Nutrition and Healthy Ageing.

Neri Cristina and D’alba Lucia (2021) described ageing as a state of reduced regenerative and adaptive capacity resulting in an easier development of morbidity; they recognised that one’s prerequisite for wellbeing and having a good quality of life is to maintain an adequate nutritional status.

It is important to watch the nutritional status of elderly adults and evaluate muscle mass regardless of the age because of the risks to malnutrition. Malnutrition can be defined as a condition of being poorly nourished, caused by a lack of one or more nutrients (under nutrition) or an excess of nutrients (over nutrition) resulting in the accumulation of body fat defined as overweight or obesity and leading to chronic diseases, diminished physical and mental function and impaired clinical outcome from disease. Chronic diseases associated with ageing include osteoporosis, obesity, cardiovascular disease and type 2 diabetes. Inadequate nutrient intake can also lead to deficiency related diseases such as anaemia, blindness and frailty.

The mechanisms that lead to malnutrition in elderly people are complex, but can ultimately result from starvation, disease or advanced ageing, alone or in combination.

Malnutrition can result to a wasting of skeletal muscles, a lower muscle mass, and reduced muscle strength; it can also lead to a decreased bone mineral mass. This can lead to an impaired musculoskeletal function, increased disability, and with reduced physical performance an increased risk of falling, with a greater risk of osteoporosis.

Moreover, malnutrition in older adults may result to an impaired immune function, with reduced cell-mediated immunity, and an increased risk of infection and delayed healing.

Below are the lifestyle factors that may play a role in ensuring older adults can live not only longer but also healthier lives.

Enjoy a varied and balanced diet

As we age, our sense of taste and smell also changes, which can affect our appetite. We could aim at making foods as tempting and tasty as possible so that eating stays enjoyable; Keeping meals from becoming bland and uninteresting by varying colours and textures as much as possible. Try adding herbs and spices such as mint, rosemary, cinnamon or thyme.

Get plenty of fruits and vegetables

Studies have shown that people who consume diets high in fruit and vegetables have a lower risk of heart disease, stroke, diabetes and some forms of cancer. They do contain minerals and phytochemicals (polyphenols, flavonoids, catechins, etc) that have beneficial effects on healthy aging; some have anti-inflammatory properties, some have shown positive effects on cognition, including flavonoid-rich cocoa drinks.

We should all be aiming for at least 5 portions of fruit and vegetables each day. This includes fresh, frozen, dried and canned fruit and vegetables, as well as smoothies and 100% fruit juices.

One portion is generally around 80g as reference.

A glass of 150ml of fruit juice counts as a maximum of one portion per day.

Choose healthier fats: favour unsaturated fats rather than saturated fats

Example of saturated fats ingredients and foods: Butter, lard, ghee, palm oil, coconut oil, cakes, chocolate (when you overeat it), biscuits, pies and pastries. The white fat you see on red meat and underneath poultry skin is also high in saturated fat.

Nuts and seeds, olive oil, oily fish, including mackerel, sardines, pilchards and salmon, contain unsaturated fats called omega-3 fats, which can help to promote a healthy cardiovascular system.

Simple swaps to reduce saturated fat in your diet:

Eat plenty of fibre and Keep Hydrated

High-fibre foods help the body stay fuller for longer so can be useful if you are watching your weight. It is also important to drink enough fluids or water when eating a diet high in fibre. Many older adults do not reach their recommended daily intake of oral fluids; in older people, an adequate hydration results in less constipation, a better neuromotor performance with fewer falls, improved rehabilitation outcomes in orthopedic patients, and a reduced risk of bladder cancer in men. To reduce the risk of dehydration, older people should aim to consume at least 1.2L of fluids per day. Such fluids can be mineral drinks, milk, fruit and vegetable juices, and also sports drinks.

Fibre such as wholegrains (wholegrain breads, wholegrain breakfast cereals, brown rice, wholemeal pasta), fruit and vegetables and pulses (like lentils, kidney beans and chickpeas), will improve digestive health and can help to protect against heart disease and some other chronic diseases as we age.

Exercise

Muscle-strengthening exercises help to limit muscle loss and bone mass that happen as we age, thus reducing the risk of falling and improve ability to perform daily tasks. Practising these types of exercise as much as we can daily will definitely help to keep and improve our muscle strength as we age.

These include:

● climbing stairs

● going out for a walk or even walking uphill or jogging

● digging the garden

● resistance exercises or using weights

● carrying your shopping, gardening tools or even grandchildren!

As an older adult, regular physical activity is one of the most important things you can do for your well-being. It can prevent or delay many of the health issues that seem to come with age as it also helps your muscles grow and keep stronger so you can keep going to your day-to-day activities independently.

Boosting B vitamins

B vitamins have a range of important functions in the body, including contributing to healthy red blood cells, releasing energy from the foods we eat, supporting nerve functioning and vision, healthy skin, and reducing tiredness.

Sources of some B vitamins in the diet include:

● folate/folic acid: Some green vegetables, grains and grain products

● vitamin B6: Fortified cereals, peanuts, pork, poultry, fish, milk and vegetables

● vitamin B12: Animal products (such as fish, meat, eggs, or dairy), fortified breakfast cereals and other fortified foods such as soya drink.

Vitamin D supplements

The Department of Health and Social Care recommends that to protect bones and muscle health, all adults including people aged 65 years and over should take a supplement containing 10µg (micrograms) of vitamin D during the autumn and winter months (between October and March). It can be difficult for us to get enough vitamin D from our diet alone because it is only found in a limited number of foods including oily fish, eggs, and vitamin D fortified foods such as some breakfast cereals, some fat spreads and dairy products.

Vitamin D plays a key role in bone health (it is needed by the body to absorb calcium), muscle function, increased bone and muscle and decrease risk of falls and fracture.

All in all, research states that adherence to healthy eating patterns, such as the mediterranean dietary pattern, is associated with longevity and reduced risk of age-related diseases. Together with some physical exercise, an adequate nutritional status contributes to the healthy ageing framework by the World Health Organisation and has the ability to improve older people’s well-being and ensure they are able to live independently in society.

Nutritional well-being is a fundamental aspect for the health, autonomy and, therefore, the quality of life of all people, but especially of the elderly.