Nutrition Requirements in the Elderly
Good Health in the Twilight Years
It is common knowledge that the demographic profile of most nations points to an increase in the population of the elderly. The nutrient requirement of the elderly and the concerns for the health and nutrition of the elderly are far different from any other population group.
After fifty years of age, there are many metabolic and physiological changes that affect the nutritional needs of an individual. There is a tremendous fall in the metabolic rate that can be as high as thirty percent over a lifetime. This results in decreased caloric needs, which can be complicated by changes in an older person’s ability to balance food intake and energy needs.
It is a good practice to talk to the elderly about the food they have taken during the day in order to monitor their state of nutrition.
Even with a decreased caloric need, many older people have difficulty getting sufficient calories, which can eventually lead to chronic fatigue, depression, and a weak immune system. This situation may not appear serious enough but can have profound effect on the health of the elderly. Hence, good health for the seniors must be on the agenda of those taking care of them. As we age our body composition changes with a decrease in lean tissue mass (as much as 25%) and an increase in body fat. Such changes can be accelerated because older adults utilize dietary protein less efficiently and may actually need a greater than recommended amount of high quality protein in their diet to maintain lean tissue mass. These changes in metabolism and physiology can be exaggerated due to complications from digestive difficulties, oral and dental problems, and medication-related eating and nutrient problems.
There is enough scientific evidence that good nutrition promotes vitality and independence whereas poor nutrition can prolong recovery from illness, increase the costs and incidence of hospitalization, and lead to poor quality of life. Good nutrition is, therefore, basic to the quality of life. And while the evidence of the value of nutritional balance is clear, the nutritional status of many older individuals lacks that balance and the problem is often complicated by a fear of foods and the diet related information that is thrust on them.
Total Calorie Requirement:
Calorie needs change in the elderly due to more body fat and less lean muscle. Less activity can further decrease in calorie needs. The challenge for the elderly is to meet the same nutrient needs as when they were younger, yet consume fewer calories. It is better to choose foods high in nutrients in relation to their calories. Such foods are considered “nutrient-dense.” For example, low-fat milk is more nutrient dense than regular milk. Its nutrient content is the same, but it has fewer calories because it has less fat.
Protein absorption may decrease as we age, and our bodies may make less protein. This does not mean protein intake should be routinely increased, because of the general decline in kidney function. Excess protein could increase the stress on kidneys.
It is also good to reduce overall fat content in the diet. While it is the easiest way to cut calories, it is often necessary because of chronic diseases.
Carbohydrates, should contribute about 60 percent of calories in the daily diet. The emphasis should however be on complex carbohydrates. The elderly are prone for Glucose. Complex carbohydrates put less stress on the circulating blood glucose than the refined carbohydrates.It is to be noted that adequate fiber, together with adequate fluid, helps maintain normal bowel function. Fiber also is thought to decrease risk of intestinal inflammation. Vegetables, fruits, grain products, cereals, seeds, legumes and nuts are all sources of dietary fiber.
Vitamins and Minerals
Vitamin deficiencies may not be obvious in many older people. However, any illness puts a stress on the body and uses up all the nutrients stores and makes the person vitamin deficient. Medications also interfere with the absorption of many vitamins. Eating nutrient-dense foods becomes increasingly important when calorie needs decline but vitamin and mineral needs remain high.
The body can store fat-soluble vitamins and usually the elderly are at lower risk of fat-soluble vitamin deficiencies. It is better to provide vitamin D-fortified milk for the housebound, nursing home residents, and anyone who does not get adequate exposure to sunlight.
Iron and calcium intake sometimes appears to be low in many elderly. To enhance iron absorption from non-meat sources, such as cereals, eat a wide selection of foods, including calcium-rich foods such as low-fat dairy products. Add vitamin C-rich fruits and vegetables. Thus, have juice or sliced fruit with cereal preparations.
Zinc can be related to specific diseases in the elderly. It can also be a factor with vitamin K in wound healing. Zinc along with vitamins C and E, and the photochemical lutein, zeaxanthin and beta-carotene may help prevent or slow the onset of age-related macular degeneration. The best way to obtain these nutrients is to consume at least five servings of fruits and vegetables, especially dark green, orange and yellow ones. Good choices include spinach, broccoli, peas, and oranges. It is also advised to consult a doctor to see if a supplement may also be necessary.
Vitamin E may have a potential role in the prevention of Alzheimer’s disease. Research has shown that eating foods with vitamin E, like whole grains, peanuts, nuts, vegetable oils, and seeds, may help reduce the risk of Alzheimer’s disease. However, the same benefits are not observed with vitamin E from supplements.
Low levels of vitamin B12 have been associated with memory loss and linked to age-related hearing loss in older adults. As we age, the amount of the chemical in the body, needed to absorb vitamin B12 decreases. To avoid deficiency, older adults are advised to eat foods rich in vitamin B12, such as eggs and dairy foods, regularly.
Drugs used to control diseases such as hypertension or heart disease can alter the need for electrolytes, sodium and potassium. Even though absorption and utilization of some vitamins and minerals becomes less effective with age, higher intakes do not appear to be necessary. As for any age group, it’s important to enjoy a wide variety of foods.
Generally, water as a nutrient receives little attention once a person is old enough to talk. However, of all the nutrients, water is the most important, serving many essential functions.
Adequate water intake reduces stress on kidney function, which tends to decline with age. Adequate fluid intake also eases constipation. With the aging process, the ability to detect thirst declines. Drink plenty of water, juice and milk to stay hydrated. Drink the equivalent to five to eight glasses everyday.
Variety of Foods
People of all ages need more than 40 nutrients to stay healthy. With age, it becomes more important that diets contain enough calcium, fiber, iron, protein, and the vitamins A, C, D and Folacin. Reduce calories, select nutrient-dense foods, and enjoy smaller portions of foods high in fat, sugar and sodium
Because no one food or pill provides all of the nutrients, eat a variety of foods to get the full spectrum of nutrients.Variety often is lacking in the diets of the elderly, who often eat the same foods over and over again. The following suggestions can be tried:
- Eat breakfast foods for lunch or lunch foods for dinner.
- Use color as a guide for variety in a meal. A good meal should provide three distinct colors on the plate.
- Increase the variety of texture in meals. Add whole grain breads/ Roti (rye or wheat), whole grain cereals, and cooked legumes (beans of all types, lentils, dried peas).
- Eat at least five servings of fruits and vegetables each day
- To reduce calories select nutrient-dense foods. Enjoy smaller portions of foods high in fat, sugar and sodium.
- Try to consume organic foods as they provide nutrition that is free from the threat posed by the harmful pesticides