Aging & Health A to Z

Nutrition

Lifestyle & Management

Diet Considerations

Protein
Because of the stress on your body as you age, and general loss of protein from muscles and internal organs, many older adults need to consume relatively higher amounts of protein than they did when they were younger. Protein deficiencies in older people can lead to more infections, fragile skin, longer healing times, and weakness.

Protein requirements increase about 50% with stress or injury. In contrast, with some diseases, such as kidney or liver disease, protein intake should be restricted. In any case, you should discuss your daily protein intake with your healthcare provider before making any major changes.

Some proteins in the blood, such as albumin, can be used to estimate nutritional status. Low albumin levels have been associated with disease, loss of function, muscle wasting, increased healthcare use, and even death. However, in any particular person, it can be difficult to know whether low albumin levels actually reflect poor nutrition, or if they simply indicate disease states or organ dysfunction. 

Carbohydrates
Much of our energy comes from the digestion of carbohydrates, which are made up of various types of sugar and starch molecules. About 50-60% of our calories should be coming from complex carbohydrates such as whole grains and cereals, and fruits and vegetables. Pasta—especially whole grain products—and a simple baked potato with the skin are excellent sources of carbohydrates.

Fats
The USDA Dietary Guidelines for Americans suggest that no more than 30% of total energy should come from fat (for all age groups). Fat insulates and protects the body, and serves as a source of energy and essential fatty acids. It also carries the fat-soluble vitamins (for example, vitamins A, D, E, and K) around the body.

Cholesterol has also been linked to nutritional status. People with serious underlying disease, such as cancer, often have low cholesterol levels (<160 mg/dL). However, similar to low albumin levels, low cholesterol levels may be a nonspecific indicator of poor health, rather than a reflection of poor nutritional status.

Vitamins and Minerals
Older adults have different vitamin and mineral requirements than younger people. Your healthcare provider or a nutritionist can advise you on the levels you need.

Fluids
As we age, our body loses some of its ability to regulate fluid levels and our feeling of thirst is no longer reliable. Being dehydrated can show up as reduced output of urine, constipation, low-grade fever, dry gums, and even confusion.

Exercise

Both undernourished and overnourished older people can benefit from regular physical activity. Try to incorporate a regular routine of physical activity or exercise into your schedule. If you are suffering from undernutrition, activities such as walking, gardening and yard work, swimming, or cleaning the house can increase your metabolic rate and spice up your appetite. It also strengthens and adds mass to your bones and muscles. Light exercise just before eating can often make you hungrier.

If your challenge is overnutrition, an individualized program of diet plus regular exercise can help you reduce calories and trim down in a healthy way. 

Management

Make sure your diet is based on foods such as whole grains, enriched cereals, brightly-colored vegetables and fruits, low-fat dairy products, lean meats and fish or meat substitutes, legumes and nuts, and oils and fats that are high in omega-3 fatty acids and are not saturated. Also do not forget to drink plenty of fluids.

• You might consider five or six small meals per day rather than three large ones, if you “fill up” quickly.
• Keep bowls of nutritious snacks (such as nuts or dried fruits) within easy reach.
• Use a little salt on food if it has not been restricted by your doctor.
• Buy groceries that are easy to prepare. Frozen precut vegetables are just as nutritious as fresh ones, and often less expensive.
• To avoid eating alone, try organizing a club of friends who will dine together regularly, or invite friends and family over. Check out Meals on Wheels or other programs that deliver ready-to-eat dinners to your home.
• Snack on nutrient-rich foods, like peanut butter on crackers. Add extra egg whites to your scrambled eggs. Make milk shakes with ice cream and protein powder added. Throw some cheese into soups or eggs.
• Add herbs and spices, lemon juice, or other seasonings to your foods to make them tastier, and avoid overcooking.
• Take time to eat at a leisurely pace, and make sure that the table and chairs are comfortable for you.
• Review your medications with your healthcare professional. If some are known to curtail appetite, see if you can switch to another medicine without that side effect.

Complications

If undernutrition is not reversed in older adults, it may lead to serious consequences including:

• Weakness and fatigue, leading to less mobility, reduced ability to work and carry out daily functions, reduced quality of life
• Depression which can lead to a further appetite reduction
• More infections that take longer to resolve because of a weaker immune system
• Low level of red blood cells (anemia)
• Reduced muscle mass, leading to more weakness and increased risk for falling
• Worsening cognitive ability.

Older adults with overnutrition may have complications including:

• Problems with the lungs, heart, kidneys and digestive systems
• Weak skin and slow would healing
• Slower recovery from surgery
• Longer hospital stays

Updated: March 2012
Posted:  March 2012