CROATIAN GUIDELINES FOR NUTRITION IN THE ELDERLY, PART I
Autori:
Darija Vranešić Bender, Željko Krznarić, Željko Reiner, Spomenka Tomek Roksandić, Zijad Duraković, Antoinette Kaić-Rak, Nina Smolej Narančić, Jasna Bošnir
Sažetak
Starenje uzrokuje brojne tjelesne i psihološke promjene koje mogu utjecati na nutritivne potrebe i nutritivni status. Prisutnost kroničnih bolesti i uzimanje lijekova mogu uzrokovati neravnotežu između potrebe za nutrijentima i prehrambenog unosa, što vodi nastanku malnutricije ili lošeg statusa uhranjenosti. Brojna istraživanja pokazuju da je malnutricija učestali problem među osobama starije dobi. Stoga redovita procjena nutritivnog statusa čini bitan dio zdravstvene skrbi za osobe starije dobi. Pritom je važno uzeti u obzir odrednice geroantropometrije. Fiziološke promjene vezane uz starenje utječu na potrebe za nutrijentima. Energetske potrebe i potrebe za makronutrijentima smanjuju se, međutim potrebe za mikronutrijentima jednake su ili veće nego tijekom zrele dobi. Dodatno, brojne psihosocijalne i socioekonomske promjene koje prate starenje mogu utjecati na prehrambeni unos. Planiranje obroka važan je dio nutritivne njege osoba starije dobi, a veoma važni mogu biti i dodaci prehrani te oralni nutritivni dodaci (enteralni pripravci) koji se propisuju kod dijagnosticirane ili prijeteće malnutricije. Radna skupina koju su činili internisti, gerontolozi, antropolozi, nutricionisti i ostali stručnjaci, posebno upućeni u liječenje gerijatrijskih bolesnika izradila je Hrvatske smjernice za prehranu osoba starije dobi. Izrada smjernica temeljena je na dokazima iz relevantne medicinske literature te kliničkim iskustvima članova radne skupine.
Summary
Aging produces numerous physical and physiologic changes, which in turn alter nutritional requirements and affect nutritional status. The presence of chronic disease, and/or medications can enhance potential disparities between nutrient needs and dietary intake, leading to malnutrition. Indeed, research suggests that malnutrition is a common condition among the elderly. Therefore, regular nutritional assessment should be done as an integral part of healthcare for elderly. Also, it is important to take in consideration all determinants of geroanthropometry. The physiologic changes associated with aging affect requirement for several essential nutrients. In general, the requirement for many nutrients decreases, concomitant with the decrease in energy needs. However, some nutrients are needed in higher amounts. Additionally, various psychosocial and socioeconomic changes that often attend aging may also alter dietary intake. Dietary planning is important part of nutritional care in the elderly. Also, some elderly persons can benefit with dietary supplements and oral nutritional supplements (enteral formulas) which can be prescribed by diagnosed or threatening malnutrition. Croatian guidelines for nutrition in the elderly have been developed by interdisciplinary expert group of Croatian clinicians, gerontologists, anthropologists, nutritionists and other professionals involved with care for elderly population. The guidelines are based on evidence from relevant medical literature and clinical experience of working group.
