Nutritional Health in Older People
Around 10 million of the population is aged over 65 years (16% of the population). Within the older age group, even greater population growth has been seen among those aged 85 years and over.
Unfortunately, these extra years added to our lifespan are not necessarily ‘healthy’, and this has a detrimental impact on the quality of life of older people. A range of factors may influence the nutritional status of older people. This might include ill health and other medical conditions, drug-nutrient interactions, lack of mobility, low incomes, social isolation or bereavement.
Energy requirements For healthy people, energy requirements decrease with advancing age. This is due to changes in body composition; a decrease in lean body tissue (muscle) and an increase in fat tissue. This means that for a given body weight older people tend to have less muscle and more fat, leading to a fall in their metabolism especially as many become less active.
Dietary recommendations for fat, carbohydrate and dietary fibre are the same for older people as for the rest of the population. For more guidance see Public Health England Eatwell Guide.
Other advice includes:
Consume 2 portions of fish each week, one of which should be oily. Oily fish contains omega-3 fatty acids which can help protect against heart disease and alleviate some of the symptoms of rheumatoid arthritis.
Eat plenty of fruit and vegetables, and include some fortified foods such as bread or fat spreads, as well as breakfast cereals with added vitamins and minerals such as iron, some B vitamins and calcium. Some functional foods may also be of benefit for particular health conditions e.g. probiotic drinks (for gut health)and yogurts with added fibre and cholesterol-lowering spreads and soya.
Taking a Vitamin D supplement. Vitamin D is produced in the skin via the action of sunlight. As older people go outdoors less they are less efficient at producing vitamin D.
It is essential to have a varied diet to ensure an adequate supply of all the essential vitamins and minerals, and enough food to cover their energy requirements.
One of the key determinants of being able to enjoy a varied diet in later life is retention of natural teeth, so good dental health throughout life is very important. In the UK, 58% of adults aged 75 years and over have no natural teeth and rely on dentures: these people tend to eat less fruit and vegetables and have lower intakes of some micronutrients such as vitamin C.
Dentists normally recommend limiting intake of sugar-containing foods and drinks to four to five occasions a day to minimise further dental problems.
Bone and joint health
It is estimated that 1 in 3 women and 1 in 12 men over the age of 55 years will suffer from osteoporosis in their lifetime.
Low vitamin D status has also been shown to increase the risk of falls. Vitamin D insufficiency is widespread in older people in the UK, particularly among those in residential care. People aged 65 years and over should take a vitamin D supplement (10?g), and eat food sources such as oily fish, and fortified breakfast cereals.
A diet rich in fruit and vegetables and low in salt may also help to delay bone ageing.
Cardiovascular disease (CVD), including coronary heart disease and stroke, is the main cause of morbidity and mortality in older people. The main risk factors, which increase as you age, include obesity, a high intake of saturates, hypertension, smoking, low levels of physical activity and diabetes. A diet that is energy-dense, high in saturated fat (bad fat) and salt, and low in dietary fibre, wholegrains, and fruit and vegetables is generally associated with an increased risk of developing CVD and other chronic diseases.
More information on heart disease can be found here.
Weight-bearing exercise also plays a crucial role in maintaining a healthy skeleton. Being active can protect against osteoporosis via its effects on muscle strength, coordination, flexibility and balance. Involvement in a range of activity types is also important as we get older, for strength and flexibility.