A nurse is teaching a group of healthy older adult clients about dietary needs. Which of the following statements should the nurse include in the teaching?

Choice A reason: The standard DASH diet limits sodium intake to 2,300 milligrams per day, which is about the amount of sodium in 1 teaspoon of table salt¹. A lower sodium version of DASH restricts sodium to 1,500 milligrams per day, which may lower blood pressure even further¹. Therefore, limiting sodium intake to 3,200 milligrams per day is not consistent with the DASH diet.

Choice B reason: The DASH diet recommends eating fewer refined carbohydrates and less sugar, as they can increase blood pressure and cholesterol levels². Instead, the DASH diet emphasizes eating more whole grains, fruits, and vegetables, which are rich in fiber, potassium, calcium, and magnesium².

Choice C reason: The DASH diet encourages consuming foods that are high in calcium, such as fat-free or low-fat dairy products, fish, beans, and nuts¹. Calcium is a mineral that helps regulate blood pressure and supports bone health³. Studies have shown that increasing calcium intake can lower blood pressure in people with hypertension³.

Choice D reason: The DASH diet advises limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils¹. Saturated fat can raise blood pressure and cholesterol levels, which can increase the risk of heart disease and stroke. The DASH diet recommends consuming no more than six percent of total calories from saturated fat¹.

Choice A reason: Crohn's disease is not commonly associated with obesity, although obesity can worsen the symptoms and complications of Crohn's disease. Crohn's disease is a type of inflammatory bowel disease that causes inflammation and ulcers in the digestive tract, especially the small intestine and colon. The exact cause of Crohn's disease is unknown, but it may involve genetic, immune, and environmental factors.

Choice B reason: Celiac disease is not commonly associated with obesity, although obesity can make the diagnosis of celiac disease more difficult. Celiac disease is an autoimmune disorder that causes damage to the small intestine when gluten, a protein found in wheat, barley, and rye, is ingested. The damage interferes with the absorption of nutrients and can lead to malnutrition, anemia, and osteoporosis.

Choice C reason: Peptic ulcer disease is not commonly associated with obesity, although obesity can increase the risk of complications from peptic ulcer disease. Peptic ulcer disease is a condition that causes sores or ulcers in the lining of the stomach or duodenum, the first part of the small intestine. The most common causes of peptic ulcer disease are infection with Helicobacter pylori bacteria and use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Choice D reason: Gastroesophageal reflux disease (GERD) is commonly associated with obesity, as obesity can increase the pressure on the lower esophageal sphincter (LES), the muscle that prevents the backflow of stomach acid into the esophagus. GERD is a condition that causes heartburn, regurgitation, chest pain, and difficulty swallowing due to the reflux of stomach acid into the esophagus. GERD can also lead to esophagitis, Barrett's esophagus, and esophageal cancer.