Nutritional Needs of the Elderly
1. Energy Requirements
Due to reduced daily activities and a slower metabolism, elderly individuals require less energy compared to middle-aged adults. Therefore, nutritional intake should ideally be balanced with energy needs. Insufficient intake can lead to weight loss, thinness, increased susceptibility to infections, and hinder longevity. Excess intake, on the other hand, may cause overweight or 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 level of activity. In October 1988, the Chinese Nutrition Society revised the "Daily Nutrient Intake Standards."
2. Protein Requirements
The rate of protein synthesis in elderly individuals decreases, with those aged 59-70 experiencing a 25%-28% reduction compared to younger adults. Consequently, elderly individuals should consume more protein-rich foods. Additionally, due to reduced appetite and digestive function, the consumed proteins should preferably be high-quality, i.e., animal proteins and legume proteins. Fish proteins are particularly suitable among animal proteins.
3. Carbohydrate Requirements
Although carbohydrates are a staple in the Chinese diet, elderly individuals, due to decreased appetite and digestive function, should reduce their carbohydrate intake, focusing more on starches. It is advisable to limit sucrose and fructose consumption because of the decline in sugar tolerance and blood glucose regulation in older adults. Overconsumption of sucrose can lead to diabetes and cardiovascular diseases. Starch also aids in the excretion of bile acids and cholesterol from the intestines. Although dietary fiber lacks nutritional components, it enhances intestinal movement, prevents constipation, lowers blood lipids and glucose, and helps prevent colorectal and breast cancers. Elderly individuals should increase their intake of dietary fiber, such as green leafy vegetables, corn, and beans.
4. Lipid Requirements
Although fats are high-energy foods that promote the absorption of fat-soluble vitamins, excessive fat intake can lead to overweight, obesity, hyperlipidemia, coronary heart disease, and gallstones. Therefore, fat intake should be appropriately reduced while maintaining an appropriate ratio of saturated to unsaturated fatty acids. Excessive intake of saturated fatty acids can lead to arteriosclerosis, whereas excessive intake of unsaturated fatty acids can result in lipid peroxidation, forming lipofuscin and causing skin aging (age spots) and cellular dysfunction. Animal fats contain more saturated fatty acids, while vegetable oils contain more unsaturated fatty acids. The total intake of saturated fatty acids should not exceed one-third, with two-thirds being unsaturated fatty acids. Marine fish and shellfish are rich in n-3 polyunsaturated fatty acids, which are the only usable unsaturated fatty acids for the elderly brain cells. Cholesterol, often found alongside fats in food, can trigger arteriosclerosis, so elderly individuals should limit their intake of high-cholesterol foods. However, completely avoiding cholesterol can lead to anemia and weakened resistance. Healthy elderly individuals should consume no less than 300 milligrams of cholesterol daily. One egg per day generally meets this requirement, or they can consume more cholesterol-lowering foods like onions, garlic, mushrooms, black fungus, golden needle mushrooms, and soybeans.
5. Vitamin Requirements
Elderly individuals experience reduced absorption and utilization of vitamins due to natural physiological decline, weakened teeth chewing ability, decreased gastrointestinal enzyme secretion, and changes in blood circulation. On the other hand, to delay aging, enhance antioxidant and immune functions, and maintain life activities, sufficient vitamin intake is necessary. Below is a brief summary of the requirements for various vitamins:
Vitamin A: Related to vision, epithelial tissue health, and hemoglobin synthesis, adequate supplementation of Vitamin A benefits the eyesight and skin health of the elderly and reduces the occurrence of anemia. Dietary sources of Vitamin A mainly come from beta-carotene, which converts into Vitamin A in the body. Sufficient Vitamin A has a role in reducing lung cancer incidence. The daily requirement for elderly individuals is 800-1000 micrograms of Vitamin A (1 microgram of Vitamin A equals 6 micrograms of beta-carotene).
Vitamin D: Due to the decline in gastrointestinal, liver, and kidney functions, elderly individuals are prone to calcium deficiency, leading to osteoporosis. Vitamin D regulates calcium and phosphorus metabolism, aiding calcium absorption. The daily requirement is 5-10 micrograms. Increasing outdoor activity time can enhance the synthesis of Vitamin D by increasing subcutaneous 7-dehydrocholesterol, aiding calcium absorption.
Vitamin E: The low antioxidant capacity in the elderly makes cells susceptible to lipid peroxidation damage, producing lipofuscin that accumulates in cells and affects cell survival. Vitamin E is a natural lipid-soluble antioxidant that protects polyunsaturated fatty acids from oxidation, reduces peroxide production in the body, eliminates lipofuscin accumulation in tissues, improves skin elasticity, delays sex gland atrophy, and has anti-aging and anti-cancer effects. Based on relevant reports and clinical experience, the daily requirement is suggested to be 50-100 milligrams.
Vitamin C: The content of Vitamin C in plasma and white blood cells decreases with age in the elderly, necessitating more adequate supplementation. Vitamin C is a water-soluble antioxidant that prevents vascular hardening, enhances immunity, and delays aging. Consuming fresh vegetables and fruits daily, along with additional Vitamin C supplements of 100-200 milligrams, is recommended. Note that excessive Vitamin C intake is not beneficial; long-term overconsumption exceeding 2 grams daily may cause kidney stones, gout, and gastrointestinal discomfort. Smoking reduces plasma and white blood cell Vitamin C levels, so elderly individuals should avoid smoking to minimize Vitamin C loss.
Vitamin B1: The need for Vitamin B1 in the elderly is similar to that of adults, with a daily intake of 1.2-1.4 milligrams. Alternating between rice and flour in the diet and appropriately increasing coarse grains like corn and oats can compensate for the insufficient Vitamin B1 content in refined rice.
Vitamin Bc: Vitamin Bc participates in carbohydrate and protein metabolism. A deficiency is common in a Chinese-style diet, so supplementation is necessary. Vitamin Bc facilitates carbohydrate and protein metabolism, 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 is a water-soluble vitamin that promotes cell generation and gastrointestinal membrane growth, helping prevent digestive tract tumors. Folic acid deficiency is common in the elderly, leading to elderly anemia. Therefore, supplementing folic acid should include B vitamins like Vitamin B1 and B12, with a daily requirement of 400 milligrams for the elderly.
6. Mineral Requirements
Minerals required by the human body have specific physiological characteristics during old age, necessitating different demands. Adequate mineral supplementation helps prevent cardiovascular diseases and osteoporosis.
Calcium: Elderly individuals are prone to osteoporosis, with men losing about 4% bone mass every decade and women losing 3%-10%. Thus, it's important to supplement calcium-rich and easily absorbable foods like soy products (tofu, tofu pudding, bean curd sticks), milk, black fungus, and seaweed. The daily requirement is 800 milligrams, along with Vitamin D to aid calcium absorption.
Sodium and Potassium: Sodium demand relatively decreases in the elderly because sodium ions increase water retention, burdening the heart. Hypertensive elderly individuals should control sodium intake and use low-sodium salt. Daily sodium intake should be controlled below 5 grams. Potassium content also decreases in the elderly, necessitating adequate potassium supplementation, reaching at least the amount needed by middle-aged individuals, i.e., 35 grams daily. The potassium-to-sodium ratio in food is generally recommended to be 5:1, encouraging potassium-rich foods like beans and vegetables.
Iron: Iron absorption ability in the elderly declines annually, compounded by insufficient iron content in the diet. Therefore, attention should be paid to iron supplementation, with a daily requirement of 1 milligram. Besides eating one egg daily, other iron-rich foods like pig liver and spinach can be consumed. Vitamin C can also be supplemented to aid iron absorption, but excessive intake should be avoided.
Magnesium: Magnesium participates in bone metabolism and regulates cell growth. However, the relationship between magnesium, calcium, and phosphorus in bone metabolism is unclear. Excessive magnesium affects bone calcification. Magnesium plays an important role in maintaining the normal structure and function of the myocardium, with a daily reference requirement of 300-400 milligrams.
Zinc: Zinc is related to the immune function, bone metabolism, and enzyme metabolism in the elderly. The adult daily requirement for zinc is 2.2 milligrams. Due to its low absorption rate, the dietary supply should be 15 milligrams. Foods high in zinc include beef, poultry meat, fish, and seafood, all containing higher zinc levels than plant-based foods. Vegetarians should consume more soy products like tofu skin.
Selenium: Selenium has a certain preventive effect against some diseases. Appropriate supplementation of selenium-containing foods in the elderly helps reduce the occurrence of certain organ tumors. The daily selenium requirement is best at 50-100 micrograms. However, excessive selenium intake can lead to poisoning, manifested by dry, brittle, and falling hair, brittle nails, numbness in extremities, and even paralysis. Selenium-rich foods include meats, seafood, liver, and kidneys, while plant-based foods have lower selenium content with significant regional differences.
Chromium: Chromium is a component of Glucose Tolerance Factor (GTF) and acts as an insulin regulator, regulating insulin and its receptor functions to maximize insulin efficiency. Chromium significantly affects lipid metabolism, with experiments showing that feeding chromium to rats with high cholesterol significantly reduces serum cholesterol levels. Given the low sugar and fat metabolism functions in the elderly, appropriately increasing chromium intake helps improve sugar and fat metabolism. The daily chromium requirement is 100-200 micrograms. Chromium-rich foods include meats, dairy products, and grain foods, with fewer contents in vegetables.
7. Water Requirements
Due to the reduced sensitivity of the thirst center, elderly individuals often do not react sensitively to dehydration, with less noticeable thirst responses. However, water supplementation is very important for the elderly. Water not only maintains fluid balance but also accelerates the excretion of waste within the body, ensuring smooth bowel movements. Therefore, elderly individuals should develop good drinking habits, frequently consuming plain water or tea, with a minimum daily water intake of around 1200 milliliters to maintain physiological fluid balance.
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