Nutritional Needs of the Elderly
1. Energy Requirements
The elderly, due to reduced daily activities and lower metabolic rates, require less energy than middle-aged adults. Therefore, nutritional intake should ideally be balanced with energy needs. Insufficient intake can lead to weight loss, emaciation, increased susceptibility to infections, and is not conducive to longevity. Excess intake, on the other hand, can cause overweight and obesity, potentially leading to conditions such as obesity, hyperlipidemia, coronary heart disease, and cerebrovascular diseases. Hence, daily food intake should be determined based on age and activity levels. The Chinese Nutrition Society revised the "Daily Nutrient Intake" in October 1988.
2. Protein Requirements
The protein synthesis rate in the elderly decreases; for those aged 59-70, it drops by 25%-28% compared to younger adults. Consequently, the elderly should consume more protein-rich foods. Given their reduced appetite and digestive function, they should prioritize high-quality proteins, i.e., animal proteins and soy proteins. Fish proteins are particularly suitable among animal proteins.
3. Carbohydrate Requirements
Although carbohydrates are a staple in the Chinese diet, elderly individuals who have reduced appetites and diminished digestive functions should also reduce carbohydrate consumption, favoring starches over sucrose and fructose. This is because the elderly's glucose tolerance and blood sugar regulation decrease, making them more prone to diabetes and cardiovascular diseases if they consume too much sucrose. Starches also aid in the excretion of bile acids and cholesterol from the intestines. Dietary fiber, while lacking in nutrients, increases intestinal motility, prevents constipation, lowers lipid and blood sugar levels, and helps prevent colon and breast cancers. Elderly individuals should consume more fibrous foods like leafy greens, corn, and beans.
4. Lipid Requirements
Although fats are high-energy foods that promote the absorption of fat-soluble vitamins, excessive intake can lead to overweight, obesity, hyperlipidemia, coronary heart disease, and gallstones. Therefore, fat intake should be appropriately reduced, and the ratio of saturated to unsaturated fatty acids should be carefully managed. Excessive saturated fatty acid intake can cause arteriosclerosis, while excessive unsaturated fatty acid intake can lead to lipid peroxidation, forming lipofuscin and causing skin pigmentation (age spots) and cell function decline. Animal fats contain more saturated fatty acids, while vegetable oils contain more unsaturated fatty acids. In total fat intake, saturated fatty acids should not exceed one-third, with two-thirds being unsaturated fatty acids. Marine fish and shellfish are rich in long-chain fatty acids derived from alpha-linolenic acid, which are the only unsaturated fatty acids that can be utilized by the elderly brain cells. Cholesterol in food often coexists with fats and can trigger arteriosclerosis. The elderly should limit high-cholesterol foods but should not eliminate them entirely to avoid anemia and weakened immunity. Healthy elderly individuals should consume no less than 300 mg of cholesterol daily. Eating one egg per day can meet this requirement, or consuming foods that lower cholesterol, such as onions, garlic, mushrooms, black fungus, golden needle vegetables, and soybeans.
5. Vitamin Requirements
Elderly individuals face challenges in vitamin absorption and utilization due to physiological decline, reduced teeth chewing ability, decreased gastrointestinal enzyme secretion, and changes in blood circulation. On the other hand, slowing aging and enhancing antioxidant and immune functions necessitate sufficient vitamin intake. Additionally, managing chronic diseases requires adequate vitamin supplementation to sustain life activities, reduce aging, and aid recovery. Below is a summary of various vitamin requirements:
Vitamin A: Vitamin A is associated with vision, epithelial tissue health, and hemoglobin synthesis. Supplementing Vitamin A benefits elderly vision and skin health and reduces anemia incidence. Dietary sources include beta-carotene, which converts into Vitamin A in the body. Sufficient Vitamin A can lower lung cancer risk. Elderly individuals need 800-1000 micrograms of Vitamin A daily (1 microgram of Vitamin A equals 6 micrograms of beta-carotene).
Vitamin D: Due to declining gastrointestinal, liver, and kidney functions, the elderly are prone to calcium deficiency and osteoporosis. Vitamin D regulates calcium-phosphorus metabolism and aids calcium absorption. Daily requirements are 5-10 micrograms. Increased outdoor activity promotes subcutaneous 7-dehydrocholesterol synthesis into Vitamin D, enhancing calcium absorption.
Vitamin E: With declining antioxidant function, elderly cells are susceptible to lipid peroxidation damage, producing lipofuscin and affecting cell survival. Vitamin E, a natural liposoluble antioxidant, protects polyunsaturated fatty acids from oxidation, reducing peroxidation, eliminating lipofuscin deposits, improving skin elasticity, delaying glandular atrophy, and possessing anti-aging and anticancer properties. The recommended daily intake is 50-100 milligrams.
Vitamin C: Vitamin C content in plasma and white blood cells decreases with age, necessitating increased supplementation. As a water-soluble antioxidant, Vitamin C prevents vascular hardening, boosts immunity, and slows aging. Consuming fresh vegetables and fruits daily, along with additional Vitamin C supplements of 100-200 milligrams, is advised. Note that excessive Vitamin C intake (over 2 grams daily) may cause kidney stones, gout, or gastrointestinal discomfort. Smoking reduces Vitamin C levels, so elderly individuals should avoid smoking to minimize Vitamin C loss.
Vitamin B1: Elderly individuals' Vitamin B1 requirements resemble those of adults, with a suggested daily intake of 1.2-1.4 milligrams. Alternating between rice and flour consumption and adding coarse grains like corn and oatmeal can compensate for Vitamin B1 deficiencies in refined rice.
Vitamin B2: Vitamin B2 participates in carbohydrate and protein metabolism and is generally deficient in Chinese diets. Adequate supplementation is necessary, with a daily requirement of 1.2 milligrams.
Vitamin B6: Vitamin B6 enhances selenium bioavailability and, when combined with Vitamin C, prevents vascular hardening and improves lipid metabolism.
Folic Acid: Also known as Vitamin M, folic acid promotes cell generation and gastrointestinal membrane growth, helping prevent digestive tract tumors. Folic acid deficiency is common in the elderly, leading to anemia. The daily requirement is 400 milligrams, and B-vitamins like Vitamin B1 and B12 should be supplemented concurrently.
6. Mineral Requirements
Mineral needs vary during old age due to unique physiological characteristics. Adequate mineral intake can help prevent cardiovascular diseases and osteoporosis.
Calcium: Osteoporosis is prevalent among the elderly, with men losing 4% of bone mass every decade and women losing 3%-10%. Foods rich in calcium and easily absorbed, such as tofu, milk, black fungus, and seaweed, should be consumed. The daily requirement is 800 milligrams, alongside Vitamin D supplementation for better absorption.
Sodium and Potassium: Sodium needs decrease with age as sodium ions increase water retention, straining the heart. Hypertensive elderly individuals should control sodium intake and use low-sodium salt, limiting daily intake to under 5 grams. Potassium levels also decrease with age, requiring supplementation to meet adult requirements (35 grams daily). A potassium-to-sodium ratio of 5:1 is recommended, with potassium-rich foods like beans and vegetables being beneficial.
Iron: Iron absorption declines with age, exacerbated by insufficient dietary iron. Daily iron requirements are around 1 milligram, with eggs, liver, spinach, and Vitamin C supplements aiding absorption. Overconsumption should be avoided.
Magnesium: Magnesium participates in bone metabolism and cell growth regulation. While its relationship with calcium and phosphorus in bone metabolism is unclear, excessive magnesium can affect bone calcification. Magnesium maintains normal myocardial structure and function, with a daily reference intake of 300-400 milligrams.
Zinc: Zinc deficiency correlates with weakened immune function, bone metabolism, and enzyme metabolism in the elderly. Adult zinc requirements are 2.2 milligrams daily, but given low absorption rates, dietary intake should reach 15 milligrams. High-zinc foods include beef, poultry, fish, and seafood, with vegetarians encouraged to consume soy products.
Selenium: Selenium has preventive effects against certain diseases. Appropriate selenium supplementation can reduce organ tumor incidence in the elderly. The daily selenium requirement is 50-100 micrograms, but excessive intake can cause poisoning, manifesting as dry, brittle hair and nails, numbness in extremities, and even paralysis. Selenium-rich foods include meats, seafood, liver, and kidneys, with plant-based foods containing lower amounts and varying regionally.
Chromium: Chromium is a component of glucose tolerance factor (GTF) and an insulin regulator, enhancing insulin efficacy. It significantly impacts lipid metabolism, with experiments showing reduced serum cholesterol in rats fed chromium. Chromium supplementation can improve sugar and fat metabolism in the elderly, with a daily requirement of 100-200 micrograms. Rich sources include meats, dairy, and grains, with vegetables containing lesser amounts.
7. Water Requirements
Due to reduced sensitivity of the thirst center, elderly individuals often fail to notice dehydration promptly. However, water intake remains crucial for maintaining fluid balance, accelerating waste excretion, and ensuring smooth bowel movements. Elderly individuals should develop good hydration habits, drinking plain water or tea regularly, with a minimum daily intake of 1200 milliliters to maintain physiological fluid balance.
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