As global life expectancy rises, the proportion of older adults is increasing dramatically, particularly in developing nations such as the Philippines.
While this longevity is a testament to scientific and societal progress, Chair/Assistant Professor at Philippine Women’s University-School of Nutrition Mavil May Cervo said it brings a corresponding challenge: the increased prevalence of disease, hospitalization, and a greater economic concern due to the progressive decline in health.
‘This is where a focus on comprehensive health, spearheaded by optimal nutrition, becomes not just beneficial, but absolutely vital for the elderly,’ said Cervo in her talk on ‘Optimizing Nutrition Across Life Stages’ held at the Philippine Women’s University.
Nutritional status
Cervo said aging brings a cascade of physiological, psychological, and neurological changes that directly impact an older adult’s nutritional status and immune response. She added that decreases in lean muscle mass, slower and less efficient immune responses, and changes in sensory perceptions like taste and smell all make maintaining a healthy diet a challenge. Meanwhile, she said dental issues, difficulty swallowing, and conditions like atrophic gastritis, which affects the absorption of key nutrients, further complicate matters.
These changes leave older adults vulnerable to several critical nutrition-related syndromes:
Sarcopenia: A progressive loss of skeletal muscle mass and strength, which is a robust predictor of poor clinical outcomes. This condition highlights the need for adequate protein intake to support muscle synthesis and repair.
Osteoporosis: Characterized by low bone mineral density, making fractures a significant risk. Proper intake of Calcium and Vitamin D is non-negotiable for bone health.
Frailty: A state of increased vulnerability resulting from age-related declines in function across multiple systems, encompassing not just physical but also psychological well-being.
Cervo said the right diet can be a powerful intervention to mitigate the effects of aging, reduce morbidity, and maintain independence. Furthermore, she said nutrition guidelines for older adults emphasize both the quantity and quality of macronutrients and the adequate intake of essential micronutrients.
Nutrient dense foods
In response to the decreasing basal metabolic rate caused by aging which reduces overall energy needs, Cervo said the focus must shift to nutrient-dense, calorie-controlled foods to ensure every calorie provides maximum nutritional benefit.
For people experiencing sarcopenia, Cervo said they require higher intake, often up to 1.2-1.5 grams per kilogram of body weight. High-biological-value sources like lean meat, fish, eggs, and milk are preferred.
She said there must be a strong emphasis on providing complex carbohydrates and on healthy fats like monounsaturated (olive oil) and polyunsaturated fatty acids to counter common insulin resistance, and on healthy fats. She said it also should involve monounsaturated olive oil and polyunsaturated fatty acids for their cardiovascular benefits.
In preventing osteoporosis, Cervo said the elderly must get a healthy dose of Vitamin D and calcium. ‘Declining sun exposure and skin synthesis often necessitate supplementation, as Vitamin D is vital for calcium absorption,’ she said.
Cervo said vitamins like Folate and B12 are crucial to counter risk factors for larger gastric lesions and cognitive decline.
Dietary management
To achieve successful dietary management in the elderly, Cervo said it will require a thoughtful, individualized approach. General guidelines include:
Individualization: Dietary plans must be tailored to the individual’s specific needs, existing health conditions, and most importantly, their economic capabilities and food preferences.
Structure: Recommending smaller, more frequent meals rather than three large ones can aid digestion, especially for those with dental issues or difficulty swallowing. Foods can be modified, like pureed vegetables, soft meats, to ensure consumption without compromising nutrition.
Physical Activity: Regular strength and resistance exercises are essential to complement nutritional efforts in fighting sarcopenia and maintaining mobility.
Oral Nutritional Supplements (ONS): If a regular diet consistently fails to meet nutritional requirements (e.g., less than 50 percent of energy intake), ONS can be a critical tool to bridge the nutritional gap.
By recognizing the interplay between age-related changes and nutritional needs, Cervo said it empowers older adults to protect their muscle strength, bone density, and immune health. ‘Optimal nutrition is the bedrock upon which they can preserve their independence, enhance their quality of life, and truly flourish in their advanced years,’ she said.a