Nutritional Needs for Aging Seniors

It’s especially important for the elderly, whose bodies don’t absorb the nutrients they need for proper function as efficiently as a younger person, and who are at a higher risk for chronic diseases such as high blood pressure, diabetes, osteoporosis and heart disease.

Specific nutritional needs for aging adults

“As we age, there are nutritional needs that shift,” says registered dietitian Andrew Wade, co-owner of Case Specific Nutrition, a counseling service that also offers a selection of dietitian-approved prepared meals. As a result, certain foods and proper hydration become even more important for well-being.

Among the trickiest changes to navigate is the increased need for protein.

To prevent the loss of muscle mass and strength that occurs naturally with age, an older person requires roughly 50% more protein than a young adult. The amino acids in protein also power up the body’s immune functions, decreasing one’s chance of getting sick.

But because people in their 70s or 80s typically move less throughout the day, and their metabolism slows down, they might not feel hungry – and no matter how hard you nag or tempt your loved ones with favorite foods, it can be difficult to convince them otherwise.

Simply being unhappy – a common emotion following life changes like the death of loved ones or declining health – can also cause a loss of appetite.

Also a concern: The body doesn’t absorb vitamin B12 as well in old age, leading to a reduction of red blood cells. Besides anemia, that can cause neurological problems such as numbness or tingling in the hands and feet, vision problems and confusion. Certain medications can also decrease absorption of vitamin B12.

In addition, our digestive system slows as we age. So it’s essential for seniors to get more fiber in their diets to improve digestion and prevent constipation, says Wade.

“It feeds gut bacteria and keeps things moving,” he says.

Complicating matters is that older adults often have more trouble chewing or swallowing food because of dental issues or the loss of control of mouth and throat muscles following a stroke or conditions such as Parkinson’s disease.

Seniors also are more apt to become dehydrated because they often just don’t feel thirsty and forget to drink or fear incontinence; a UCLA School of Nursing study published in 2019 found that up to 40% of elderly people may be chronically underhydrated.

Also, our taste receptors start to break down as we age, resulting in diminished taste for most seniors. That can make food bland and unappetizing.

“There’s a lot going on,” says Laura Ali, a registered dietitian and culinary nutritionist and author of “Mind Diet for Two,” a cookbook focused on “brain healthy” foods. “And that can be a challenge.”

Clues and conversations

So how do you know if your senior is eating and drinking properly, especially if you don’t live nearby and visit often?

And just as important, what can you do to help them get the healthful calories and fluids needed to nourish an aging body?

For starters, it’s important to have frequent and respectful conversations.

Simple questions like “how is your appetite,” “what’s in the fridge” and “what did you have for dinner” can give important clues, so long as you come from a place of curiosity and don’t pander, says Wade. “You don’t want to sound patronizing.”

Clues in monitoring nutritional needs for aging: Sudden Weight Loss in Seniors

Keeping in touch with your loved one’s physician – by email or virtually, if you’re not local or they don’t want you to tag along on appointments – can also help provide data points, since they’re probably getting weighed during visits; trending down on the scale can be a sign of undereating.

Doctors and pharmacists also can provide information about which medications might affect appetite or cause issues with chewing or swallowing.

‘It’s never one size fits all’

When Pittsburgh private chef Brandon Blumfield prepares meals for elderly clients, “I always get to know them before cooking,” he says. That includes not learning just what they want but what they need, he notes.

Often that means modifying a recipe to reduce fat and sodium, and portioning the food to fit each eater’s appetite. For those who have issues with gripping utensils, he also cuts the food to smaller sizes that are more manageable. “It’s never one size fits all.”

To help with hydration, Ali recommends a refillable water bottle with time markers placed next to a chair or bed for easy access if the senior has mobility issues, or keeping a lightweight pitcher and cup handy. If they don’t like plain water, add some fruit or berries for flavor, or a squeeze of lime or lemon. Providing ready access to fruits and vegetables with high water content, such as watermelon, cucumbers, lettuce and tomatoes, also can prevent dehydration, along with liquid foods such as soups and broths.

Encouraging them to take small, consistent sips throughout the day instead of trying to chug several ounces in one (uncomfortable) fell swoop is another smart move. Wade suggests giving them a shot glass necklace they can wear around their necks and refill every 15 or 20 minutes.

Counting calories

Calorie-wise, it all depends on the individual, as some seniors need more and some need less.

One useful tool in figuring out which camp your loved one falls into is the USDA’s “MyPlate” guide, available both on the web and as an app. It helps calculate what and how much to eat based on age, sex, height, weight and physical activity level. For example, an 80-year-old woman who stands 5-foot-4 and has less than 30 minutes of moderate activity a day requires 1,600 calories, including 5 ounces of protein, 5 ounces of grains, 3 cups of dairy, 2 cups of veggies and 1½ cups of fruit.

If your senior is undereating, Ali says one solution is to figure out ways to concentrate calories and protein into smaller amounts of food. Adding a bit of powdered milk to a glass of milk or plate of scrambled eggs is a great way to sneak protein into a meal without changing taste. Several small meals throughout the course of a day instead of three squares is another. Regular exercise can also boost appetites.

Another strategy would be to start the day with one of the body’s main sources of energy: carbohydrates. A simple breakfast of toast is easy to digest and will get the appetite going, says Wade. If their taste runs salty, add a little peanut butter; if it’s sweet, pair the toast with some jam.

For those with chewing or swallowing issues, texture is key. Softer foods such as cottage cheese, milkshakes, smoothies, cereal and milk, oatmeal or mashed potatoes are good options, along with berries and fruit. So are eggs, which have the added benefit of providing protein.

Nutritional shakes like Ensure are easy to criticize because they have very little protein and a lot of sugar, notes Wade, but they are a source of calories that are intentionally filling for older adults.

“It’s not right for everybody, but if they have no appetite and are withering away and losing tissue, having them sip on something that tastes like a milkshake and building on that is a tool in the toolbox,” he says.

When it comes to adding protein, both animal sources (lean meats, fish, poultry, eggs, dairy) and plant sources (tofu, lentils, chickpeas, beans, quinoa) will work their magic. Vitamin B12 is also found naturally in foods like meat, eggs and dairy products, and seafood; good sources of fiber include beans, whole grains, brown rice and my elderly mother’s favorite nosh: popcorn.

Also, don’t be afraid to salt to taste when cooking from scratch – it can make food taste better – but keep a watchful eye if your senior suffers from high blood pressure. Current Dietary Guidelines for Americans recommends adults limit sodium intake to less than 2,300 mg per day – or about a teaspoon of table salt.

Salt-free seasoning blends add big flavor without the sodium. Try Penzey’s Poultry Seasoning, Mural of Flavor, Arizona Dreaming, Sunny Spain, Sunny Paris, Forward, and Tuscan Sunset, California Seasoned Pepper, and more

Cooking with ingredients that naturally contain high-enough levels of sodium can keep your senior from reaching for the salt shaker. Chef Blumenthal, for instance, seasons roasted vegetables with low-sodium tamari he waters down with apple cider vinegar and spices. He also adds flavor with mustard, capers and olives.

Finally, keep in mind that older adults are at a higher risk for foodborne illness because their body’s immune response to disease is weaker. So if you or they are cooking meals at home, make sure you always wash your hands, are careful not to cross contaminate and always cook (and store) food at the right temperature.

Three recipes to support nutritional needs for aging

High-Calorie Egg Muffins

PG tested

Makes 12 muffins

These are like mini crustless quiches. You can swap the cheese with other varieties, use different vegetables, and add in canned salmon or other meats to boost the protein. These freeze well and can be reheated in the microwave. They are an easy breakfast or midmorning or afternoon snack.

Ingredients:

• 6 large eggs
• 1/2 cup nonfat powdered milk
• 1/2 cup half and half
• 1 cup shredded cheddar cheese
• 2 cups thinly sliced spinach
• 1/4 teaspoon each black pepper and nutmeg

Directions:

1. Preheat oven to 350 degrees Fahrenheit. Spray the wells of a 12-cup muffin tin with nonstick cooking spray.
2. In a medium bowl, whisk the eggs until fluffy. In a small measuring cup, mix the powdered milk with the half and half until the powder has dissolved. Add the milk mixture to the eggs and whisk to combine.
3. Add the cheese and the spinach to the egg and milk mixture and mix well. Evenly distribute the egg mixture between the 12 muffin tin cups.
4. Place in the middle of the preheated oven and bake for about 20 minutes or until the muffins puff up and are firm to touch.
5. Cool on a wire rack. The muffins will deflate as they cool.

– Laura Ali

High-Calorie and High-Protein Mocha Shake

PG tested

Makes 1 1/2 cups

For anyone who loves the combination of coffee and chocolate, this high protein drink is a delicious afternoon snack that will help fill in some of the nutritional gaps people with low appetites may experience. It is filling so may be best tolerated split into 2 servings. It is also an easy way to dress up a meal replacement drink.

Ingredients:

• 8 ounce (1 can or bottle) meal replacement coffee-flavored drink (such as Ensure or Boost)
• 1/2 cup vanilla ice cream
• 1/4 cup nonfat powdered milk
• 1 tablespoon unsweetened cocoa powder

Directions:

• Mix all ingredients in a blender or by hand, and pour into a glass.

– Laura Ali

Roasted Garden Cherry Tomato Sauce

Ingredients:

• 1 pound cherry tomato
• 1/3 pound yellow onion (roughly chopped)
• 1 teaspoon olive oil
• Salt and pepper to taste
• 4-5 tablespoons olive oil
• 1 tablespoon garlic (minced)
• 1 ounce fresh basil (whole leaves)
• 1/2 cup white wine
• Cold water (as needed)
• Salt and pepper to taste

Directions:

1. Toss cherry tomatoes, yellow onion (roughly chopped), olive oil, salt and pepper together in a bowl and transfer to lined baking sheet. Roast at 400 degrees for 15-20 minutes (until tomatoes have blistered and onion is slightly burnt).
2. In a large saute pan (or medium pot), heat olive oil on medium-high, add garlic and stir for 1 minute, then add basil and stir for 1-2 minutes until fragrant. Add the tomato and onion mixture (with any juices from the baking sheet) to the pan/pot and continue to stir on medium-high for 1 minute. Add white wine and a splash of water and bring to a simmer. Let reduce for 7-10 minutes (the larger the batch, the longer the reduction time).
3. Remove sauce and add to a blender, blend on high for approximately 2 minutes until all ingredients are smooth and incorporated. Add water if sauce is too thick.
4. Enjoy as a fresh pasta sauce, as a pizza sauce or dipping sauce! Stores for 7 days in the fridge and up to 6 months in the freezer for large batches.

– Dominick Grande

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