Nutrition in Old Age
• Gerontology: The medical study of the ageing
• Geriatrics: The study of diseases that afflict the
• Geriatric nutrition: Nutrition for the elderly.
What is old age?
• Old age is best defined as age of retirement that is
60+ years and above.
• The organic process of ageing is called senescence.
• Ageing brings physiological, psychological and
immunological changes which influence the
nutritional status of a human being.
• Loss of teeth
• Decreased Neuromuscular
• Impaired hearing and failing
• Change in body composition.
• Change in gastro-intestinal
• Change in cardiovascular
• Change in respiratory function.
• Change in renal function.
• Change in skeletal tissue.
Changes in organ functions
• Decrease in sense of taste
• Decrease in saliva secretion.
• Mouth and teeth problems.
• Swallowing difficulties
• Decrease in stomach
• Decrease in function of liver
• Decrease in function of
• Decrease in function of
• Decrease in the function of
• Energy metabolism.
Socio psychological changes
• Food habit.
• Economic aspects.
• Lack of nutritional knowledge.
• Loss of self esteem.
• Loss of independence.
• Prevention, retardation
and treatment of
diseases affiliated with
• Adequate and balanced
nutrition is important with
respect to the
perpetuation of the
• Energy requirement reduces.
• Reduced physical activity.
• Basal metabolic rate decreases(15-20%) due to reduced
muscle mass and other metabolically active tissue mass.
• Increase in fatty tissue.
Sex Sedentary Moderate
male 1883 kcal 2216 kcal
Female 1706 kcal 2007 kcal
• Requirement reduces.
• Impaired glucose intolerance can lead to hypoglycemia,
hyperglycemia, and type II diabetes mellitus.
• Insulin sensitivity can be enhanced by balance energy
intake, weight management and regular physical activity.
• 50 percent energy should derive from carbohydrate.
• Production of body organs.
• Restoration of cells.
• 1g = 4 calories
• Protection of body from external
• Facilitating recovery in conditions
• Protection and strengthening of
• Development of resistance to
diseases by strengthening of the
Soya beans 30-35g
• Dementia and CVD may share risk factors like high
of dietary intake & total fat.
• Emphasis should be placed on reducing the intake
of saturated fat and choosing mono saturated or
poly saturated fat sources.
• Sufficient intake of ω-3 fatty acids helps in visual
acuity, hair loss, tissue inflammation, improper
digestion, poor kidney function and mental
• Source of energy(1g=9 calories).
• Essential for production of some hormones which ensure
functions of the body.
• Omega 3 fatty acids reduce risk of heart attacks and
strengthen immune system and protect people from
• Fat sources:
Milk and Yolk
Fat requirements in old age
• Minimum 25% of daily energy intake should be provided
• If not much limitations caused by diseases the amount to
be consumed is 35-40g.
• Half from vegetative liquid oils and the other half from olive
• Since too much causes obesity and cancer, cardiovascular
diseases, it is necessary to avoid excessive consumption.
• Calcium: 800mg/day
• To compensate age related bone loss, to improve calcium
balance and to decrease prevalence of fracture.
• Ca absorption efficiency decreases, vitamin D level decreases so
need more Ca.
• Total food consumption decrease so Ca supplements needed.
• Iron: 30mg/day
• Deficiency is seen in elderly due to inadequate iron intake,
blood loss due to chronic disease or reduced non-heam iron
absorption. Vitamin C deficiency also reduce iron absorption.
• Mild anemia affect health due to less efficient circulation of
• Some features like delayed wound healing, decreased taste
sensitivity and anorexia are associated with zinc deficiency.
• But healthy elderly don’t show zinc deficiency.
• Low vitamin D levels- Parkinson disease.
• 200 mg of vitamin E to improve immune system.
• Calcium and vitamin D improves bone density and prevent fractures.
• Vitamin E, carotenoids and vitamin C enhances health of elderly.
• Vitamin C intake level of 150-250 mg/day to fight against cataract.
• Requirement of vitamin B6 increases due to atrophic gastritis.
• Deficiency of folic acid may result anemia and elevated serum homo-
cysteine level which is a risk for cardiac diseases.
• Vitamin B12 deficiency leads to pernicious anemia.
• While 70% of the body is water in the adult
period, this amount decreases to 50% in elderly.
• Loss of 15% of body water cause loss of life.
• Helps in:
Digestion, absoption, transportation of food
Operation of cells, tissues and organs
Monitoring of body heat
Slickness of the joints
Removal of harmful substances from the body.
• Prevention of overweight problems
• Protection from intestinal cancer.
• Lowering blood cholesterol.
• Increases activities of intestine and prevention of
• Regulation of blood sugar and protection from the diabetes.
• Sources: Legumes, grains, vegetables and fruits
• 25-30g of fibre consumption per day is sufficient.
• Chemical substances found in vegetables and
fruits have preventive features against health
problems. These substances are phytochemicals.
Nutrition related problems of the
• Malnutrition and Under nutrition.
• Cardiovascular diseases
• Mental insufficiency,
• loss of memory, brain damage
• Immune system weakness
Principles of nutrition in old age period
• No. of daily meal should be regulated as 3 main and 3 interim
• High amount of fibre as legumes & wholegrain must be
• 8-10 glasses of water (1500ml) should be consumed.
• High level of calcium should be consumed.
• Fish should be consumed atleast twice a week(omega 3 fatty
• Salt and sugar consumption should be limited.
• Healthy ageing begins from childhood
• Eat well to age well.
• Old age is second childhood-
• World Health Organisation-
• Geriatric Nutrition- ebook by Tom Brody