UTTARAKHAND VARISHTH NAGRIK KALYAN SAMITI

DIET FOR THE ELDERS – WHAT THEY NEED

What are nutritious food and a well-balanced diet?
Nutritious food is one that contains all the essential nutrients - proteins, fats, carbohydrates, vitamins and minerals. A well balanced diet should contain all these in correct proportions and adequate amounts. Proteins, fats and carbohydrates provide the energy required for various activities. Vitamins and minerals do not supply energy but play an important role in the regulation of several essential metabolic processes in the body.

Does the quantity of food that an elderly person eats matter?
The quality, not the quantity matters. The requirements of essential nutrients vary with age, sex, level of physical activity and the height & weight of the individual.  Even a simple diet can be nutritious.

For example 100 gm of wheat contains nearly 12 gm of protein, while the same quantity of rice has only 6.4 gm of protein. Similarly 100 gm of Ragi contains 344 mg of Calcium, while the same quantity of Rice has only 9 mg of Calcium.

Do elder people need less food?
The energy requirements of a person decrease with increase in age. This is because of a lowered basal metabolic rate and the reduced physical activity. Approximately there is a reduction of 8% per decade from the age of 55-75 yrs.

How important are Proteins to the elderly?
Proteins provide the essential Amino acids and the amount of Protein in the diet is an important measure of the adequacy and quality of the diet. The recommended quantity is one gm. per kg. body weight. In the elderly, up to 12 -14% of the total calories should be from proteins. But, due to decreased appetite and poor digestion, the elderly tend to consume less protein. Also, living alone means eating more carbohydrates which are easier to cook and less expensive.

How much of fat is allowed in the diet of the elderly?
Fat is a concentrated source of energy. It adds palatability to food. The diet should contain 30 - 40 gm of fat and half of it should be in the form of vegetable oil, rich in essential fatty acids. A diet with high content of saturated fatty acids (Ghee, Butter, Coconut oil, unrefined oils) tends to increase the level of cholesterol in the blood.

Are Carbohydrates necessary in an Elder's diet?
The body needs Carbohydrate because it cannot make it from other nutrients. The recommended quantity is minimum 100 gm per day.

What are the most important minerals needed for good health?

Calcium is very essential for an average elderly person. As people become older, the bones become demineralised. This is called Osteoporosis. So Calcium intake should be not less than 400 mg per day. Foods rich in calcium are Ragi, Green leafy vegetables, milk, fenugreek leaves, drumstick leaves and sea food.

Phosphorus, dietary fiber, drugs, alcohol, menopause, illness and exercise may all affect absorption of minerals in the body.

Iron deficiency leads to Anemia. So the diet of the elderly should contain sufficient amount of iron. Greens are rich in iron, cheaper than other vegetables and easily available most of the time. Elders should include some variety of greens in their diet everyday. Other foods rich in Iron are: Wheat flour, Ragi, Jaggery, Dates and Liver. The recommended daily quantity is 30 mg per day.

What are the Vitamins needed by the human body?
Vitamins are help in the utilising of major nutrients like protein, carbohydrate and fat in the body. They cannot be made in adequate quantities by the human body. So, they have to be present in the food that we eat. They are:
Vitamin A, D, E, K, C (ascorbic acid) and Vitamin B Complex (Thiamin -B1, Riboflavin, Niacin, Pyridoxine-B6, Biotin, Folate, Cobalamins- B12).

How important is it for the elderly to drink plenty of water?
The elderly do not recognise the need to maintain the volume of water excreted. The fluid intake should be at least 1.5 - 2 liters per day for a normal elderly person.

How important is Roughage or Dietary fiber in the diet for the elderly?
The elderly require sufficient fiber or roughage in their diet to avoid constipation. This fiber is the indigestible carbohydrate present in the food. Rough fiber is not well-tolerated by the intestine in old people. But, the tender fiber of vegetables, fruits and whole-grain cereals will encourage normal bowel movements. The elderly tend to use harmful laxatives and mineral oils. This should be substituted by a fiber-rich diet and adequate fluid intake. Some good sources of Dietary Fiber are: Ragi, Wheat, Italian Millet, Horse gram, Green leafy Vegetables, Plantain Stem, Drumstick, Bitter gourd, fruits like Dates, Figs, Guava, Wood Apple and Sweet Lime.

What is an ideal diet for the elderly?
The ideal diet of the elderly person should be wholesome and nutritious. It should have carbohydrates, proteins, fats, mineral & vitamins apart from dietary fiber. They should also take plenty of water. It does not matter whether it is a vegetarian or non-vegetarian diet. But they should be able to chew their food which could be easily digested.

Note: The Diet of the elders with high BP, high Cholesterol levels, heart disease, obesity or other problems should be altered as per the advice of the doctor.

Many elders do not have a full complement of teeth. What is the dietary advice for them?
People who have lost their teeth should try to wear artificial dentures. If the do not do so they begin to take liquid or semi-solid food. This decreases the nutritional value of their diet. Where there is a genuine difficulty in chewing, then the food can be chopped fine (vegetables). Some types of food can be put into a blender. Milk, Paneer, Egg-white, soft raw fruits like banana, papaya, cooked apples and fruit juices can be given. Well-cooked and minced chicken or well-cooked fish can be taken by non-vegetarians. Finely chopped raw vegetables and soups can be given. For those not suffering from a sugar problem, ice-creams, jellies and puddings can be given.

Which Diet is better - Vegetarian or Non-Vegetarian?
First of all, there are 5 different types of vegetarians.

1. Those who don't eat meat of some animals (e.g., Beef or meat of rabbit etc.) or some organs (e.g. Brain)
2. Those who eat only fish and dairy products
3. Those who don't eat meat or fish but will eat eggs and drink milk.
4. Those who do not eat meat or any animal product.
5. There are a few who do not eat anything but fruits.

Advantages of vegetarian foods are:

• They are easily chewable, especially for the elderly who have lost their teeth.
• Many elderly feel that vegetarian food is more easily digestible.
• Vegetarian foods are cheaper than non-vegetarian foods.
• Some vegetables can be eaten raw preventing the loss of nutrients while cooking.
• Vegetarian foods do not contain as much fat as non-vegetarian foods.

Vegetarians should take care to include Soya beans, groundnuts, lentils, mushrooms to get a sufficient supply of proteins.

Advantages of Non-Vegetarian foods are:

• Non-vegetarian foods are rich in protein of high biological value and in Vitamin B complex, especially B12 which is not available in plant foods.
• Fish, especially the small varieties are a rich source of calcium.
• Egg-white is good source of protein and easily digested. 

The incidence of high BP, Heart disease, Obesity and high cholesterol levels is found to be greater among non-vegetarians. Elders who suffer from these problems should reduce the intake of fleshy foods in their diet. Egg-white and most varieties of fish contain less fat, but are rich in protein, vitamins and minerals.

Vegetarian or non-vegetarian, the decision depends on various factors such as cultural or dietary habits of the family, personal preference, taste and avoidance of certain foods for health reasons. Whatever the case, a well-balanced diet supplying proteins, fats, carbohydrates, vitamins and minerals should be taken.