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Healthy Living: DETERMINE Your Nutritional Health1

Linda B. Bobroff 2

Figure 1. Older female fruit vendor
Figure 1.  Older female fruit vendor
Credit: Photo by Chris Goldberg (CC BY-NC 2.0)

The warning signs of poor nutritional health are often overlooked. Use this checklist to see if you and/or someone you care for may be at nutritional risk. Circle the number next to each item that applies to you.

Table 1. 

DETERMINE checklist

Then, look at the following pages to learn more about the warning signs of poor nutritional health and what you can do to improve your nutritional health. Check the "What does your nutritional score mean?" section to see what your nutritional score means.

Figure 2. Check mark
Figure 2.  Check mark
Credit: Graphic by PNASH (CC BY 2.0)

The first letters of the terms on the next two pages spell out the word DETERMINE. Use these words to remind you of the warning signs of poor nutritional health. If any of these signs apply to you or someone you care for, read in the boxes on the right side of the pages what you can do to decrease risk of poor nutritional health. Then, in each box check the steps that you will take to improve your nutritional health status.


Any disease, illness, or chronic condition that causes you to change the way you eat, or makes it hard for you to eat, puts your nutritional health at risk. People with confusion or memory loss may not remember what, when, or if they have eaten.

What you can do:

  • Choose foods you are able to eat.

  • Use herbs or spices to improve taste.

  • Eat small meals and snacks.

  • Use reminders to eat; for example, put a note on your refrigerator or bathroom mirror.

Eating Poorly

Eating too little or eating too much can lead to poor health. Eating the same foods day after day, or not eating fruits, vegetables, and milk products daily also can cause poor nutritional health. Also, drinking alcohol can make many health problems worse.

What you can do:

  • Choose a variety of foods you like.

  • Have fruit with breakfast and snacks.

  • Limit alcohol use.

  • Boost up your meals; for example, add grated carrots to sandwiches or make soups with low-fat milk instead of water.

Tooth Loss/Mouth Pain

We need a healthy mouth, teeth, and gums to be able to eat a variety of foods. Missing, loose, or rotten teeth make it hard to eat; so do dentures that don't fit well or cause mouth sores.

What you can do:

  • Take care of your teeth and gums!

  • Be sure your dentures fit right.

  • Visit the dentist regularly.

  • Choose foods you are able to eat.

Economic Hardship

About one in ten Americans over age 65 (over 4 million people) live in poverty. Spending less than about $40 per week for food makes it very hard to get the foods you need to stay healthy.

What you can do:

  • Use available resources such as food stamps (SNAP).

  • Share meals with a friend.

  • Use coupons and buy store brand foods.

  • Eat less expensive protein foods, such as lentils, eggs, and pinto, lima, and kidney beans.

Reduced Social Contact

Just over one-fourth of all people over 65 years old live alone. Being with people daily has a positive effect on morale, well-being, and eating habits.

What you can do:

  • Share meals with a friend.

  • Eat at congregate meal sites or senior centers.

  • Stay in touch with family and friends.

Multiple Medications

Many Americans over 65 years old take multiple medications daily. Getting older may change the way the body responds to certain drugs. The more medicines you take, the greater the chance for side effects. This may include increased or decreased appetite, change in taste, constipation, drowsiness, diarrhea, or nausea. Large doses of vitamins or minerals act like drugs and also can cause harm.

What you can do:

  • Buy all medicines at one pharmacy.

  • Talk to your pharmacist about the medicines you take.

  • Learn about possible interactions between foods and medicines you take.

  • Make a list of all your medicines, including vitamin/mineral supplements and over-the-counter medicines. Take this list to all your doctor visits.

Involuntary Weight Loss/Gain

Losing or gaining weight when you are not trying to do so is an important warning sign that must not be ignored. Also, being either overweight or underweight increases your chance of poor health.

What you can do:

  • Eat healthy foods every day.

  • Stay as active as you can.

  • Tell your doctor about any change in your appetite and/or weight.

Needs Assistance in Self Care

The majority of older people are able to eat and take care of themselves. However, almost one half of people age 65 or older have trouble walking, shopping, buying and cooking food, and/or eating.

What you can do:

  • Stay in contact with family and friends.

  • Take advantage of available services such Meals on Wheels and food delivery programs from grocery stores or online food companies.

Elder Years Above Age 80

Most older people lead full and productive lives. But as age increases, risk of frailty and health problems increase.

What you can do:

  • Check your nutritional health often.

  • Stay as active as possible.

  • Treat yourself well with good meals.

What does your nutritional score mean?

If your score is: 0 to 2


Recheck your nutritional score in 6 months.

If your score is: 3 to 5

You are at moderate nutritional risk.

See what you can do to improve your eating habits and lifestyle. A registered dietitian (RD), your office on aging, senior nutrition program, senior citizens center, county Extension service, or health department may be able to help. Recheck your nutritional score in three months.

If your score is: 6 or higher

You are at high nutritional risk.

Make an appointment to see your doctor, a registered dietitian, or other qualified health or social service professional soon. Bring this checklist to your appointment. Talk with them about any problems you may have. Ask for help to improve your nutritional health. Also, use some of the "What You Can Do" tips for each of the items you circled.

Figure 3. Visit
Figure 3.  Visit


  • Warning signs suggest risk, but do not represent diagnosis of any condition.

  • If you have questions or concerns about your nutritional score, check with your health care provider.


Administration for Community Living. (2018). Announcing the 2017 Profile of Older Americans. Accessed September 17, 2018.

U.S. Census Bureau. (2018). Income and Poverty in the United States: 2017. Accessed September 28, 2018.

U.S. Department of Agriculture. (2018). Official USDA Food Plans: Cost of Food at Home at Four Levels, U.S. Average, July 2018. Accessed September 17, 2018.


1. This document is FCS8547 (la versión en español de este documento es Vida Saludable: DETERMINE su salud nutricional (FCS8547-Span)), one of a series of the Department of Family, Youth and Community Sciences, UF/IFAS Extension. Original publication date June 1998. Revised July 2015 and September 2018. Visit the EDIS website at Adapted with permission by the Nutrition Screening Initiative, a project of the American Academy of Family Physicians, The American Dietetic Association, and the National Council on the Aging, Inc.; and funded in part by a grant from Ross Products Division, Abbott Laboratories.
2. Linda B. Bobroff, PhD, RDNN, professor, Department of Family, Youth and Community Sciences; UF/IFAS Extension, Gainesville, FL 32611.

Publication #FCS8547

Date: 12/4/2018

    Fact Sheet


    • Linda Bobroff