Geriatric Nutrition by Annette B. Natow and Jo-Ann Heslin. Boston, Massachusetts, CBI Publishing Co., 1980. 332 pp. $15.95.
Nutrition and geriatrics have long suffered from benign professional neglect. Emphasis on science and technology as well as negative societal attitudes were responsible. It is only within the last decade that the two disciplines received the study and research they merited. Now, happily, Natow and Heslin have combined these subjects and, in doing so, they have made a major contribution to gerontology.
The purpose of the book is to establish a nutritional resource for those who deal with older adults. The authors begin by explaining the nature of the aging process and then make a smooth transition to the changes wrought in the body's systems, with one minor exception. It is confusing to read on p. 20 that the absence of hydrochloric acid (achlorhydria) increases after the age of 60, next to read the functions of hydrochloric acid and then to read "...the reduction of hydrochloric acid thus may interfere with protein digestion and mineral absorption as well as. . .cause digestive upsets." Hypochlorhydria would seem to be a more precise word.
The chapter on nutrition and health problems of the aged is particularly valuable because of the explicit and meticulous way it demonstrates the essential aspects of diet therapy. Common geriatric health problems - diabetes, arthritis, anemia, and hypertension, to name a few - are described, along with the various nutritional factors involved.
As one would expect, there is comprehensive information on energy nutrients, vitamins and minerals, drug interaction, and alcohol and dietary supplements. I would rate highly the chapter on appropriate food selection, which carefully covers such topics as budgeting, marketing, convenience foods, and meat alternatives. Too many elderly people eat diets that are low in protein and high in carbohydrate. Often this is because meat is the highest priced item in the market basket. The authors offer practical choices other than meat that still fall within the recommendations of the daily food guide. This chapter includes tables illustrating the topics covered, in addition to some interesting recipes and menus that accent good nutrition and thrift.
In keeping with the holistic approach to clients, the authors describe psychosocial aspects of aging and the impact of environment. They then offer common sense suggestions for counseling the elderly homemaker. Professionals will appreciate the "how to" chapter (Chapter 11, "Nutrition Education in Later Years"), with its methods and plans for developing and using teaching aids. The suggestions range from discussion topics to audiovisual materials.
I was impressed by the number of cited references and suggested readings, which are only a small part of the rich resource information listed. While Natow and Heslin have ample tables and charts explaining their work, there are very few photographs. Pictures are the "frosting on the cake" and unfortunately are often limited by publishers for reasons of space and cost.
Geriatric Nutrition is a scholarly work that should form a part of the health care professional's library.