Nutritional Needs During Old Age

NUTRITIONAL NEEDS DURING OLD AGE

1. Energy

The energy requirement decreases due to

1.     decreased physical activity

2.     reduction in lean body mass and increase in adipose tissue,

3.     decrease in resting metabolic rate by 15-20 percent due to changes in body composition and physical inactivity.

The calorie intake should be adjusted to maintain weight. The energy requirements for different age groups 60 years and above are given in table 8.1.

2. Protein

The protein requirement do not change during old age. It is the same as adults i.e. 1g / kg of body weight. Since the calories are reduced without decrease in proteins the diet should be protein rich when compared to a normal adult diet.

3. Carbohydrate

Since the calorie requirement is reduced the carbohydrate content should also be proportionately reduced. Due to impaired glucose tolerance and gastro intestinal disturbances like constipation, emphasis should be on taking complex carbohydrates.

4. Fat

The fat requirements are also reduced corresponding to the energy requirements. The intake of saturated fat should be less and that of unsaturated fat more.

Energy requirement (k.cal / 24 hrs ) of male and female 60 years and above with different body weights

Sex    : Body weight Kg - Energy requirementfor sedentary activity k.cal

Male :

60 1976

 65 2072

 70 2176

 75 2280

Females :

60 1864

 65 1944

 70 2024

(Nutrient requirement and recommended Dietary allowance for Indians, ICMR, 2002)

5. Minerals

Calcium needs increases during old age due to increasing mobilization of calcium from bones and incidence of osteoporosis. During old age 1000mg of calcium is recommended per day because of the following reasons.

1.     Limited availability of calcium from foods.

2.     To compensate age related bone loss and to improve calcium balance.

3.     To prevent fractures and tooth decay.

4.     To compensate decreased efficiency in calcium absorption.

Aging does not affect iron needs. Hence iron needs are same as that for adults. Mild anaemia may affect the health of old people due to inefficient circulation. Therefore iron intake should be adequate during old age.

6. Vitamins

1.     Vitamin A requirements remain the same i.e., 600 mg of retinol

2.     Inadequate exposure to sunshine may affect vitamin D levels in which case supplementation may be required.

3.     Vitamin C requirements increase due to stress and medications. The antioxidant vitamins such as vitamin E, carotenoids and vitamin C have been identified to promote health of the elderly.

4.     Vitamin B₆ requirements are also increased due to atrophic gastritis which interferes with absorption. Liver dysfunction is an additional risk factor for Vit. B₆ deficiency.

Besides these various nutrients, water should be consumed in plenty as such or as fluids like buttermilk, fruit juice and soups. Intake of sufficient fluids reduce the load on kidneys and relieves from constipation by stimulating peristalisis.

The quantity of food stuffs to be included in a balanced diet for elderly is given in List.

List: Balanced diet for an elderly person for a day

Food Stuff : Quantity ( raw ) g Males Females

Cereals : 350 225

Pulses : 50 40

Vegetables : 200 150

Green Leafy vegetables : 50 50

Roots and Tubers : 100 100

Fruits : 200 200

Milk and Milk Products : 300 300

Sugar : 20 20

Fats and oils : 25 20

(Source : 'Dietary tips for elderly', NIN, ICMR Hyderabad 2000)