General guidelines apply to older people, but an increased risk of malnutrition and muscle wasting should be taken into account.
A balanced diet is vital to well-being and health, particularly for elderly people who are more at risk of malnutrition, muscle wasting and related chronic diseases. As shown by research undertaken in the endocrinology department of a French hospital and published in the journal Médecine des maladies Métaboliques, nutritional balance plays a role in life expectancy and independence.
Elderly people can be divided into three categories: (1) those who have aged well, are independent and are well-nourished; (2) the fragile, who suffer from nutritional imbalance and are under medication for several afflictions; (3) those who are dependent, suffer from several illnesses and are often in residential care. Advice for the first group differs little from guidelines for the general population, subject to regular check-ups. For the second group, nutritional balance is key because medication puts them at risk of nutritional imbalance. The third group are at risk of falling, depression, muscle wasting and malnutrition and a balanced diet is a determining factor in their health and well-being.
Contrary to popular belief, older people require as much nourishment as younger generations. Exercise or metabolic imbalance, especially malnutrition, increases requirements. Restrictive diets are to be avoided at all costs.
|Energy||30–35 kcal/kg/day (malnutrition: 35–40 kcal/kg/day)|
|Protein||1–1.2 g/kg/day (malnutrition: 1.5–1.8 g/kg/day)|
|Fat||35–40% of total energy intake (TEI)|
|Sugars||50–55% of TEI|
|Vitamin D||800 Ul/day|
|Water||at least 1.5l/day|
No restrictions for overweight persons such as <1 600 kcal/day or <200 g carbohydrate/day. Account for eating habits, lifestyle, socio-economic context and pathologies.
Eat at least three varied meals a day, of sufficient quantity, plus snacks if necessary. The evening meal should be sustaining. Avoid going more than 12 hours without eating. Eat several high-energy snacks per day rather than three traditional meals.
– Is intake sufficient? Quality is important. Cater for tastes, encourage regular hydration without waiting to feel thirsty, do not forbid wine but restrict amount.
– Help patients improve their diet: suggest snacks and menus and if necessary, set up home delivery.
– Avoid instilling bad habits and inciting guilt (salt-free diet)
– For diabetics: avoid simple carbohydrates for starters and between meals. Make sure mealtimes remained shared. Medication should be adapted to habits, not the other way around.
– For anorexics or under-nourished patients, enrich meals with foodstuffs such as eggs and cheese, or dietary supplements, provided they do not replace meals.
La nutrition des personnes âgées. B Bauduceau, G Belmejdoub, C. Dognon, L Bordier. Médecine des maladies Métaboliques – May 2017 – Vol. http://www.em-consulte.com/article/1123661/article/la-nutrition-des-personnes-agees