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Millions of older people don’t get enough nutrients – how to spot it and what to do about it

Cork/Reading: By 2050, approximately a quarter of the UK population is expected to be over the age of 65. With this in mind, the World Health Organisation (WHO) has put “healthy ageing” on its agenda. This means finding ways to maintain health, wellbeing and functional ability in order to have a good quality of life and enjoy the later years.

Everyone ages at a different rate – but there are some things that can influence how well we age, such as by making changes to the types of activity we do and the foods we eat.

Older adults are generally less physically active than they were when they were younger and because of this, their energy intake requirement may decrease. However, there is a difference between energy requirements and nutrient requirements, and nutrient requirements actually remain the same, if not increase, as we get older.

This means we need to get more nutrients into less energy which can be tricky as older adults often have lower appetites. This is why scientists suggest that it may be necessary to enrich the food of older people to maintain the nutrient intake.

How to spot when someone isn’t eating enough?

Several studies have shown that undernutrition affects one in ten older people living independently at home. However, it affects five in ten older people living in nursing homes, and seven in ten older people in hospital.

Being overweight, even obese, does not protect against undernutrition. And when older adults lose weight, they lose muscle, meaning that they are more likely to lose their abilities to do daily tasks.

Weight loss in older adults is a key sign of malnutrition that needs to be addressed – but it can be easily missed, especially when many older adults associate the idea of thinness with good health. But clothing that’s too loose or a watchstrap that floats on the wrist are all warning signs of undernourishment.

Similarly, if someone you care for has started to say things like, “Oh, I don’t want much food today, I’m not hungry”, “I’m not hungry, it’s natural, I’m getting older”, or “I’d rather just have a biscuit to be honest,” then these could be warning signs. An effective way to keep on top of this is regular weighing at least once per month which enables a quick response to potential indicators of malnutrition.

Getting more nutrients into less food

If people are eating small amounts of food, it is important to think about how to add more nutrients into it. A very effective technique, “fortification” is commonly done with pre-made products such as breakfast cereals, plant-based milk and bread in the UK.

Fortification (adding foods, ingredients or nutrients into to existing foods or meals) is easy to do at home as well and can provide a flexible approach for older adults as it allows them to continue eating the foods that they most enjoy.

For older adults in particular, protein is a very important nutrient, because of muscle loss (sarcopenia) which is a natural part of ageing. This could be slowed down or even reversed by eating enough protein at regular intervals throughout the day. A few ways to increase protein include:

• Adding dairy ingredients such as milk, high-protein yoghurt, Quark (soft cheese), milk powders, eggs and cheese into meals – even into simple foods like mashed potato.

• Nuts are a great source of protein, try adding ground almonds to savoury or sweet meals (beware of nut allergies).

• Soy protein can be a convenient and cost-effective option, either for vegetarians or to further fortify minced-meat meals.

• Look in the sports section of supermarkets to find whey protein powders. These are marketed to gym enthusiasts, but actually whey is one of the best proteins to stimulate muscle growth. This versatile ingredient can be mixed into porridge before cooking or used it as a substitute for other powdered ingredients in baking.

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