People may be living longer, but quality of life tends to wane with aging. The burden of disease increases significantly after age 65. As a result, older adults commonly take multiple medications, further exacerbating their risk of frailty and premature death.
But it doesn’t have to be like this. Chronic diseases have solid foundations in lifestyle behaviours, including diet. Addressing some common myths around diet and nutrition in older adults can shine some light on healthy aging.
People lose muscle mass with aging, resulting in lower energy needs. But it’s important to stay active and maintain strong muscles, which also support good bone density. Even if slower metabolism reduces calorie requirements, more than ever, older adults need a full range of nutrients and fibre from a variety of whole foods to maintain good health.
Taste and smell can decline with age, impacting appetite. But skipping meals can cause a downward spiral. It can lower blood glucose levels and increase risk of malnutrition. If appetite is low, eat sweet fruit, add salt and herbs to meals for flavour, and have small portions and regular snacks with high nutrition density – ensuring protein needs are met.
Nutritional supplements can never replace the full range of vitamins, minerals, protein, healthy fats, polyphenols and fibre provided by a whole food diet. Sometimes they are necessary to supplement a healthy diet though. Vitamins most at risk in aging are B12 and Vitamin D. Protein shakes can provide a concentrated protein source if appetite is low.
Although a little extra padding is okay in older years, overweight and obesity increase risk of chronic disease at any age. It is recommended that older people who are overweight shed 5-10% of their body weight over 6 months for improved health. The best approach is to eat whole foods and avoid highly processed foods with refined carbohydrates and unhealthy fats.
While overweight and underweight bring a host of health problems, poor health can still afflict people in the normal weight range. An unhealthy diet can cause chronic inflammation – associated with a range of physical and mental health problems. A whole food diet low in processed foods is important at any age or weight.
Thirst is not generally a reliable indicator of fluid needs, particularly in older years when thirst sensation declines. For this and several other reasons, dehydration is an oft-overlooked problem in older adults. It can lead to poor health, hospitalisation and death. Even mild dehydration can cause weakness, dizziness, low blood pressure and increased falls risk. Ensure plenty of fluids are freely available, particularly water and herbal tea.
Although body parts endure gradual wear and tear with age, being sick is not normal. Good health can be maintained with good nutrition, regular hydration, healthy weight, physical activity, mental stimulation, social engagement and careful monitoring of any unnecessary medications.
Dementia risk is associated with several lifestyle factors including low physical activity and poor diet. Research suggests a Mediterranean-style diet – high in plant foods and healthy fats with moderate amounts of fish and dairy and low intakes of red meat and processed food – is protective. B vitamins, antioxidants (abundant in plant foods) and omega-3s may also reduce dementia risk.
Thinking of malnutrition tends to generate images of starving people in third world countries. But malnutrition is silently affecting aging people at home. It afflicts a third of older adults admitted to hospital and over half of aged care residents – and it is often overlooked.
Malnutrition in aging can have serious consequences for physical and mental health, recovery from illness and quality of life. Prevention is best, so it is important to detect malnutrition early.
How can you tell if your loved one – whether it be partner, parent, grandparent or someone you care for – is malnourished or at risk for malnutrition? Here are some clues to be aware of.
The primary, most obvious symptom is weight loss. Technically malnutrition is defined as unintentionally losing 5-10% body weight over 3-6 months. Other indicators include baggy clothes and belts. Even loose jewellery (e.g. rings) and dentures are tell-tale signs.
Food provides calories and essential nutrients needed to produce energy. Not meeting nutritional needs through diet can result in tiredness, weakness and dizziness. A clue here could be reduced levels of mobility. Look out for diminished muscle mass – a risk factor for sarcopenia.
It’s commonly recognised that depression can affect people’s appetite. But nutrients from food – carbohydrates, protein, healthy fats, vitamins and minerals – are also vital for healthy brain function. Not getting enough can impact mood and even lead to major depression.
Aging and some medications can alter taste and appetite. Eating less can, in turn, reduce appetite. Strategies to provide tasty, nutrient-rich food, small meals and regular snacks can help mitigate this.
You can’t fool your dentist. Teeth and gums are a key indicator of nutrition and health status. Swollen or bleeding gums are early oral symptoms of malnutrition. If malnutrition progresses, it can cause irreversible tooth decay.
Check brushes and clothes for excess hair. Hair loss and lack lustre hair can reflect poor nutrition status, particularly insufficient protein and iron. Nails also become dry, brittle and discoloured if essential nutrients are lacking. When iron levels drop too low, nails can start curling upwards, signalling possible iron-deficiency anaemia.
Our immune system needs nutrients to prevent and ward off disease. Frequent illness and infections can reveal poor nutrition status. Also be on the watch for easy bruising and wounds that don’t heal easily.
Chronic constipation can signal insufficient food intake to mobilise the digestive tract; it can also reflect inadequate fibre and/or dehydration – common in older adults. Conversely, watch out for persistent diarrhoea because this can decrease nutrient absorption and exacerbate malnutrition.
Several strategies can prevent and alleviate malnutrition. Most important are regular meals and snacks containing protein and energy, a variety of food from the key food groups, and regular drinks to avoid dehydration.
Barriers and catalysts of eating need to be identified and addressed, and every effort made to help older people enjoy food and the enhanced wellbeing that it delivers.