Eating a healthy balanced diet is a priority at every age. As we get older, it’s crucial in helping us maintain our vitality and giving us the fuel we need to recover from illness and injury.
“Good nutrition plays an important role in healthy ageing,” says Helen Cummins, a registered dietitian at the UCC School of Nursing. “A diet high in vegetables, fruits, wholegrains, lean meats such as chicken or turkey, fish, and dairy products is recommended for older adults to keep well.”
The right diet can help us avoid two common conditions of ageing: sarcopenia and osteoporosis. “Our muscles, which play an important role in movement and function, can become smaller in size and weaker with ageing,” says Aisling O’Grady, a senior dietitian at Cork University Hospital (CUH). “This is known as sarcopenia.”
It's not only muscles that change with age. “Osteoporosis, a condition characterised by low bone density which often results in fractures, is more prevalent in older adults,” continues O’Grady. “In recent years, some researchers have begun to focus on the co-existence of these two conditions, often referred to as osteo-sarcopenia.”
But there are a lot of steps you can take to keep these conditions at bay.
“Exercising and being mindful of the foods we eat are vital to maintaining good musculoskeletal health, minimising muscle loss, and maintaining healthy bones,” says O’Grady. “It’s what allows us to continue moving, walking, and carrying out the daily activities we enjoy.”
So, what foods should we be mindful of eating?
The average adult loses up to 8% of their muscle mass every decade after the age of 30. According to the Irish Nutrition and Dietetics Institute (INDI), protein can help us fight this by making new cells and keeping muscles healthy.
“Foods such as lean meats, eggs, dairy products, and plant-based sources like nuts, seeds, chickpeas, beans and lentils should be included in every meal,” says O’Grady.
Calcium and vitamin D are essential for bone health. Calcium helps to build and maintain bones while vitamin D helps the body to absorb calcium.
Calcium is found in milk, cheese, yogurt, fortified cereals, dark green leafy vegetables, and canned fish (be careful of the bones!).
However, getting enough vitamin D may require taking a supplement. “Ireland does not get a lot of sunshine, which is our main source of vitamin D,” says Cummins. “A small number of foods – oily fish, egg yolks, liver, and fortified foods – can provide us with some but it may not be enough for the amount we need for strong bones. Talk to your GP or pharmacist about taking a supplement.”
Ensuring we get enough fibre is another priority. “It’s important for preventing constipation,” says Cummins. “It can also help lower cholesterol and high blood pressure.”
The Irish Nutrition and Dietitics Institute says that 80% of Irish people do not eat enough fibre, with older people at particular risk of deficiency.
Cummins has tips for increasing fibre intake. “Eating fruit and vegetables at each meal is a good way,” she says. “You can always eat stewed or tinned versions if you have trouble with hard fruits and vegetables. Peas, beans, porridge, oat bran, high-fibre breakfast cereals, and wholemeal or wholegrain breads are good sources too.”
As we get older, it is common for our appetite to reduce. There are many possible reasons for this. We may be less active, which means we need fewer calories. Some of us might struggle with chewing or swallowing food.
“Older people may have conditions that require them to alter their diets or use medications which affect their appetite or disrupt the body’s ability to absorb or use nutrients,” says Cummins. “Some even end up malnourished, which is when the body is not getting all the nutrients it needs.”
According to research carried out in 2012, 145,000 people in Ireland are malnourished or at risk of malnutrition at any given time, with older people and those living in nursing homes at the greatest risk of all. This level of nutritional deficiency leads to increased infections, poor wound healing, and delayed recovery from injury and illness.
If our appetite declines but our nutritional needs remain the same, how do we avoid becoming malnourished?
“It can be challenging,” says O’Grady. “But eating little and often can help as can paying close attention to the foods we choose, aiming to get as much nutrition as possible in a smaller portion.”
She recommends adding additional nutrients to food. “Dietitians refer to this as food fortification,” she says. “For example, adding dried skimmed milk powder to milk can increase its energy and protein content. This milk can then be used when cooking.”
Cummins advises paying attention to fluid intake. “Drink between meals rather than just before or during,” she says. “That stops you from filling up too quickly.”
It’s important to pay close attention to fluid intake in general. As we age, the body is less able to recognise hunger and thirst signals, which can make us more prone to dehydration. Periods of illness and certain medication types can also increase our risk.
“Dehydration can cause constipation, dizziness, headaches, and fatigue,” says Cummins. “Aim for eight glasses of fluids each day but don’t fill up on too much tea or coffee as the caffeine can dehydrate you. The best options are milk and water.”
We should also keep an eye on our weight as we age. Many people lose weight unintentionally as they get older, especially after periods of illness or injury.
“This can indicate that your body is not getting enough nutrition to aid recovery,” says O’Grady. “When you are unwell, your body needs more nutrition to help you get better.”
It can also mean loss of muscle mass (sarcopenia). “We need to make every effort to prevent this decline,” says O’Grady. “This includes eating the right amounts of the right ingredients. It’s very important that you speak to a healthcare professional if you are losing weight. They will suggest ways of amending your diet to meet your specific nutritional needs.”
Failing to do so can be detrimental. “Not meeting your body’s needs can hinder your recovery and can lead to muscle loss, which can then affect your ability to move and function,” says O’Grady.
Protein is a key nutrient at this time. “Getting enough protein at each meal can help with wound healing in particular,” says Cummins.
Of course, this is easier said than done when you are ill, especially if you do not have much appetite. “Eat what you can when you can and drink plenty of fluids between meals,” says Cummins.
A high-protein drink may also be beneficial. “While we should all aim to get our nutrients from food, if you are experiencing a lack of appetite or if you have been losing weight, a protein-rich supplement drink might help,” says O’Grady. “Discuss this with a medical professional as it is important that the drink meets your specific needs.”
Cummins and O’Grady urge us all, no matter what age we are, to enjoy our food. “When it is once again safe to do so, try to eat in the company of others,” says Cummins. “We benefit not just from the actual eating of food but from the social aspect of eating it with family and friends.”
“Many of our favourite memories stem from sharing food those we love,” says O’Grady. “Mealtimes provide structure and routine to our day while dining with others can be an enjoyable part of our social lives.”
Should we take supplements to ensure that we are meeting all of our nutritional needs as we age?
1. The advice from dietitians is to aim to get as many of our nutrients as possible from the food we eat.
2. Eating a wide variety of fruits and vegetables as well as nuts and seeds will increase our intake of vitamins and minerals. It will also add fibre to our diet.
3. Wholegrain carbohydrates are also recommended as they take longer to break down and result in fewer fluctuations in blood sugar levels.
4. Lean meats such as chicken or turkey, fish, eggs, and dairy products as well as nuts, seeds, peas, beans, and pulses are all great sources of protein, which is one of the vital nutrients for healthy ageing.
5. If we are ill, losing weight, or suffering from a lack of appetite, a high-protein drink may be advised. It is important to seek the advice of a GP or pharmacist to discuss the best options.
6. Iron levels can fluctuate in old age. It is recommended that we get our levels tested regularly and take a supplement if advised to do so by a doctor.
7. A vitamin D supplement may also be required for bone health. We get most of our vitamin D from the sun but due to our temperate oceanic climate, many of us are deficient. The Department of Health now advises that adults aged 65 and older take a daily supplement of 15mgs of vitamin D to protect their bone and muscle health.