Geriatric Nutrition

1. Nutrition in Old Age
Food biochemistry
Presented by:
Arijit Acharjee
FPB15015

2. Introduction
• Gerontology: The medical study of the ageing
process.
• Geriatrics: The study of diseases that afflict the
elderly.
• Geriatric nutrition: Nutrition for the elderly.

3. What is old age?
• Old age is best defined as age of retirement that is
60+ years and above.
• The organic process of ageing is called senescence.
• Ageing brings physiological, psychological and
immunological changes which influence the
nutritional status of a human being.

4. Physiological changes
• Loss of teeth
• Decreased Neuromuscular
coordination
• Impaired hearing and failing
vision.
• Anorexia.
• Change in body composition.
• Change in gastro-intestinal
tract.
• Change in cardiovascular
system.
• Change in respiratory function.
• Change in renal function.
• Change in skeletal tissue.

5. Changes in organ functions
• Decrease in sense of taste
and smell.
• Decrease in saliva secretion.
• Mouth and teeth problems.
• Swallowing difficulties
• Decrease in stomach
functions
• Decrease in function of liver
and gallbladder
• Decrease in function of
intestine.
• Decrease in function of
immune system.
• Decrease in the function of
nervous system.
• Energy metabolism.

6. Socio psychological changes
• Food habit.
• Economic aspects.
• Loneliness.
• Lack of nutritional knowledge.
• Depression.
• Anxiety.
• Loss of self esteem.
• Loss of independence.

7. Nutrition
• Prevention, retardation
and treatment of
diseases affiliated with
ageing.
• Adequate and balanced
nutrition is important with
respect to the
perpetuation of the

8. Nutritional requirements
• Energy
• Carbohydrate
• Protein
• Lipid
• Minerals
• Vitamins
• Fats
• Water
• Fibre
• Phytochemicals

9. Energy
• Energy requirement reduces.
• Reduced physical activity.
• Basal metabolic rate decreases(15-20%) due to reduced
muscle mass and other metabolically active tissue mass.
• Increase in fatty tissue.
Sex Sedentary Moderate
male 1883 kcal 2216 kcal
Female 1706 kcal 2007 kcal

10. Carbohydrate
• Requirement reduces.
• Impaired glucose intolerance can lead to hypoglycemia,
hyperglycemia, and type II diabetes mellitus.
• Insulin sensitivity can be enhanced by balance energy
intake, weight management and regular physical activity.
• 50 percent energy should derive from carbohydrate.

11. Protein
• Production of body organs.
• Restoration of cells.
• 1g = 4 calories
• Protection of body from external
effects.
• Facilitating recovery in conditions
of fracture.
• Protection and strengthening of
muscles.
• Development of resistance to
diseases by strengthening of the
immune system.
Foods
comprising
Protein
Protein
amounts
Leguminous
seeds
20-25g
Soya beans 30-35g
Meat,
chicken,fish
15-22g
Cheese 15-25g
Egg 12-13g
Cereals 8-12g
Milk 3-4g

12. Lipid
• Dementia and CVD may share risk factors like high
intake
of dietary intake & total fat.
• Emphasis should be placed on reducing the intake
of saturated fat and choosing mono saturated or
poly saturated fat sources.
• Sufficient intake of ω-3 fatty acids helps in visual
acuity, hair loss, tissue inflammation, improper
digestion, poor kidney function and mental
depression.

13. Fats
• Source of energy(1g=9 calories).
• Essential for production of some hormones which ensure
functions of the body.
• Omega 3 fatty acids reduce risk of heart attacks and
strengthen immune system and protect people from
depression.
• Fat sources:
 Milk and Yolk
 Meat

14. Fat requirements in old age
• Minimum 25% of daily energy intake should be provided
from fats.
• If not much limitations caused by diseases the amount to
be consumed is 35-40g.
• Half from vegetative liquid oils and the other half from olive
oil.
• Since too much causes obesity and cancer, cardiovascular
diseases, it is necessary to avoid excessive consumption.

15. Minerals
• Calcium: 800mg/day
• To compensate age related bone loss, to improve calcium
balance and to decrease prevalence of fracture.
• Ca absorption efficiency decreases, vitamin D level decreases so
need more Ca.
• Total food consumption decrease so Ca supplements needed.
• Iron: 30mg/day
• Deficiency is seen in elderly due to inadequate iron intake,
blood loss due to chronic disease or reduced non-heam iron
absorption. Vitamin C deficiency also reduce iron absorption.
• Mild anemia affect health due to less efficient circulation of
blood.
• Zinc
• Some features like delayed wound healing, decreased taste
sensitivity and anorexia are associated with zinc deficiency.
• But healthy elderly don’t show zinc deficiency.

16. Vitamins
• Low vitamin D levels- Parkinson disease.
• 200 mg of vitamin E to improve immune system.
• Calcium and vitamin D improves bone density and prevent fractures.
• Vitamin E, carotenoids and vitamin C enhances health of elderly.
• Vitamin C intake level of 150-250 mg/day to fight against cataract.
• Requirement of vitamin B6 increases due to atrophic gastritis.
• Deficiency of folic acid may result anemia and elevated serum homo-
cysteine level which is a risk for cardiac diseases.
• Vitamin B12 deficiency leads to pernicious anemia.

17. Water
• While 70% of the body is water in the adult
period, this amount decreases to 50% in elderly.
• Loss of 15% of body water cause loss of life.
• Helps in:
 Digestion, absoption, transportation of food
eaten.
 Operation of cells, tissues and organs
 Monitoring of body heat
 Slickness of the joints
 Removal of harmful substances from the body.

18. Fibre
• Prevention of overweight problems
• .
• Protection from intestinal cancer.
• Lowering blood cholesterol.
• Increases activities of intestine and prevention of
constipation.
• Regulation of blood sugar and protection from the diabetes.
• Sources: Legumes, grains, vegetables and fruits
• 25-30g of fibre consumption per day is sufficient.

19. Phytochemicals
• Chemical substances found in vegetables and
fruits have preventive features against health
problems. These substances are phytochemicals.

20. Nutrition related problems of the
elderly
• Obesity
• Malnutrition and Under nutrition.
• Osteoporosis
• Cardiovascular diseases
• Diabetes
• Cancer
• Hypertension
• Mental insufficiency,
• loss of memory, brain damage
• Constipation
• Immune system weakness

21. Principles of nutrition in old age period
• No. of daily meal should be regulated as 3 main and 3 interim
meals.
• High amount of fibre as legumes & wholegrain must be
consumed.
• 8-10 glasses of water (1500ml) should be consumed.
• High level of calcium should be consumed.
• Fish should be consumed atleast twice a week(omega 3 fatty
acids).
• Salt and sugar consumption should be limited.

22. Conclusion
• Healthy ageing begins from childhood
itself.
• Eat well to age well.
• Old age is second childhood-
Aristophanes

23. References
• http://beslenme.gov.tr/content/files/yayinlar/
ingilizce_yayinlar/books/yaslilik.pdf
• World Health Organisation-
http://www.who.int/en/
• Geriatric Nutrition- ebook by Tom Brody