For the Aged, Nutrition is Important, Too

By Wong Siau Fui

WHILE Malaysians are now living longer, WONG SIAU FUI says there are steps that must be taken to ensure they are living healthier, too,

The quality of life for Malaysians has improved tremendously over the past five decades.

Life expectancy has also increased to 69 years for man and 74 years for women.

The elderly (aged 65 years and above) are walking a fine line between under-nutrition and over-nourished.

If an individual fails to eat sufficiently, he/she is more likely to develop malnutrition over a period of time.

On the other hand, more Malaysians are now struggling with lifestyle diseases such as diabetes, cardiovascular diseases and hypertension due to the tendency to to “overindulge” in high fat (especially saturated fat), high cholesterol, high salt, high refined sugar food.

There are common factors between nutrition and ageing, mainly due to the physiological and physical change. Thence, the nutritional needs of the elderly are different from the younger population.

Common physiological changes are loss of muscle strength, slower digestion system, depletion in vitamins and mineral synthesis leading to higher risk of infection or low immunity.

As for the physical changes, elderly is often at a higher risk of fall due to loss in muscle strength and poor eyesight, which in turn limits their physical activity.

Ill-fitted denture, side effects of treatment like post surgery or permanent deficit of some diseases also have high impact on their oral intake, which may lead to increased risk of malnutrition.

Here are some dietary recommendations for the ageing population:

* Calorie intake

Often people would say: “I want to go on diet”. Is there such a thing as being “on” and “off” diet? How much calories you need is highly dependent on how much you “expend” or use for your daily activities.

The more active you are, the higher the calories allowance. For the elderly, the calories needs usually stay between 1,800 and 2,000kcal a day as their metabolism slows down.

Again, every individual needs would be different, with some needing extra calories to avoid being underweight and some having to shed few kilos to maintain healthy weight.

* Texture modification and food fortification

Due to chewing and/or swallowing difficulty, eating can be a challenging task for the elderly. Diet modification may be needed to ensure adequate oral intake.

Soft stewed food, soupy meal, chopped or minced dishes are recommended.

It is common these days for the elderly to take additional supplements or food fortifiers to ensure sufficient nutrient and mineral intakes.

For instance, those who are bedridden or mostly staying in-door would benefit from regular multivitamin doses.

Some may also need extra protein to prevent malnutrition.

* Cholesterol

The most conventional method to cardiovascular diseases (CVD) cases is to increase awareness of healthy eating among the young.

As age is a non-modifiable risk factor for CVD, it is recommended that the elderly minimise their dietary cholesterol intake.

The liver accounts for up to 80 per cent of the body cholesterol needs. The rest of the cholesterol supply comes from food.

The American Heart Association recommends that no more than 300mg of dietary cholesterol to be taken a day.

* Calcium intake

Calcium is a crucial mineral in maintaining strong bones. The recommended intake of calcium varies according to the different age categories.

The Recommended Nutrient Intakes (RNI) for elderly Malaysian is 1,000mg calcium daily, irrespective of gender.

One thousand milligrams of calcium is equivalent to two glasses of milk, plus two servings of major calcium sources like dairy products, sardines and soy or soy products.

In relation to calcium, vitamin D plays an equally important role in bone health.

Generally, a good 15 minutes of morning sunlight exposure would provide sufficient intrinsic factors for vitamin D production through the skin.

* Salt intake

Changes in taste bud is common among the elderly. This is because the taste receptors in their tongue is less sensitive than before.

It is often found that the elderly request for a “stronger” taste in their food to enhance the food palatability. For example, they may add more salt and soy sauce or eat more preserved food.

In general, excessive salt intake is associated with high blood pressure.

* Fluid and constipation

Constipation is another common silent issue among the ageing generation. As a result of minimal physical activity, failure to feel thirsty or reduced frequency to the toilet, sufficient fluid intake is a major concern.

Fluid is essential not only in maintaining the hydration status but also preventing constipation. It is recommended for elderly to drink at least 10 glasses of fluid a day.

These fluids can be coming from beverages, soup or even through solid food intake. In addition, they can consider eating at least three servings of vegetable and fruit daily.

* Wong Siau Fui is a member of Malaysian Dietitians’ Association. This article is courtesy of Malaysian Dietitians’ Association

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