Overview

With baby boomers reaching their 50s and 60s and the growth rate of the U.S. population age 65 years and older expected to double over the next twenty years, the need to prepare for an expanding population of older adults has never been as urgent as it is now. The growing size and changing demographics of aging adults place new demands on the food supply, with older adults not only being more susceptible to certain foodborne illnesses or health complications caused by those illnesses but also likely to experience significant changes in dietary needs and nutrition. While there is still a great deal to learn about what constitutes an “optimal diet” for older adults, available evidence indicates that dietary needs change with aging as a result of sensory loss and other physiological changes, changes in food preparation, and other eating-related behaviors. The fast-growing nature of the U.S. older population also creates new communication challenges with respect to educating older adults about how to manage a nutritious diet, how to prepare and store food safely, and how to act in the event of a safety-related food recall. In recognition of these trends and challenges, the Institute of Medicine’s (IOM’s) Food Forum convened a one-and-a-half-day workshop in October 2009 to explore food supply issues of relevance to aging adults. Specifically, the purpose of the workshop was to address the questions: What are the future challenges to providing healthy and safe foods to aging populations, and what can be done to meet those challenges?



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Overview With baby boomers reaching their 50s and 60s and the growth rate of the U.S. population age 65 years and older expected to double over the next twenty years, the need to prepare for an expanding population of older adults has never been as urgent as it is now. The growing size and changing demographics of aging adults place new demands on the food supply, with older adults not only being more susceptible to certain foodborne illnesses or health complications caused by those illnesses but also likely to experience significant changes in dietary needs and nutri- tion. While there is still a great deal to learn about what constitutes an “optimal diet” for older adults, available evidence indicates that dietary needs change with aging as a result of sensory loss and other physiological changes, changes in food preparation, and other eating-related behaviors. The fast-growing nature of the U.S. older population also creates new com- munication challenges with respect to educating older adults about how to manage a nutritious diet, how to prepare and store food safely, and how to act in the event of a safety-related food recall. In recognition of these trends and challenges, the Institute of Medicine’s (IOM’s) Food Forum convened a one-and-a-half-day workshop in October 2009 to explore food supply issues of relevance to aging adults. Specifically, the purpose of the workshop was to address the questions: What are the future challenges to providing healthy and safe foods to aging populations, and what can be done to meet those challenges? 

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 PRoVIdIng HEAltHy And SAFE FoodS AS WE AgE Jointly sponsored by the Interagency Risk Assessment Consortium (IRAC),1 the Food and Drug Administration’s (FDA’s) Center for Food Safety and Applied Nutrition (CFSAN), and the Food Forum, the workshop served as an opportunity for experts in various disciplines to discuss the size, demographics, and health status of community-dwelling populations more than 50 years of age; bring attention to the food safety and nutritional concerns that arise in these populations; and provide insight on how new food processing and reformulation technologies and consumer messaging can be used as preventive approaches to reducing the food and nutritional concerns for this growing segment of the U.S. population. Food Forum Chair Michael Doyle opened the meeting with some brief introductory remarks about the general role of the IOM Food Forum and the objectives of the workshop. He also identified the planning committee respon- sible for organizing the workshop: Suzie J. Crockett of General Mills; Kerry Dearfield, U.S. Department of Agriculture (USDA), Food Safety and Inspec- tion Service (FSIS); Steven Gendel, FDA/CFSAN; Gordon Jensen, Depart- ment of Nutritional Sciences, Pennsylvania State University; Marge Leahy, The Coca-Cola Company; and Pamela Starke-Reed, National Institutes of Health (NIH) Division of Nutrition Research Coordination (DNRC). Doyle’s comments were followed by an introductory presentation by Stephen Sundlof, Director of FDA/CFSAN. The remainder of the work- shop was organized into six sessions: (1) size and demographics of aging populations; (2) changes in physiology with age; (3) food safety concerns for aging populations; (4) nutrition concerns for aging populations; (5) communicating with aging populations; and (6) future challenges and solu- tions to providing healthy and safe foods to aging populations. The final session included a panel discussion amongst four panelists and the audi- ence. Many of the major themes of the workshop were revisited during this final session. The organization of this report parallels the organization of the work- shop itself. The introductory chapter, Chapter 1, includes a summary of Dr. Stephen Sundlof’s presentation and a summary of the major overarching themes of the workshop presentations and discussions. Chapter 2 summa- rizes the presentations and the discussion that occurred during the session on size and demographics of aging populations (i.e., session 1), Chapter 3 sum- marizes the presentations and discussion of the session on changes in physi- ology with age (i.e., session 2), and so on. Summaries of the major themes of the workshop, including suggestions put forth by individual participants 1 Founded in 1997, IRAC comprises all federal agencies, institutes, and centers with risk analysis responsibilities for food safety. Information about IRAC members and activities is available online at http://www.foodrisk.org/IRAC/.

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 oVERVIEW for possible solutions to some of the key challenges to improving nutrition and food safety in older adults, can be found in Chapters 1 and 7. The meeting transcripts and presentations served as basis for the sum- mary. These proceedings summarize only the statements of workshop par- ticipants and are not intended to be an exhaustive exploration of the subject matter. The agenda for the workshop appears in Appendix A, and Appen- dix B lists the workshop participants. Appendix C contains the biographical sketches for the presenters, moderators, and panelists. Appendix D lists acronyms and abbreviations used throughout the workshop. The reader should be aware that the materials presented here express the views and opinions of individuals participating in the workshop either as presenters, panelists, or audience members, and not the deliberations or conclusions of a formally constituted IOM committee. The objective of the workshop was not to come to consensus on any particular issue or formulate recommendations for future action. The goal was to illuminate issues, not resolve them. Nor was the objective to comprehensively address all food supply issues of relevance to aging adults, although the workshop did cover a very broad spectrum of some of the most important issues. Rather, the goal was to serve as a mechanism for individuals from a variety of government, academic, industry, and citizen groups to discuss and debate issues openly and identify possible approaches for addressing some of the most pressing food safety, nutrition, and communication issues of relevance to aging adults. It should be noted at the outset that there were questions raised but no decision made about the most appropriate language to use when dis- cussing aging populations. Different presenters used different terms, rang- ing from “mature” to “senior” to “elderly.” Part of the language problem stems from the fact that aging is not something that begins at a certain age, rather it is a lifetime process, as several workshop participants em- phasized. When asked when “old age” begins, people respond differently depending on their own age. When discussing an “aging population,” some people may have in mind the population age 65 years and older, while others may be referring to the population age 50 and older and still others the population age 85 and older. Also, some workshop participants mentioned not wanting to use offensive language when referring to older adults, although there was no discussion around what would be consid- ered offensive. One of the most commonly used terms was “older adult.” While the rapporteurs of this workshop summary used many of these terms interchangeably, they likewise favored “older adult.” This summary highlights the dramatic differences between older adults ages 50 to 65 and adults age 85 and above.

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