Nutrition during middle and old age

The average life expectancy for people in India has improved greatly in last few decades. This is mainly due to advances in medical sciences, improved nutrition, hygienic and sanitation conditions and other social and economic factors. With increase in the life expectancy it means that people are living for longer and hence there has been a substantial increase both in the proportion and total number of elderly folks. Presently in India there are over 55 million people aged 60 years and above. This forms nearly 6.5percent of the total population. With aging population, there are number of different issues that need to be looked at including the health and well being of this section of population. One aspect that is quite significant and is often ignored is the proper and healthy nutrition.

To explore this further, in this article not only we will look at what the main issues that can affect the health of elderly but also how to ensure that people are eating not only nutritious food but also meeting their requirements.

It is a well known fact that by the time one reaches adulthood, body growth, particularly in terms of height and weight stops. However, what is not obvious to the outside world is that the wear and tear of the human body continues. This means that the body still requires adequate food sources to repair body tissues continuously and to maintain this function the human body requires adequate amount of all the nutrients. The elderly need to make sure that they have both proper and adequate nutrition so that they do not unnecessarily have diet related issues at this stage of life. Needless to say any diet related issues will have a serious impact on their health.

Before dealing with the nutritional requirements of adults and old people, it is important that we understand some critical points regarding food. The main functions of the food are to provide energy and to maintain growth and repair of the body and protecting the body against diseases.

The basic nutrients of the food are carbohydrates, protein, fat, vitamins and minerals. Vitamins can be subdivided into two categories, water soluble that includes Thiamine, Riboflavin and Vitamin C etc and secondly fat soluble which includes Vitamin A, D, K and E. Minerals include Iron, Iodine, Calcium and Phosphorous and many other trace elements like Zinc.

The food groups can be divided into mainly three categories according to their functions. These are

• Foods for energy like staple food (rice wheat, jowar bajara), roots and tubers, jaggery and sugars and fats and oils.
• Foods for growth and maintenance like pulses/legumes, peas and beans, nuts and other dry fruits, milk and milk products, and eggs , meat, fish and chicken.
• Foods for proper functioning and protection against diseases. These include milk and milk products, leafy and yellow and colorful fruits and vegetables, meat, eggs and fish.

The nutritional requirements is different for every person and requirements are dependent on number of factors including –

• Age.
• Sex of the person.
• Activity.
• Body Weight.
• Height and Composition (the body physique).
• Climatic Conditions.
• Body growth/Breakdown and repair of body tissues.
• Physiological stress.

In the case of adults, nutritional requirements for the men and women differ mainly due to difference in body weight and body composition and are not directly related to gender except requirements of nutrients like Iron which is required more in women unto menopause.

It is clear that at different stages of our life, our food requirements change. Before planning diets for the older people it is necessary to keep in mind, the factors which are associated with the aging. These include;

• Physiological changes.
• Loss of teeth.
• Decreased neuromuscular coordination.
• Impaired hearing and failing vision.
• Diminished sense of taste and smell.
• Physical discomfort.
• Changes in body composition.
• Changes in gastrointestinal tract.
• Changes in cardiovascular system.
• Changes in respiratory system.
• Changes in renal function.
• Changes in skeletal tissues.
• Hormonal changes.
• Socio psychological changes
• Food habits

Above changes cause a number of health issues for elderly people including obesity, under nutrition and malnutrition, osteoporosis, cardiovascular diseases and diabetes. To manage the health of the elderly, it is critical that not only do they take nutritious and balanced diet, they should go through medical checkups at regular intervals, take medicines/supplements regularly, if prescribed by the doctor and do regular exercise, go for walk as per their capacity .
Other than looking after the physical well being of their body, it is also important that they look after the mental faculties also. They should keep themselves constructively busy to avoid boredom. Be more tuned in to their environment and keep them well informed about various issues related to their well beings, safety, security. To avoid loneliness, depression and anxiety, they should be in regular contact with their friends, relatives and colleagues. As physical and mental health is all interrelated, every aspect should be given importance and attention.

Below are given few tips for diets of normal healthy elderly people;

• To maintain good health diets should include all the nutrients in required amounts.
• Care should be taken that none of the meals is missed by them.
• Liberal amount of milk and milk products should be included.
• Intake of simple sugars and energy rich foods like sweets and ice-creams, fried or high fat foods , cereals and starches should be reduced as energy requirements of elderly people are quite low .( See table no 1.)
• Fresh and seasonal fruits and vegetables particularly green leafy vegetables should be included to meet the vitamin and mineral needs. But care should be taken that vegetables and fruits are washed properly.
• As in the aged people, constipation, diabetes and cardiovascular diseases are quite common .Therefore adequate amount of foods rich in dietary fiber should be included. Whole cereal dahlia /porridge/ whole cereal bread and biscuits rich in fiber can be part of their snacks /breakfast.
• The food for elderly should be modified and as far as possible variety may be provided. Food should be colorful, attractive and tasty and should be served in pleasant surroundings so as to arouse their appetite and interest in food.

Table 1
Per Day Energy requirements of elderly males and females with different body weight In India.
(Above 60 years age )

Body weight (kg)	sedentary males	sedentary females
50	1768	1704
55	1872	1784
60	1976	1864
65	2072	1944
70	2176	2024

 

 

 

 

Major food groups and values
Table 2

Food groups	Major nutrients	Food exchange
Body building	Protein	Milk, Meat, Pulse
Energy Giving	Carbohydrates and Fat	Cereal/ starches, Fat ,Sugar
Protective	Fiber, Minerals ,Vitamins, And Dietary	Vegetables(Excluding Starchy vegetables, fruits

 

 

 

 

 

(Source;Nutritive Value of Indian foods(yr 2000)

* Nirmal Tikku, Ex Deputy Director, NIPCCD , New Delhi, INDIA

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