You know you're getting older -- the mirror tells you so, and so do those nagging aches and pains. But what you may not know is that your body needs different nutrients now -- and in different ratios -- than it did when you were younger. At first, the changes may creep up on you with only minor consequences, but eventually the results can be serious, experts say. Studies have found that between 15 and 50 percent of all seniors suffer from poor nutrition or even malnutrition.
Physical limitations and mobility problems are part of the problem, says Amy Sheeley, nutrition specialist with the Massachusetts Senior Living Program. Shopping, preparing, and cooking food can be daunting when you have health problems, don't drive, or simply don't have the energy to tackle making a meal.
Living alone also makes older adults even less likely to take good care of themselves, she says. "The traditional dishes people are used to cooking may seem too complicated or difficult to make just for one or two portions," Sheeley says. In one study, conducted in Canada, researcher surveyed 400 older adults and found that nearly half of those living alone had at least four warning signs of poor nutritional health. And several studies have found that elderly men who live alone (and who may not be experienced cooks) are particularly likely to develop poor eating habits and nutritional deficiencies. And of course, says Sheeley, the risks become even greater for seniors on low, fixed incomes.
Signing up for meal delivery programs, hiring in-home care, or moving to a residential living community are all potential solutions for those who need help sticking to a healthy meal plan. Here are the top 5 nutritional issues to be aware of as you age, and what to do about them.
1. You Need More Protein
A perfect storm of factors comes together as you age that can cause you to become protein-deficient without your even noticing, says Shirley Chao, director of nutrition at the Massachusetts Executive Office of Elder Affairs. "Protein is very important for older people, yet we see many people not getting enough," Chao says. First, you may find yourself skipping meals and filling in with snacks, since decreasing appetite tends to make meals less appealing. And snacks, unfortunately, tend to be carbohydrates, not protein. Then there's the fact that you may be cutting back on salt, sugar, fat, or all three, inadvertently causing you to eat less meat, dairy, and other good protein sources. Lastly, your senses of smell and taste change as you age, making some foods – unfortunately, often saltier or sweeter snack foods -- taste better, while healthier foods may taste bland.
Despite all these changes, your body still needs a regular supply of protein to maintain a healthy metabolism, Chao says. And in fact, protein becomes more important to combat age-related decline in lean muscle mass.
What to Do:
Going more than eight hours without protein can affect your body's ability to maintain muscle and bone and to keep producing enzymes that are important for digestion and metabolism, experts say. But if, like many adults, you start your day with cereal, toast, or other carbs and skip or postpone lunch, then before you know it you've gone all day without any serious amount of protein.
- Eat protein in at least two meals or snacks.
- Have yogurt or eggs for breakfast, or add peanut or almond butter to your toast.
- Don't skip lunch, or at least make sure your afternoon snack is also protein-rich.
Research has shown that zinc can improve a declining sense of taste, particularly if you're zinc-deficient. And it just so happens that the best sources of zinc are eggs, meat, and seafood, so eating these foods will help break the low-protein cycle.
2. You Don't Absorb Certain Vitamins and Nutrients as Well
Over time, changes in the function of your digestive system make it more difficult for your body to absorb and metabolize certain specific nutrients. In most cases, the problem is a decreasing amount of stomach acid, which is necessary to break down these nutrients from their original food sources, says Sheeley. Lower levels of digestive enzymes also lower nutrient absorption.
The biggest culprit is vitamin B12, also known as cobalamin, which from age 50 on becomes more and more difficult to absorb, leading to deficiency. Deficiencies of the other B vitamins, particularly B6 and folic acid, are also common. As you age, you're also more likely to develop vitamin D deficiency because your skin's ability to convert vitamin D from sunlight decreases as you age. Unfortunately, vitamin D is necessary for the absorption of calcium, a nutrient most older adults don't get enough of to begin with. And your body needs adequate amounts of both calcium and vitamin D to keep bones strong and avoid age-related bone loss.
What to Do:
Take advantage of the increased absorption that occurs when you combine certain foods.
- Vitamin C improves absorption of iron, so add a potato side dish when you eat red meat, squeeze lemon on fish, and have juice with your breakfast cereal or top it with fruit.
- Vitamin C also helps you absorb calcium, so add tomato to your cheese sandwich or pizza, and top bean burritos and tacos with salsa.
- Postmenopausal women may need to take a calcium supplement, since calcium absorption decreases with hormonal changes and women are at higher risk for bone loss.
- Folic acid is now added to many cereals and other foods, so you can boost your intake that way, and you may want to ask your doctor about taking a vitamin B supplement.
Be aware that certain medications, such as proton pump inhibitors, antacids, and metformin, used to treat diabetes, can interfere with B12 absorption. If you're B12 deficient and your doctor suspects it's caused by malabsorption, you may need vitamin B12 shots to get around the problem.
3. You Need Fewer Calories, More Nutrient-Dense Foods as You Age
As your metabolism slows, the calories tend to stick (you may have noticed), which is one reason you gain weight as you get older. Meanwhile, you're probably less active, and therefore burning fewer calories, too. For this reason, you need the calories you eat to count, which means they need to pack a nutritional punch.
What to Do:
There are a number of simple substitutions you can make that increase the ratio of vitamins, minerals, and protein to calories.
- Switching to nonfat or low-fat milk, which has pretty much the same nutrient content as whole milk, with less fat and fewer calories.
- If dairy is difficult for you to digest, almond and soy milk are nutritious substitutes.
- Similarly, switch to lean meats instead of fatty meats, brown rice instead of white rice, and fresh fruit instead of canned fruit, juice, or applesauce.
- To achieve the biggest gain in nutrients over calories, of course, you have to cut back on sweets and other non-nutritive foods.
4. You Need More Fiber
You probably know that fiber is key to healthy digestive and bowel function, and that when you don't get enough of it you tend to get stopped up. (And using laxatives to treat constipation prevents the body from digesting and absorbing nutrients, doing double damage to your health.) But you may not know that in the past few years, a host of studies have hailed fiber as a wonder food that strengthens the immune system and combats inflammation, offering protection against diabetes, heart disease, and cancer, as well as a host of digestive diseases and conditions. In addition, fiber helps absorb fats from your blood, so if you have high cholesterol, doctors recommend that you help lower it by upping your fiber intake.
What to Do:
Fiber is particularly important in the morning.
- Start your day with oatmeal, bran or oat-based cereal, or toast made with high-fiber bread.
- Some of the highest-fiber foods are beans and legumes; pinto beans have a whopping 19 grams of fiber in a one-cup serving, lentils and split peas have 16 grams, and kidney beans have 13 grams.
- Many fruits, nuts, and vegetables, including apples, berries, broccoli, pecans, and greens, are high in fiber as well.
- As a general rule of thumb, the more fresh, whole, unprocessed foods you eat, the higher your fiber intake.
If you can't get enough fiber from your diet, a fiber supplement is a good idea, but experts stress that fiber supplements don't provide the nutrients of real food and thus are no substitute.
5. You Don't Feel Thirsty -- but You Become Dehydrated More Easily
One interesting age-related change that few people are aware of is that we don't notice thirst as much. The reason? Neurological and chemical changes cause the body's regulating mechanisms to become less sensitive, so you aren't prompted by the normal thirst-based trigger to drink. This is one reason dehydration is such a common problem among the elderly, experts say. Compounding this problem is the fact that as you lose lean muscle mass, you have less storage capacity for water. More than 70 percent of total body water is stored in lean muscle tissue, experts say. But you need just as much water, or even more, to stay healthy as you age. In addition to preventing dehydration, drinking enough water reduces stress on your kidneys, which don't work as efficiently as you age. Drinking enough water is also key to preventing constipation.
What to Do:
The advice to drink six to eight glasses of water doesn't change as you age -- the difference is that you may need to schedule your drinks in order to remember, whether you feel thirsty or not.
- Some experts advise using a water bottle with measurements on it, so you can keep track of how much you've drunk.
- Carry water with you when you go out, especially if you're exerting yourself.
- Coffee and tea are fluids, but they are also diuretics, so accompany your morning coffee or tea with a glass of water.
- Juice, soup, and fruit also boost your liquid intake.