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Taking Control of Chronic Disease to Age Well

Introduction

In South Carolina, more than 60% of adults over age 65 have more than one chronic disease. The Centers for Disease Control and Prevention (CDC) defines a chronic disease as a condition that lasts one year or more, needs ongoing medical attention, and/or limits daily activities.1

Many chronic diseases are linked to a few main risk factors:

  • Smoking increases the risk for cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD).1
  • Excessive alcohol use can lead to high blood pressure, heart disease, stroke, liver disease, and some cancers.1
  • Poor nutrition and lack of physical activity raise the risk of obesity, type 2 diabetes, stroke, certain cancers, and depression.1

While medicine and other treatments are important, nutrition therapy guided by an Registered Dietitian Nutritionist (RDN) is a key part of preventing and managing disease. This article explains why RDNs are essential members of the healthcare team for improving the health and quality of life of older adults.2

Chronic Disease in South Carolina

Chronic diseases have a major impact on older adults in South Carolina:

  • The leading causes of death among adults 65 and older include heart disease, cancer, Alzheimer’s disease, COPD, stroke, diabetes, accidents, kidney disease, and septicemia.3
  • In 2020, more than one in three deaths among adults 65+ were caused by heart disease or cancer.3
  • Chronic Kidney Disease (CKD), atrial fibrillation, and heart disease are among the top 10 causes of hospitalizations for adults 65+.3
  • Chronic diseases drive most of the nation’s $4.9 trillion in yearly healthcare costs—about 90% of this spending goes to people with chronic or mental health conditions.1,4

The Role of RDNs in Chronic Disease Management

RDNs are food and nutrition experts who meet national education and training standards.5 They work in many settings, including hospitals, schools, community health programs, government agencies, private practice, and foodservice.

RDNs use their knowledge of food and nutrition to help prevent and manage chronic diseases. Their work includes:5

  1. Assessment and Diagnosis
    • Review medical history, lab results, medications, lifestyle, and diet.
    • Identify nutrition-related risk factors that may contribute to disease.
  2. Individualized Medical Nutrition Therapy (MNT)
    • Create personalized meal plans based on the person’s health condition, preferences, and culture.
    • Adjust nutrition goals to support disease management.
    • Provide evidence-based nutrition advice that works alongside medical care.
  3. Preventing Disease Progression
    • Help manage weight, blood pressure, blood sugar, and cholesterol through education and meal planning.
  4. Monitoring and Evaluation
    • Track health progress using nutrition and lab data.
    • Update nutrition plans as conditions or test results change.

Common Diet-Related Chronic Diseases and Nutrition Management

Type 2 Diabetes / Prediabetes6

  • Risk factors: Eating too many refined carbs and added sugars, not enough fiber, and consuming excess calories.
  • RDN approach: Encourage fiber-rich foods, whole grains, and balanced meals to help manage blood sugar and weight.

Cardiovascular Disease7

  • Risk factors: Diets high in saturated fat, sodium, and added sugar; low intake of fruits and vegetables.
  • RDN approach: Tailor energy and protein needs to prevent muscle loss; manage sodium and fluids to support heart health.

Obesity8,9

  • Risk factors: Eating large portions of processed, high-calorie foods and drinking sugary or alcoholic beverages.
  • RDN approach: Reduce added sugars and fats, increase complex carbohydrates and fiber, and promote long-term healthy weight goals.

Chronic Kidney Disease (CKD)10

  • Risk factors: High intake of animal protein, sodium, phosphorus, and saturated fat.
  • RDN approach: Adjust diet based on disease stage and dialysis needs, with energy goals of 25–35 kcal/kg/day and protein intake of 0.55–1.2 g/kg/day. Encourage a Mediterranean or plant-based diet.

Hypertension (High Blood Pressure)11

  • Risk factors: Diets high in sodium and saturated fat and low in potassium, calcium, and magnesium.
  • RDN approach: Promote the Dietary Approaches to Stop Hypertension (DASH) diet, reduce sodium (1,500–2,000 mg/day), and encourage foods rich in potassium, calcium, magnesium, and vitamin D. Limit alcohol.

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) *(formerly Non-Alcoholic Fatty Liver Disease)*12-14

  • Risk factors: Diets high in saturated fat and refined carbohydrates.
  • RDN approach: Limit high-calorie fats and added sugars, replace saturated fats with unsaturated fats (like omega-3s), and choose low-glycemic foods such as fruits, vegetables, and whole grains.

Learn more about what an RDN can do for you at EatRight.org. 

 

This article was written by Alexandria Dow, Winthrop University Dietetic Intern, in collaboration with the SC Department of Public Health.

 

 

References

1. About chronic diseases. Center for Disease Control and Prevention website. https://www.cdc.gov/chronic-disease/about/index.html. Updated 2024. Accessed Oct 8, 2025.

2. Slawson DL, Fitzgerald N, Morgan KT. Position of the academy of nutrition and dietetics: The role of nutrition in health promotion and chronic disease prevention. Journal of the Academy of Nutrition and Dietetics. 2013;113(7):972–979. https://www.jandonline.org/article/S2212-2672(13)00528-5/fulltext. Accessed Oct 8, 2025. doi: 10.1016/j.jand.2013.05.005.

3. Live Healthy South Carolina D. Healthy aging south carolina.

4. Fast facts: Health and economic costs of chronic conditionshttps://www.cdc.gov/chronic-disease/data-research/facts-stats/index.html. Updated 2025. Accessed Oct 8, 2025.

5. Registered dietitian (rd) or registered dietitian nutritionist (rdn) certification. Commission on Dietetic Registration website. https://www.cdrnet.org/rdn. Accessed Oct 8, 2025.

6. O’Hearn M, Lara-Castor L, Cudhea F, et al. Incident type 2 diabetes attributable to suboptimal diet in 184 countries. Nat Med. 2023;29(4):982–995. https://www.nature.com/articles/s41591-023-02278-8. Accessed Oct 8, 2025. doi: 10.1038/s41591-023-02278-8.

7. Chareonrungrueangchai K, Wongkawinwoot K, Anothaisintawee T, Reutrakul S. Dietary factors and risks of cardiovascular diseases: An umbrella review. Nutrients. 2020;12(4):1088. https://pmc.ncbi.nlm.nih.gov/articles/PMC7231110/. Accessed Oct 8, 2025. doi: 10.3390/nu12041088.

8. NHLBI N. Overweight and obesity - causes and risk factors. National Heart, Lung, and Blood Institute website. https://www.nhlbi.nih.gov/health/overweight-and-obesity/causes. Updated 2022. Accessed Oct 8, 2025.

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