Nutritional guidelines for the elderly – fundamental principles
The guidelines for elderly nutrition have been laid out in the Pyramid of Healthy Nutrition and Physical Activity for older adults. Meals should be smaller but more frequent – around 5–6 per 2–3 hours. Regular nutrition prevents debilitation and malnutrition development and allows the avoidance of hunger that may lead to consuming an excessive amount of food, which burdens the digestive tract. The basis of the diet should be vegetables and fruits – sources of vitamins and fiber.
Appropriate nutrition for the elderly - Avoid these components
Although there is no evidence that specific components should be completely excluded from the diet in the general population, there are several components whose intake should be limited in the elderly.
Salt and products with high salt content
(e.g. Prepared spice blends, ready-made and processed meals, meat and smoked products) - excessive intake of these products facilitates the development of diseases such as hypertension, cardiovascular diseases and stomach cancer. Meals should primarily be seasoned with aromatic herbs.
Red meat and processed meat items
Such food items as deli meats, sausages, and frankfurters are a source of saturated fatty acids, which can have a negative impact on cholesterol levels (especially LDL fractions) and increase the likelihood of heart diseases.
Animal fat products
This group primarily comprises butter, edible fats, and meats with substantial fat content such as lard or bacon. Similar to red and processed meats, they serve as sources of saturated fatty acids. Sugar and confectioneries mainly provide simple sugars that contribute to the development of overweight and obesity, heightening the risk of type 2 diabetes, lipid disorders, or dental caries.
Beverages containing sugar
Similar to confectionery, beverages containing sugar are a source of simple carbohydrates. Furthermore, consuming carbonated beverages can result in a reduction in the sensation of thirst, which is unfavorable for elderly individuals.
Alcohol consumption
Alcohol consumption is associated with a decrease in the absorption of vitamins and minerals, as well as the potential disruption of the action of certain medications. Furthermore, alcohol consumption has a negative impact on the functioning of the body, as it impairs cognitive function, increases the risk of dehydration, and irritates the digestive system. It should also be mentioned that lactose, the sugar found in dairy products, is a problem for many people, as they often observe lactose intolerance in old age, which is linked to a decline in the activity of the enzyme lactase responsible for breaking down lactose. However, it is not necessary to give up dairy products if they are well tolerated. In the case of lactose intolerance, products with reduced lactose content (available in most stores) or fermented dairy products can be chosen, which are often better tolerated, as they have a lower lactose content, and thus a partial breakdown of lactose occurs during the fermentation process.
Avoiding Dehydration in the Elderly through Proper Hydration
One of the challenges of old age is the decreased ability to feel thirst. Inadequate fluid intake can lead to dehydration, resulting in deteriorating well-being, cognitive impairment, or decreasing physical ability. Therefore, it is important to ensure adequate fluid intake - at least 2 liters per day, even if no thirst is felt. The main source of hydration should be water, but fruit and vegetable juices, dairy products (milk, kefir, yogurt, etc.), coffee, and tea can also be utilized. It is also advisable to include liquid meals (such as soups or smoothies) and foods with high water content (fresh fruits and vegetables) in the diet. Especially in the summer, on hot days, attention should be paid to the amount of fluids consumed. High temperatures can exacerbate water and electrolyte loss in the elderly. Therefore, during temperatures above 37°C, it is worth considering an additional glass of water per degree and, if necessary, supplementing sodium and potassium.
Diet of the elderly and medications
Many elderly people suffer from chronic ailments that necessitate continual medication consumption, which may also impact their nutrition. Prior to commencing a new medication, it is advisable to consult with your doctor whether you should ingest it before, during, or following a meal, and subsequently adjust your meal times to correspond with these recommendations as well as the recommended intervals between doses. Additionally, it is important to peruse the package insert and consult your doctor if the medication has no interactions with food components. All medications should be taken with a considerable amount of water. Certain medications may limit the absorption of mineral constituents. An example are medications from the group of proton pump inhibitors (PPI) employed in the treatment of gastric ailments, reflux, or infections with Helicobacter pylori bacteria. Their prolonged use may lead to magnesium and vitamin B12 deficiency. During treatment, it is therefore crucial to routinely monitor your nutritional status with your doctor.
Nutrition for elderly individuals with chronic diseases
The previously mentioned nutritional guidelines pertain to the general elderly population. However, it is frequently the case that chronic diseases arise, which require individual modification of recommendations. Individuals with type 2 diabetes or insulin resistance should take particular note of the index and glycemic load of meals. On the other hand, conditions located within the digestive tract may necessitate a low-residue, easily digestible diet. In elderly individuals, there are often dental issues and difficulties in chewing and swallowing, which may result in the need to change the consistency of products. In certain cases, a liquid, semi-liquid or slurry diet may need to be implemented to facilitate food intake.
Monitoring the health status of the elderly: preventive and control examinations
Elderly individuals should frequently undergo preventive and control examinations to ensure appropriate care for their health. Among the recommendations are monitoring of blood glucose, cholesterol, and electrolyte levels, as well as screening for heart disease, cancer, and osteoporosis. Utilizing preventive programs available in family doctor clinics is recommended. Elderly individuals with chronic illnesses should be under constant medical supervision and regularly monitor their health status. Prevention is a crucial component of maintaining the health of the elderly, and proper nutrition plays a significant role in this. The diet should be varied and provide necessary nutrients, such as proteins, calcium, dietary fiber, and unsaturated fatty acids. At the same time, intake of sugar, fats, salt, and alcohol should be limited.