Nutritional Interventions

Nutritional Intake

Dietary patterns—the combination of foods and beverages consumed over time—strongly influence weight and other aspects of health and well-being. Food composition, as well as physiological and psychological factors all influence feelings of hunger, appetite, cravings, satiation, and satiety and impact consumption patterns (OMA, 2025). The USDA’s Dietary Guidelines for Americans 2025-2030 provides recommendations for dietary intake across the lifespan, including for older adults. These guidelines note that some older adults have reduced caloric needs but still require equal or greater amounts of key nutrients such as protein and certain vitamins, and that fortified foods or supplements may be needed for this population (USDA, 2025).

USDA Nutrition Guidelines

USDA recommendations call for paying attention to caloric intake and hydration; prioritizing protein at every meal; consuming dairy, vegetables, and fruits; consumption of healthy fats and whole grains; limiting highly processed foods, added sugars, and refined carbohydrates; and limiting alcoholic beverages (USDA, 2025).

Dietary Patterns for Weight Loss

A variety of dietary patterns may be used to promote weight loss, including Mediterranean, DASH, vegetarian, ketogenic, and others (OMA, 2025). Various types of calorie-restricted diets (e.g., low fat and low carbohydrate) produce similar amounts of weight loss over time (OMA, 2025). 

According to the Obesity Algorithm 2025®, principles of healthful nutrition choices for weight loss include (OMA, 2025):

Consumption of healthful proteins and fats, such as seafood and dairy products, while being mindful of caloric content. (Healthful fats include monounsaturated and polyunsaturated fats, which are associated with reduced cardiovascular risk.)
Consumption of vegetables and fruits in their whole form, as well as nuts, legumes, and whole grains.
Complex carbohydrates over simple sugars; low glycemic index foods over high glycemic index foods; high fiber foods over low fiber foods.
Minimizing energy-dense foods and beverages such as sugar-sweetened beverages, juice, cream.
Minimizing trans fats and excessive sodium.
Reading labels rather than marketing claims.
Recognition of the importance of diet quality, beyond merely focusing on calories and individual nutrients.
Focus on whole foods, as opposed to ultraprocessed foods. The degree to which foods are processed can be classified using the NOVA Food Classification System.

Protein Needs and Personalized Nutrition in Older Adults

Dietary protein intakes of less than 0.8 g/kg body weight per day can exacerbate declines in muscle size, quality, and function in older adults. On the other hand, 1.0 to 1.6 g/kg body weight per day may promote greater muscle strength and function.

When working with individuals to create a negative caloric balance to promote weight loss, clinicians should individualize recommendations and consider (OMA, 2025):

Eating behaviors and meal patterns

Social and environmental influences

Cultural background, traditions, and food availability

Time constraints and financial issues

Nutritional knowledge, literacy, and cooking skills

Medical conditions and medications potentially affected by the nutrition plan

Supporting Healthy Eating in Older Adults with Obesity

Many older adults with obesity could benefit from a referral to a registered nutritionist (RD) or dietitian (RDN) to provide support with improving dietary patterns. (Note that individuals who give advice about nutrition have a wide range of training and experience; patients should be referred to credentialed RDs or RDNs.) However, primary care providers can and should provide support for improving dietary patterns as well, including discussion of basic nutritional principles with a focus on food groups that should be enhanced and food groups that should be minimized (Pennings et al., 2025). 

Practice Pearl | Nutrition and Dietician Guidance

Kathryn N. Porter Starr, PhD, RDN, Associate Professor of Medicine – Geriatrics, Duke University School of Medicine, Research Health Scientist, Durham VA Health System

When recommending weight loss, particularly in older adults with multiple chronic conditions, it’s critical to be purposeful and avoid vague advice like simply ‘lose weight.’ Restriction without guidance can be harmful. Working with registered dietitians to provide medical nutrition therapy that aligns with the patient’s health status is key. Additionally, older adults have increased protein needs to counter anabolic resistance, so we recommend about 30 grams of high-quality protein three times a day to preserve muscle mass.

Dietary Supplements and Weight Loss

Importantly, numerous dietary supplements are marketed for their ability to support weight loss. Claims associated with such products include that they reduce appetite or increase metabolism. In the United States, more than $2 billion is spent annually on dietary supplements for weight loss and roughly 15% of adults have used a dietary supplement to support weight loss (ODS, 2022). More information about Dietary Supplements for Weight Loss is available from the Office of Dietary Supplements of the National Institutes of Health. Older adults should be advised to discuss the use of any dietary supplements with a member of their health care team. Any dietary supplements that are used should be carefully evaluated to assess any available data about potential risks and benefits, as well as the potential for drug interactions with any medications the person uses. In addition, specific products should be assessed to determine whether they comply with good manufacturing practices to guard against adulterated or mislabeled products. 

Resources

GSA maintains a page of educational resources about Nutrition for Older Adults that address a range of important issues. For example, the GSA Momentum Discussion Podcast episode, Nutritional Needs of Older Adults with Obesity, explores complex issues around dietary needs of older adults, including the importance of assessing for and addressing sarcopenia, and highlights how comprehensive nutritional care can support function, independence, and quality of life while enabling the older adult to reach and maintain their desired body weight. The National Institute on Aging offers Healthy Meal Planning: Tips for Older Adults.

Evaluate | Approaches to Implement