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BIOLOGICAL FACTORS

Integumentary System
     deficiencies
          -decreased vitamin D production -> decreased calcium absorption by the small intestine
Circulatory System
     deficiencies
          -atherosclerosis reduces blood flow through the digestive system -> reduced digestion and absorption of various nutrients
          -atherosclerosis and high blood pressure -> greatly altered diet (salt, water, lipid restrictions)
Respiratory System
     deficiencies
          -emphysema -> difficulty obtaining, preparing, and eating proper diet
Nervous System
     deficiencies
          -dementias or strokes -> disabilities -> difficulty planning, obtaining, preparing, and eating proper diet
          -decreased sense of smell from aging, Alzheimer's, Parkinson's -> loss of interest in eating
          -age changes in flavor preferences -> altered diet
          -decreased sensory function and coordination -> difficulty obtaining, preparing, and eating proper diet
          -decreased thirst sensation -> water deficiency
Eyes and Ears
     deficiencies
          -decline in vision -> difficulty obtaining, preparing, and eating proper diet including reading labels for instructions and nutrient content
Muscle System and Exercise
     deficiencies
          -weakness and decreased exercise -> decreased eating to prevent weight gain
     excesses
          -weakness and decreased exercise -> excess energy intake for body needs
Skeletal System
     deficiencies
          -disabilities (fractures, arthritis) -> difficulty obtaining, preparing, and eating proper diet, more reliance on prepared foods -> less fresh fruits and vegetables, less activity -> less kcals used -> obesity
     excesses
          -disabilities (fractures, arthritis) -> decreased exercise -> lower energy use -> obesity
Digestive System
     deficiencies
          -mouth region
               -slower healing of oral mucosa -> sores -> discomfort -> less eating
               -tooth disease or loss -> altered or bad tastes, discomfort when eating, trouble eating firm (fruits and vegetables) or drier foods, swallowing large pieces -> less eating, less fiber intake, indigestion and maldigestion
               -decreased saliva from infected salivary ducts, diabetes, medications, radiation therapy -> dry mouth, decreased taste -> less eating
          -esophagus
               -slowed and spastic peristalsis, refluxing from stomach -> discomfort, difficulty swallowing -> less eating
               -esophageal rings and webs -> difficulty swallowing (discomfort) -> limited food selection and less eating
               -sliding hiatal hernia -> refluxing, esophagitis -> less eating
               -diabetes -> slower peristalsis -> difficulty swallowing -> less eating
          -stomach
               -decreased HCl -> altered small intestine bacterial flora -> altered digestion and absorption of many nutrient
               -decreased intrinsic factor production -> decreased vitamin B-12 absorption by small intestine
               -acute gastritis -> discomfort -> less eating
               -atrophic gastritis -> decreased production of HCl, intrinsic factor, and pepsin -> decreased protein digestion -> indigestion -> decreased eating and protein maldigestion -> protein deficiency
               -gastric peptic ulcer -> pain with eating -> less eating, need for altered diet, obstruction, antacid use -> deficiencies, obstruction -> malnutrition, use of certain antacids (containing Mg)
          -small intestine
               -decrease in absorption of vitamins A, D, and K, and zinc
               -decreased lactase -> lactose intolerance -> decreased dairy intake
               -decreased vitamin D production by skin and activation by kidneys -> decreased calcium absorption
          -large intestine
               -constipation -> laxative use (depending on type) -> water, mineral, and vitamin A, D, E, and K deficiencies. -very high fiber diets -> decreased mineral absorption
               -diarrhea -> water and mineral deficiencies
               -fecal incontinence -> less ability to obtain foods (shopping), social isolation -> less or altered eating
               -diseases (diverticulitis, cancer) -> altered diets -> malnutrition
          -liver
               -slight decrease in vitamin C storage -> increased risk of vitamin C deficiency (Note that vitamin C is not stored well in the body.)
               -cirrhosis -> liver malfunction -> poor storage and conversion of nutrients, decreased vitamin D activation and bile production -> poor fat digestion and vitamin A, D, E, and K absorption
          -gall bladder
               -stones -> pain (especially with fats) and decreased fat digestion -> discomfort (less eating), decreased fat and vitamin A, D, E, and K absorption
          -pancreas
               -pancreatitis -> decreased protein and fat digestion, diabetes (slowed peristalsis)
 excesses
              -peptic ulcer -> antacids with magnesium -> magnesium excess
Urinary System
     deficiencies
          -urinary incontinence -> less ability to obtain foods (shopping), social isolation -> less or altered eating
          -kidney disease -> less protein intake to decrease nitrogen wastes in blood (BUN)
Endocrine System
     deficiencies
          -hyperparathyroidism -> decreased appetite -> less eating
          -hyperthyroidism -> increased metabolic rate -> excess energy use -> underweight
     excesses
          -non-insulin dependent diabetes mellitus (NIDDM) -> excess eating -> obesity
Immune System
     deficiencies
          -various autoimmune disorders -> malfunctions in salivary glands, stomach, small intestine, and large intestine functioning) -> altered taste and decreased absorption (e.g., vitamin B-12, vitamin K, Fe, Ca, Zn)
Alcoholism
     deficiencies and excesses
          -alcohol -> less eating, decreased functioning of the liver and other digestive organs, altered the absorption and utilization of several nutrients -> certain deficiencies and excesses (See page 10-51+)
Medications
     deficiencies and excesses
          -from altered appetite, diet, absorption, utilization, and elimination
Cancer
     deficiencies
        -  growth of cancer -> loss of appetite and excess nutrient use (cachexia)
 

SOCIAL FACTORS

Deficiencies
     -cultural limitations on food choices
     -religious factors
     -transportation to food sources
Deficiencies and Excesses
     -loss of companionship (spouse, other family members, friends, retirement) -> altered appetite -> less eating or over eating
     -institutionalization -> imposed diets, foods overcooked or heated for extended periods
     -inadequate educational opportunities
     -inadequate social programs -> inadequate social contact, assistance with food preparation and eating, or exercise

PSYCHOLOGICAL FACTORS

Deficiencies and Excesses
     -depression -> altered appetite -> less eating or over eating, slowed peristalsis -> constipation -> laxative use
     -stress, loneliness, boredom, grief -> less eating or over eating
     -ignorance -> poor diet planning
     -eating habits -> excess eating after activity levels decline

ECONOMIC FACTORS

Deficiencies and Excesses
     -fixed income, limited income, retirement, high medical bills, -> less money -> cannot afford proper diet
     -advertising
     -availability and price of proper and varied foods
     -cost of food storage and preparation facilities

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