Nutritional Needs of Older Adults - Part 1

As we age, our nutritional needs change significantly due to various physiological, lifestyle, and health-related factors. Ensuring that older adults maintain a balanced and nutritious diet is crucial for promoting health, preventing chronic diseases, and enhancing the quality of life. According to the US Department of Agriculture, US older adults have an Healthy Eating Index (HEI, a measure of how balanced and nutritious their diet is) higher than other age groups, but there is much space for improvement. Globally, older adults appear to have many problems related to undernutrition. This article delves into the specific nutritional requirements of older adults and practical strategies to meet these needs.

1. Calories and Energy:

Older adults generally require fewer calories due to decreased physical activity and a slower metabolic rate. However, they still need nutrient-dense foods to meet their nutritional needs without excessive calorie intake.

2. Protein:

The recommended dietary allowance (RDA) of protein for adults over the age of 18 is 0.8 grams per kg of body weight per day. Adequate protein intake is vital to prevent muscle loss, support immune function, and maintain overall health. Due to rapid loss of muscle mass associated with aging, it is recommended that older adults consume more protein. The exact amount might be dependent on who you ask but it generally ranges from 1.0 to 2.0 grams of protein per kilogram of body weight, daily. There are several sources of protein – including, fish, meats, dairy, eggs and plant-based protein (lentils, quinoa, chickpeas, green peas and oatmeal). It is also recommended that protein intake is spread throughout the day. It is important to consider whether an older adult has normal kidney function when increasing protein intake. Some older adults avoid eating high-protein food due to difficulties with chewing and poor digestibility, and feeling heavy and full after eating these meals. Furthermore, intake of red meat and processed meat is associated with high risk of certain types of cancers so it’s important to choose the sources of protein carefully and in a balanced manner.

3. Vitamins, Minerals and others:

There are specific vitamins and minerals that are associated with enhanced health outcomes in older adults. Incorporating these into the diets of older adults is therefore essential. A few of them are listed below.

- Vitamin D and Calcium: Essential for bone health, reducing the risk of osteoporosis and fractures. Recent studies suggest that the goal of Vitamin D status should be to reach a serum level of 25(OH)D > 50 nmol/L. Of course, these standards might vary based on ethnicity and geographical location too. Vitamin D and calcium can be obtained through eggs, fish, dairy, and leafy greens. It is important to speak with your doctor about your vitamin D status and supplementing if you are not getting sufficient amounts through the diet, and through sun exposure.

- Vitamin B12: This is a water soluble B-vitamin that must be obtained through the diet. It is important for neurological function and red blood cell formation. Absorption decreases with age, so supplementation may be necessary. Sources are fish (salmon, sardines), eggs, clams, oysters and meat.

- Potassium: This helps maintain blood pressure levels and can be obtained through bananas, citrus fruits, avocados, tomatoes, lima beans, fish and poultry. Older adults are at a higher risk of hyperkalemia (having too much potassium in the blood) because they might be on medication that affects potassium levels and aged kidneys are less efficient at potassium clearance.

- Fiber: Aging can lead to profound changes in the GI tract including altered gut microbiome and intestinal physiology. The general fiber recommendation for adults over the age of 50 is 30 g daily for men and 21 g for women. Eating a diet rich in fiber (plenty of fruits and vegetables, whole grains and legumes) can help support digestive health and prevent constipation. Emerging evidence also suggests that high fiber intake is associated with reduced risk of type 2 diabetes and heart disease.

4. Hydration:

Older adults are at a higher risk of dehydration due to a reduced sense of thirst and potential kidney function decline. Ensuring adequate fluid intake is critical. This is especially important for older adults who live in warm or tropical climates because changes of dehydration is much higher. It is recommended that older adults drink at least 8 glasses of water a day, though the exact amount needed might vary based on individual need. Among other things, avoiding caffeine can also help to minimize dehydration.

In part 2, we will discuss common nutritional challenges faced by older adults and other strategies to improve chances of healthy aging through nutrition. It is important to speak to your doctor before starting any dietary supplements or specific diets.