Nutrition in the Very Old
The older population is growing rapidly thanks to a gain in human longevity, with increased life expectancy and reduced mortality.
In 2016, the population of the European Union comprised 27.3 million very old people (aged 80 or over). However, living longer can increase the risk of nutrient deficiencies, multiple diseases and invalidity.
Diet is one factor that affects health and dietary changes can help curb age-related diseases. A group of British scientists updated and summarized recent epidemiological evidence from several European studies of ageing that have investigated diet and nutritional status in very old adults. They examined the Newcastle 85+ Study, UK and the Life and Living in Advanced Age, New Zealand – unique on-going studies involving single birth cohorts monitored over several years.
Their report summarizes the issues to be taken into account when addressing nutritional status in the very old.
Different places, different diets
The results of European studies indicate that diet in the very old varies greatly from country to country and depends on the availability of food as well as preferences.
However, the studies report that this population runs the risk of malutrition (insufficient protein intake) and a lack of micronutrients such as vitamin D, calcium and magnesium due to a number of factors (environment, medication, health status, financial status etc.).
A balanced diet with protein and vitamin D are essential
Carbohydrates such as cereals and bread are their main sources of energy and provide most macronutrients, folate and iron. Meat and milk are the main sources of protein and vitamin B12. A balanced diet including fruit, almonds, fish or sea food, dairy products, wholemeal bread and cereals, soup, alcohol and coffee are associated with improved physical performance and muscular strength compared to an imbalanced diet. Two factors seem to play a role in the physical abilities of the very old: sufficient intake of protein and vitamin D.
The energy content of foodstuffs
The diet of very old people should be assessed with the help of their carers, to prevent errors.
Recommendations for younger adults do not apply, due to multiple pathologies in the very old.
For example, they require less energy but they still need plenty of protein, essential fatty acids and micronutrients. This means increasing the density of the food eaten, while accounting for habits and preferences. Special dishes or dietary supplements can help.
Despite no consensus concerning requirements of the very old 1g of protein per kg of bodyweight per day is considered the norm, combined with exercises to maintain muscle density. A vitamin D supplement of between 40 and 60nmol is also beneficial to muscle health. Diets with plenty of fruit, vegetables, almonds, dairy products, fish and wholemeal cereals no doubt slows down decline in muscle strength.
Nutrition in the Very Old. Granic A, Mendonça N, Hill TR, Jagger C, Stevenson EJ, Mathers JC, Sayer AA. Nutrients. 2018 Feb 27;10(3). pii: E269. doi: 10.3390/nu10030269. http://www.mdpi.com/2072-6643/10/3/269