At old age i.e above 65 years nutritional care is extremely important in order to promote healthy life style as well as for the prevention of various diseases. The risk of various age related diseases such as diabetes , hypertension, heart diseases , osteoporosis can be reduced by diet modification , also healthy diet helps in the treatment of these diseases along with medications.
Aging is a normal process which involves decline in physiological functions. Organs change with age , however the rate of change differs among individuals. These changes effects the efficiency of organs and individuals to perform various functions. Factors which determines how aging progresses include genetics, socio_economics conditions and life style. Following are the physiological changes of ageing that directly effects eating behaviour of older adults and may occurs as a result of poor dietary habits.
- Sensory losses
Reduce senses of tase, smell, sight, hear and touch are common in old age and may lead to less food intake as a result of decreased appetite, feeding ability and food recognition. Studies reveal that lack of vitamin b12 in diet have been associated with increased ringing in the ears of older adults and low Vitamin D levels contributes to hearing loss.
- Oral health
The feeling of dry mouth , untreated dental caries and tooth loss are the common problems of old age and may cause difficulty in chewing and swallowing which eventually leads to decrease consumption of fresh fruits, meats and vegetables.
- Gastrointestinal functions
It is the most common factor that directly effects the food intake and health of old people .Gastric problems include
- Frequent onset of diarrhoea and constipation
Glucose intolerance or non insulin dependent diabetes become more common in later ages. These age related changes may become worse by obesity , lack of physical activity and certain drug. Treatment of glucose intolerance usually involves diet modification along with exercise and medications.
Old age is associated with progressive decline of elasticity of blood vessels and total peripheral resistance which increases the risk of cardiovascular diseases. This include hypertension, atherosclerosis, angina and stroke.
Loss of immune function
Immune function decline with age. The term immunosenescence is used to describe the loss of immune function in older individuals over 65 years of age. Studies suggests that supplements of vitamin E enhance the immune functions in older adults.
Nutritional requirements of older adults
The nutritional requirements for older adults are similar to younger adults but in different amounts . Due to the decrease in physical activity and decline in metabolic rate , the caloric requirements at old age is usually lower than younger people. Average caloric intake for male above the age of 51 is 2300 kcal per day and for females is 1900 kcal. Health problems in elderly arise when the intake is less than 1500 kcal.
As the people grow older the body composition changes which results in decrease in skeletal muscles and reduction in organ tissues, blood components and immune bodies. All of which contributes to impaired wound healing, inability to fight infections and loss of skin elasticity. All of which increases the need of exogenous protein from diet. For that reason the recommended dietary allowance of protein for older adults is 1 gram per kg of the body weight. However the amount of proteins needed for older adults suffering from kidney disorders is slightly less than the normal individuals.
The primary source of protein for elderly are animal proteins which is also a good source of iron, vitamin b12, folic acid, biotin and other nutrients. Eggs, fish, poultry and lean cuts of red meat should be given to older adults on regular basis.
The recommended dietary allowance for carbohydrates for older adults is 50-60% of the daily calories. Most of the carbohydrates should come from complex carbohydrate such as whole grains, vegetables, fruits and legumes. Fiber is important for older adults in order to prevent constipation and regulate bowel movement. Glucose tolerance usually declines with age and it is usually advisable to limit consumption of sugary foods such as desserts, cakes and soft drinks.
Fats and lipids
The recommended dietary allowance for fats is less than 30% of total calories. Emphasis should be given on limiting saturated fats, and trans fats and choosing monounsaturated and unsaturated fat sources .
Good source of fats for older adults like normal individuals are olive oil, nuts, soybean , canola and corn oil.
Minerals and vitamins
Calcium and vitamin D is necessary for bone health and for the prevention of osteoporosis. 10 mg of Vitamin D supplement is normally recommended daily for older adults. The risk of vitamin B12 deficiency in old age increases because of the low intake and lack of intrinsic factor which facilitates b12 absorption. The older adults with no history of renal impairment are recommended to eat more potassium as it helps to reduce blood pressure. Older adults should eat variety of fruits and vegetables along with fortified cereals in order to avoid micronutrient deficiency. Sometimes supplementation of vitamin and minerals become essential when the diet is failed to provide enough vitamins and minerals needed.
General guidelines for good nutrition in old age
- Balance your intake with physical activity. 30 minutes of light exercise in a day is essential to preserve independence in old age.
- Choose whole grains carbohydrates options such as whole wheat , brown rice and oatmeal for breakfast.
- Add fish in your diet at least twice a week.
- Don’t omit fat completely from diet instead change the quality of fat . Olive oil, flaxseeds and flaxseed oil, nuts , corn oil, are healthy options. Avoid saturated and trans fats.
- Opt for frequent small meals instead of three large meals.
- Take three servings of low fat dairy daily in order to keep bones healthy.
- Use less salt. Replace with low salt substitutes such as potassium chloride if not kidney patients.
- Limit high sugar, processed and fried foods.
- Consume at least five portion of fruits and vegetables daily as they are rich in antioxidants and nutrients which helps to keep you healthy and boost immune system.