. Chalermsri C, Herzig van Wees S, Ziaei S, Ekström EC, Muangpaisan

W, Rahman SM. Exploring the Experience and Determinants of the Food
Choices and Eating Practices of Elderly Thai People: A Qualitative
Study. Nutrients. 2020 Nov 13;12(11):3497. doi: 10.3390/nu12113497.
PMID: 33203013; PMCID: PMC7696600.

11/29/2023 26
 THANK YOU

11/29/2023 27