Ageing is a biological process which is influenced by gender, race and genetics.
Healthy ageing is associated with a number of physiological, cognitive, social and lifestyle changes that influence dietary intakes and nutritional status. Nutrition deserves special attention to people who reach old age which is essential for their good health. There is a higher burden of various diseases and greater risk of malnutrition. Thus, the role of nutritional care is to help the aged achieve a healthy, purposeful and independent living. A healthy older person may therefore have some decline in health but still be considered relatively healthy.
Changes in nutritional status of older adults
- Age-related decline in muscle mass. The main effect of a loss of muscle mass is a reduction in muscle strength, which results in a decline in physical function (including fatigue), and impaired mobility and balance.
- Loss of bone and total body calcium. Calcium absorption is known to decrease with age in both genders. Thus, adequate calcium and vitamin D status is essential for minimizing bone loss following menopause and preventing fractures.
- Decline in gastrointestinal digestive and absorptive functions: Fat and protein digestion may be affected by a reduction in pancreatic enzyme secretion.
- Altered immune function: Altered regulation of the immune system, resulting in an increased incidence of infections and poor recovery from disease. Poor nutrition can both contribute to a decline in immune status and result from poor immune status.
- Sensory changes: taste and smell: Relatively common with ageing.
- Changes in food intake: All these age associated changes influences the food intake
- Changes in mental health and cognition status will also happen in older adults.
After the age of 30 years, the nutritional requirements change.
- Energy: Since metabolic rate decreases and muscle mass is also reduced, the caloric intake should be adjusted to maintain the body weight.
- Carbohydrate: Since there is lesser caloric requirements, carbohydrate intake is also reduced. An impaired glucose tolerance can lead to hypoglycaemia, hyperglycaemia and type II diabetes mellitus. Including complex carbohydrates like whole grains cereals and pulses rather than simple sugars helps manage these conditions.
- Protein: Reduced skeletal tissue mass in older adults results in decreased protein store. Thus protein rich foods such as milk and curd can be included in the diet. On the other hand, poor appetite and digestion problem might result in lesser consumption of protein leading to several infections and anaemia.
- Lipids: Higher intake of fat leads to cardio vascular diseases, thus reduction in the intake of saturated fats and choosing monounsaturated or polyunsaturated fat sources such as omega-3 fatty acid may help several problems associated with ageing.
- Minerals: There is an increased calcium need since there is increased losses especially for women over 50 years of age. In order to decrease the prevalence of fractures and dental carries and to improve calcium balance, 800mg/ day of calcium is recommended for women over fifty.
- Vitamins: Antioxidant vitamins such as vitamin E, carotenoids, vitamin C enhances the health of elderly. Old age become vitamin D deficient due to decreased exposure to sunlight. Thus dietary supplementation with calcium and vitamin D improves bone density and prevent fractures. There is an increased requirement for vitamin B6 owing to atrophic gastritis which interferes with absorption. Diets rich in folate should be encouraged to reduce the risk of cardiovascular diseases and anaemia.
The onset of menopause is considered to be one of the most important phases in the life span of a female. The term “menopause” means the end of the cycle of monthly menstrual bleeding. Menopause develops as the result of decreased estrogen and a disruption of the hormonal cycle associated with ovulation. The absence of menstrual periods for 12 months is usually used as the definition of “natural” menopause. The age at which menopause occurs varies widely ranging from late thirties to late fifties with the range for most women being between ages 48 and 55 years.
There’s a lot of changes in the body during menopause, together with increasing age and lower energy expenditure, cause an important change in fat distribution, leading to central obesity, and insulin resistance. Hot flashes, which are the primary symptom of menopause, appear to be caused by dysfunction of the central thermoregulatory system when estrogen availability is decreased. Following a proper diet with essential nutrients helps maintain the hormonal balance and modulate other functions.
- Calcium and Vitamin D- There is a loss of calcium due to aging and this increases during menopause because of the loss of oestrogen. In time, the bones can become weak leading to fractures. Thus foods rich in calcium and vitamin D should be an important part of diet for women during menopause.
- Iron: Menstruation is a unique physiological phenomenon in young women, characterized by the periodic high levels of estrogen and the shedding of the endometrium. Because of this monthly blood loss, iron deficiency is prevalent in premenopausal women. There’s also an observation that suggests, in contrast to iron deficiency leading to cold intolerance, an increase in iron might play a role in postmenopausal hot flashes. Intake of right amount of iron is necessary.
- Fiber: Since menopause is associated with several risk factors including cholesterol related problems such as obesity and heart diseases, it is good to have fiber-rich foods in the diet.
Along with healthy food choices, being physically active is also important. Lifestyle factors are also key players in weight gain during the menopause. Weight gain during the menopause can increase the risk of heart disease, type 2 diabetes and various types of cancers, including colorectal cancer and breast cancer. Eating a variety of foods to get all the nutrients and following a healthy lifestyle can help prevent diseases and also relieve difficult menopausal symptoms.
- Srilakshmi, B. (2002). Dietetics (Revised. New age international publication).
- Dietary Guidelines for Indian- A Manual; ICMR, National Institute of Nutrition.
- Marsman, D., Belsky, D. W., Gregori, D., Johnson, M. A., Dog, T. L., Meydani, S., ... & Griffiths, J. C. (2018). Healthy ageing: the natural consequences of good nutrition—a conference report. European journal of nutrition, 57(2), 15-34.
- Menopausal Syndrome- National Health Portal of India
- What is Menopause? National Institute on Ageing
- Menopause- NHS