NUTRITIONAL NEEDS DURING OLD AGE
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.
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.
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.
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
(Nutrient requirement and recommended Dietary allowance for Indians, ICMR, 2002)
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.
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)