How to prevent malnutrition in older adults?

The state of malnutrition in older adults is related to the appearance and worsening of some diseases. Find out how to prevent it.

Last update: 25 February, 2022

Aging leads to a series of changes that compromise well-being. Loss of taste or smell, chewing and swallowing problems, lack of appetite, depression, among others, can cause malnutrition in older adults. By not treating or preventing it in time, the consequences can range from functional disability to death.

Malnutrition is considered an inadequate nutritional status, either due to excess or deficit. The latter is known as “protein-energy or mixed malnutrition”. In the case of the elderly, this leads to a decrease in relevant nutrients, such as vitamins C, D and A, folic acid, magnesium, calcium and potassium.

Consequently, diseases do not take long to appear or those already installed tend to worsen. For this reason, it is essential to ensure optimal nutrition at this stage and, of course, timely treat any state of malnutrition. Here are some recommendations.

What is malnutrition and what is said about the elderly?

The term “older adult” refers to the last years of a person’s life. It is a group of the population that is 65 years old or older. However, each country has its own life expectancy.

In 2016, for example, Spain had one of the highest life expectancies in Europe and the world. The ages were between 80 and 83 years between men and women, respectively.

As for malnutrition, the Royal Spanish Academy defines it as a condition caused by an inadequate or insufficient diet, or by a defect in the metabolism of food. Between 6 and 15% of non-hospitalized older adults, and between 25 and 60% of those institutionalized, suffer from malnutrition.

There is also a type of “excessive malnutrition”, which is related to being overweight and obese. In this case, the older adult usually eats in a disorderly manner and with a diet abundant in sugars and starches.

Poor nutrition in the elderly poses a high risk of disease.


Malnutrition as a common type of malnutrition

One of the most common malnutrition disorders in older adults is malnutrition. It is a disorder of body composition. In particular, there is an excess of water outside the cells, a deficit of potassium, muscle mass and fat tissue. There are 3 types of malnutrition:

  • caloric. What happens due to a decrease in caloric intake.
  • protein. What happens when there is not enough protein in the diet.
  • Mixed. Also known as “protein-calorie”.

In Spain, of the total population with malnutrition, 70% are elderly.

Causes of malnutrition in the elderly

The causes of malnutrition in the elderly are complex and depend on several factors. Next, we detail the most relevant.

Due to aging changes

A series of physiological changes occur as a result of changes in metabolism with age.

  • reduction of muscle mass, which corresponds to 1% per year and is proportional to the level of physical activity.
  • Decreased taste due to loss of papillae and smell.
  • Reduction in saliva secretion, which causes difficulty chewing and swallowing.
  • Decreased gastric secretion, which hinders the absorption of iron, folate, calcium and B12.
  • Early satiety and constipation.
  • Lactose intolerance.
  • Decreased absorption of vitamin D.
  • Reduced calcium absorption.
  • Hormones of anorexia predominate.

Alteration of certain activities

  • Physicallack of mobility.
  • Sensory, visual, auditory or communication.
  • psychics, such as depression, dementia, paranoia, alcoholism and smoking.
  • Social, such as loneliness, low income, and poor dietary habits.

Diseases

Diseases also lead to states of malnutrition in older adults. This especially when your treatment it forces dietary restrictions and changes in habits.

  • Chronic diseases, such as cardiovascular disorders, arthritis, osteoporosis or diabetes.
  • Oral alterations, such as the lack of teeth that prevent good chewing.
  • Neurodegenerative diseases, such as senile dementia, Alzheimer’s, Parkinson’s, among others.
  • Digestive diseases, such as diverticulosis, colitis, gastritis, ulcers, diarrhea, constipation, among others.
  • Cancer.
  • hyperthyroidism


How to prevent malnutrition in older adults

There are many ways to prevent malnutrition in older adults. These range from the appropriate selection of food, to having a good company at mealtime.

According to the food guide, for healthy older people, An ideal average diet should consider the following:

  • 10 to 15% energy from protein.
  • 30 to 40% from fat.
  • Between 50 and 60% from carbohydrates.

Here are some recommendations for a healthy diet.

Maintain a diet with a variety of fruits and vegetables

It is important to select a wide variety of fruits and vegetables as sources of antioxidants, fiber and vitamins. Vitamin A, vitamin C and other pigments —such as anthocyanins from fruits— are associated with well-being and the prevention of chronic diseases.

The fiber in fruits and vegetables will also help prevent constipation, which tends to be common in older adults. An easy way to get fiber is by preparing raw fruit juices.

Consume healthy vegetable oils

Olive oil is recommended for its high content of monounsaturated fatty acids that prevent or help treat cardiovascular disease. Also, it is convenient to include fatty acids such as omega 3, which is found in fish, nuts and soybean oil.

Omega 6 fat —whose sources are seed oils such as corn, sunflower, canola, among others— should be kept in a lower ratio than omega 3. Its intake lowers the level of total cholesterol and “bad” cholesterol that clogs arteries.

To prevent malnutrition in older adults, it is recommended that no more than 23% of calories come from fat. In addition, only 10% should be of the saturated type, such as those provided by dairy, meat, coconut or palm oil.

Eat more fish as a source of protein

Fish are a good source of excellent quality protein. According to the United States Department of Agriculture (USDA), a raw fish fillet provides about 28 grams of protein.

In addition, according to INFOPESCA, blue fish provide long-chain fatty acids, such as EPA and DHA. These, in addition to protecting the heart, have anti-inflammatory effects, improve brain function and visual health.

Increase the consumption of milk and derivatives

The Spanish Society of Geriatrics and Gerontology recommends the consumption of dairy products with lower fat content as a source of protein, calcium and riboflavin in the diet. They also provide niacin, vitamin A, and vitamin B12.

Calcium—along with vitamin D— contributes to the prevention of osteoporosis, common in older adults. If lactose intolerance is present, it is recommended that dairy products be lactose-free.

Add a new flavor to food

The loss of taste and smell in the elderly can be a cause of loss of appetite. In response to this, it is advised to use natural herbs and spices that enhance the flavor. However, avoid excess salt.

Consult the doctor to add supplements to the diet

Nutritional supplements may be necessary in the older adult to restore the levels of some minerals or vitamins. Of course, you need to check with your doctor first.

include snacks

Mid-morning or afternoon snacks should be rich in additional nutrients to those provided by the main meals. These snacks are very helpful for older adults who feel full before they finish eating. An example might be low-fat yogurt with fruit bits and a whole-grain cracker.

Low-fat dairy foods are ideal for adding calcium to the diet of older adults.

Other recommendations on feeding and care of the elderly

  • encourage exercise. It must be consistent with the physical capabilities of the older adult. Activity can help improve appetite and build muscle and bone.
  • Be aware of the nutritional status of the elderly in case of being in an institution. It is possible that the caregivers are not aware of the nutritional conditions in which they are found.
  • Ensure intake of between 1.5 to 2 liters of fluids per day. Aging is associated with fluid loss inside and outside the cells; hence the importance of staying hydrated. Thus, they must be constantly provided with water, in addition to juices, infusions or broths.
  • Prepare meals according to the cultural habits of the elderly.
  • whet your appetite with an attractive presentation.
  • Consider the preferences of older adults.
  • In case of any type of illness, it is necessary to consult with the doctor or specialist in nutrition and dietetics.
  • Ensure moderate exposure to the sun. This to allow the activation of vitamin D and favor the absorption of calcium. Of course, the adult should use sunscreen.
  • Finally, in case of malnutrition, hypercaloric dishes must be adapted so that the recommended diet has a greater follow-up.

What is there to remember?

Aging is an unstoppable physiological process. However, a healthy diet, abundant in antioxidants, vitamins, minerals and with an adequate adjustment of macronutrients, can prevent malnutrition and other chronic diseases of this stage.

The diet must be accompanied by a better lifestyle, that includes exercises, company and good care by health professionals. Thus older adults will be able to lead an old age with dignity.

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