Directory UMM :Data Elmu:jurnal:N:Nutrition And Food Science:Vol30.Issue6.2000:
Background
EU-funded project on
the elderly
Caroline A. Martin
The author
Caroline A. Martin is Project Administrator, Nutritional
Sciences, UCC, Cork, Ireland.
Keywords
Older people, Health care, Nutrition, European Union
Abstract
On 1 February 2000 the project HealthSense (``Healthy
eating: how changes in sensory physiology, sensory
psychology and socio-cognitive factors influence food
choice'') was launched. This is a multi-disciplinary, crosscultural project funded by the Fifth Framework of the
European Union, a programme that has been conceived,
among other tasks, to improve the quality of life for
European citizens. The project involves 24 participating
centres from ten European countries. There are currently
over 100 scientists of varying disciplines working on the
project which comprises eight individual working groups
or work packages. Each participating centre will work for
the duration of the project (36 months) within a particular
work package that has specific objectives, all of which are
necessary as parts of the overall objective. The overriding
objective of the project is to provide voice-of-the-olderconsumer information which will enable policy makers,
R&D and consumer groups who support the elderly to
provide foods appreciated by older people.
Electronic access
The current issue and full text archive of this journal is
available at
http://www.emerald-library.com
Nutrition & Food Science
Volume 30 . Number 6 . 2000 . pp. 279±282
# MCB University Press . ISSN 0034-6659
With improvements in health-care, living
standards and socioeconomic status, more
adults are living to old age. The proportion of
the world's population aged 65 and over is
projected to increase from the current 6 per
cent to 15 per cent by the year 2025. If you
take the population of Europe in 1990, 13.7
per cent was over 65 and it is predicted that
by 2025 this proportion will have increased to
22.4 per cent (US Census Bureau, 1993). By
the twenty-second century it is estimated that
there will be more Europeans over 60 years
than under 20. This demographic shift creates
a major public health problem; that with
increasing age there is an increased risk of
development of a number of age-related
pathologies. With ageing, there is loss of bone
tissue, reduced respiratory function, decline
in cognitive function, impaired immune
function, increased susceptibility to infection
and increased risk of heart disease and cancer,
all of which reduce the quality of life (Barnett,
1994; Khaw, 1997). However, there is now
increasing evidence that many of the
biological changes and risk for chronic disease
which have been attributed to ageing are
really due to sub-optimal diets and nutrient
intakes (Blumberg, 1994; Beckman and
Ames, 1998; Morrissey and O'Brien, 1998).
While nutritional status surveys of the elderly
have shown a relatively low prevalence of
frank nutrient deficiencies, there is a marked
increase in risk of malnutrition and evidence
of subclinical deficiencies with a direct impact
on function (Blumberg, 1997). The
significance of these observations becomes
clear with the recognition that nutritional
status influences the age-related rate of
functional decline in many organ systems.
The evidence is therefore undisputed that diet
and nutrition are directly linked to many of
the chronic diseases afflicting older adults
(Committee on Diet and Health, Food and
Nutrition Board, Commission on Life
Sciences, National Research Council, 1989).
The public health challenge
A major societal challenge, and one that has
been identified by the European Union, is to
improve quality of life and prevent or reduce
disability and dependency in this ageing
population. In the light of the evidence
279
EU-funded project on the elderly
Nutrition & Food Science
Volume 30 . Number 6 . 2000 . 279±282
Caroline A. Martin
already outlined, diet and nutrition present
themselves as a fundamental part of the
solution to this challenge as well as to the
public health challenge to reduce morbidity.
The effect of age on nutrient requirements
is difficult to quantify for older adults because
there is such great variability in ageing
(Chernoff, 1995). Different individuals age at
different rates and, within a particular person,
ageing occurs at different rates within the cells
and systems of the body. Generally it is
assumed that energy intake and energy
expenditure decrease with age. The declining
need for energy is primarily due to a reduction
in the amount of lean body mass and a more
sedentary lifestyle. Unfortunately with this
decline in need for energy comes a critical risk
of malnutrition. Decreasing energy intake
with advancing age has important
implications for the diet in terms of protein
and micronutrients (Blumberg, 1997).
Although there is a decrease in energy
requirements with advancing age, there is no
parallel decrease in the need for most other
nutrients ± in fact, protein and certain vitamin
requirements may actually increase
(Chernoff, 1995). Increases in the status of
vitamins B6, B12 and folate, for example, will
offer significant protection against
cardiovascular disease, and certain deficits of
neurocognitive function (Blumberg, 1994).
Dietary quality becomes difficult to ensure
when overall energy intake is low and requires
a careful selection of nutrient-dense foods. At
present, it seems that the gap between actual
nutrient consumption common among older
adults and the recommended intakes from
diets associated with health promotion and
prevention of chronic diseases is large
(Blumberg, 1997). This begs the question,
why does food consumption decrease to such
an extent with advancing years and what are
the factors that affect both food choice and
food consumption?
Factors affecting food intake of elderly
people
Food choice, like any complex human
behaviour, is influenced by many interrelating
factors. It is not determined entirely by
physiological or nutritional need, but is also
influenced by social and cultural factors. A
number of models seeking to delineate the
effects of likely influences have been put
forward in the literature (for a review, see
Shepherd (1989)). In one particular model,
the various factors influencing food choice
have been categorised as those related to food,
to the individual making the choice and to the
external economic and social environment
within which the choice is made (Shepherd,
1985).
One of the well established factors that
affects food choice is the sensory perceptions
to food stimuli. Chemical and physical
properties of the food are perceived by the
individual in terms of sensory attributes.
These sensory attributes of foods can be
categorised, in broad terms, as appearance,
texture, trigeminal mouthfeel, odour and
taste. The ability to perceive these sensory
attributes in addition to actually liking them
determines whether or not an individual
consumes a particular food (Shepherd, 1999).
There are inter-individual variations in
sensitivity to stimuli and, as ageing
progresses, the senses (individually or
together) may degenerate. For example, the
number of taste buds decrease with increasing
age, which in turn causes a gradual decrease
in sensitivity to tastants (Schiffman et al.,
1979). The impact a change in sensory
capability has on food preferences and food
intake is unclear. From a physiological point
of view, one might assume that a consumer
will require an increase in the intensity of a
certain stimulus in proportion to any decrease
in sensitivity to that stimulus. For this reason,
a recommendation to enhance the flavour of
foods has been widely advocated. On the
other hand, from the psychological viewpoint, it can be argued that a person's
preferences are entirely acquired, and can be
continuously re-acquired during a slow
decline in sensory capability. The real truth
may lie somewhere in the middle for there is
little doubt that certain types of texture (e.g.
hard or sticky foods) may cause problems for
elderly people.
Age-related deficits in taste and smell have
been reputed to decrease the enjoyment of
food, reduce food consumption and lead
eventually to malnutrition and ill health
(Schiffman, 1997). On the other hand, a
number of studies have reported that undernutrition per se is a causative factor in
producing alterations in taste and smell
(Davidson et al., 1998). The evidence is clear
that elderly people often suffer from olfactory
and/or taste deficits. However, what is not
280
EU-funded project on the elderly
Nutrition & Food Science
Volume 30 . Number 6 . 2000 . 279±282
Caroline A. Martin
clear is the impact of these deficits on food
choice, nutrition and health.
Objectives of HealthSense
One of the key objectives of HealthSense is to
generate scientific data on the relationship
between sensory physiology and food
preferences. Reliable and valid tests will be
developed to measure the capability of the
four types of sensory perception (texture,
trigeminal, odour, and taste), which have a
direct impact on preferences before and
during consumption. Another objective is to
study the degradation of sensory capability in
the ageing and determine how this affects
their food preferences and general wellbeing.
Free-living European consumers in five
different age categories will express their
preferences for real foods which represent the
typical range of texture and flavour types
encountered. Comparisons of these
preferences across the different age sections
and across cultures will be made and related
to the sensory capabilities (including
interactions and compensations between the
senses) of the individuals tested. The role of
past experiences with food, recalled by
memory, and how these influence
preferences, will also be objectively
determined. It is well recognised that memory
plays a significant role in personal preferences
and aversions, in meal patterns and in meal
satisfaction. Methods will be developed to test
sensory memory (visual, auditory, olfactory,
gustatory, tactile and other somato-sensory).
The immediate social context within which a
meal is eaten can also influence food choice
and consumption. For example, work by de
Castro and de Castro (1989) has shown that
the amount of food consumed increases with
an increasing number of individuals present at
a meal. HealthSense will gain insight into the
influence of situational factors on the
relationship between sensory impressions and
food appreciation. This relationship will then
be validated in real life situations, with
optimised food products. The data generated
from each of these sensory-oriented tests will
be used by both the food industry and health
policy makers to develop foods with optimal
sensory attributes for elderly consumers.
As outlined earlier, other factors influencing
food choice include those relating to the
individual making the choice. For instance,
psychological differences between individuals,
such as personality, may have a significant
influence on food choice (Shepherd and
Farleigh, 1986). Factors relating to the
external economic and social environment
within which the choice is made will also
affect food choice (Shepherd, 1999). The
culture in which individuals are brought up
will strongly influence the types of choices
made, and social interactions will have a
profound effect on attitude towards food and
eating behaviour (Shepherd, 1999). There are
also many factors in the context within which
the choice is made that are likely to be very
important. HealthSense will address each of
these issues in detail by way of qualitative and
quantitative EU surveys. A series of group
discussions and in-depth interviews will be set
up in five European countries to investigate
and quantify the attitudes of elderly people
with respect to food-related issues and how
these may affect food choice behaviour. The
surveys will examine possible influences on
food choice including: taste, price, healthy
eating, convenience, availability, appearance,
ease of preparation and portion size. The
mentality of the ageing towards food will also
be studied ± in other words, whether people
``live to eat'' or ``eat to live'' will be
investigated. HealthSense will review the
provisioning strategies of different household
types and how factors such as distance of
shops from consumers, who helps with the
shopping, affect food choice. HealthSense
will also obtain knowledge on how nutritional
information is likely to be received and
practised among elderly people according to
their health and socio-demographic status. It
will determine the best way to communicate
nutritional information.
In summary, this project brings into sharp
focus the issues which determine the choice of
foods and how the ageing and elderly deal
with barriers to food choice and enjoyment.
An understanding of the mechanisms of food
choice and acceptance is an integral part of all
attempts to improve the competitiveness of
the European food and drink sector. As there
would now appear to be both a need and an
economic environment for the development
of foods specifically designed for a rapidly
growing elderly population (Peleg, 1993), the
information which HealthSense produces will
underpin the development of the European
industry and will support continuous
advances in food technology, which, in turn,
281
EU-funded project on the elderly
Nutrition & Food Science
Volume 30 . Number 6 . 2000 . 279±282
Caroline A. Martin
will provide significant opportunity for
companies to produce cutting-edge nutritious
foods.
References
Barnett, Y.A. (1994), ``Nutrition and the ageing process'',
British Journal of Biomedical Science, Vol. 51,
pp. 278-87.
Beckman, K.B. and Ames, B.N. (1998), ``The free radical
theory of ageing matters'', Phys. Rev., Vol. 78,
pp. 547-81.
Blumberg, J.B. (1994), ``Nutrient requirements of the
healthy elderly ± should there be specific RDAs?'',
Nutrition Reviews, Vol. 52, pp. 515-18.
Blumberg, J.B. (1997), ``Nutritional needs of seniors'',
Journal of the American College of Nutrition,
Vol. 16, pp. 517-23.
Chernoff, R. (1995), ``Effects of age on nutrient
requirements'', Clinical Geriatric Medicine, Vol. 11,
pp. 641-51.
Committee on Diet and Health, Food and Nutrition Board,
Commission on Life Sciences, National Research
Council (1989), Diet and Health: Implications for
Reducing Chronic Disease Risk, National Academy
Press, Washington, DC.
Davidson, H.I., Pattison, R.M. and Richardson, R.A.
(1998), ``Clinical undernutrition states and their
influence on taste'', Proceedings of the Nutrition
Society, Vol. 57, pp. 633-8.
de Castro, J.M. and de Castro, E.S. (1989), ``Spontaneous
meal patterns of humans: influence of the presence
of older people'', American Journal of Clinical
Nutrition, Vol. 50, pp. 237-47.
Khaw, K.T. (1997), ``Epidemiological aspects of ageing'',
Phil. Trans. Royal Soc. London B. Biol. Sci., Vol. 352,
pp. 1829-935.
Morrissey, P.A. and O'Brien, N.M. (1998), ``Dietary
antioxidants in health and disease'', International
Dairy Journal, Vol. 8, pp. 463-72.
Peleg, M. (1993), ``Tailoring texture for the elderly:
theoretical aspects and technological options'',
CRC ± Critical Reviews in Food Science and
Nutrition, Vol. 33, pp. 45-55.
Schiffman, S.S. (1997), ``Taste and smell uses in normal
ageing and disease'', Journal of the American
Medical Association, Vol. 278, pp. 1357-62.
Schiffman, S.S., Orlandi, M. and Erickson, R.P. (1979),
``Changes in taste and smell with age: biological
aspects'', in Ordy, J.M. and Brizee, K. (Eds), Sensory
Systems and Communications in the Elderly (Ageing
10), Raven Press, New York, NY, pp. 247-68.
Shepherd, R. (1985), ``Dietary salt intake'', Nutrition and
Food Science, Vol. 96, pp. 10-11.
Shepherd, R. (1989), ``Factors infuencing food preferences
and choice'', Handbook of the Psychophysiology of
Human Eating, Wiley, Chichester, pp. 3-24.
Shepherd, R. (1999), ``Social determinants of food choice'',
Proceedings of the Nutrition Society, Vol. 58,
pp. 807-12.
Shepherd, R. and Farleigh, C.A. (1986), ``Preferences,
attitudes and personality as determinants of salt
intake'', Human Nutrition: Applied Nutrition,
Vol. 40, pp. 195-208.
US Census Bureau (1993), An Ageing World II ±
International Population Reports, US Government
Printing Office, Washington, DC.
282
EU-funded project on
the elderly
Caroline A. Martin
The author
Caroline A. Martin is Project Administrator, Nutritional
Sciences, UCC, Cork, Ireland.
Keywords
Older people, Health care, Nutrition, European Union
Abstract
On 1 February 2000 the project HealthSense (``Healthy
eating: how changes in sensory physiology, sensory
psychology and socio-cognitive factors influence food
choice'') was launched. This is a multi-disciplinary, crosscultural project funded by the Fifth Framework of the
European Union, a programme that has been conceived,
among other tasks, to improve the quality of life for
European citizens. The project involves 24 participating
centres from ten European countries. There are currently
over 100 scientists of varying disciplines working on the
project which comprises eight individual working groups
or work packages. Each participating centre will work for
the duration of the project (36 months) within a particular
work package that has specific objectives, all of which are
necessary as parts of the overall objective. The overriding
objective of the project is to provide voice-of-the-olderconsumer information which will enable policy makers,
R&D and consumer groups who support the elderly to
provide foods appreciated by older people.
Electronic access
The current issue and full text archive of this journal is
available at
http://www.emerald-library.com
Nutrition & Food Science
Volume 30 . Number 6 . 2000 . pp. 279±282
# MCB University Press . ISSN 0034-6659
With improvements in health-care, living
standards and socioeconomic status, more
adults are living to old age. The proportion of
the world's population aged 65 and over is
projected to increase from the current 6 per
cent to 15 per cent by the year 2025. If you
take the population of Europe in 1990, 13.7
per cent was over 65 and it is predicted that
by 2025 this proportion will have increased to
22.4 per cent (US Census Bureau, 1993). By
the twenty-second century it is estimated that
there will be more Europeans over 60 years
than under 20. This demographic shift creates
a major public health problem; that with
increasing age there is an increased risk of
development of a number of age-related
pathologies. With ageing, there is loss of bone
tissue, reduced respiratory function, decline
in cognitive function, impaired immune
function, increased susceptibility to infection
and increased risk of heart disease and cancer,
all of which reduce the quality of life (Barnett,
1994; Khaw, 1997). However, there is now
increasing evidence that many of the
biological changes and risk for chronic disease
which have been attributed to ageing are
really due to sub-optimal diets and nutrient
intakes (Blumberg, 1994; Beckman and
Ames, 1998; Morrissey and O'Brien, 1998).
While nutritional status surveys of the elderly
have shown a relatively low prevalence of
frank nutrient deficiencies, there is a marked
increase in risk of malnutrition and evidence
of subclinical deficiencies with a direct impact
on function (Blumberg, 1997). The
significance of these observations becomes
clear with the recognition that nutritional
status influences the age-related rate of
functional decline in many organ systems.
The evidence is therefore undisputed that diet
and nutrition are directly linked to many of
the chronic diseases afflicting older adults
(Committee on Diet and Health, Food and
Nutrition Board, Commission on Life
Sciences, National Research Council, 1989).
The public health challenge
A major societal challenge, and one that has
been identified by the European Union, is to
improve quality of life and prevent or reduce
disability and dependency in this ageing
population. In the light of the evidence
279
EU-funded project on the elderly
Nutrition & Food Science
Volume 30 . Number 6 . 2000 . 279±282
Caroline A. Martin
already outlined, diet and nutrition present
themselves as a fundamental part of the
solution to this challenge as well as to the
public health challenge to reduce morbidity.
The effect of age on nutrient requirements
is difficult to quantify for older adults because
there is such great variability in ageing
(Chernoff, 1995). Different individuals age at
different rates and, within a particular person,
ageing occurs at different rates within the cells
and systems of the body. Generally it is
assumed that energy intake and energy
expenditure decrease with age. The declining
need for energy is primarily due to a reduction
in the amount of lean body mass and a more
sedentary lifestyle. Unfortunately with this
decline in need for energy comes a critical risk
of malnutrition. Decreasing energy intake
with advancing age has important
implications for the diet in terms of protein
and micronutrients (Blumberg, 1997).
Although there is a decrease in energy
requirements with advancing age, there is no
parallel decrease in the need for most other
nutrients ± in fact, protein and certain vitamin
requirements may actually increase
(Chernoff, 1995). Increases in the status of
vitamins B6, B12 and folate, for example, will
offer significant protection against
cardiovascular disease, and certain deficits of
neurocognitive function (Blumberg, 1994).
Dietary quality becomes difficult to ensure
when overall energy intake is low and requires
a careful selection of nutrient-dense foods. At
present, it seems that the gap between actual
nutrient consumption common among older
adults and the recommended intakes from
diets associated with health promotion and
prevention of chronic diseases is large
(Blumberg, 1997). This begs the question,
why does food consumption decrease to such
an extent with advancing years and what are
the factors that affect both food choice and
food consumption?
Factors affecting food intake of elderly
people
Food choice, like any complex human
behaviour, is influenced by many interrelating
factors. It is not determined entirely by
physiological or nutritional need, but is also
influenced by social and cultural factors. A
number of models seeking to delineate the
effects of likely influences have been put
forward in the literature (for a review, see
Shepherd (1989)). In one particular model,
the various factors influencing food choice
have been categorised as those related to food,
to the individual making the choice and to the
external economic and social environment
within which the choice is made (Shepherd,
1985).
One of the well established factors that
affects food choice is the sensory perceptions
to food stimuli. Chemical and physical
properties of the food are perceived by the
individual in terms of sensory attributes.
These sensory attributes of foods can be
categorised, in broad terms, as appearance,
texture, trigeminal mouthfeel, odour and
taste. The ability to perceive these sensory
attributes in addition to actually liking them
determines whether or not an individual
consumes a particular food (Shepherd, 1999).
There are inter-individual variations in
sensitivity to stimuli and, as ageing
progresses, the senses (individually or
together) may degenerate. For example, the
number of taste buds decrease with increasing
age, which in turn causes a gradual decrease
in sensitivity to tastants (Schiffman et al.,
1979). The impact a change in sensory
capability has on food preferences and food
intake is unclear. From a physiological point
of view, one might assume that a consumer
will require an increase in the intensity of a
certain stimulus in proportion to any decrease
in sensitivity to that stimulus. For this reason,
a recommendation to enhance the flavour of
foods has been widely advocated. On the
other hand, from the psychological viewpoint, it can be argued that a person's
preferences are entirely acquired, and can be
continuously re-acquired during a slow
decline in sensory capability. The real truth
may lie somewhere in the middle for there is
little doubt that certain types of texture (e.g.
hard or sticky foods) may cause problems for
elderly people.
Age-related deficits in taste and smell have
been reputed to decrease the enjoyment of
food, reduce food consumption and lead
eventually to malnutrition and ill health
(Schiffman, 1997). On the other hand, a
number of studies have reported that undernutrition per se is a causative factor in
producing alterations in taste and smell
(Davidson et al., 1998). The evidence is clear
that elderly people often suffer from olfactory
and/or taste deficits. However, what is not
280
EU-funded project on the elderly
Nutrition & Food Science
Volume 30 . Number 6 . 2000 . 279±282
Caroline A. Martin
clear is the impact of these deficits on food
choice, nutrition and health.
Objectives of HealthSense
One of the key objectives of HealthSense is to
generate scientific data on the relationship
between sensory physiology and food
preferences. Reliable and valid tests will be
developed to measure the capability of the
four types of sensory perception (texture,
trigeminal, odour, and taste), which have a
direct impact on preferences before and
during consumption. Another objective is to
study the degradation of sensory capability in
the ageing and determine how this affects
their food preferences and general wellbeing.
Free-living European consumers in five
different age categories will express their
preferences for real foods which represent the
typical range of texture and flavour types
encountered. Comparisons of these
preferences across the different age sections
and across cultures will be made and related
to the sensory capabilities (including
interactions and compensations between the
senses) of the individuals tested. The role of
past experiences with food, recalled by
memory, and how these influence
preferences, will also be objectively
determined. It is well recognised that memory
plays a significant role in personal preferences
and aversions, in meal patterns and in meal
satisfaction. Methods will be developed to test
sensory memory (visual, auditory, olfactory,
gustatory, tactile and other somato-sensory).
The immediate social context within which a
meal is eaten can also influence food choice
and consumption. For example, work by de
Castro and de Castro (1989) has shown that
the amount of food consumed increases with
an increasing number of individuals present at
a meal. HealthSense will gain insight into the
influence of situational factors on the
relationship between sensory impressions and
food appreciation. This relationship will then
be validated in real life situations, with
optimised food products. The data generated
from each of these sensory-oriented tests will
be used by both the food industry and health
policy makers to develop foods with optimal
sensory attributes for elderly consumers.
As outlined earlier, other factors influencing
food choice include those relating to the
individual making the choice. For instance,
psychological differences between individuals,
such as personality, may have a significant
influence on food choice (Shepherd and
Farleigh, 1986). Factors relating to the
external economic and social environment
within which the choice is made will also
affect food choice (Shepherd, 1999). The
culture in which individuals are brought up
will strongly influence the types of choices
made, and social interactions will have a
profound effect on attitude towards food and
eating behaviour (Shepherd, 1999). There are
also many factors in the context within which
the choice is made that are likely to be very
important. HealthSense will address each of
these issues in detail by way of qualitative and
quantitative EU surveys. A series of group
discussions and in-depth interviews will be set
up in five European countries to investigate
and quantify the attitudes of elderly people
with respect to food-related issues and how
these may affect food choice behaviour. The
surveys will examine possible influences on
food choice including: taste, price, healthy
eating, convenience, availability, appearance,
ease of preparation and portion size. The
mentality of the ageing towards food will also
be studied ± in other words, whether people
``live to eat'' or ``eat to live'' will be
investigated. HealthSense will review the
provisioning strategies of different household
types and how factors such as distance of
shops from consumers, who helps with the
shopping, affect food choice. HealthSense
will also obtain knowledge on how nutritional
information is likely to be received and
practised among elderly people according to
their health and socio-demographic status. It
will determine the best way to communicate
nutritional information.
In summary, this project brings into sharp
focus the issues which determine the choice of
foods and how the ageing and elderly deal
with barriers to food choice and enjoyment.
An understanding of the mechanisms of food
choice and acceptance is an integral part of all
attempts to improve the competitiveness of
the European food and drink sector. As there
would now appear to be both a need and an
economic environment for the development
of foods specifically designed for a rapidly
growing elderly population (Peleg, 1993), the
information which HealthSense produces will
underpin the development of the European
industry and will support continuous
advances in food technology, which, in turn,
281
EU-funded project on the elderly
Nutrition & Food Science
Volume 30 . Number 6 . 2000 . 279±282
Caroline A. Martin
will provide significant opportunity for
companies to produce cutting-edge nutritious
foods.
References
Barnett, Y.A. (1994), ``Nutrition and the ageing process'',
British Journal of Biomedical Science, Vol. 51,
pp. 278-87.
Beckman, K.B. and Ames, B.N. (1998), ``The free radical
theory of ageing matters'', Phys. Rev., Vol. 78,
pp. 547-81.
Blumberg, J.B. (1994), ``Nutrient requirements of the
healthy elderly ± should there be specific RDAs?'',
Nutrition Reviews, Vol. 52, pp. 515-18.
Blumberg, J.B. (1997), ``Nutritional needs of seniors'',
Journal of the American College of Nutrition,
Vol. 16, pp. 517-23.
Chernoff, R. (1995), ``Effects of age on nutrient
requirements'', Clinical Geriatric Medicine, Vol. 11,
pp. 641-51.
Committee on Diet and Health, Food and Nutrition Board,
Commission on Life Sciences, National Research
Council (1989), Diet and Health: Implications for
Reducing Chronic Disease Risk, National Academy
Press, Washington, DC.
Davidson, H.I., Pattison, R.M. and Richardson, R.A.
(1998), ``Clinical undernutrition states and their
influence on taste'', Proceedings of the Nutrition
Society, Vol. 57, pp. 633-8.
de Castro, J.M. and de Castro, E.S. (1989), ``Spontaneous
meal patterns of humans: influence of the presence
of older people'', American Journal of Clinical
Nutrition, Vol. 50, pp. 237-47.
Khaw, K.T. (1997), ``Epidemiological aspects of ageing'',
Phil. Trans. Royal Soc. London B. Biol. Sci., Vol. 352,
pp. 1829-935.
Morrissey, P.A. and O'Brien, N.M. (1998), ``Dietary
antioxidants in health and disease'', International
Dairy Journal, Vol. 8, pp. 463-72.
Peleg, M. (1993), ``Tailoring texture for the elderly:
theoretical aspects and technological options'',
CRC ± Critical Reviews in Food Science and
Nutrition, Vol. 33, pp. 45-55.
Schiffman, S.S. (1997), ``Taste and smell uses in normal
ageing and disease'', Journal of the American
Medical Association, Vol. 278, pp. 1357-62.
Schiffman, S.S., Orlandi, M. and Erickson, R.P. (1979),
``Changes in taste and smell with age: biological
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