Defining the specific nutritional needs of older persons

For older adults, the benefits of healthy eating include increased mental acuteness, resistance to illness and disease, higher energy levels, faster recuperation times, and better management of chronic health problems. 

As we age, eating well can also be the key to a positive outlook and staying emotionally balanced. But healthy eating doesn’t have to be about dieting and sacrifice. Eating well is all about fresh, colourful food, creativity in the kitchen, and eating with friends.

Older persons are particularly vulnerable to malnutrition. Moreover, attempts to provide adequate nutrition may lead to many practical problems. First, their nutritional requirements are not well defined. Since both lean body mass and basic metabolic rate declines with age, an older person’s energy requirement per kilogram of body weight is also reduced.

Dietary fat seems to be associated with cancer of the colon, pancreas and prostate. Atherogenic risk factors such as increased blood pressure, blood lipids and glucose intolerance, are all significantly affected by dietary factors and play a significant role in the development of coronary heart disease. Degenerative diseases (such as cardiovascular and cerebrovascular disease, diabetes, osteoporosis and cancer) are among the most common diseases affecting older persons. All of these diseases are affected by diet.

Elevated serum cholesterol, a risk factor for coronary heart disease in both men and women, is common in older people and this relationship persists into very old age. Intervention trials have shown that reduction of blood pressure by 6 mm Hg reduces the risk of stroke by 40% and of heart attack by 15%, and that a 10% reduction in blood cholesterol concentration will reduce the risk of coronary heart disease by 30%.

Dietary changes seem to affect risk-factor levels throughout life and may have an even greater impact in older people. Relatively modest reductions in saturated fat and salt intake (which would reduce blood pressure and cholesterol concentrations), could have a substantial effect on reducing the burden of cardiovascular disease. Increasing consumption of fruit and vegetables by one to two servings daily could cut cardiovascular risk by 30%.

Enjoy your food

As with all things in life, moderation in our intake is important, but we also need to focus on variety! Eat more fruits, vegetables, legumes and whole grain cereals as they supply the body of much needed fibre, vitamins and minerals. Always choose the higher in fibre option e.g. brown rice, potato in skin, and oats instead of mielie porridge and thicken gravies with oats or red lentils. Make sure to drink adequate fluids (6-8 glasses of water, cool drink, Rooibos tea, unsweetened ice tea) when you are increasing your fibre intake.

Salt is an acquired taste! 

The food that we consume daily has enough natural salts to provide the body’s needs. Remove the salt container from the table. Read labels carefully – words like sodium chloride, sodium nitrate, MSG and sodium propionate all means salt! Claims such as “no salt added” or “low salt” do not guarantee low sodium content. Beware of foods that have a high sodium content such as canned, processed and convenience foods, as well as processed foods such as sausages, bacon, luncheon meats (e.g. polony), potato crisps, salted nuts, savoury biscuits, vegetable extracts, powdered soups, gravy powders, stock cubes, sauces, dressings, processed cheese, soya sauce, olives, dips and pickles.

Eat less fat, especially saturated fat and cholesterol. Grilling, roasting, microwaving, oven baking, barbequing (on an open grill for the fat to drip off), boiling or steaming are all good methods of preparation. Buy good quality meat cuts. Trim all visible fat from meat before preparation and remove the skin from poultry before cooking. Stir-frying is an excellent way of preparing healthy and quick food. Use stock, water or fruit juice instead of oil. Use breadcrumbs, oats and cheese together when a recipe calls for a cheese topping. Allow meat juices to cool down before preparing gravy in order to remove the fat. Limit dishes with rich sauces e.g. white and cheese sauce.

What is the take home message? 

Balance, moderation and variety are still the keywords for healthy eating, even when you are a senior in society.

MEET THE EXPERT

Berna Harmse is a private practicing dietitian in Cape Town, she holds a MSc in Dietetics and has a special interest in oncology nutrition. She is also an external lecturer at Stellenbosch University Division of Human Nutrition.

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