Topic 4.3: Nutrient requirements and dietary considerations for older adults

Older adults usually need fewer calories to maintain their weight due to less mobility and muscle mass. Therefore, it is important for their diet to include nutrient-dense foods to cover their energy and nutrient requirements.

Carbohydrates

• Older adults are advised to eat one portion of starchy foods such as pasta, rice, bread and cereals at each meal and opt for whole grain starchy foods. In addition, they are recommended to eat at least five portions of fruit and vegetables per day to get adequate dietary fibre intake.

Protein

• Older adults may have higher protein requirements to maintain or minimise muscle mass loss. Therefore, it is recommended to have a portion of lean meat such as poultry, fish, eggs, dairy or legumes with each meal. It is also recommended to have at least 2 portions of fish per week of which one portion of oily fish and no more than four portions of oily fish per week.

Fat

• Older adults are advised to reduce foods high in saturated fat such as butter, high-fat and processed meat, high-fat dairy and pastries. In cooking and salads, it is recommended to swap butter with plant-based and vegetables oils.

Vitamin D

• Vitamin D deficiency is very common among older adults, particularly in those who are frail, malnourished or institutionalised with limited mobility and access to sunlight exposure. Foods that contain vitamin D are oily fish, egg yolks, and fortified foods. Vitamin D supplements are also recommended for older adults with deficiency.

Calcium

• Older adults, particularly postmenopausal women, may have higher calcium requirements than younger adults. Older adults are recommended to eat 3 portions of low-fat low-salt dairy foods per day such as milk, yoghurt and low-fat cheese. Alternatively, they can choose calcium-fortified dairy-free foods. Other non-dairy food sources of calcium are legumes, green leafy vegetables like kale and fish with edible bones (e.g., sardines).

B vitamins (folate, B6, B12), iron, and potassium

• Although requirements do not increase by age, adequate intake of these nutrients is important for older adults as loss of appetite, dental problems, medication and body changes due to ageing may impair their intake from diet. An adequate intake of these nutrients can be achieved via a balanced diet with fruit, vegetables and lean meat.

• Adequate fluid intake is very important as the risk of dehydration is higher for older adults. Body changes occurring with ageing such as reduced renal function, loss of thirst, swallowing problems and dementia are among factors that may contribute to reduced fluid intake in older adults.
• Older adults are recommended to drink 2.0-2.5 litres of total water intake per day. Total water intake includes plain water and water included in beverages (tea, coffee) and in foods with a high water content (soups, fruit and vegetables).