1. International Council on Active Aging Theme Day: “Eat Healthy, Stay Strong” Module Guide: Overview of Malnutrition, Fighting Muscle Mass Loss, Science & Good Nutrition, Community Nutrition Resources

2. Introduction ●—Health and wellness become priorities as you age ●—Remaining active supports your mental and physical health ●—Nutritional health plays a critical role in maintaining strength for your favorite activities and in helping combat illnesses

3. Module Overview Modules detail important nutrition issues for healthy aging and to stay strong: Module 1: Fighting Muscle Mass Loss Module 2: Overview of Malnutrition Module 3: Science & Good Nutrition Module 4: Community Nutrition Resources

4. Fighting Muscle Mass Loss How Strong Are You? How frequently do you exercise? Are you often out of breath walking in your home? Do you find it difficult to carry your groceries?

5. Fighting Muscle Mass Loss Starting at age 40, adults lose on average 8% of muscle mass each decade, and the rate of loss increases to 15% per decade after age 70. Malnutrition can accelerate process and cause greater losses Muscles make up 50-60% of your body weight Muscles have a role beyond movement and helping with balance Your muscles are protein powerhouses! Healthy muscles are essential to your physical strength, organ function, skin integrity, immunity, and wound healing You lose muscle mass up to 3X faster with illness or injury

6. Fighting Muscle Mass Loss New AARP poll of Americans 50+ found 1 in 2 wished they had more strength/energy to participate in activities they enjoy Over 1/3 rd reported being hospitalized, of these top concerns were: Loss of strength (40%) Muscle loss (21%)

7. Fighting Muscle Mass Loss Weakness Decelerated walking speed Less strength Unintentional weight loss Exhaustion Low physical activity Body pain and cramps Know the Signs Talk to your doctor or Registered Dietitian Nutritionist (RDN) if you have signs of muscle loss Ask about how exercise and nutrition can help fight muscle mass loss Seek Medical Attention Know the Signs Seek Medical Attention

8. Fighting Muscle Mass Loss Protein and a special ingredient called HMB can work together to help you: Preserve and protect muscle – which may allow you to: Regain strength and energy Remain active and independent Maintain lean body mass for strength and mobility Support recovery from illness, injury and surgery HMB comes from the amino acid leucine, a building block of protein HMB is found in small amounts in some foods, but it’s difficult to get enough HMB from your regular diet alone Using oral nutrition supplements can help ensure you get protein and special ingredients like HMB In combination, protein and HMB can help fight muscle loss

9. Overview of Malnutrition What Do You Know About Malnutrition? —What does malnutrition mean to you? —What does malnutrition look like to you? —Have you ever discussed malnutrition with your physician or dietitian? If so, what diet changes were recommended?

10. Overview of Malnutrition What is Malnutrition? Malnutrition is caused by a lack of proper nutrition, which can be due to: (1) not having enough to eat (2) not eating enough of the right foods (3) being unable to digest, absorb, or transport food properly (4) having increased nutrient needs or (5) a combination of these factors Over time malnutrition results in loss of fat stores and/or muscle stores Malnutrition can occur in people who are underweight, overweight, or obese

11. Overview of Malnutrition What are the Signs? Two important signs of malnutrition are: 1. Unintentional weight loss 2. Lack of appetite You may be diagnosed with malnutrition if you have 2 or more of the following characteristics: Weight loss over time Loss of muscle mass Insufficient food intake compared with nutrition requirements Loss of fat mass Fluid accumulation Measurably diminished grip strength

13. Overview of Malnutrition What You Can Do Eat (even though you may not feel hungry) Eat 5 or 6 small meals during the day Eat a bigger meal earlier in the day Have easy, convenient meals and nutritious snacks on hand Eat nutrient-rich foods, such as low-fat yogurt, cheese, and nuts Make food taste good again by adding herbs and spices to restore flavor Have food ready Prepare and freeze extra servings Carry single-serving packages of healthy snacks, such as dried fruits, nuts, peanut butter and crackers, or granola bars

14. Overview of Malnutrition What You Can Do Eat right! Try to eat at least 5 ounces of lean meat, poultry or fish each day Include 1.5 cups of colorful fruits and 2 cups of vegetables each day—fresh, frozen or canned Choose low-fat milk, yogurt and cheese (adults need 3 servings of dairy a day) Make sure at least half of your bread, cereal, pasta or rice servings are whole grains Consider oral nutritional supplements like Ensure ® and/or Enlive ® Talk to your doctor Talk to your doctor about your nutritional intake and what your body needs to recover if you have been sick or hospitalized

15. Science & Good Nutrition The body requires important nutrients as you age to support overall health and muscle strength 9 out of 10 aging adults fail to meet key nutrient intake levels recommended for a healthy and active life People tend to eat less food as they age— particularly high-quality, protein-rich foods— and their bodies don’t process nutrients as efficiently

16. Good Sources of Protein Protein is in every part of your body and plays a major role in: building, repairing and maintaining tissues, making important hormones and enzymes, transporting nutrients After age 50, you can’t process protein as well as when you were young Edamame (1 cup)17 grams Greek Yogurt (170 gm)17 grams Cottage Cheese (1/2 cup)14 grams Black beans (1/2 cup)14 grams Eggs (2 large)12 grams Milk (1 cup)8 grams Tuna (6 oz)40 grams Fish (6 oz)40 grams Chicken (4 oz)35 grams Lean Red Meat (4 oz)35 grams Tofu (1/2 cup, firm)20 grams Enlive ®, Ensure ® (8 oz)20 grams

17. Science & Good Nutrition There is a growing body of research showing the role nutrition plays in our health and in helping fight muscle mass loss and malnutrition… A new NOURISH study builds on this research Showed nutrition’s role for adults aged 65 + who were in the hospital and malnourished, while recovering from a heart or lung disease Results: showed no significant differences between the two groups for the primary composite endpoints The study group who consumed a specialized oral nutrition supplement with protein (20g), HMB, and Vitamin D – was associated with a significant (50%) reduction in 90-day mortality

18. Community Nutrition Resources & Education for Older Adults National Academy on an Aging Society Survey: The majority of family caregivers reported that the older adult in their care does not use any community nutrition resources Family caregivers wish more older adults in their care were using community nutritional resources

19. Community Nutrition Resources & Education for Older Adults AARP Foundation Food insecurity among older adults remains a serious problem, and it is getting worse Community nutrition resources are available to help

20. Community Nutrition Resources & Education for Older Adults Food Programs Supplemental Nutrition Assistance Program (SNAP): http://www.fns.usda.gov/snap/eligibilityhttp://www.fns.usda.gov/snap/eligibility Senior Farmers’ Market Nutrition Program: http://www.fns.usda.gov/sfmnp/senior-farmers-market- nutrition-program-sfmhttp://www.fns.usda.gov/sfmnp/senior-farmers-market- nutrition-program-sfm Commodity Supplemental Food Program: http://www.fns.usda.gov/csfp/eligibility-how-applyhttp://www.fns.usda.gov/csfp/eligibility-how-apply Emergency Food Assistance Program: http://www.fns.usda.gov/tefap/eligibility-and-how-applyhttp://www.fns.usda.gov/tefap/eligibility-and-how-apply Community-Based Programs Meals on Wheels: http://www.mealsonwheelsamerica.org/?gclid=CL-qu4u-9csCFQcKaQod8zADzghttp://www.mealsonwheelsamerica.org/?gclid=CL-qu4u-9csCFQcKaQod8zADzg Senior Center Meal Programs: https://www.ncoa.org/national-institute-of-senior-centers/tips-for-senior- centers/what-you-dont-know-about-your-local-senior-center/https://www.ncoa.org/national-institute-of-senior-centers/tips-for-senior- centers/what-you-dont-know-about-your-local-senior-center/

21. Community Nutrition Resources & Education for Older Adults Nutrition Tips ChooseMyPlate http://www.choosemyplate.gov/older-adultshttp://www.choosemyplate.gov/older-adults Tufts MyPlate for Older Adults http://hnrca.tufts.edu/myplate/http://hnrca.tufts.edu/myplate/ DASH Eating Plan www.nhlbi.nih.gov/health/health-topics/topics/dashwww.nhlbi.nih.gov/health/health-topics/topics/dash What’s on Your Plate? www.nia.nih.gov/health/publication/whats-your-platewww.nia.nih.gov/health/publication/whats-your-plate Nutrition Services National Council on Aging Toolkit ncoa.org/nutritiontoolsncoa.org/nutritiontools Registered Dietitian Nutritionist eatright.org/find-an-experteatright.org/find-an-expert Area Agency on Aging Office eldercare.gov/Eldercare.NET/Public/Index.aspxeldercare.gov/Eldercare.NET/Public/Index.aspx Medicare Nutrition Therapy Services medicare.gov/coverage/nutrition-therapy-services.htmlmedicare.gov/coverage/nutrition-therapy-services.html Reimbursement Coverage for Oral Nutrition Supplements: http://pathwayreimbursement.com/http://pathwayreimbursement.com/

22. Get linked to community resources today!

23. Support for this program provided by: 2016