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Nutrition and the Golden Years
Ageing well is without a doubt an issue for current medicine. A quality diet can slow the effects of natural ageing and the emergence of certain illnesses linked to age. A balanced diet can allow for ageing all the while helping to conserve a good quality of life.
> Risks of deficiencies and malnutrition linked to ageing
Ageing often brings on physiological modifications that weaken elderly people. With regards to nutrition, this can translate into a higher risk of malnutrition.
Physiological ageing can mean:
• Loss of taste and smell perception: taste cells renew much slower, and the influence of medication can lower appetite;
• Dental problems: dietary choices can be limited by having to consume softer or chopped foods;
• Ageing of the digestive system: lowered secretions, slower transit…
Other risk factors:
• Social isolation;
• Reduced resources;
• Ignorance of dietary needs;
• Dietary abuse;
• Depression.
> Nutritional needs of the elderly
Energy Intake
Frequently we wrongly believe that, with age, dietary needs diminish. Nevertheless, even if physical activity is much more limited, one has to maintain a balanced diet. An elderly person, much like an adult, needs at least 30 kcal/kg/day, which means roughly 2,100 kcal/day for someone weighing 70kg.
Proteins
Proteins serve to build muscle mass and antibodies. They are thus essential for the immune system and help avoid loss of muscle (sarcopenia), that leads to falls and fractures.
Daily consumption should be between 1g and 1.2g per kg of weight, which means between 70g and 84g for someone weighing 70kg. This intake can be met by consuming 3 or 4 dairy products and 150g of meat (or equivalent) per day.
Carbohydrates
Carbohydrates are a source of energy that can be rapidly used. They are necessary for proper muscle and brain functions. Among their uses, they help ensure proper cellular synthesis of proteins. Carbohydrate intake should be about 50% of total energy intake (TEI), and individuals should focus on complex carbohydrates (breads, cereals, dried vegetables) and on sweet foods (simple sugars).
Lipids
Lipids make up the fatty matter of living organisms. They supply the most concentrated form of energy. They are vital for essential fatty acid intake and lipid soluble vitamins. Lipid needs for the elderly are around 35% of their TEI. We can find them in oils, butter, fats, some meats, fish, cheese…
Water
Water is important to regulate body temperature, deliver of nutrients, manage cellular mass and eliminate waste. During ageing, the proportion of water in the system diminishes and the risks of dehydration increase. On top of that, the elderly feel thirst much more slowly. As such, it is necessary to drink at least 1.5 litres of water a day.
Fibres
Fibres represent the bone structure of plants. For humans, they help regulate absorption, digestion and metabolism. The elderly need between 20 and 25 grams of dietary fibre per day. They can be found in breads, fruits and vegetables.
> Encourage eating
For the elderly, the eating environment is very important. According to French researchers in the hospital and geriatric nutrition domain, the appreciation of the quality of a meal is linked to the material environment (table setting, dishes) for 40% of those questioned – and the global setting (decorations, ambiance, service staff) by another 40%. Only 20% of elderly participants saw the quality and quantity of food served as being the most important factor in their experience.
Retirement homes, for example, should carefully chose cutlery and dishes, and focus on ergonomic and malleable models. The resident's appetite can be stimulated by an original presentation of meals. A well set table with a beautifully presented meal, bright colours, etc...
Many residences have adopted a concept based on finger foods for the disoriented. These residents can maintain their autonomy and their self-esteem.
Finally, the attitude of personnel is very important. More and more residences train their staff to understand the importance of listening to residents in order to avoid malnutrition by adapting to their personal needs.
What is therapeutic cooking?Show
Many more establishments are offering therapeutic cooking workshops, allowing residents to re-engage with a familiar activity and find their points of reference. This activity can limit the disorientation of residents with dementia and contributes to manual retraining (utensil use, precise gestures, coordination) and patients with amnesia (focus, concentration, recall of memories). It also promotes communication and interaction between residents.
Meals, made by residents with the help of a facilitator, allows for sense stimulation: smells (cooking aromas), sight (colours and forms of the ingredients), touch (textures and temperatures), taste (acidity, saltiness), and even hearing (water boiling, crackle of stir-fried vegetables).
What foods can you offer those with swallowing or dental problems?Show
You should not confuse chewing or dental problems with swallowing problems. Chewing problems affect those who have difficulty chewing food. They should be provided with a well cooked or soft diet in order to eat better. Swallowing problems are different: small bits of food often time get stuck in the pharynx, thus it is important to provide semi-solid food easy to swallow, not too dry and given in proper portion sizes. Too much food will fall out of the mouth, and not enough food will be harder to swallow. There are techniques available for those with dietary trouble, at the quality, texture quantity and rhythm level.
AlbuminShow
Is the dominant protein in blood. It is produced by the liver and contained in some foods, such as milk and eggs. Albumin is essential for the human body. It help, among other things, the proper distribution of liquids throughout the body's different structures, such as vessels, tissues and the space that separates them, called the interstitial area. It also vehicles a number of hormones, fatty acids, and bilirubin. In the blood, the level of albumin is lower in cases of malnutrition or nephrotic syndrome, a kidney illness that is responsible for protein leakage in urine.
BMIShow
Body Mass Index is a measure that allows us to estimate an individual’s girth. This indicator is calculated using height and mass. According to the WHO classification, BMI = mass/(height²). Values between 18 and 25 are considered normal BMI. But individuals over 65 are excluded from this calculation. Their ideal weight can be slightly more than these values.
MalnutritionShow
This refers to the reduction in dietary intake, which leads to multiple deficiencies and a deterioration in health. The first clear symptom of malnutrition is weight loss. As such, weight loss of 5% in a month, or 10% in six months, is a sure sign of the existence of malnutrition.
