Muscle accounts for 45% of bodyweight in young adults. This drops to 27% in the old, who chronically show a marked decrease in the size and strength of skeletal muscle.1 Muscle changes are conspicuous in the little muscles of the hands and face and in the muscles of mastication. The facial muscles sag and become imbalanced. Chronic dietary protein inadequacy may be concerned in depressed immune function, decreasing muscle strength, and poor wound healing in older adults. Until recently, it was believed that adults should ingest 0.8 g of protein per kilogram of weight daily,3 but recent guidelines have suggested an increase to 1 to 1.25 g of highquality protein.4,5 The best sources of protein are meat and fish. These foods ought to be boiled (poached or braised), not fried; boiling prepares meats and catch the gastrointestinal tract by wearing down the complex proteins in to the more easily digested proteoses, whereas frying denatures and coagulates the proteins and makes them difficult to digest.


The United States Food and Drug Administration (FDA) guidelines recommend a diet with 25 to 35% of its daily calorie intake in the shape of fat. In addition, it advises that saturated fat intake be reduced to significantly less than 10% of daily calories, and that cholesterol be restricted to significantly less than 300 mg daily.6,7 These recommendations are for several adults, without any differentiation for the elderly.


Current dietary guidelines from the United States Department of Agriculture (USDA)6 claim that carbohydrates should compose from 45 to 65% of daily calories, and the complex carbohydrates (starches) are preferred over simple carbohydrates (sugars). Now, carbohydrate intake of 130 g/day has been suggested for adults over 70 years of age, with a recommendation that “added sugars” (soft drinks, candy, desserts, etc.) constitute only 25% of total energy intake.


Water, the main nutrient in the diet, is essential to all or any body functions. Water loss from perspiration, elimination, and the lungs should be balanced every day by an adequate intake from drinking tap water, beverages, soups, and other foods, especially vegetables. If this balance isn’t maintained, and if water loss exceeds intake, chronic dehydration can result. Bariatric patients are particularly prone to negative water balance, often due to excessive water loss through insufficient or damaged kidneys. Mucosal surfaces become dry and easily irritated in the dehydrated patient. Insufficient fluid consumption in general (and water consumption in particular) may have a deleterious effect on salivary gland function and on overall health. The common sedentary male adult must consume at the least 2900 mL of fluid daily, and the average sedentary female adult at the least 2200 mL per day, in the form of noncaffeinated, nonalcoholic beverages, soups, and foods. Solid foods contribute approximately 1000 mL of water, by having an additional 250 mL based on the water of oxidation.


There’s no definite requirement for dietary fiber in the daily diet of bariatric patients. Different varieties of dietary fiber donate to the motility of the gastrointestinal tract. In studies of different populations, a diet abundant with fiber appears to be correlated with decreased rates of cancer and cardiac disease. A rise in dietary fiber is prescribed in the treatment of several common diseases, namely constipation, hemorrhoids, diverticulosis, hiatal hernia, varicose veins, diabetes mellitus, hyperlipidemia, and obesity.10,11 The existing recommendation is 14 g of fiber for each and every 1000 calories consumed each day,12 and the U.S. FDA requires that dietary fiber be listed on the nutrition facts panel on food labels.


Bone serves since the skeletal structure to which the muscles are attached and acts as a storehouse for calcium. Calcium is an essential mineral that is required for many functions in the torso, including transmission of nerve impulses (lack of calcium leads to convulsions), cell membrane integrity, and blood coagulation. Bone serves as the internal supply of calcium when the exogenous sources (dietary) become deficient.1,14 Adequate calcium intake is needed for bariatric patients of all ages. Milk and milk goods are the best sources of calcium. The majority of the approximately 2 to 3 pounds of calcium present in the torso is concentrated in the bones and teeth. The calcium needs of bariatric patients are approximately 1000 mg per day.

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