NUTRITION FOR

ELDERLY
Shalini(M Sc,RD)
Chief Dietitian,Fortis Hospital
AGEING THE PROCESS
Ageing in humans refers to a multidimensional process
of physical, psychological and social change.
Some dimensions of ageing grow and expand over time,
while others decline. Reaction time, for example, may
slow with age, while knowledge of world events and
wisdom may expand.
Research shows that even late in life, potential exists for
physical, mental, and social growth and development.
As part of ageing process,the functioning of the organ
may change which may influence nutritional status.
CHANGES THE BODY
UNDERGOES.
Sensory Changes
Sensory changes include a decline in sight and
peripheral vision, hearing, smell and taste. The
losses are neither total nor rapid, but they do
affect nutritional intake and health status.
Changes in smell and taste are more obvious. If
food doesn't taste appetizing or smell appealing,
intake is reduced.
Structural Changes
As we age, we lose lean body mass.This results in
decrease of BMR. Metabolic rate declines
proportionately with the decline in total protein tissue.
Cardiac capacity can be reduced and cardiac function
impaired by chronic diseases such as atherosclerosis,
hypertension or diabetes.
Changes also occur in the kidneys, lungs and liver, and
in our ability to generate new protein tissue.
In addition, aging can slow the immune system's
response in making antibodies.
 Loss of lean body mass also means reduced
body water -- 72 percent of total body water is in
lean muscle tissue.
Total body fat typically increases with age. As
we age, fat tends to concentrate in the trunk and
as fat deposits around the vital organs.
However, in more advanced years, weight often
declines.
We lose bone density. After menopause, women
tend to lose bone mass at an accelerated rate.
 Medications and illness. Some medications
and health problems can often negatively
influence appetite and may also affect taste.
Digestion. Due to a slowing digestive system,
less saliva and stomach acid is generated as we
get older, making it more difficult for our body to
process certain vitamins and minerals, such as
B12, B6 and folic acid, which are necessary to
maintain mental alertness, a keen memory and
good circulation.
Lifestyle changes
Loneliness and depression. Loneliness
and depression affects diet. For some,
feeling down leads to not eating and in
others it may trigger overeating. Be aware
if emotional problems are affecting your
diet, and take action by consulting your
doctor or therapist.
Nutritional requirement
Energy:
BMR reduces after the age of 35 yrs due to reduced muscle
mass.There is also a reduction in physical activity,thus reducing the
energy requirements.
Thus,the calorie intake should be according to the physical activity
and physiological conditions.
Protein:
With the increase in age,there is an decrease in protein
stores.Thus,there is an increased requirement for protein rich
foods.Deficiency of protein can lead to oedema,anaemia and
decreased resistance to infections.
--------------
Fats:
Fats are required in moderate quantities.It is required for dissolution
of fat soluble vitamins.
Minerals:
Calcium-Calcium needs increases during old age.With the advance
in age,there is an increased calcium losses through demineralization
of bones and thus resulting in osteoporosis.The calcium requirement
goes upto 1000mg per day.
Iron-The iron requirement for elderly remains the same as an adult
(30 mg/day).However,deficiencies are seen due to inadequate iron
intake,blood loss due to some chronic disease,Vitamin C deficiency
etc.
Vitamins:
The requirements for vitamins remains the same,but,if there is a
condition that results in vitamin loss or reduced absorption,then
there is a need for supplementation.
Vitamin B,C,E,Carotenoids have a significant role to play to enhance
the health of the elderly.Reduced exposure to sunlight causes
Vitamin D deficiency.
Water:
Very important for hydration and stimulation of peristalsis.
Fibre:
Required for proper peristalsis and in reduction of cholesterol.It needs
to increased gradually,if one is not used to it.
Common problems in old age
Osteoporosis-progressive bone disease that is characterized by a
decrease in bone mass and density which can lead to an increased
risk of fracture. The diet must contain ample amount of calcium in it.
Obesity-When calorie intake is greater than calorie utilized,excess
results in overweight and obesity.Obese are susceptible to diabetes.
Anaemia-Inadequate intake,reduced absorption or blood loss may
result in anaemia.An iron rich diet along with foods rich in vitamin C
is needed.
Constipation-Loss of tone,stress,medication,resisting the urge to
defecate ,pain from haemorrohoids or tissues,lack of exercise,low
fibre diet and insufficient fluids can cause
constipation.Thus,inclusion of sufficient fibre and fluids along with
exercise helps in combating constipation.
Lifestyle related diseases
Coronnary heart disease
High blood pressure
Stroke
Diabetes
Abnormal blood fats
Cancer
Osteoartirits
Sleep apnea
Gall stones
Obstacles & how to overcome
them
Loneliness
Eating with others can be as important as adding vitamins to your diet. A
social atmosphere stimulates your mind and helps you enjoy meals. When
you enjoy mealtimes, youre more likely to eat better. If you live alone,
eating with company will take some strategizing, but the effort will pay off.
Loss of appetite
First, check with your doctor to see if your loss of appetite could be due to
medication you're taking, and whether the medication or dosage can be
changed. Try natural flavor enhancers such as garlic, onions, ginger, and
spices to boost your appetite.
Difficulty chewing
Prefer easy-to-eat food. Eat steamed or boiled veggies and soft food
Consult your dentist to make sure your dentures are properly fitted.
Dry mouth
Drink 8 10 glasses of water each day. Make the gravies nutrient dense,so
that even the soft or semisolid food provides you with enough nutrients.
Unhealthy eating habits
Try to know how to make a healthy,balanced diet, tasty and
enjoyable as well,so that you may give up the unhealthy eating
habits easily.
Start making small changes in your eating pattern if the present one
is not so healthy.
Adoptsmall and frequent meal pattern.

Monotonous eating habits

No matter how healthy your diet, eating the same foods over and
over is bound to get boring.
Try out new varieties for sticking on to your diet plan.
 When cooking is difficult
Try working out easier and do-able
cooking options.
And seek help.