Both House and Senate last month unanimously passed HR 6197 to reauthorize the Older Americans Act. OAA is the most significant federal law governing the organization and delivery of a number of social services for older Americans. The largest component of the OAA is the nutrition program, which provides both congregate and home delivered meals ("Meals On Wheels") to millions of Americans.

"Nutritional well being is critical in assuring quality of life for our older citizens," says ADA President and registered dietitian Judith A. Gilbride, RD. "Congress developed a balanced, forward looking approach to healthy aging that ADA was pleased to support. With the aging of American society, ADA felt it was essential to begin to prioritize offerings to older adults with cost effective solutions and to commit to a review of the OAA nutrition program in order to demonstrate their ability to improve health outcomes and lower health care costs for those served, as well as improve meal quality and nutrient content."

Optimizing nutritional status is a powerful way to enhance the lives of older Americans. Studies show that poor nutritional status, excessive or inadequate intake of nutrients and fluids, is a major problem affecting millions of older Americans. Inadequate intake is estimated to affect more than a third of community dwelling individuals over age 65.

Dietary quality ratings of free-living Americans age 65 years and older, as measured by the Healthy Eating Index, show the vast majority have diets that were ranked as needing improvement or that were poor. And even in hospitals and nursing facilities, undernutrition can prevail.

Meanwhile, more than 80 percent of older Americans have one or more of the chronic diet-related diseases including hypertension, diabetes, and dyslipidemia, singly or in combination. These conditions have adverse health consequences that could be prevented or reduced with appropriate nutrition intervention.

Healthy aging for all Americans requires adequate nutrition to maintain health, prevent chronic diet-related disease, and treat existing disease. Those seniors who routinely eat nutritious food and drink adequate amounts of fluids are less likely to have complications from chronic disease or to require care in a hospital, nursing home or other facility. Thus, it makes sense to emphasize nutrition, nutrition education, nutrition screening, counseling and assessment by dietitians for seniors.

According to Josafina G. Carbonell, assistant secretary of Health and Human Services for Aging, "The OAA Nutrition Program is a proven success story. It effectively targets older adults who are poorer, more likely to live alone, and are at higher nutritional risk."

Registered dietitians are familiar with benefits of strong, functioning nutrition programs such as the OAA programs. It is not uncommon that nutrition screening can identify problems before they become life threatening. For the patient who may be admitted to the hospital for weeks in order to care for sore on the foot, knowing how to control diabetes is the real key to his or her health and independence.

If wounds do not heal, amputation might be necessary. But medical nutrition therapy provided by a registered dietitian along with home delivered meals through the Meals on Wheels program can work together to help the patient control the diabetes, resulting in a more rapid healing. The total cost of a nutrition intervention, which includes nutrition counseling related to meal planning, food preparation, and diet enhancement - is several hundred dollars - far less than the cost of even one day in the hospital, not to mention the additional costs in health care and support services had the foot been amputated.

"ADA strongly supported this OAA reauthorization because it increases access to nutrition care and services, and lays the groundwork for improved nutrition care," says Gilbride. The new law:

• Increases recognition of the important role of registered dietitians and other qualified nutrition professionals in meal planning, nutrition education, and nutrition screening, counseling and assessment.
• Emphasizes the critical link between nutrition and the prevention of chronic disease.
• Provides family caregivers better access to nutrition programs.
• Authorizes the first independent evaluation of OAA nutrition programs by the Food and Nutrition Board of the National Academies of Science's Institute of Medicine. From this, policymakers will be able to judge how OAA programs can be improved.

Source: American Dietetic Association Quick Link American Dietetic Association