Aging & Health A to Z
Care & Treatment
To treat malnutrition effectively, the underlying causes must first be identified. Then the causes can be addressed and may be resolved. For example, poorly fitting dentures can be adjusted or grocery deliveries can be arranged.
Many cities and towns have programs, such as “Meals on Wheels,” that deliver fully prepared meals to housebound, older people. Check with local senior citizen centers, or government offices.
Even though you may not need as many calories (usually about 1600) as you get older, foods must be extra rich in nutrients like proteins, vitamins, minerals, fiber, and fluids to fulfill your needs. Not only do fiber and fluids keep your digestion regular, but fiber can also lower your cholesterol. Avoid saturated fats, trans fats, or cholesterol to keep your heart healthy. On the other hand, polyunsaturated and monounsaturated fats (such as olive oil and canola oil) are good for you, if eaten in moderation.
Generally, try to include the following nutrient-dense foods in your meals every day:
- Complex carbohydrates (at least 5 servings of whole grains like whole wheat bread, old-fashioned oatmeal, brown rice. Avoid refined products like white bread, instant or sugary cereals.)
- Seeds, nuts, and legumes.
- Fruits and vegetables (at least 5 servings)
- Low-fat dairy products (2-4 daily servings), especially if you have osteoporosis (thinning of the bones)
- Meats, fish, poultry, eggs, nuts, or beans (legumes) (at least 2-3 servings)
- Plenty of fluids (5-8 glasses), even if you do not feel thirsty.
To counteract loss of taste and smell, try to make foods more appetizing by using spices, foods of different colors, and interesting textures. Add lemon juice and herbs. Also, a little salt is usually not problematic, unless your healthcare professional has forbidden it.
Dental or Oral Problems
If you are having trouble with poorly fitted dentures, missing or loose teeth, or jaw problems, have your dentist adjust your dentures or address your dental health. Prepare foods so that they can be chewed without boiling them to uninteresting mush. Many foods can be chopped, stewed, or grated so that they are still appealing but easier to manage.
If arthritis or other condition makes it difficult to use utensils easily, consider specially designed utensils, or “finger foods.”
Many people have more trouble digesting dairy products when they get older. Aged cheeses like cheddar cheese, some yogurts, and lactose-reduced products are good options. There are even lactose-free ice-creams on the market.
Problems with swallowing (dysphagia)
Older people may have trouble swallowing for a variety of reasons, including dry mouth from medications, dementia, muscle loss, or diseases of the nervous system. If you or someone you are caring for has increasing difficulty swallowing food, or if it going down the wrong way regularly, speak to your healthcare professional. Often simple approaches can remedy the situation.
Vitamins and Minerals
Vitamin and mineral deficiencies may occur quite often in many older people. The most common are:
- Vitamin D: particularly important for older adults with osteoporosis in absorbing calcium. (Older people are less able to produce vitamin D from sunlight in their skin than younger people.)
- Folic acid: Too much extra folic acid can be harmful.
- Iron: absorbed better with plenty of vitamin C in the diet.
- Calcium: Absorbed more easily from food than from supplements.
- Vitamin B12: Good sources include fortified cereals, lean meat, some fish and seafood.
- Potassium, magnesium and sodium: may need to be supplemented if you are taking certain blood pressure or heart medications. Good sources include fruits, vegetables, low-fat milk and yogurt.
The best way to make sure you get important vitamins, minerals, and plant chemicals (phytochemicals) is to eat plenty of brightly colored green, orange, and yellow vegetables including broccoli, kale, spinach, carrots and squash (at least 5 servings each day).
If you are taking any herbal or alternative products, let your healthcare professional know. Some of these preparations can interact with medicines or food and cause serious consequences.
Many older people do not feel thirsty when they become dehydrated, so the problem of dehydration can be common in older people. Try to drink 5-8 glasses of water or other liquids every day to keep your kidneys and digestion working well.
Many drug and grocery stores now stock supplements in the form of drinks (Boost, Ensure), nutritional bars, cookies, and powders that can be added to drinks or other foods. These are usually nutrient-dense, may come in high or lower-calorie preparations, and often have good concentrations of vitamins and minerals. Use them as additions to regular meals, not as a substitute—as between-meal snacks or before bedtime. Although expensive, these supplements can be very helpful for some older adults.
If undernutrition is severe, you or your loved one may need to be hand-fed for a while or fed with the help of a tube or intravenous line. In these situations, the malnourished person may need to be in a hospital, at least at the beginning, until caregivers or family members have the expertise to carry out feeding at home. These feeding techniques can be effective, for example, in getting someone over a temporary swallowing problem after a stroke or surgery. However, for long-term care, tube feeding probably does not prolong or add to the quality of life.
Counseling is helpful for older people trying to eat well. You can find a registered dietitian in your area by visiting the website of the Academy of Nutrition and Dietetics.
As you get older, you will probably be less physically active. You also do not need to consume as much food as you did when you were young because older people have reduced energy needs. But if you continue to eat the same way as before, and do not increase your exercise level, you may begin to gain weight. For many older people, this pattern leads to overweight or even obesity. Obesity is linked to many chronic health problems such as diabetes, cardiovascular disease, stroke, and cancer.
The best dietary strategy is to decide on a target weight that is appropriate for your height and body type, and to aim for a gradual weight reduction. Decrease your calorie intake by:
- eating less calorie-rich foods
- increasing your consumption of nutrient-rich, high-fiber fruits, vegetables and grains
- reducing portion sizes.
Dietitians or nutritionists can be extremely helpful in finding a diet that you can enjoy while you take off the pounds.
Updated: March 2012
Posted: March 2012