Nutrition secrets for older people unveiled: Q&A

A musculoskeletal health expert has identified calcium, protein and vitamin D as key nutritional challenges for older people.

Last month, the government allocated $12.9m to lift the standard of food and nutrition in aged care, with independent dietitians conducting 500 yearly meal assessments.

Caoileann Murphy, a dietitian, musculoskeletal health expert in older people and ACU researcher, said maintaining a healthy diet through life can help 'put more nutrients in the bank' for later.

"There are certain nutrients that can be a concern for older people and they may fall short in meeting them," Ms Murphy said.

Aged Care Insite spoke with Ms Murphy, who shared valuable insight on the relationship between nutrition and exercise for the wellbeing of older people.

ACI: What are some ways we can promote healthy ageing through our diet?

CM: You're always going to benefit from having a healthy diet over the course of your life.

Take, for example, bone health.

Our bone health tends to peak in late adolescence, remains steady for a while, and then it starts to decline.

If we ensure we eat enough calcium in adolescence, it can help us put 'more bone in the bank' so to speak.

Overall, eating healthy during your life can put you at a lower risk of obesity, heart disease, type 2 diabetes and certain types of cancers.

What are some challenges in nutrition that older people in particular face?

It's important to note that it differs for each individual, regardless of age.

One 75-year-old may be physically active and healthy, while another 75-year-old may have health issues and chronic illnesses.

These factors affect nutritional requirements and the optimal diet for each individual.

But there are certain nutrients that can be a concern for older individuals and they may fall short in meeting them.

For example, calcium intake is important as people age, especially for women.

From the age of 50, women are recommended to increase their intake of dairy foods, which are the main source of calcium, to four servings per day.

Men over 70 are advised to increase their dairy servings to three and a half, while younger men are recommended two and a half servings. Another area of concern is vitamin D.

Our skin synthesises a significant amount of vitamin D when exposed to sunlight.

However, as we age, our ability to produce vitamin D diminishes.

Therefore, older people are recommended to obtain more vitamin D through their diet.

So, the requirements increase for individuals aged 50 and over, and then again for those above 70.

It can be challenging to obtain vitamin D from food sources, although some options include fatty fish, eggs, and fortified breakfast cereals.

Luckily, supplements can also be a beneficial way to incorporate vitamin D into the diet, as it can be difficult to consume enough through food alone.

Another important aspect for older adults is protein intake.

In Australia, it is recommended that individuals over 70 consume more protein in their diet.

This is because, starting in our fifties, we tend to gradually lose muscle mass and strength.

One of the contributing factors to this is our reduced effectiveness in utilising dietary protein for muscle synthesis as we age, so increasing protein intake can help preserve muscle mass and strength.

Another challenge faced by older individuals is that their calorie requirements tend to decrease as they become less physically active.

But their need for other nutrients, such as vitamins, calcium, and protein, remains the same or even increases.

So, it's important for older people to focus on nutrient-dense foods rather than those high in calories to ensure they still obtain all the necessary nutrients while consuming fewer calories per day

And then there's fibre, another important aspect.

As people age, they have an increased risk of constipation, and fibre plays a crucial role in addressing this issue.

Unfortunately, dietary intake data shows that older people generally don't consume enough fibre.

Good sources of fibre can be found in whole grains, fruits, vegetables and legumes.

Additionally, fluid intake is closely related to fibre consumption.

As people get older, their sense of thirst tends to decline, leading to underconsumption of fluids among older adults.

When consuming sufficient fibre, it is essential to pair it with an adequate fluid intake to avoid exacerbating constipation.

Furthermore, there are two other factors worth mentioning.

The first is salt. As people age, their sense of taste may decline, leading older individuals to desire more salt in their diet.

However, we know that excessive salt intake is detrimental to blood pressure, which tends to increase with age.

Therefore, it is important to limit the consumption of salty foods and instead enhance flavour using herbs and spices.

The second factor is vitamin B12. As we age, our ability to absorb vitamin B12 may decline for some individuals.

Therefore, it is crucial to undergo regular testing to ensure adequate levels of vitamin B12.

Can muscle mass be improved through diet alone? 

While diet plays a role in maintaining muscle health, it's primarily through exercise, particularly resistance training, that we can significantly improve muscle mass. 

Exercise has a more powerful effect on building and preserving muscle mass as it stimulates muscle protein synthesis, which creates new muscle tissue. 

But a balanced and nutritious diet with adequate protein is essential to support muscle repair and growth in conjunction with exercise.

How does exercise help in combating sarcopenia?

Exercise offers several benefits in combating sarcopenia.

Sarcopenia is the age-related loss of muscle mass and strength in older adults. 

It is a common condition associated with aging, and it can significantly impact physical function and overall health.

Firstly, regular physical activity, especially resistance training, helps stimulate muscle protein synthesis and promotes the growth and repair of muscle tissue. 

It also enhances muscle strength, crucial for maintaining mobility and independence as we age. 

Additionally, exercise can improve balance, coordination, and overall physical function, reducing the risk of falls and injuries. 

By engaging in regular exercise, older adults can significantly slow the progression of sarcopenia and maintain better overall muscle health.

In what ways is protein intake important for preserving muscle mass in older adults? 

Protein intake is crucial for preserving muscle mass in older adults. 

Protein provides the essential amino acids necessary for muscle tissue repair, maintenance, and growth. 

As we age, our bodies become less efficient at using dietary protein for muscle building, making consuming sufficient amounts of high-quality protein even more important. 

Adequate protein intake helps support muscle health, promotes muscle protein synthesis, and reduces muscle breakdown. 

It's recommended for older adults to include protein-rich foods such as lean meats, fish, poultry, dairy products, legumes, and tofu in their diets to support muscle preservation.

Are older adults less efficient in using protein for muscle building? 

Yes, as people age, their bodies become less efficient at using dietary protein for muscle building. 

This phenomenon, known as anabolic resistance, means that older people require slightly higher amounts of protein to stimulate muscle protein synthesis than younger individuals. 

But research suggests that older adults can still achieve similar muscle-building responses to younger people by consuming slightly higher amounts of protein, particularly in conjunction with resistance exercise. 

By ensuring adequate protein intake, older adults can overcome the age-related decline in muscle-building efficiency and support muscle health.

How much protein should older adults consume to support muscle health?

To support muscle health, older adults should aim to consume around 0.4 grams of protein per kilogram of body weight per meal. 

This slightly higher protein intake within each meal helps maximise muscle protein synthesis rates. 

Distributing protein intake evenly throughout the day is also beneficial for muscle health. 

For example, consuming protein-rich foods at breakfast, lunch, and dinner can provide a steady supply of amino acids for muscle repair and growth. 

It's important to note that individual protein needs may vary based on factors such as physical activity levels, overall health, and specific goals, so consulting with a healthcare professional or registered dietitian is recommended to determine personalised protein recommendations.

Can a Mediterranean diet really help with healthy aging and muscle preservation?

Yes, the Mediterranean diet has been widely recognised for its numerous health benefits, including healthy aging and muscle preservation. 

This dietary pattern emphasises whole foods, such as fruits, vegetables, whole grains, legumes, nuts, and seeds. 

It also includes moderate amounts of lean proteins, such as fish and poultry, and healthy fats, such as olive oil. 

The Mediterranean diet is rich in antioxidants, anti-inflammatory compounds, and essential nutrients, which can promote overall health, cardiovascular function, and brain health. 

Additionally, this diet is associated with a reduced risk of chronic diseases, including muscle loss and frailty in older adults. 

However, while the Mediterranean diet can contribute to muscle preservation, it should be combined with regular exercise, including resistance training, for optimal results.

What other factors besides diet and exercise contribute to healthy aging? 

While diet and exercise are key factors in healthy aging, there are other important aspects to consider. 

Maintaining a healthy weight is essential, as excess body weight can increase the risk of various chronic conditions.

Managing stress levels and adopting stress-reducing techniques, such as meditation or hobbies, can also contribute to overall well being. 

Sufficient sleep is crucial for physical and mental restoration, and it plays a vital role in supporting healthy aging. 

Avoiding smoking and limiting alcohol consumption are important lifestyle choices that can positively impact long-term health. 

Plus, maintaining social connections and engaging in activities that provide mental stimulation, such as learning new skills or participating in community events, contribute to a fulfilling and vibrant life in older age. 

Taking a holistic approach to health and considering these various factors can promote healthy aging and enhance overall well being.

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