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Nutrition for the Elderly

Renuka Berry

Helping the elderly choose wisely from among the food groups can improve their health and zest for life. As a matter of fact, these recommendations wouldn't be bad for adults of any age to use daily!

Old people are physically less active and therefore need less food. Though it is difficult to change the food habits drastically at this age, but still the amount of food can be reduced and a few minor changes can be made as per the requirement. Over the years, many destructive changes occur in the body.

These include damage to cell wall which may predispose to heart disease and stroke, damage to the internal mechanism of the cells leading to genetic damage and a possible predisposition to cancer, reduced immune function and damage to proteins in the skin causing an increase in skin wrinkling. As a result of these common health problems and bodily changes that occur with aging, people over the age of 70 years have:

  • Decreased energy needs
  • A need for increased nutrient density in daily food selections
  • An increased need for fiber (20 g/d)
  • Increased needs for calcium (1200-1400 mg/d), vitamin D (600 IU), and vitamin B-12 (with nutritional supplements sometimes necessary to achieve these levels)
  • Special concerns for adequate hydration. Drinking 8 cups of fluid/day is recommended, in addition to any alcohol or caffeine-containing beverages consumed, and regardless of a lack of sensation of thirst.
Hallmarks of Food Selection Guides Important for Older Healthy, Active Adults
  • Choosing a variety of foods
  • Eating a diet high in grain products, fruits and vegetables
  • Eating a diet low in saturated fatty acids and cholesterol
  • Using low to moderate amounts of sugar, salt, and alcohol
  • Balancing energy intake with physical activity
  • Choose the lower number of recommended servings from each food group.
  • For grain products, choose whole grain, enriched/fortified products; brown rice rather than white; and a high fiber breakfast cereal fortified with vitamin B-12 and folic acid.
  • From the vegetables and fruits, choices should include deeply colored produce and the whole food rather than just the juice. Dark green, orange, red and yellow ones should be chosen often.
  • Dairy choices should emphasize low fat selections, with at least 3 calcium-rich product servings/d, or the equivalent in calcium-fortified orange juice or in nutritional supplements.
  • From the meat/poultry/fish/dry beans/egg/nuts food group, choose a variety of lean cuts of meats and poultry. Eat fish at least once a week and legume dishes at least twice a week instead of a meat main dish.
  • Most fat choices should be limited. Those chosen should consist primarily of a variety of liquid oils, or foods prepared with oils, rather than hydrogenated or saturated fats.
  • Food selections with refined carbohydrates (sugar) should be kept to a minimum.
Energy and Protein Requirements
Energy requirements of elderly people are slightly lower than those for younger adults. However, requirements for all other nutrients are as for the young adult. Therefore, the diet needs to become more nutrient dense, i.e. a diet, which provides a large number of nutrients relative to the overall energy intake.

Energy requirements are determined by many factors including the basal metabolic rate, levels of activity, the presence of infections or fever and the need for weight loss or gain. It is often assumed that with old age, organ function decreases, physical activity decreases, and lean body mass decreases and hence, metabolic rate decreases. This may not necessarily be the case if physical activity is maintained.

Protein requirements remain similar to those for younger adults. If energy intakes are inadequate, the body uses protein stores (muscle) to obtain energy. Therefore, an adequate energy intake is essential to minimise protein loss. This is particularly important during illness when energy and protein requirements are usually higher.

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