Nutritional Care in Elderly

What is Nutritional Care in Elderly?

The nutritional care provided to the elderly focuses on customizing dietary practices to cater to the specific requirements of aging individuals. It involves providing a well-rounded diet that includes vital elements necessary for sustaining health.

Dietary Challenges in the Elderly of Pakistan

The Decline of the immune system is a state of a paradox among the elderly, 65 years and above because of Immune essence (1). Promoting Healthy Eating Habits for seniors is needed once you grow old In addition to this, the presence of chronic diseases among the elderly predisposes them to acquire infections (2). The demographic data from WHO has affirmed that the elderly population in the entire world will triple by 2050 and the growth of the subpopulation 85 years and above would accelerate (3). Now the question is; is this a problem for Pakistan? It is indeed a huge problem because our aging population with low socioeconomic status and impaired immune functions is at increased risk of morbidity and mortality (4).

Why Elderly people find it Difficult to Eat:

The following are the few causes that affect the nutrition intake of the elderly.

• Dentary issues
• Loss of sense of smell
• Dull taste buds
• Psychological issues
• Low income
• Isolation
• Illness

How Healthy Eating improves the health:

The main intervention that delays aging is Nutrition (6). Although dietary requirements decline with age there is mounting evidence stating that adequate nutrition is a major determinant in aging and inadequacies in the diet lead to micronutrient deficiencies resulting in loss of muscle mass, and strength and decline in cognitive and overall health status (7). Because of these changes, it may be necessary to ensure you or your family member is getting the right balance of nutrients. Healthy Nutrition improves:

• Nutrient absorption
• Prevent chronic disease
• Maintain muscle mass
• Maintain bone health
• Improve physical function
• Improve Quality of life

Essential Micronutrients for Older people

Micronutrients	Dosage	Food Sources
Vitamin A	4500 IU for men 3500 IU for women	Butter, Liver, Egg Yolk
Vitamin D	800 IU for both men and women	Milk, Fortified Cereal, Egg yolk
Vitamin K	120 ug for men 90 ug for women	Walnuts, Cucumber, Tomatoes
Vitamin C	90 mg for men 75 mg for women	Guavas, Oranges, Strawberries
Vitamin B6	1.7mg for men 1.5 mg for women	Carrot, Sweet Potatoes, Flax seeds
Vitamin B12	500 ug for both men and women	Yogurt, Chicken, Red meat
Folate	400 ug for both men and women	Beetroot, Channa, Lentils
Calcium	1200 mg for both men and women	Banana, Apple, Almonds
Iron	300 mg for both men and women	Spinach, Lentils, Kidney Beans

Which supplements should older people take daily?

The essential nutrient supplements are important for the elderly to maintain a healthy diet. Calcium, Iron, and Folate are crucial to meet the needs of the aging body. If you are unsure about taking a supplement it is best to reach out to your dietitian or your health care provider.

Why Vitamin A is important?

These functions include enhancing immunity against infections, enhancing vision in low-light conditions, and maintaining skin health. However, Vitamin A should be consumed once a week as a high level of it increases the risk of bone fracture. Food rich in Vitamin A includes:

• Fish oil
• Butter
• Green onion
• Cheese
• Sweet potato

Why Vitamin D is important?

This vitamin is essential for individuals of all ages, as it plays a crucial role in the development and maintenance of strong and healthy bones, teeth, and muscles. Healthcare professionals might recommend elderly persons to take vitamin D with supplemented calcium to enhance bone health and prevent osteoporosis. Food rich in Vitamin D includes:

• Yogurt
• Eggs
• Oatmeal
• Cashew
• Cereal

Why Vitamin C is important?

Vitamin C is important to readily absorb the iron. It also boosts the immune system and increases bone mass density. Food rich in Vitamin C are:

• Strawberries
• Guava
• Potatoes
• Oranges
• Legumes

Why Calcium is important?

Osteoporosis is a prevalent concern among the elderly population, especially women. It is the phenomenon where bone density decreases, hence raising the likelihood of fractures. Ensuring an adequate intake of calcium is crucial in combating osteoporosis. The food rich in Calcium includes:

• Milk
• Sardines
• Lentils
• Almonds
• Raisins

Why Iron is Important?

Iron is a vital mineral for bone cells; a low level of iron results in Osteoporosis and impacts Osteogenesis. Deficiency also impacts the healthy body functions. Food rich in Iron includes:

• Beef Liver
• Red meat
• Dried fruits
• Legumes
• Kidney Beans

My Plate for Older Adults:

These are the give food groups and the serving size according to the US department of Agriculture (USDA)

• Grains: include whole wheat roti, oatmeal, barley porridge, white boiled rice, or brown rice.
• Fruits: All fruits are recommended including dry fruits but avoid using canned fruits with sugar syrup. For Elderly residents, 1.5 to 2 cups of fruits are recommended.
• Vegetables: Eat a variety of vegetables and avoid using raw salads that have been made for a very long time. For Elder residents 2 to 3 cups of vegetables are recommended.
• Protein: Protein sources include, chicken, fish, eggs, beans, legumes, peas, and nuts. Avoid using, processed foods such as deli, tuna, and sausages. 5 to 6 oz. cups of Protein is advised for older adults.
• Dairy: This includes, low-fat milk, cheese, and low-fat yogurt. 3 cups of dairy is advised for older adults.

How much Grains can older adults consume and what are the healthy food resources?

According to the US Department of Agriculture (USDA), 5 to 6 oz. of Grains are recommended. Instead of processed grains, it is healthy to consume whole grains.

SWAP THIS	WITH THAT
Instant Oatmeal	Whole Oats
White rice	Brown rice
Potato chips	Popcorn
White bread	Whole grain bread

How much Fruits can older adults consume?

According to US department of Agriculture (USDA) 1.5 to 2 cups. Of fruits are recommended.

How much Vegetables can older adults consume?

According to US department of Agriculture (USDA) 2 to 3 cups. Of vegetables are recommended.

How much Protein can older adults consume?

According to the US Department of Agriculture (USDA) 5 to 6 cups. Of proteins are recommended.

Why is Fiber important and how much should older adults consume?

Fiber is a form of carbohydrate that aids in the regulation of our digestive tract. It also prevents heart disease, type 2 diabetes, and specific forms of cancer. Inadequate fiber intake can lead to constipation and increase the risk of chronic illnesses. However, around 95% of adults fail to consume an adequate amount of this nutrient in their daily dietary intake.

For persons aged 51-71+, the recommended daily fiber intake is 30 grams for males and 21 grams for women. Fiber can be obtained from a variety of plant-based and whole-grain foods, including as

• Banana
• Cabbage
• Almonds
• Whole grain bread

Good Fats for Adult

Polyunsaturated and monounsaturated fats, which are considered healthy fats, can lower the risk of overweight and obesity, as well as cardiovascular disorders, while also promoting heart health. As per the World Health Organisation (WHO), it is advised to consume a maximum of 30% of total fat in the diet. Within this limit, it is recommended to restrict the intake of saturated fat to less than 10% and Trans fat to less than 1%.

Common sources of Poly and monounsaturated fats are:

• Fatty fishes
• Eggs
• Olive Oil
• Almonds
• Coconut

Healthy weight of seniors

According to National Institute of Health, seniors with BMI (Body Mass Index) of 25-27 is considered healthy. In young adults this range of BMI is considered as overweight however in the elderly higher BMI protects against nutritional deficiencies. This range of BMI should be maintained with healthy diet and regular exercise.

Fluid Intake Recommendations

Older adults should attempt to drink enough fluids to be hydrated and support overall health. While individual needs vary, basic standards suggest that men should consume about 3.7 liters (125 ounces) of total water per day, while women should consume approximately 2.7 liters (91 ounces) per day. This includes fluids from drinks like water, herbal tea, and low-fat milk, as well as fluid-rich foods like fruits and vegetables. It is critical to monitor hydration levels frequently, especially for elderly persons who may have decreased thirst sense. Chronic health issues and drugs might have an impact on fluid demands, therefore it's best to see a healthcare provider for personalized recommendations."

The Food Balance to Rescue

If you feel your elderly family members are struggling with nutrition. The Food Balance Clinics will provide you with a thorough nutrition exam, and a comprehensive elderly meal planning, that is made to cater to the needs of the patient in the comfort of your home via virtual or physical clinics. At our clinics, we offer preference to the older people in appointments provided we have accommodation available. In case your family member is wheelchair bound kindly inform our representative beforehand.

Conclusion

By optimizing senior nutrition, we can significantly improve their quality of life. Sufficient nutrition has become a significant factor in promoting a graceful aging process. Although there may be a decrease in dietary needs as individuals age, an increasing body of evidence suggests that adhering to a well-balanced diet is crucial for the preservation of muscle mass, strength, cognitive function, and overall health. Book now and get connected with our dietician.