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Nutritional Issues in Older Adults

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Nutrition problems are common among older adults and significantly impact their health, including muscle loss, osteoporosis (brittle bones), anemia, weight loss, dementia, and mood swings.

Symptoms of Nutrition Problems
Symptoms can include weight loss, muscle atrophy, swelling in various parts of the body (such as the feet, ankles, and thighs), decreased muscle strength, etc.

 
Compared to the working-age population, older adults are at a higher risk of experiencing weight loss and malnutrition. Several factors contribute to weight loss in older adults, including:
  1. Inadequate intake of nutrients and energy from food, stemming from issues with chewing, oral health problems, swallowing difficulties, the use of multiple medications, slow digestion, and impaired nutrient absorption.
  2. Decreased appetite.
  3. Sarcopenia (muscle loss with aging).
  4. Chronic conditions or diseases, such as cancer and infectious diseases.
  5. Emotional issues, such as depression.
  6. Reduced ability to taste and smell.
In addition to identifying and addressing specific factors contributing to nutritional problems in older adults, it is crucial to adjust dietary intake to promote weight gain.

 
Older adults should receive adequate energy intake, ideally between 1,500 to 2,000 calories per day, by consuming foods from all five food groups. This intake should be divided into three main meals and at least two snacks daily. Each meal should include vegetables and fruits to increase fiber intake.
  1. Protein: The proportion of protein in the diet is crucial for maintaining muscle mass, preventing muscle loss, and repairing damaged parts of the body. Older adults typically require about 1 gram of protein per kilogram of body weight per day. For example, a person weighing 60 kilograms should consume 60 grams of protein daily, choosing high-quality sources such as lean meats, eggs, skimmed milk, and soy products.
  2. Carbohydrates: Carbohydrates provide energy for the body and are found in foods such as rice and flour. Older adults should consume an adequate amount of these foods to maintain a healthy body weight and opt for complex carbohydrates, such as brown rice, whole wheat bread, and Job’s tears.
  3. Fat: Older adults require a small amount of calories from fat to ensure the body receives essential fats and fat-soluble vitamins. It is advisable to limit the consumption of high-fat foods such as animal fats, butter, oil, coconut milk, and heavy cream.
  4. Vitamins and Minerals: Older adults with nutritional issues may also experience deficiencies in essential vitamins, such as vitamin B-12, vitamin D, and iron. It is recommended to consume foods rich in these vitamins and minerals. However, if dietary intake is insufficient, doctors may recommend supplements of these essential vitamins and minerals necessary for the body.
  • Calcium: Calcium helps prevent osteoporosis and promotes bone mineral density. Older adults require at least 1,000 milligrams of calcium daily, with an average of 300 milligrams per meal. Foods rich in calcium include calcium-fortified soy milk, fresh cow’s milk, dairy products (such as unsweetened yogurt), soybeans, soy products (like tofu), small whole fish (such as ricefish), and dark green leafy vegetables and orange vegetables (such as Chinese broccoli, bok choy, ivy gourd, noni leaf, pumpkin, and carrot).
  • Iron: Older adults may experience iron deficiency due to insufficient intake of iron-rich foods and reduced iron absorption efficiency. Foods high in iron include red meat (such as pork and beef), leafy green vegetables, cabbage, cauliflower, green beans, red beans, and black sesame seeds.
  • Vitamin C: Vitamin C aids in the absorption of iron from food, prevents gum bleeding, and promotes faster wound healing. Foods rich in vitamin C include broccoli, potatoes, bell peppers, spinach, papaya, mango, strawberries, guava, and oranges.
  • Potassium: Potassium is essential for maintaining normal blood pressure, supporting efficient muscle and nervous system function, and regulating fluid balance in the body. Dietary sources rich in potassium include bananas, oranges, guavas, dried fruits, tomatoes, cabbage, cauliflower, broccoli, spinach, oatmeal, and brown rice.
  • Vitamin B12: Vitamin B12 is essential for the formation of red blood cells, brain cells, and nerves. Prolonged deficiency in vitamin B12 can lead to anemia and increase the risk of memory impairment. Foods rich in vitamin B12 include all types of meat (such as beef, chicken, and pork), whole eggs, fish, yogurt, cheese, and milk. Older adults who consume limited amounts of meat or have absorption issues may be at risk of vitamin B12 deficiency.
  • Magnesium: Magnesium is essential for various bodily functions, including the immune system, nervous system, muscles, heart, and bones. It is abundant in foods like fish, leafy green vegetables, bananas, and various types of beans.
  • Vitamin A: Vitamin A helps maintain the eyesight by slowing degeneration and supports tissue growth and the body's immune system. Dietary sources of vitamin A include spinach, carrots, sweet potatoes, pumpkins, papayas, and ripe mangoes.
  • Vitamin D: Vitamins D aids in the absorption of calcium and prevents bone-related disorders. Normally, the body synthesizes vitamin D when exposed to sunlight. However, older adults who do not receive adequate sunlight may not produce enough vitamin D. Therefore, it is advisable for them to regularly consume grains, mushrooms, and vitamin D-fortified milk to ensure they get enough of this essential vitamin.
  • Vitamin E: Vitamin E is a potent antioxidant that helps protect cells in the body from damage. It is abundant in avocados, various nuts, sunflower seeds, peanut butter, sesame seeds, and all types of cooking oils.
  • Zinc: Zinc supports the efficiency of the immune system and improves appetite. Older adults generally require less zinc than younger individuals and may experience decreased zinc absorption with age. Dietary sources rich in zinc include meat, seafood, and eggs.
  1. Fiber: Fiber supports a healthy digestive system and prevents intestinal problems. Consuming adequate fiber can help prevent conditions like heart disease, diabetes, and certain types of cancer. High-fiber foods are commonly found in vegetables, fruits, and hard-shelled lentils/nuts. Therefore, older adults should regularly include vegetables and fruits in every meal.
  2. Water: Water helps transport nutrients to various organs in the body and aids in eliminating waste, keeping individuals feeling refreshed, preventing constipation, and maintaining hydrated skin. As individuals age, they may not feel thirsty or drink enough to meet their body's daily needs. Therefore, older adults should drink water regularly, aiming for at least 6-8 glasses per day, and should drink before feeling thirsty. It is advisable to limit caffeinated beverages such as tea and coffee to no more than 1 cup per day.
  • Bureau of Nutrition, Department of Health, Ministry of Public Health. Nutrition for the elderly. Available from: https://nutrition2.anamai.moph.go.th/th/book/206126 [Accessed 4 July 2024].
  • Yodpetch S, et al. School for the Elderly: How to Become a Healthy Elderly Person. Bangkok: Mada Publishing: 2017.
  • Kaewanun C. Nutrition of the elderly. EAU Heritage Journal: Science and Technology. 2018;12(2):112-119.
Last modify: January 09, 2025

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