Ask a Dietitian > Food for thought: Why nutrition is especially important for the elderly

Food for thought: Why nutrition is especially important for the elderly

August 20, 2020

Older people are particularly vulnerable to malnutrition, which has a serious and far-reaching impact on quality of life.

Malnutrition – when the body isn’t receiving enough nutrients to support its functions – is a serious problem in older populations worldwide. Our bodies rely on energy (from macronutrients such as carbohydrates, proteins and fats) to function and maintain muscle. Elderly people require more nutrients than others because their bodies are less efficient at using them. This, compounded with the fact that the elderly tend to eat less, can lead to muscle wastage, which affects balance and can increase the risk of falls.

In Australia, studies have found that half of all residents going into aged care centres are malnourished, and up to 50% per cent are at risk of being malnourished.[1] Malnutrition creates a vicious cycle in the elderly, leaving them less able to enjoy life and more vulnerable to health problems.

What causes malnutrition as we age?

Malnutrition is a stealthy condition that can sneak up on older people without them realising. It’s generally caused by a mix of social, physical and psychological issues.

Taste, smell and appetite usually decline as we get older. This means regular eating habits may fall by the wayside, especially for people who live alone or find food preparation difficult. The act of eating can become problematic too, especially for those who find it hard to chew or swallow, or who have dental issues. Those with dementia can forget to buy, prepare or eat food, or develop irregular eating habits.

The social causes of malnutrition are equally important. Older people may be on low incomes and ‘save’ on food in order to afford other things. Those with limited mobility can find it hard to shop or cook meals. Eating alone can be a dispiriting experience, leading people to lose interest in preparing or enjoying meals.

For those with swallowing difficulties, dining with others can be embarrassing or frustrating, as they cough and choke. For this reason, they can become socially isolated. Eating food of the right texture can restore their dignity and confidence.

What are the health risks of malnutrition?

Older people suffering from malnutrition are at a greater risk of other health problems. In the first instance, they’re likely to have reduced energy to cope with daily life due to loss of muscle mass and strength. This leads to a greater risk of physical injury, through falls or accidents, and reduces quality of life. Having less energy also means less ability to get out and about, meaning fewer social interactions and greater dependency on others.

Malnourished elderly people are more likely to be immunocompromised, meaning they are more susceptible to infection. Their wounds take longer to heal, and they have less resilience to bounce back from illness or accidents. Their recovery times are longer, which may extend hospital stays and delay rehabilitation. In turn, the longer they are bed-bound or with limited mobility, the more they are likely to suffer from muscle loss and decreased bone mass.

The economic cost of untreated malnutrition in elderly populations is high. Older people who are less able to fend for themselves need more care in the community and more time in hospital.

The value of high-protein, nutrient-rich food

Few health conditions can be fixed with a single silver bullet – and malnutrition is no different. However, ensuring malnourished older people get high-protein, nutrient-rich food can have a significant impact on their quality of life.

As we age, our bodies use protein less efficiently, and so we need more of it to maintain muscle mass and strength, bone health and other essential physiological functions. Even healthy elderly people need more protein than when they were younger to help preserve muscle mass. 

Recent research suggests that older people who eat more protein are less likely to lose their ability to function in everyday life. A 2018 study that followed nearly 3000 elderly people over 23 years found those who ate the most protein were 30 per cent less likely to become functionally impaired than those who ate the least amount.[2]

In 2019, research across six aged care facilities using The Pure Food Co fortified products showed a 10 per cent reduction in falls. Among elderly people, those consuming Pure Food purees experienced a 32 per cent increase in energy, a 60 per cent decrease in hospital stays and a 44 per cent decrease in falls.

Clinical Impact of Pure Food

This infographic demonstrates some of the tangible clinical outcomes seen when residents in Aged Care move to a Pure Foods diet.

InterRai Reporting

To support facilities in continuous improvement efforts, we partner with InterRAI to prepare reports for aged care customers demonstrating the clinical impacts of Pure Foods.  

All products made by The Pure Food Co are fortified with plant protein to support increased protein intake. Fortified foods make it easier for older people to meet their increased nutrient requirements, and if they have health issues related to swallowing or chewing problems the right texture is needed to support good food intake.

These innovative products are designed by chefs and dietitians to appeal to people who may have lost their appetite for food. Using high quality ingredients, they are sourced locally where possible and combined with extra pea and rice protein, energy and fibre to ensure every mouthful is as nutritious as it is delicious.

All The Pure Food Co products comply with the IDDSI framework for correct textures to ensure reduced risk at mealtimes, so they’re perfect for people with eating difficulties, as well as those recovering from surgery or living with disabilities.

Dysphagia & Symptoms

Learn about dysphagia and its signs & symptoms that are a major risk for malnutrition especially in older people.

The IDDSI Framework

The IDDSI framework standardises terminology, definitions and testing methods for texture modified foods and liquids.

Food across IDDSI

Learn what food looks like across different levels of the IDDSI framework.

References

[1] Senior, S., Richter, M., Allen, J. & Wham, C. (2019). Prevalence of malnutrition and dysphagia in advanced age adults newly admitted to age-related residential care. Proceedings, 8, 22; doi:10.3390/proceedings2019008022 

[2] https://academic.oup.com/biomedgerontology/article/75/1/123/5106141

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