Nutritional Sciences Program, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195, USA. Correspondence: Adam Drewnowski, 305 Raitt Hall, Box 353410, University of Washington, Seattle, Washington, 98195 or adamdrew@u.washington.edu. o Tel: 206 543 1730 o Fax: 206 685 1696

Abstract: People eat less and make different food choices as they get older. It is unclear what impact these dietary changes may have on health status. However, lower food intake among the elderly has been associated with lower intakes of calcium, iron, zinc, B vitamins and vitamin E. Low energy intakes or low nutrient density of the diet may increase the risk of diet-related illnesses and so pose a health problem. Several factors may influence this observed decline in energy intake. Older adults tend to consume less energy-dense sweets and fast foods, and consume more energy-dilute grains, vegetables and fruits. Daily volume of foods and beverages also declines as a function of age. Physiological changes associated with age, including slower gastric emptying, altered hormonal responses, decreased basal metabolic rate, and altered taste and smell may also contribute to lowered energy intake. Other factors such as marital status, income, education, socioeconomic status, diet-related attitudes and beliefs, and convenience likely play a role as well. Many age-related nutritional problems may be remedied to some extent by providing nutrient-dense meals through home delivery or meal congregate programs. Management of medical and dental problems and the provision of vitamin and mineral supplements may also be effective. More studies that integrate nutrition research, public health intervention, and outcomes research are needed to determine the impact of diet on nutrition, health, and overall quality of life.

Key words: Nutrition, aging, dietary choices, elderly, energy intakes.