Better Eating for Better Aging

Eating right is essential at any age; however, as we get older, our bodies and brains have different nutrient needs. Aging is linked to the bodily changes that can make you prone to nutritional deficiencies in fiber, potassium, calcium, vitamin D, protein, and B12. Older adults are at greater risk of chronic diseases such as diabetes, cancer, dementia, and heart disease, and health conditions such as bone loss (osteoporosis), lower muscles mass (sarcopenia), high blood pressure, and low (underweight) or excessive body weight (overweight or obesity).1 Let's take a look at the special nutritional needs of older adults.

Fiber: As we get older, our intestinal system slows down and can hold on to foreign bacteria and toxins longer. This can put us at risk for constipation, upset stomachs, diarrhea, food-borne illnesses, and cancer. Constipation is common among older adults, especially women. Some reasons are that people move less, eat less fiber, drink less water, and take medication that can slow the digestive system. High-fiber diets are linked to lower diverticular disease and lower cholesterol levels. Diverticular disease, common in older adults, is when small pouches form in the colon and become infected or inflamed. It is a painful and sometimes debilitating disease. Dietary fiber may also reduce the risk of diabetes. Eat fiber-rich foods such as beans, peas, oats, grains, bread, cereals, and whole fruits and vegetables to help the intestinal system remain regular and healthy.  

More potassium, less salt: Eating foods with the recommended amount of potassium while reducing the salt in the diet can lower the risk of high blood pressure and help manage it. Potassium is present in all body tissues and is needed for our cells to function normally. Instead of salt, use herbs and spices for flavor. To get adequate potassium, choose nutrient-rich foods such as fruits, vegetables, beans, and low-fat dairy products. Dried apricots and prunes are exceptionally high in potassium. Most adults, however, get their potassium from foods or drinks that have lower nutrient content, such as coffee, tea, potatoes, and nonalcoholic beverages.2

Calcium and Vitamin D:  Most women over 50 and men over 70 years old do not get the recommended amount of calcium.3 Older adults need more calcium and vitamin D to help maintain bone health and for the muscles and blood vessels to function. Calcium also helps to release hormones and enzymes. To meet the increased need for calcium, we need to consume calcium-rich foods such as dairy, kale, broccoli, sardines, and salmon. Other choices include calcium-fortified products like non-dairy drinks like soy or nut milk and some breakfast cereals. 

Vitamin D helps the body absorb calcium to help build bones and teeth. Vitamin D is also required by the immune system to fight off invading germs and help the muscles move and the nerves ability to carry messages throughout the body. Low levels of vitamin D have shown a greater risk of depression as this vitamin is needed for the brain to function properly.4  Good sources of vitamin D include eggs, fatty fish (i.e., salmon, tuna, and trout), and fortified beverages and foods. Your body can make vitamin D when exposed to the sun; however, as we age our ability to make vitamin D decreases.4  

Vitamin B12: B12 is a water-soluble vitamin (the body does not store it) and is vital to maintaining normal brain function, keeping nerves healthy, and producing DNA and red blood cells. Vitamin B12, along with folate and vitamin B6, can lower homocysteine levels, a compound linked to an increased risk of heart disease, stroke, and dementia.5  

Vitamin B12 is absorbed in the stomach with the help of a protein called intrinsic factor, which works with stomach acids. Some people do not produce enough intrinsic factors, have enough stomach acid, or eat enough foods with B12 in them. At least 20% of older adults have a condition in which chronic inflammation has damaged the cells that produce stomach acid. Low stomach acid can affect the absorption of B12, calcium, iron, and magnesium. People at risk of B12 deficiency are older adults, people on metformin for diabetes, people taking acid-blocking and other antacids, strict vegans, and those who have had intestinal surgery.6 

Symptoms of vitamin B12 deficiency include:

• Fatigue/weakness/dizziness- related to problems with red blood cell (RBC)production, the leading carrier of oxygen throughout the body. 
• Cognitive difficulties such as thinking, reasoning, and memory loss-challenges interacting, frustration
• A swollen, inflamed tongue and mouth ulcers - causing a lack of desire and inability to eat
• Numbness or tingling in hands, legs, and feet - leading to falls, reduced physical activity, and isolation
• Pale or yellowish skin - due to anemia from problems with DNA and red blood cell production
• Mood changes/dementia - linked to depression, personality changes, and memory loss. 

Food sources of vitamin B12 include lean meat, fish, seafood, and fortified cereal. Only animal foods have vitamin B12 naturally in them.5

Protein. Sarcopenia, the loss of muscle mass and strength, happens as we age. It is a significant cause of weakness, falls, and loss of independence among older adults. Eating more protein, drinking milk, or taking protein supplements, has been shown to help slow the muscle loss rate and help build and maintain muscle mass, along with strength/resistance training.7  About 30% of men and 50% of women over age 70 do not consume enough protein.8  Good sources of protein in foods include:

• Soy products like tofu, edamame, and tempeh

• Chickpeas, beans, lentils

• Almonds, peanuts, seeds

• Broccoli, potatoes, kale

• Quinoa, whole grains

• Spirulina (algae)

• Lean meats, poultry, eggs, seafood, and dairy

 

Many older adults can improve their diets by choosing a wider variety of proteins that would include more vitamins and minerals.

Fluids/Water: Drinking enough fluids, especially water, is a challenge for many older adults. There are several reasons for this. One is that the sensation of thirst declines as we age, and most of us do not realize we are dehydrated. Thirst is the body signaling to the brain that we need to drink. Some of us have issues with mobility or concerns about bladder control, so we avoid drinking. This way we do not have to risk bladder accidents or not getting to the bathroom in time. Not getting enough fluids can lead to dehydration, such as improper digestion, low blood pressure, high blood sugar, and cognitive issues. Planning times during the day to drink fluids and keeping a variety of nonalcoholic fluids handy can decrease the risk of dehydration. Also, preparing for reduced mobility and bladder control issues can increase our confidence and ability to drink fluids. 

Good fats: Heart disease is the number one cause of death by chronic disease for older adults. Choosing food that is low in saturated fats (solid at room temperature) can help reduce heart disease risk. A healthy diet should include "good fats," such as polyunsaturated and unsaturated fats, found in avocados, vegetable oils, fish, nuts, and seeds.

The aging body has unique needs to remain healthy. Selecting nutritious foods and meeting these needs is a daily action to help reduce our chance of disease and improve our quality of life. Being mindful of good food choices can support the needs of older adults.

Resources

1. Academy of Nutrition and Dietetics. Special nutrient needs for older adults. April 2021. org.Available at https://www.eatright.org/health/wellness/healthy-aging/special-nutrient-needs-of-older-adults. 
2. National Institutes of Health, Office of Dietary Supplements. Potassium. gov. March 22, 2021. Available at https://ods.od.nih.gov/factsheets/Potassium-Consumer/. 
3. National Institutes of Health, Office of Dietary Supplements. Calcium. gov. March 22, 2021. Available at https://ods.od.nih.gov/factsheets/Calcium-Consumer/.
4. National Institutes of Health, Office of Dietary Supplements. Vitamin D. gov. March 22, 2021. Available at https://ods.od.nih.gov/factsheets/VitaminD-Consumer/. 
5. National Institutes of Health, Office of Dietary Supplements. Vitamin B12. gov. January 15, 2021. Available at https://ods.od.nih.gov/factsheets/VitaminB12-Consumer/. 
6. Skerrett, P. Vitamin B12 deficiency can be sneaky, harmful. edu. February 11, 2019. Available at https://www.health.harvard.edu/blog/vitamin-b12-deficiency-can-be-sneaky-harmful-201301105780.
7. Nowson C, & O'Connell S. Protein requirements and recommendations for older people: A review. 2015 Aug, 7(8): 6874-6899. doi: 10.3390/nu7085311.
8. US Department of Agriculture and US Department of Health and Human Services.  Dietary Guidelines for Americans: 2020-2025, 9th edition. December 2020. Available at DietaryGuidelines.gov.