12 Oct 2010
Eating properly with a balanced diet is important for the older folks to stay healthy as their nutritional needs change with age
It’s an aspect of ageing that most people do not pay enough attention to. But changes to the body as people become older have an impact on their nutritional needs.
Not getting enough of the right nutrients could result in health problems. Insufficient calcium and vitamin D lead to osteoporosis and an increased risk of fractures.
A lack of iron can lead to anaemia, while poor levels of vitamin B12 can affect the normal function of cells in the gut. Insufficient fibre aggravates constipation and bowel problems.
Poor nutrition also exacerbates the condition of patients with pre-existing medical problems. For example, a high intake of cholesterol-rich foods could lead to cardiac issues.
Older folk who eat less are more prone to deficiencies in vitamin B6, B12, folate and zinc, explains Ms Nehal Kamdar, a senior dietitian from Raffles Hospital.
So there is a need to ensure that the elderly receive a nutrient-rich diet with complex carbohydrates as one of the main sources of calories for energy, adequate protein for cell repair, fat-soluble and water-soluble vitamins, and minerals for their overall well being.
Says Ms Teo Soo Lay, a dietitian at the Singapore General Hospital (SGH): “A diet with varied choices of whole grains, fruits, vegetables, lean meats, legumes and dairy can help fulfil these fundamental needs.”
To ensure that sufficient amounts of the right nutrients are included in the diet, it is best to have home-cooked meals as the amount and type of oil and salt can be regulated. But it is not impossible to eat well when eating out, notes Ms Teo.
To eat out healthily, ensure that food from every group is included and choose the healthier options, she advises.
For example, go for soupy noodles instead of dry ones, choose plain rice over flavoured rice like nasi lemak or chicken rice, avoid dishes cooked with coconut milk such as laksa and curry, and opt for steamed, grilled, roasted or poached dishes over deep-fried ones.
Certain medications such as antibiotics and cancer treatment agents are linked to changes in taste and smell, and this affect the older folks’ desire to eat.
They can get around this problem by making eating a social event or by enhancing food with aroma and flavours, advises Ms Kamdar. Spices and herbs, such as garlic, ginger, onion and pickles can help to make food tastier. Different textures can also keep food interesting.
When medication affects the appetite, a dietitian can assist to ensure that nutritional needs are met.
“The meal plan would take into account the dietary preference, medical and physical limitations of the elderly,” says Ms Kamdar. “This reduces the chances of poor nutrition.”
Why older folks don’t eat well
● Changes in appetite and thirst due to altered taste buds and decreased taste acuity can lead to picky eating.
● Medications can affect taste buds, cause nausea or diarrhoea and loss of appetite, or alter the absorption efficacy of nutrients.
● Missing teeth or poorly fitted dentures may affect their ability to eat properly and healthily.
● Older folks may feel full after consuming just a small amount of food or do not feel thirsty even when they are dehydrated.
● Metabolic changes in ageing can lead to general poorer absorption of nutrients.
● Financial problems could lead to cutting back on meals.
● Depression due to the loss of loved ones could lead to loss of appetite.
Information provided by Ms Teo Soo Lay of Singapore General Hospital and Ms Nehal Kamdar of Raffles Hospital.
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Dept of Dietetics & Nutrition Services
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