Let’s face it: Nutrition needs evolve as we age. And healthy eating is important for healthy aging.
A healthy diet and lifestyle can help prevent inflammation, obesity, and chronic diseases, such as type 2 diabetes. These conditions can lead to imbalances in the gut microbiome, which can create a domino effect that leads to a comprised immune system and a variety of diseases. In fact, most deaths from chronic illness in the U.S. are preventable and related to how we live, according to research published in The Permanente Journal.
For older adults, proper food and nutrition, as well as physical activity and healthy social and emotional support, may be able to prevent some hypertension, heart disease, type 2 diabetes, osteoarthritis, and cognitive decline — once thought of as inevitable outcomes of aging.
“As individuals reach later decades of their life, there are notable changes in the body composition,” says Anna Liggett, MD, a geriatrician with Northwestern Medicine in Deerfield. “Bone mass, lean muscle mass, and water content all decrease, while fat mass generally increases. The consequence of these changes in body composition is that you cannot have a one-size-fits-all approach for all adults. You must consider the older adult body different than younger middle-aged adults.”
Even taste buds decrease in number and function, meaning older adults taste and smell things differently than younger adults do. This can make food choices challenging, but remember: A healthy aging diet is associated with independence, well-being, and safe living in older adults.
A healthy aging diet
“We have different nutrient needs as we age. At 60 and older, there should be a greater focus on protein intake throughout the day, slightly greater amounts of protein recommended, plus more emphasis on immune building,” says Kristin A.R. Gustashaw, RDN, a dietitian who specializes in gerontological nutrition at Rush University Medical Center.
Protein needs in older adults range from 1.0 to 1.2 grams per kilogram of body weight, depending upon the muscle demands for protein in an individual.
It’s not enough just to eat more protein, you also have to create the demand for protein through daily physical activity that includes strength and muscle building movement.
“Whey protein (found in yogurt, cottage cheese, and ricotta cheese) is shown to be great for building aging muscle, which is high in leucine, the amino acid primarily responsible for triggering protein synthesis.” Gustashaw says.
Recent research has proposed a Healthy Aging Diet Index for people over 65 years old — which includes recommendations for fiber, unsaturated fatty acids, protein, added sugar, folic acid, calcium, vitamin D, and fluids. The goal: to help people enjoy a functional life devoid of chronic diseases.
“In healthy adults as the body ages, there is a decrease in metabolic rate — the speed and efficiency that your body process nutrients — as well as a decrease in hormone production, decreased immune response, an increased rate of insulin resistance, and the body produces less stomach acid,” Gustashaw says.
“This decrease in acid production plays a role in how and where bacteria – good and bad — populate the gut,” she says. An overgrowth in bacteria can mean that more bacterial proteins bind to vitamin B12, leading to the need for B12 supplementation in older adults.
Older adults may also need other vitamin supplementation, such as vitamin D. “Decreased synthesis of vitamin D through the skin [in older adults] results in an increased need for a supplemental source,” Gustashaw says. “Getting outdoors every day is important for health and well-being, but getting adequate vitamin D from the sun all year round is not possible,” so it’s important to consume enough vitamin D through your diet and supplements.
“Fruits and vegetables, which are high in antioxidants such as vitamins A, C, and E, as well as selenium and carotenoids, are powerful players for health in older adults,” Gustashaw says. As we age, an imbalance of oxygen metabolism called oxidative stress can occur. “Over time, this stress can damage cells and tissues. Foods rich in antioxidants can help reduce free radicals from cells as well as help reduce the damage they cause.”
Aging is associated with many physiological changes, Liggett says, including a decrease in appetite.
“If an older adult eats only one or two meals a day and fills up quickly, they may not meet an adequate nutritional intake need for that day, leading to weight loss. In this scenario, it is important to stress the concept of grazing throughout the day to ensure adequate caloric intake,” Liggett says.
For older adults who are underweight, Liggett suggests getting in adequate calories even through sweets and empty-calorie foods because “the risk of being underweight far outweighs the risk of consuming low-nutritional-value food.”
The aging mind
Nutrition plays a key role in keeping the aging brain sharp. “One of the most common questions I get from older adults is for advice to protect against dementia and cognitive decline,” Liggett says.
From leafy greens to berries to fatty fish, older adults should plan to eat plenty of produce, whole grains, and healthy fats like nuts, seeds, avocado, olive oil, and seafoods.
The combination of two proven diets — the Mediterranean and DASH diets — has shown great benefits for cognitive health. These diets are packed with fruits and vegetables and include less red meat.
“Especially try to incorporate a diet with rich with dark berries, leafy greens, and fatty fish such as salmon, halibut, and tuna to help preserve cognitive health,” Liggett says.
Meal planning for older adults
To make meal planning and prep easy, start by considering your food preferences. Next, plan single sheet pan meals (for easy prep and clean up), and balance meals with at least three food groups.
Gustashaw advises older adults to incorporate fresh, frozen, and canned foods each week to help with variety, ease of preparation, and managing budgets without sacrificing nutrition. A double portion of a healthy snack can turn into a small meal, too.
The bottom line: Nutrient needs change in the later decades of life. Any care plan for older adults needs to include optimal nutrition with an emphasis on fruits, vegetables, protein, healthy fats, and fluids to optimize health and prevent chronic diseases.
Healthy Aging Diet Index
This table displays the recommended nutrients and daily amounts for people over 65 to prevent diseases related to aging.
Recommended Daily Dose
|Dietary Fiber||20 – 35 grams|
|Folate||300 – 1,000 mcg|
|Calcium||1,000 – 1,300 mg|
|Sodium||1,200 – 2,800 mg|
|Vitamin D||5 – 10 mcg|
|Total Fat||15% – 35% of total calories|
|Saturated Fat||Less than 10% of total calories|
|Omega-3 Fatty Acids||1% – 2% of total calories|
|Total Proteins||0.8 – 1.5 grams per kg of body weight|
|Simple Sugars||Less than 10% of total calories|
|Liquids||Greater than 6 cups|
Source: Adapted from “Design of the Healthy Ageing Diet Index,” Nutricion Hospitalaria.