Eating habits and physical activity among the elderly

Old age produces numerous changes which make it necessary to adjust eating habits in order to remain healthy

Individuals are classed as belonging to the third age after the age of 65, although ageing is a natural, progressive, physical and psychological process experienced by everyone at different rates. The majority of the elderly population has a poor diet as a result of bio-psycho-social factors that accompany old age:

• Reduction in their basal metabolic rate, with reduced levels of physical activity.
• Loss in body water and bone mass at this stage of life.
• Increase in body fat and decrease in muscular tissue.
• Changes in the condition of the oral cavity and mastication, deglutition and saliva secretion problems.
• Changes to functional capacity, affecting mobility and increasing the risk of falls.
• Gastrointestinal problems which encourage constipation.
• Increase in blood pressure and blood sugar levels.
• Problems sleeping and in some cases sleep apnoea.
• Reduced feeling of thirst.
• Psychosocial changes including limited resources, depression, taking of medication, social isolation or dependence.
• Increased prevalence of chronic illness.
• Poor eating habits: low intake.

 

Diet among the elderly

At this stage of life, energy expenditure decreases as physical activity and the metabolic activity of the lean body tissue are reduced. The calorie requirements for males over 60 years of age are 2400 kcal and for females, 2000 kcal. This calorie intake is reduced by 10% every decade after age 60. Diets should have a high nutrient density content.

 

The distribution of macronutrients follows the principles of a balanced diet:

• 10-15% of the total calories from proteins.
• 25-30% of the total calories from fats.
• 55-60% of the total calories from carbohydrates.

 

Proteins. In spite of reduced energy expenditure, protein requirements remain the same, at 0.8-1g/kg/day. 60% should be animal protein (meat, fish, eggs, milk) and 40% vegetable protein (pulses, nuts and seeds).

 

The protein intake should be increased during times of stress caused by infection or illness. An excess of proteins in the body may result in renal overload.

 

Carbohydrates. Ideally, these should be complex carbohydrates, as they are easier to digest and do not lead to ups and downs in sugar levels. A fibre intake of 20-25 grams per day is essential to prevent constipation. Fibre-rich foods include cereals, bread, pulses, vegetables, rice.

 

In old age, glycemia levels are high and therefore special care should be taken when eating cakes and pastries to avoid sudden increases in blood glucose levels which could have negative consequences.

 

Fats. The quality of dietary fat is fundamental for preventing chronic illness. Unsaturated fats are to be preferred to saturated fats and levels of polyunsaturated fatty acids (omega-3), found in blue fish, should be maintained to help prevent cardiovascular disease, infection and inflammatory problems.

 

Water and fluids. The elderly have a high risk of dehydration. This is because the thirst mechanism changes, the functional capacity of the kidney is reduced and there is a predisposition towards constipation. A minimum of 2 litres or 8 glasses of fluid per day should be taken in the form of water, infusions or broths together with the consumption of foods with a high water content.

 

Vitamins. Micronutrient requirements are similar to those of the adult population and can be obtained with a normal diet without requiring supplements. Deficiencies in B-group vitamins and vitamin C (found in oranges and other fruits) are sometimes observed, as their absorption is reduced due to digestive problems or interactions with medication.

 

Minerals. The most important minerals are calcium and iron, which are often deficient. Iron absorption is reduced but is not usually deficient and an intake of 10 mg/day is recommended for individuals over the age of 60. Red meats, entrails, fish, egg yolk and pulses are good sources of iron.

 

Calcium is usually lacking and an intake of 1200-1400 mg/day is required to reduce the risk of osteoporosis. Dairy products are recommended to meet the calcium requirements and sunshine is recommended to obtain vitamin D, which is essential to the calcium metabolism.

 

Control the intake of sodium to less than 5 g/day to prevent the increase of blood pressure.

 

Physical activity among the elderly

Physical activity is related to the ageing process as it plays a part in the relationship between functional capacity, muscle and bone mass and the prevention of illness.

 

Moderate physical activity throughout life helps to reduce the risk of mortality and disability, by increasing agility and reducing the number of falls. It is also effective against the loss of muscle mass and helps to improve the maintenance of bone density.

 

Studies show that physical activities requiring resistance, such as weight-lifting, are the most suitable for elderly people, as they increase the cardiac rate and respiration, enhancing the prevention of chronic illness, particularly cardiovascular disease.

 

Individuals should be physically active for 30 minutes a day and take exercise as part of their lifestyle and in accordance with their own limitations.