Nutrition and the Aging Adult
Aging is a dynamic and complex process that results from cellular, physiological and psychological changes. Although many elderly individuals exhibit a decline in organ function and in metabolic activities, a number of them show no decline in functional status with age. This distinction has led to distinguishing "successful" aging from "usual" aging, which may reflect pathology more often associated with a lifetime of poor health habits, including poor dietary patterns, smoking, drinking, limited exercise and other stress-related factors rather than aging alone.
As you age, your body becomes less forgiving, and you'll have to make more of an effort to eat well and stay fit. Ideally, you've been practicing healthy eating habits throughout your life. But most of us don't live in an ideal world, and often we don't pay attention to our health until we reach middle age and beyond. But middle age is still a good time to start thinking about how to stay healthy in your later years. Your nutritional needs are pretty much the same at 40, 50, 60 and beyond as they were when you were younger — with some minor variations.
A decade long study of the elderly indicated that calorie intake per kilogram of body weight showed no association with age in men, suggesting that current weight, rather than age, determined energy intake. Intake of protein, as well as fat, carbohydrate and cholesterol, decreased slightly but not significantly with age. The results in women were similar. Over the nine years of the study, there were significant decreases in a number of dietary nutrients. However, these changes were offset by reductions in physical activity and/or changes in body composition. The lower energy intake didn't result in changes in weight. The decrease in total fat and cholesterol intake were related to a fall in plasma cholesterol levels. The study suggests that changes in lifestyle over time, rather than age per se, resulted in the dietary changes observed in this healthy elderly population.
Thus, as you age, you need fewer calories, but exactly how much you should eat still depends on how active you are. Because you're eating less food to maintain a healthy weight, you have to be more careful about what you choose to eat. As the years pass and you lose lean body mass (muscle), your metabolic rate slows down and you burn calories more slowly. Exercise is the best way to maintain lean body mass and speed up your metabolic rate.
Even presumably healthy elderly people may exhibit vitamin and mineral deficiencies. For example, older people tend to have decreased exposure to sunlight that activates vitamin D. They also are less likely to ingest vitamin D fortified foods and beverages.
Fiber, Vitamin D and Calcium
Fiber is more important than ever to prevent constipation and gastrointestinal conditions such as diverticulosis (formation of pouches in the lining of the large intestine).
At around age 40, calcium and other minerals start to move out of bones faster than they can be replaced. In women at menopause, the drop in estrogen (which helps bones hold on to calcium) causes greater bone loss than in men.
To preserve bone health and prevent osteoporosis, older people should strive for 800 International Units (IU) of vitamin D daily. An inexpensive way to get enough vitamin D is by taking multivitamins. Most generic multiple vitamins contain 400 IU. Look for foods and drinks that have vitamin D added. One multiple vitamin combined with vitamin D fortified foods should be enough for most elderly people.
The general recommendation for daily calcium intake is 1,200 milligrams. Calcium supplements up to 1,000 milligrams a day are recommended for people who can't get enough of the mineral from their diet. Experts frequently recommend calcium carbonate and calcium citrate for people who take supplements.
Although there is still much enthusiasm for antioxidants in healthy foods, taking antioxidant supplements does not provide the same benefit. Multiple studies have shown that vitamin E, beta-carotene and other antioxidant products don’t improve health outcomes. Instead, individuals should eat a variety of foods that will provide a rich natural source of these vitamins.
As you age, physical disabilities, such as loss of sight and mobility and a failing appetite (caused by dental problems, reduced saliva production and a decline in the ability to taste), make eating less rewarding for the elderly than for the young. By age 75, for example, people have only half as many taste buds as they did at 30. In addition, loneliness, depression and the financial restrictions of living on a fixed income can interfere with an older person's ability to buy and prepare healthy food.
Because food is often associated with social events, preparing food and eating alone can be difficult for older people who have reached a stage in life where many of their loved ones have either died or moved away. For many, a loss of appetite follows the loss of companionship. Older men who have lost their wives (who did the cooking) may be at special risk.
The following tips may help provide better meals for an elderly person:
- Lack of teeth and dental decay make chewing difficult, contribute to poor nutrition and also give food an abnormal taste. Many elderly people who have dentures don't wear them because they're uncomfortable. Bone loss, which occurs in osteoporosis, makes dentures hard to fit. Older individuals should have regular dental care.
- If chewing is a problem, try softer foods that have been chopped or pureed.
- Four or five smaller meals might be easier for an older person to handle than three larger ones.
- Add a little more spice to foods to enhance their flavor.
- If certain foods are disliked, try substitutes within the same food group. For instance, if milk is unacceptable, try yogurt, cheese or even low-fat ice cream.
- Public and private programs offer meals for people 60 years and older at senior centers throughout the country. These programs provide social interactions that may be just as beneficial to an elderly person as the meals.
One way for seniors to pack a lot of good nutrition into a little meal is to drink it in the form of a shake. Start with a cup of low-fat or skim milk (or an alternative such as soy milk or almond milk, which can be found in health food stores) and a small banana in a blender. Depending on individual taste, add a spoonful of wheat germ or bran and/or another fruit such as strawberries, peaches, pineapple, mango or kiwi. A heaping spoonful of powdered nonfat dry milk or soy powder will add extra calcium and protein. Also look for milk and powders that are fortified with vitamin D.