By Dr. Gerard Muraida
The ancient Greek physician Hippocrates said it best: “Let food be your medicine and medicine be your food.” Today, the practice of nutrition is the science or practice of utilizing or consuming foods, and its subset of geriatric nutrition applies those principles to delay the effects of aging or disease. Geriatric nutrition also aids in the management of physical, psychological, and psychosocial changes commonly associated with growing old.
Aging is not a disease but a natural process that requires special considerations.
There are several aging factors that affect the nutritional status of seniors. For example, functional impairments such as arthritis and strokes may impact a person’s ability to deliver food to their mouth, chew, and swallow safely. Over-the-counter medications and prescription medications can alter taste and lead to absorption deficiencies, weight loss, and even malnutrition.
Physiologically, as body mass index decreases, caloric needs decrease. With decreased absorption of nutrients, there is the possibility of developing neurologic conditions. Depression, anxiety and other mental illnesses may lead to decreased appetite, as can social issues, such as eating alone.
Nutrients are the substances in food that our bodies require for energy, growth, maintenance and function. These nutrients are carbohydrates, proteins, fats, water, vitamins, and minerals. As we age, our calorie requirements may decrease due to reduced expenditure of energy and a lower metabolic rate. The average caloric RDA (recommended daily allowance) for women is 1,600 calories and 2,400 calories for men.
Carbohydrates should make up approximately 50 percent of daily consumption. (Fiber, a subclass of carbohydrates, is especially good for promoting bowel function.) Proteins should comprise at least 10 percent of daily caloric intake. As muscle mass decreases, protein intake is extremely important. Eggs, peanut butter, beans, meat, poultry, and fish are good sources of protein. Finally, 30 percent should be from fats, which are important for transport and absorption of vitamins.
Vitamin D plays an important role in bone health and immunity. Vitamin B12 is needed to keep the central nervous system functioning properly. Fatty fish, such as trout, salmon, tuna, and mackerel, are among the best sources of vitamin D. Sunlight can also be a major source of vitamin D. Many adults get their vitamin D from fortified foods, such as milk. One cup of fortified 2 percent milk contains 2.9 micrograms of vitamin D, compared to 14.2 micrograms in 3 ounces of salmon. Still, older adults often don’t get enough of either Vitamin D or B12 and may take supplements to compensate.
As we age, our sensation of thirst diminishes. As a result, seniors drink fewer fluids than younger adults. In addition to decreased thirst, some seniors avoid fluids due to incontinence concerns. Staying well-hydrated plays a critical role in helping the body digest food and absorb nutrients. Dehydration can be dangerous and can lead to dizziness, increased fall risk, constipation, decreased kidney function and even kidney failure.
Every five years, the United States Department of Agriculture publishes its Dietary Guidelines for Americans. The next edition is scheduled for release this year. Keep in mind that these are general guidelines and may not apply to everyone, in every situation. Individuals eat in different ways and that’s OK. The guidelines are meant to provide a framework and some guidance on how you can eat more healthfully as you age. Ask your health care provider how food can be your medicine.
