FEEDING THE ELDERLY

Aging affects very significantly and sometimes severe processes of digestion, absorption,

utilization and excretion of nutrients. This will condition the dietary, nutritional and

culinary of individuals or groups of older strategies.

Certain factors have to do directly with the physiological system. It is the very degradation

of biosystems based carbon exposed to the ravages of oxidation and accumulation of toxic

material.
However, what most damage is caused in the elderly of today are marginalization and loneliness

which condemn in this modern and “practice” of which we are so proud.

Aging is a natural ongoing process of human beings, each person experiences with different

intensity. At present, it is difficult to establish the beginning of this stage of life

exclusively a function of age, due to increased longevity observed in Western societies.

However, it is considered that a person is living alone after 65 years, reserving the term of

very old to those over 80. In Europe 12% of the population consists of people 65 years and is

projected to reach in 2000 to 15%. This increased longevity and, consequently, life expectancy

is attributed to improved standards of living standards, the decline in infant mortality and an

improvement in medical care. In the latter group of cases, nutrition plays a very important

role.

People who reach a certain age they face physical, psychological and social problems derived

from proper biological changes of age, and condition, sometimes very narrowly, the ability to

perform as natural as the act is “EAT THE DAILY”. In many cases, these problems can not be

solved completely, but overcome thus allowing a better quality of life.

Energy requirements
It is not well documented that the energy requirements (BMR decrease) decrease with age,

especially now that the activity is higher in the elderly. Diets with lower energy intake to

1800 kcal for women and 2300 kcal for men, are likely to be inadequate in protein, and

micronutrients, so should be avoided. For the calculation of energy requirements should take

into account the need to maintain energy balance in terms of physical activity and basal

metabolic rate (which has not been clearly shown to decrease with age).

Protein requirements
Maintenance of nitrogen balance is very important for the body, and sets the standard for

establishing the requirements and protein servings.

The protein portion is related to the energy, it would seem that due to reduced protein content

in body mass, the needs are lower, but this assumption is not true. We must ensure adequate

intake especially in patients with chronic diseases and the elderly who live alone. The usual

recommendation is 0.75 g / kg / day, as well as for other adults. The protein deficiency states

can cause serious disorders: skin changes, edema, fatigue etc. they may worsen or alter the

health status of the elderly.

Carbohydrate requirements
No special recommendations for carbohydrate by the RDA. The American Heart Association and

Cancer recommended as carbohydrates provide 55-60% of total caloric value of the diet. A

contribution of up to 200 gr. these nutrients daily, is well tolerated by the elderly.

Decreased glucose tolerance suggest diets high in complex carbohydrates and fiber (whole grains

and vegetables), avoid excessive consumption of sucrose and lactose, if intolerance.

Lipid Requirements
Although heart disease that cause one of the highest mortality rates in today’s society, and is

directly associated with elevated levels of blood cholesterol, it is not advisable completely

reduce fat intake in the diet. Apart from the 65 years, the effectiveness of highly restrictive

diets fat is discussed to prevent cardio-vascular risk. We must choose, as in diets at all

ages, foods that provide monounsaturated fatty acids (olive oil and vegetables in general), not

least to ensure the contribution of fat soluble vitamins.

Although for this population, the RDA does not provide specific recommendations on fat intake

should not be less than 30% of total kcal that contribute to the diet. Generally less than 100g

/ day are well tolerated.

The quality of fat is also an important factor. It is recommended that 10-15% of the fat you

eat should be monounsaturated. This type of fat is the most in products such as oleic acid,

which is the main component of olive oil, as well as soy and corn, also in the beef. Another

10% can be in the form of saturated fatty acids, which can be obtained from seed oils and beef,

and about 8% of polyunsaturated fatty acids that are well represented in foods such as

sunflower oil and oil palm.

Mineral requirement
It is important to ensure proper minerals in general and particularly of iron, zinc and

calcium.
It seems to be justified an increase in calcium intake due to malabsorption problems of this

mineral, discussed in the previous section, and prevention of osteoporosis. 800 mg / day are

recommended for women aged 51 years.

Also appears important calcium / phosphorus ratio in the diet. Establish a relationship

recommendations 1/1 and therefore a total of 800 mg of phosphorus / day.

With iron deficiency must be careful. Due to the high prevalence of anemia in the elderly, it

could think of iron as the main role in this process. Apparently this is not the case (Manore

et al, 1989), anemia in the elderly often have their origin in blood loss mainly through the

intestine.

Therefore there is a recommendation of supplemental iron, since due to the decrease of the

absorption capacity would be useless. An amount of 10mg / day is recommended. Must know as

ascorbic acid elements increase the bioavailability of iron and hence the ability to be

absorbed, while phytates, saved, phosphates, tea and the decrease antacids.

Iron is best absorbed which is in animal tissues, and the worst of plant tissues. This is the

reason that leads to recommend for this stage of life, a daily intake minimum food (meat, eggs

or fish) to ensure the supply of iron in an easily accessible form.
The zinc concentration tends to decrease with the decrease of the total caloric intake. The

recommendation is 12-15 mg / day. Low levels of this metabolite may occur related to immunity,

ulcers, etc alterations but is not warranted recommending supplements because of malabsorption

problems.

Hypertension is one of the most common problems in the elderly, related to the recommendations

of minerals in the diet. It is recommended to limit to 2 g / day sodium ration to counteract

and supplement the diet with magnesium and potassium to enhance diuresis. (Kannel, 1988).
Recommendations for selenium are the same as for the adult population and that the RDA set at

55-70 micrograms / day. It is very relating to vitamin E and performs an important role as an

antioxidant.

Requirements of vitamin
A deficiency in vitamin D appears to be due, in many cases, lack of sun exposure to many

different problems elderly (immobility, institutionalization, etc.). In cases where minimal sun

exposure is not possible, it is necessary to ensure the diet 300 IU / day through food.

Vitamin A does not appear to decrease problems so usual diets for adults 1000 RE / day for men

and 800-900 for women is recommended, and a balanced and varied diet; fruits, vegetables,

carbon hydrates, can be ensured. Some animal foods are particularly rich in vitamin A as

retinol: liver, fish liver oil, milk, etc.

Ascorbic acid tends to fall mainly in people with a history of smoking, stress. Vitamin C

levels are also reduced deficiency in these two vitamins is related to the appearance of

purple, changes in the gums, breakage of small diameter blood vessels (capillaries), etc. In

both cases the consumption of foods rich in these nutrients is recommended (oranges,

tangerines, potatoes) rather than dietary supplements because they are best absorbed from food.

Sources of:

Vitamin A
apricot, plum, cherry, tangerine, peach, melon, spinach, sweet potatoes, cabbage, spinach,

beans, carrots, butter, milk, cheese.

Vitamin B
apricot, plum, cherry, tangerine, peach, spinach, cauliflower, cabbage, endive, peas, beans,

corn, turnips, carrots, nuts, rice, oats, milk, cheese, pork.

Vitamin C
apricot, plum, cherry, strawberry, lemon, tangerine, apple, melon, orange, brussels sprouts,

spinach, green beans, potato, pepper.

Vitamin D
Sunlight. Milk, butter, eggs.

Water
Dehydration is one of the most common problems in this population so recommended consumption is

2-3 l / day as adequate intake.

Fiber
This element is very important in the diet, and is recommended for other stages of life without

limitation. However, at this stage of life you have to be cautious in the recommendations. It

is very important to take the proper amount of fiber to avoid constipation problems, but the

amount given should not be an added impediment absorption of certain metabolites such as

vitamins and minerals. It has already been mentioned the problem of intestinal malabsorption.