The Basics of Geriatric Nutrition

Life is about making adjustments, and that includes our diets. According to Lindsay Johnson, a Registered and Licensed Dietitian who works as a Clinical Dietitian at Barnes-Jewish Extended Care, how the body processes foods changes as we age.

“When we grow older, the rate at which we burn calories (our metabolic rate) slows, we lose muscle mass, and even our organs start to slow,” Lindsay says. However, people can still give their bodies the fuel they need to maintain or even improve their health by adhering to a proper diet.

What follows are general guidelines for seniors and geriatric nutrition. Specific medical conditions may require different adjustments to a person’s diet. Please consult your physician before adding supplements or vitamins to your health regimen or beginning a new diet.

A Good Starting Point — Back to Basics

For people of any age, a diet that is rich in fruits, vegetables, and fat-free or low-fat milk and milk products is most often recommended by nutrition experts. The emphasis is also on consuming whole grains, fish, poultry, beans, seeds, nuts, and less sugar.

Determine Your Caloric Needs

Depending on activity levels and body type, older women typically need 1,600-2,200 calories per day, while men require 2,000-2,800 calories per day. Exercise is beneficial for many reasons, but one is that more calories are burned during and after exercise. Another benefit — muscle burns more calories than fat, even while you’re resting.

Protein and Geriatric Nutrition

A lack of protein can lead to bone density loss (osteoporosis) and weaken the immune system. However, Lindsay cautions that the digestive system of older adults is not as adept at processing the B vitamins found in meats, such as steak.

“As you age, there is less acid available in your stomach to break down the meat,” she says. “This means less B12 is absorbed. People can develop anemia, even though they are eating the same amount of meat as when they were younger.”

The family of B vitamins, including B12, work together to rebuild the body. “Every day we are recreating ourselves, and without B vitamins we are not as efficient at rebuilding our bodies,” Lindsay says.

More easily digestible forms of protein include lentils, beans, and chickpeas.

Lindsay also suggests that seniors try eating an acidic citrus fruit like pineapple to assist in breaking down the protein, especially if you are enjoying a steak for dinner.

Water Intake is Important for Seniors

Dehydration is more common in older adults due to a reduced sense of thirst. “The part of the brain (hypothalamus) which controls our thirst mechanism slows a bit as we age,” Lindsay says. “So it may not be sending out a strong signal to our bodies indicating that it needs to drink.”

She notes that because seniors have been made aware of this, some overconsume water, causing an imbalance in the nerves, muscles, and bodily tissues.

According to Lindsay, an average older female who requires 1,600 calories per day would need about 6.5 cups of water each day. For a man burning 2,200 calories per day, the requirement would be around 8 cups. If the woman is physically active, add another cup. A physically active man would need an additional 2 cups.

Fiber Does More Than You Think

Fiber regulates the digestive system, can lower cholesterol, and help control blood pressure. Some sources of fiber are fruits, vegetables, whole grains, and legumes.

Proper Intake of Vitamins and Minerals

Seniors may consult with their physicians to determine which vitamins and minerals they may need to consume more of. Many seniors don’t know that common vitamins and minerals can be consumed directly through the foods you eat, avoiding the need for additional supplements.

Omega-3

Foods rich in omega-3 can lower elevated triglyceride levels, and help with stiffness and joint pain. Sources include salmon, halibut, herring, sardines, tuna, walnuts, flaxseed, and canola oil.

Folate/folic acid

Another one of those B vitamins—folic acid—also helps in maintaining the metabolic cycle that creates energy for your body. Fortunately, many breakfast cereals today are fortified with folic acid (read the food label on the side of the box). Folic acid also is found in fruits and vegetables.

Calcium

Vital to maintaining bone density, calcium is particularly important for women as their bones thin with age. Some sources include milk, kale, broccoli, sardines, edamame, and tofu.

Vitamin D

Vitamin D aids in the absorption of calcium. Lindsay suggests milk or calcium-fortified almond milk, yogurt, kale or broccoli. Also, a little sunlight on the skin before you cover up and lather on the sunscreen—15-30 minutes per day—will provide vitamin D.

Potassium

Among its many functions, potassium aids in maintaining muscle tissue, and facilitates heart and kidney functions. It also helps lower blood pressure and decreases the risk of stroke.

Avocados, bananas, spinach, and sweet potatoes are good sources of potassium.

Note: if you are taking a diuretic, you may be vulnerable to potassium loss through frequent urination. A sign of this is your urine turns darker. Talk to your doctor about this. Often, a potassium supplement is prescribed by your doctor to counter this effect.

Magnesium

“Magnesium is very calming for the body,” says Lindsay. “People who might have sleeping problems or have sore, achy muscles could eat a handful of almonds each day, or consume other high-magnesium foods. One of its key functions is in maintaining energy levels.

Lindsay suggests a “calm start” to your day by eating a small bowl of oatmeal with 1/2 of a medium banana sliced on top, and a 1/3 cup of almonds, and sunflower and pumpkin seeds mixed together.

How Seniors Should Handle Alcohol

“If you’re drinking alcohol with your meal, it is competing with B vitamins for absorption in your system, and anemia can result,” says Lindsay.

Many other problems, including liver damage, can result from alcohol consumption. Other alcohol-related problems for seniors include balance problems, which can lead to falls, and mixing alcohol with medications can be deadly (talk to your doctor). Also, reaction times that have slowed with age will slow even further with alcohol consumption, which poses a serious risk while driving.

Remember, an older adult does not metabolize foods and beverages as well. What a person used to drink at age 30 will not be what they are able to tolerate as a senior.

Lindsay recommends the following daily limits for senior adult alcohol consumption:

• Women: one standard can of beer OR one 4-6 oz. glass of wine OR 1.5 oz. of hard liquor.
• Men: two standard cans of beer OR two 4-6 oz. glasses of wine, OR 3 oz. of hard liquor.

Putting it All Together

As we age, we should expect to make changes to our diet and lifestyle — but it’s not as hard as you might think! Now that you have the basics of geriatric nutrition, you can work with your doctor to develop a diet that suits your needs.

At Bethesda, we believe that great health begins with great nutrition. Check out our blog for more senior health and wellness tips.