The geriatric population makes up the fastest growing segment of our society. It has been projected that nation’s population aged 65 and over will exceed 31.8 million by the year 2000. Although it is known that nutritional status plays a significant role in the quality of life of the elderly, methods for the assessment of the nutritional needs of this population and identification of appropriate dietary goals to ensure their health has just begun.

With increasing age, lean body mass, metabolic rate and physical activity decline and protein tissue is gradually replaced with fat, even though the individual may not become overweight. The decrease in physical activity and metabolic rate mandate a downward adjustment of caloric intake to prevent excessive weight gain. For men, energy expenditure decreases by 21% between ages 20 and 74 and by another 31% between ages 75 and 99. The National Research Council has suggested that calorie intake be reduced by 5% per decade after the age of 55. This caloric reduction should be effected by reducing fat and carbohydrate intake, since protein requirements are at least as great in the elderly as in younger age group.

nutrition and aging

Over half of the population over the age of 65 years has hypertension and/or diabetes. Dietary recommendations for the elderly to reduce or control these conditions include the reduction of fat, sugar, and sodium intake. Dietary fat should consist of roughly equal quantities of saturated, monounsaturated, and polyunsaturated types in order to reduce cholesterol intake. Sugar intake should be decreased to reduce overall caloric intake and also because of the suggestion that sugar may synergize the hypertensive effect of sodium. Controversy exists over the degree to which sodium intake should be restricted in the elderly, although it is generally acknowledged that sodium restriction should be considered adjunctive to the management of hypertension in this population.

Diabetes in the elderly is frequently associated with excess body weight, which is, in turn, associated with an imbalance between calorie intake and energy expenditure. Control of the elderly diabetic patient requires great care to ensure a diet that supplies the essential nutrients without excess calories. The goal of such a diet is to supply adequate protein, vitamin, mineral, and fiber intake while reducing carbohydrate and fat intake to affect a gradual weight loss.

During aging, there is a continuous loss of bone calcium; beginning around the age of 40 and, at approximately 60 years of age, calcium absorption from the gastrointestinal tract begins to substantially decline. For the elderly, decreased absorption of calcium may be controlled by such problems as an inadequate dietary intake of calcium-rich food such as dairy products, a deficiency of lactase with the resultant excess lactose interfering with calcium absorption, and hypovitaminosis D. these effect contribute significantly to the high incidence of osteoporosis that occurs in this population. To offset the effect of reduced calcium absorption, it has been suggested that a calcium intake of 1000 mg/day or higher, and a vitamin D intake of 600-800 IU/day should be provided, either by dietary adjustment or supplementation.

Other substantive change that are encounter during aging include a reduced production of saliva which makes food less palatable; reduction in taste and smell activity; impaired digestion (especially fats and lactose); and loss of teeth or poorly fitting dentures. The combination of these effects may lead to decreased appetite and deficiencies of essential nutrients. Anemia is also often seen among the elderly. Its etiology has been related to deficiencies of iron, folic acid, and/or vitamin B12, but may also be related to a higher requirement for these nutrients during the aging process.
Cartilage