Despite all the data and tools available, coupled with the United States being the most abundant food-producing nation in the world, many older adults simply do not receive the nutrients that they need. Malnutrition, a complicated issue, may follow.

Defined as a diet low in calcium, protein and calories, as well as inadequate fluid intake, undernourishment or malnutrition can be the result of one or more compounding factors.
According to the Administration on Aging, factors that contribute to a lack of nutritional health in older adults include eating too little, eating alone, neglectful caretaking, taking medications, suffering from chronic diseases or conditions, financial difficulties, and functional limitations.
There are also a number of natural age changes in the body that can contribute to undernourishment in seniors:
· A natural byproduct of aging is a decline in taste and smell. For example, scientists estimate that many receptors in the nose (essential to taste) and approximately two-thirds of taste buds have died by the time an individual reaches age 70.
· Oral diseases such as tooth decay or loss, periodontal disease, or cancer can negatively impact nutritional intake. People with missing teeth or incomplete or missing dentures are at a high risk for malnourishment. Medicare does not pay for dentures, so if they are lost or stolen, it is important for families to help replace them.
· Reduced absorption of nutrients and consuming too little food, puts seniors at risk of vitamin and mineral deficiency.
· Medications and multiple drug interactions can affect appetite and deplete certain minerals.
· Changes in the digestive system may make eating less enjoyable and even difficult.
· Limitations on mobility, for example, from arthritis, may interfere with the ability to shop for food, prepare food and eat it.

The Modified MyPyramid for Older Adults attempts to address many of these issues:
· The foundation of the new pyramid portrays physical activities that seniors can take advantage of, such as walking, housework, and yard work. Physical activity is one way to mitigate chronic disease, obesity and hypertension. It can also improve quality of life. .
· The pyramid stresses the importance of consuming fluids by having a row of 8 glasses as the second level of the foundation.
· Packaged fruits and vegetables, in addition to fresh fruits and vegetables are shown on the pyramid. For example, bags of frozen vegetables might be easier to prepare, have a longer life than fresh vegetables, and can be resealed to minimize waste. These factors are important to consider for those seniors who live alone or have limited mobility.
· The pyramid gives numerous examples of fiber rich foods, which are critical to digestive health: whole grain products, whole fruits and vegetables, and even dried fruits and vegetables.
· The top of the pyramid has a flag representing supplemental nutrients, such as calcium, vitamin D and vitamin B12, which are often needed since medications and the natural aging process can result in decreased absorption of vitamins and minerals. Doctors frequently recommend that people with an acute or chronic illness increase zinc, which aids in wound healing and immune function. Supplements, however, should only be taken under the supervision of a medical professional.