Nutrition for Seniors

There’s a reason older adults commonly love their toast and tea. It doesn’t require intense meal preparation such as chopping, peeling or grating. On top of that, it’s inexpensive and familiar. But when an adult over 65 falls into the habit of consuming this easy combo day in and day out, serious problems can arise.

Poor nutrition among seniors

What starts out as a habit of comfort food may end up profoundly affecting a senior’s quality of life. Chronically poor nutrition can lead to weakness, falls, malnutrition and susceptibility to illness. Sometimes the stakes are even higher: it can mean more visits to the hospital, a permanent move to a care facility or worse. And far from being a remote possibility, the risk of poor nutrition is a reality for one out of three Australian seniors.

Changes in fuel consumption

The physiological changes that occur in older age make proper nourishment more important than ever. Ageing tends to bring a loss of muscle, as well as changes in nutrient metabolism. Dr Heather Keller, a professor of nutrition and ageing at the University of Waterloo in Canada, says this means older bodies have unique nutritional needs.

“We know that for some nutrients, older adults actually need more nutrition than younger adults do,” she says. “Calcium and vitamin D would be the two big ones that I think of ... [because] we know that people have increased likelihood of osteoporosis as they age.”

Keller also emphasises the need for protein for seniors, in order to avoid a condition called sarcopenia—the loss of muscle strength and mass. “The research to date suggests that [seniors] are actually not consuming enough protein to prevent that sarcopenia,” she says. “As they age they may not be able to adapt as readily to low intake.”

Multiple roadblocks

With age, individuals come across more barriers to eating diverse and balanced meals. Older adults, therefore, need special vigilance when it comes to achieving a quality diet.

It’s easy to understand how this happens when we think of an actual scenario. For example, imagine an elderly woman living by herself in an apartment who would like to eat a meal of poached salmon, rice with peas and a lightly dressed salad sprinkled with sunflower seeds.

But now, in your mind’s eye, take away the seeds, because her dentures make them uncomfortable to eat. In fact, take away the entire salad, because her ankles were swollen that morning and she couldn’t walk to the grocery store for fresh lettuce. Then take away the salmon, because she had extra expenses this month and fish fillets exceed her tight budget. What remains on her plate is not enough to give her the nutritional support she needs.

Other seniors face different barriers to a healthy diet. Keller explains that some seniors—in particular, women who have spent years cooking for a brood—lose interest in cooking for one. “Their identity is wrapped up in being a nurturer with food,” Keller says. “So in this generation of women who are recent widows, we find that some do not adapt well to eating alone.”

Physical and mental health problems also interfere with food intake. Statistically, those with depression have a very high risk of nutritional problems, as do those who take more than five medications a day. Drugs’ side effects might include impaired taste perception or altered appetite, which can easily sap the enjoyment out of meals.

Assessing risk

Recent research found that two questions go a long way towards determining whether an older adult is in a risky place, nutritionally speaking.

• Do you skip meals almost every day?
• Has your weight changed by more than 4.5 kg in the past six months?

If the answer to either of these questions is yes, it’s a nutritional red flag.

Other signs of substandard sustenance include constant fatigue requiring naps, muscle weakness such as the loss of hand grip strength, a less robust appetite and changes in the ability to do everyday things, such as getting out of an armchair. In Keller’s experience, these signs are particularly prone to showing up during a period of change in a senior’s life, whether it’s a move, the loss of a spouse or the surrender of a driver’s licence.

Filling up the tank

Caloric requirements depend on many things, including one’s gender and level of physical activity. Generally, seniors aged 71 and older require anywhere from 6490 to 10,470 kilojoules every day.

Frances Arnold is a registered dietitian who serves the over-65 population. Giving an example of a senior who requires 5000 kilojoules per day, she says, “Rather than focusing on kilojoules, I emphasise that people focus on the content of those kilojoules. You can eat 5000 kilojoules that actually deplete your body of nourishment, such as sugar, additives and trans fats ... Or, you can eat 5000 kilojoules that restore your body, helping defend you from rapid ageing, colds, flu and chronic diseases."

Keller would agree. “If you don’t have anything in your gas tank, guess what? Your car doesn’t go,” she says. “We’re recognising more and more the importance of quality food.” She recommends eating from at least three food groups at every meal, while including a good source of protein and at least one fruit or vegetable.

Keller and Arnold offer their top tips for helping older adults achieve a better diet.

Power up with protein

The buzz at a recent research meeting, says Keller, was around the one change that is thought to hold the greatest potential for improving function and quality of life in those over 65: the inclusion of 30 g of protein in each meal. 

Not all protein sources are expensive—vegetarian proteins are generally easier on the wallet, as are certain types of animal proteins and fish. Including 30 g of high-quality, budget-friendly protein in a meal can look like

• 3/4 cup (180 ml) plain Greek yoghurt and 1/2 cup (125 mL) raw almonds
• half of a roasted chicken breast
• 2 hard-boiled eggs, 1 piece of rye bread and 60 g cheddar cheese
• half a tin of salmon and 1 cup (250 mL) edamame (shelled and prepared soybeans)

Eat frequently

“Trying to spread the nutrition throughout the day would be key,” says Keller. Even a few walnuts or grapes count, and regular small portions could go down more easily.

Eat socially

A teenager eating alone might simply take a photo of her roasted mushroom agnolotti to share with all her friends on social media. Most seniors have to plan a little harder to make eating social.

When it’s not suitable to invite people over for meals, seniors can take advantage of community centre programs that focus on food, or just meet up with friends. “Building it into your life is the trick,” says Keller. “Maybe it’s a food club where [people] would exchange recipes, like a lunch club where they meet once a month at someone’s house.”

Eat functional foods

For those with a low appetite, functional foods—those tailored to offer a health benefit beyond basic nutritional needs—can be a good way to pack more nutrients into fewer bites. Health food stores have an array of common products, from yoghurt to eggs, that are boosted with bioactive compounds such as antioxidants, dietary fibre, omega-3 fatty acids, plant sterols, prebiotics and probiotics.

Add to comfort foods

Arnold says comfort foods can be a great starting place for stimulating appetite and interest in eating; adding easy-to-eat extras can make them more nutritious. So an older adult doesn’t always need to shy away from macaroni and cheese, but could boost its nutritional value by adding plain Greek yoghurt, avocado chunks or a spoonful of nutritional yeast.

Create routine

Establishing food routines can reduce the burden of planning and choosing every meal. Maybe it’s always porridge with toppings for breakfast, protein and steamed vegetables for lunch, and some kind of soup for dinner. Speaking with a professional nutritionist can help establish standard menus that cover all the nutritional bases.

Another routine that might make it easier for seniors to access good-quality foods regularly is by ordering through a weekly food delivery service. That way, if they don’t make it to the store for fresh ingredients one day, they’ll still have a full fridge. Many services specialise in natural, local and organic products. Ask around at farmers’ markets or stores, ask friends and family or do an online search to find a local option.

Enlist visitors

While hosting a younger family member or friend, a senior might ask the visitor to do something that will make a balanced diet a little easier to achieve that week. Cutting up carrots or portioning raw chicken might even be a pleasant activity for the visitor while chatting.

Stellar seniors’ supplements

Older adults should consider these nutritional supplements, subject to the advice of their health care practitioner.

Foods fit for seniors

While a personalised nutritional plan is ideal, most seniors would benefit from having more of these foods in their diet.