- Old age brings changes in organ functions like reduced sensory abilities, decreased digestion and absorption of nutrients, and lowered kidney and immune function. - Nutritional requirements in old age decrease for energy but not for protein, vitamins, and minerals. Diet should emphasize easy-to-digest foods high in protein, calcium, vitamins C and D. - Common health problems in old age like obesity, osteoporosis, diabetes, and cardiovascular disease can be influenced by diet. Maintaining balanced nutrition is important for healthy aging.

1. Old age
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2. contents
 Introduction
 characteristics.
 changes in organ functions
 Nutritional requirement.
 Problems of old age .
.

3. Introduction of old age
Old is not a disease but a biological process that no one
can avoid . A little care and caution will prevent or
delay disabilities . With proper care every one can
enjoy long run , healthy ageing . As age advance
, several chronic disease effect our healthy . Many of
these like obesity , hypertension and diabetes are diet
related and enhance can be controlled and even
prevented by modifying our diet .

4. Characteristics
1) SENSORY LOSSES – the sense of taste , smell , sight
,anorexia, loss teeth , xerostomia . Also decline in
neuromuscular coordination are common problems
which lead to less food intake as result of decrease
appetite , food recognition and self feeding ability

5. 1) CHANGES IN GASTROINTESTINAL TRACT – secretion
of digestive enzymes and juices decrease which result in
incomplete digestion of food as result absorbtion and
utilization of nutrient are affected adversely .
2) CHANGES IN CARDIOVASCULAR SYSTEM – narrowing
of lumen , thickening of arterial walls and lowered
myocardial contractibility .
3) RENAL FUNCTION – working ability of kidney decreases
as a result the elimination of waste products and
reabsorption or nutrient are affected

6. 1. REDUCED HARMONES LEVEL
2. IMMUNOCOMPETENCE – immune function
decline with age .
3. PSYCHOLOGICAL FACTORS –like depression
, anxiety , loneliness , food habits , loss of self esteem
can affect apatite digestion , energy level weight , and
well being

7. Changes in organs
function with ageing that
may influence nutrient
requirements

8. Age (years)
Estimated energy requirement
for males (kcals per day)
Estimated energy requirement
for females (kcals per day)
19-50 2550 1940
51-59 2550 1900
60-64 2380 1900
65-74 2330 1900
75+ 2100 1810

9. Organfunction
• Taste and smell
• Salivary glands
• Gastric function
and emptying
changes
• Decreased taste buds on
tongue.
• Decrease in salivary
secretion causes feeling
of dry
mouth, xerostomia.
• Decreased secretion of
hydrochloric acid
intrinsic factor and
pepsin.
• Above 60 years of age
rapid rate of emptying
of liquids.
• Decreased calcium
absorption.
Effectsonnutrition
• Loss of ability to detect
salt and sweet.
• Difficulty in chewing
and swallowing make
them avoid certain food
particularly curnchy.
• Decreased
bioavailability of
minerals, vitamins and
proteins.

10. • Skeletal function
• Opthalmic
factor
• Psychological
factors
• Changes in bone density
• Opacity of eye lens
• depression
• Increased requirement of
calcium.
• Increased requirement
• Can affect
appetite, digestion, energy
level ,weight and well
being.

11. • teeth • Loss of
teeth and
wearing
dentures.
• Decreased

12. Nutritional requirements
 Energy –after the age of 35 the basal metabolic rate
decreases due to reduced muscle mass and other
metabolically active tissue mass . Also there is
reduction in physical activity which affects the energy
needs .
 Sarcopenia, an age related loss in skeletal muscle is
the result of decline in muscle strenth.

13. Lean body mass declines approximately 2 to 3% per
decade.
Body protein level in the healthy elderly is 30-40% less
than that in young adults.
The average body fat % in meals increases from about
15 % when young to 25%.
The calorie intake should be adjusted to maintain the
body weight constant. In the case of obese the calorie
intake should be adjusted to reduce the body .

14.  Energy requirement decreases with age beyond 30
years.
 Although the energy requirements decreases, the
decreases the requirements for protein, vitamins and
minerals do not diminish.

15. protein
 As people age there is a decrease in skeletal tissue
mass. This results in decrease in store of protein
provided by skeletal muscle and may be inadequate to
meet the needs for protein synthesis. Hence the
dietary protein intake is more important to meet
essential needs.
 A protein intake of 1.0g per kg , the normal adult
requirement, is safe during old age.

16.  Food should be protein rich compared to adult normal
food .
 To meet this adequate quantities of protein foods such
as milk and curd can be included.
 Deficiency of protein result of oedema, anaemia and
lowered resistance to infection. The total caloric intake
11-12% should be from protein.

17. carbohydrate
It is necessary that at least 50% of calories are derived
from charbohydrates .
An impaired glucose tolerance in elderly can lead to
hypoglycaemia, hyperglycaemia and two type diabetes
mellitus .
Insulin sensitvity can be enhanced by balance energy
intake, weight management and regular physical
activity.

18. calcium
Calcium needs during old age increased.
Women over 50 years of age who are not receiving
estrogens require more calcium as there is increased
loss resulting in demineralisation of bone .
For women over fatty ,1000mg/ day is recommended
for the following reasons:

19.  Calcium is available only from a limited foods.
 To compensate age related bone loss and to improve
calcium balance.
 To decrease the prevalence of fractures and dental
decay.
Calcium absorption efficiency decrease, vitamin D
levels decline and hence men also require more
calcium.

20.  Milk is an important source of calcium for elderly
 As caloric requirement decrease, total food
consumption decreases, hence calcium supplements
are essential.
 Mild anaemia affects the healthy of old people due to
less efficient circulation of blood.

21. iron
 Iron prevent intake should be adequate to prevent
anaemia .
 Iron requirement can be same as adult man, 30mg.
 If there is anaemia, supplemental iron can be given.

22. zinc
 Such features of old age such as delayed wound
healing , decreased taste sensitivity and anorexia also
findings associated with zinc deficiency.
 Older people who avoid flesh foods may be at
increased risk of poor zinc status.

23. Vitamin D
 Elderly people are at risk for vitamin D deficiency due
to decreased exposure to sunlight .
 Prudent dietary supplementation with calcium and
vitamin D improves born density and may prevent
fractures in a healthy elderly population.

24. Vitamin C
 Stress, smoking and some medication can increase
vitamin C requirement.
 Vitamin C may be protective against cataract at an
intake level of between 150 and 250mg per day which is
possible to achieve from dietary sources alone.

25. Vitamin E
 Vitamin E has also been found to be a potent nutrient
for reducing the decline in cellular of immunity that
occur in the elderly .
 Change in immune system can be overcome by taking
200 mg of vitamin E.

26. water
 With aging a progressive decline in the water content
therefore 1ml of water for each kcal of food consumed
for all people of ages is recommend.
 Water stimulates peristalsis and thus aids in
combating constipation. Dehydration can result in the
mental confusion, headaches and instability. Elderly
should be advised to consume some fluids at interval.

27. fiber
 Increase consumptions of dietary fiber are corelated
with decreases rate of heart diseases. Fiber stimulates
peristalsis.
 It is essential to consume fiber containing food but
increase should be gradual other wise bowel
discomfort ,distension will result.
 Rough fiber, bran and mature vegetable are not
advised .
 Fiber also helps in reducing cholesterol which may
reduce the incidence of atherosclerosis.

28. Fat and essential acids
 These requirements for the aged have not been dealt
with by ICMR .
 With advancement of age , since the energy
requirements are reduced, the requirement of energy
nutrients i.e. carbohydrates and fats also needs
reduction.

29. Other fat soluble vitamins
 As already mentioned in adulthood, ICMR not given
any recommendations for vitamin D .
 If the elderly are confined indoors and do not get
enough sunshine, they should be given supplements of
this vitamin.
 No recommendations have been given for vitamin E
and vitamin K.

30. Five Steps to Healthy Eating

31.  Cereals
 Vegetable ands
 Pulses ,nuts, milk products, fish and chicken
 Egg and red meat
 Oil , ghee , butter

32. Dietary guidelines
 Empty calorie foods should be taken minimum and calorie
dense foods should be avoided.
 Foods rich in protein, vitamin and mineral should be
included.
 Vegetables and fruits are good sources of antioxidants. A
minimum of five servings should be taken.
 Fat promotes weight gain. Fat particularly fat should be
limited

33.  Soft well cooked foods are preferred.
 Food should be less salty and spicy .
 Fried and concentrated foods be avoided
 High fiber diet including green and whole grains are to
included in the diet.
 Easily digestable steamed foods like idlis can be part of
the diet.

34.  Plenty of fluids and semisolid foods should be taken.
 2-3 serving of low fat milk should be included in diet.
 Tobacco chewing, smoking and betel leaves chewing
are the habits which may affects consumption of food
in diet.

35. PROBLEMS OF OLD AGE
The elderly are at a risk of poor nutrition due to
economic pressure , reduced mobility depression
loneliness , ageing tissues and inadequate food
consumption .
NUTRITION RELATED PROBLEMS ARE
OBESITY – it is higher among elderly . Because of
more consumption of calorie and sedentary life style .
Obese are susceptible to diabetes ,cardio vascular
disease , arthritis ,

36. OSTEOPOROSIS- loss in bone density and bone mass . Its
primarily found in middle age . Bone demineralization
takes place at faster rate than bone mineralization . Bones
become porous lighter and fragile .
DIABETES – it increases with age in booth male and female .
The elderly are at a risk of poor nutrition due to economic
pressure , reduced mobility , depression loneliness , aging
tissues , and inadequate food consumption.
CARDIO VASCULAR DISEASE – hypertension , acute
myocardial infection, congestive cardiac failure is high
among elderly

37. CONSTIPATION – it is infrequent passes of stools which
are more often drier or harder than normal . The stools
becomes harder and drier because move to slowly
through colon . The natural contraction and rhythm of
colon might be disturbed due to loss of tone , stress
medication , illness , resisting the urge of defecate.
ANEMIA- inadequate intake of iron causes fatigue
, anxiety , lack of energy and sleeplessness caused by
low dietary intake lack of iron or vitamin c or blood
loss .
MALNUTRITION- due to various physiological and
socio psychological changes , food intake of the elderly
may decreases.