Nutrition and ageing
Getting older means changes in body, mind and social situations, all of which impact what and how we eat and drink. Good nutrition is crucial for staying mentally and physically healthy, as well as helping to prevent illness. But what our body needs as we age, changes. Here, we look at what those changes can be and how to stay on top of nutritional needs.
How age affects eating and appetite
The senses
Our taste buds decrease as we age. Younger adults usually have 10,000-15,000 taste buds. By age 70, the number of taste buds can decrease by more than 60%, which impacts our ability to detect flavours, and food may start to taste bland or boring.
Smell receptors reduce their activity, as does our taste for salty and sweet. This can make food taste bitter or sour. The loss of smell makes food less appealing and can lead to poor food choices.
Diminished or loss of hearing makes it hard to hold a conversation during a meal and can limit a person’s enjoyment of an otherwise social experience.
General health also plays an important role in our sense of taste at any age. Head injuries, medicinal drugs, respiratory infections, cancer, radiation, and environmental elements such as smoke and other airborne irritants can all contribute to an impaired sense of taste, and exposure to many of these factors increases as we get older.
Not everyone’s sense of taste declines in the same way, however. Changes are known to be diverse among different people and genders, and not everyone shows the same level of impairment as they age. Research has indicated that keeping a healthy diet, an active lifestyle, and ensuring a low to moderate consumption of the five tastes – sweet, sour, salt, umami and bitter – could help to slow down the changes in taste buds.
Teeth
Dentition, which is the make-up of a set of teeth (how many, their arrangement, and their condition), and how well dentures fit, can cause people to avoid crunchy or chewy foods.
The way we chew can affect our ability to detect tastes. If we don’t chew food well, this can reduce the way food is broken down, in turn reducing the information sent to our taste buds. Dentures, particularly if they don’t fit well, can affect chewing in this way. On top of this, the amount of saliva we produce can also lessen as a result of ageing, which means less fluid to help food break down and carry information to taste receptors.
Hydration
Older people experience an increasing disassociation between how hydrated their bodies are and how thirsty they feel because of changes in their brain. Coupled with medications or diseases that increase a person’s need for fluids, it’s no wonder that elderly dehydration is a common cause of hospitalisation.
As we age, our bodies lose kidney function and are less able to conserve fluid—this condition often becomes acute after age 70. Keeping hydrated helps kidneys to work better, cognition to remain clearer, and medications to be better absorbed. Coffee, tea, soups, ice blocks, and juicy fruits and vegetables all contribute to a person’s healthy hydration. But be aware that gastrointestinal changes, such as constipation and gas, may cause older people to avoid fruits and vegetables.
What do elders need to be healthy?
When an older person doesn’t get the proper levels of nutrition or hydration, their symptoms can often be mistaken for a disease or illness.
But as our bodies age, our approach to cooking, eating, and socialising over meals can change drastically. So, unless we pay special attention to the shifting needs of our loved ones, we may assume it’s “business as usual” and miss an opportunity to be proactive and supportive.
Consider these changes that can affect nutrition and hydration in older people:
The power of choice
Deciding what we eat is part of being an independent adult. Losing the ability to manage that for ourselves is a big deal. That’s why good nutrition starts with shopping and cooking.
Taking on helping with these tasks can be a big ask in an already busy life – and it can be tempting to just do it for them, rather than with them. But if you do it all, and they have no role in planning their own meals or shopping to choose their ingredients, it is easy for them to lose interest in the food itself. It may also contribute to them feeling a loss of power in their own lives, or feeling like a burden. Being involved, thinking about what they want to eat and selecting what gets bought can help with appetite – and with the feeling that they still have some independence.
Good company
If you are supporting someone who is living alone, remember that even if they can still shop and make meals without help, it can be hard to find the motivation to cook every night. Having something tasty on hand in the freezer to warm up every now and then is a great alternative. But dinner alone all the time is not a great way to promote interest in eating. A regular family dinner can see a dwindling appetite suddenly improve amazingly.
If you are providing meals when you haven’t got time to eat together, you might want to make enough food for two or more people. They can eat one portion and freeze the rest for another day, or you could suggest that they ask a friend or neighbour around for dinner once a week.
How to boost nutrition:
Calcium and vitamin D
As people get older their bone density can get weaker. Calcium and vitamin D are critical for keeping bones strong and preventing fractures. Did you know that women need to increase their calcium intake 20 years earlier than men? Women need more calcium at age 51, whereas for men it’s at age 70. The dietary requirement for vitamin D also doubles for both men and women in the 51–70 age group.
Provide milk and/or milk products daily to help with meeting the increased dietary requirements for protein, riboflavin, vitamin B6, vitamin D and calcium. Other dietary sources of calcium include broccoli, dried fruit, canned fish and nuts.
Make sure they’re getting enough time outside in the sun. As well as giving the benefits of physical activity, it can help boost vitamin D levels too.
Protein
Protein maintains muscle mass and provides energy. Good protein sources are red meat, poultry, fish, seafood, eggs, and nuts and seeds, all of which can help provide amino acids, fats, vitamins and minerals to maintain lean muscle mass.
Potassium
Consuming adequate potassium, along with limiting sodium (salt) intake, may lower the risk of high blood pressure. Good sources of potassium are fruits, vegetables, beans and low-fat or fat-free dairy products.. Also, choose and prepare food with little or no added salt.
Keep things moving with fibre
As we get older, our body processes things more slowly and less efficiently. This can lead to bowel problems, such as constipation. Dietary fibre can help with this processing, as well as help lower the risk for heart disease and reduce risk for Type 2 diabetes.
The best way to keep things moving is to drink plenty of fluids and keep up the fibre. Fruit and vegetables are a great source of dietary fibre to help keep bowels healthy and regular, and have the added bonus of a range of vitamins and minerals.
Whole grain breads and cereals are a good option too and also contain protein, vitamins and minerals, including calcium and iron.
What causes issues with nutrition?
Loss of appetite can be a major factor in nutritional issues. There can be many reasons for a person to lose their appetite, such as a medical condition, a mental health problem, or taking certain medications.
Decreased sense of taste and/or smell. Many of the conditions that affect older adults and/or the medications they take can reduce their sense of smell and taste. This can make it difficult to enjoy eating, or even unpleasant to eat.
Difficulty chewing and/or swallowing. Dental problems can affect many older adults and can contribute to a vicious cycle of poor eating and malnutrition. As older people become malnourished and lose weight, their dentures may not fit correctly, making eating even more difficult. Problems with swallowing can affect many older adults too.
Loss of physical strength or mobility. Elders who are frail or immobile are often unable to shop and/or cook. Even something as simple as opening a can of soup or a frozen dinner and putting it into the microwave can be difficult for someone who is physically limited.
Chronic conditions and medications. Older adults often have at least one chronic condition and take several These can interfere with digestion, and even absorption of certain nutrients.
Mental and emotional factors. Mental illness such as depression, dementia, and social isolation affect many elders and can dampen their desire and ability to eat.
Financial insecurity. Financial problems can make it difficult for many older adults to access the nutrition they need.
Signs that their nutrition needs attention:
Constant tiredness
Weight loss
Brittle, dry hair
Ridged or spoon-shaped nails
Dental problems
Changes in bowel habits
Mood and mental health issues
Easy bruising and slow healing
Slow immune response
How to get things back on track
Make meals and snacks nutrient-dense.
Add extra calories without extra volume.
Add extra sauces, gravies, and grated cheese to entrees and side dishes.
Stir powdered skim milk into milk, milkshakes, and cold and hot cereals.
Add honey, molasses, or maple syrup to hot cereal.
Sprinkle wheat germ into hot or cold cereals, and add it to baking, like breads and muffins.
Use herbs and spices when preparing food. Because many elders have a reduced sense of taste and smell, it’s helpful to make food as full of flavour as possible. Try cooking with garlic and onion, or garlic and onion powder. You can boost dishes with good salt-free seasoning blends, and fresh or dried herbs can pack a great flavour punch scattered over roasted vegetables or stirred into sauces
Make meals colourful and appealing. Instead of regular mashed potatoes, try mashed sweet potatoes (kūmara) or pumpkin for a colourful and nutritious boost. Instead of plain pasta, try it with a vibrant red tomato sauce scattered with some fresh green basil leaves, or a grating of Parmesan cheese.
Serve several small meals and snacks. Older people with less appetite can be overwhelmed by large meals. Smaller, more frequent meals and snacks can be much easier for them to manage.
Don’t fill up between meals. Little and often is great, but make sure they aren’t filling up on things like coffee, tea, and soft drinks, especially too close to dinner time. A cup of tea just before dinner can really reduce what gets eaten.
Make mealtimes enjoyable and social. Serve a variety of foods. Research shows that older adults eat more when presented with a range of foods to choose from. Here are some strategies to increase the variety on the table:
Include foods from every food group and of all different colours
Invite friends over for a pot-luck dinner
Go out for a buffet-style Sunday brunch.
Use nutritional supplements when necessary. While a well-balanced diet is the best bet, some people may find it easier to sip a nutritional supplement drink than to eat a meal. But always talk to your doctor or dietitian to see if this is a suitable option.
Use local community services. Many communities offer a wide range of nutrition services for older adults, including community dining sites, home-delivered meals, and home visits with registered dietitians. Research shows that meal services, such as Meals on Wheels, can improve or help maintain nutritional status in seniors. Contact your local GP, community centre, or District Health Board (DHB) to find out what’s available in your area.
Top tips for a healthy diet. Drinking plenty of liquids throughout the day, especially water. If they are underweight or have a small appetite, try to encourage them to eat nutritious snacks throughout the day for energy and good nutrition.
Encourage eating with others when possible for vital social interaction and support and to help share the cooking load.
