Over 65s in Ireland urged to eat ‘more meat and dairy’, but told ‘no drinking tea during meals’
Written by the FSAI’s Scientific Committee at the request of the Department of Health for scientific advice, the report said it provides comprehensive food-based dietary recommendations that, as part of an overall lifestyle approach, enable people over 65 live life optimally to their individual potential.
The report said the over 65s need ‘high quality proteins to stimulate muscle protein’ and recommended that healthy older adults eat a more protein-dense diet consisting of foods such as meat poultry, fish, dairy and eggs.
Older adults at risk of ‘low intake’ dehydration need adequate amount of drinks, it added. Women, it said, need 1.6 litres and males 2 litres per day. However, the report added that “strong tea should only be consumed between meals and not during meals, as it interferes with absorption of iron and zinc”.
Zinc deficiency is likely to be common in older adults, particularly those who are dependent on residential care. The prevalence of iron deficiency, meanwhile, increases with age, particularly among those in residential care and those aged over 80 years. Even mild deficiency causes increased ill health and mortality. Iron and zinc needs are best met through meat intake, said the report.
Low status of vitamin B12 is also of particular concern in older adults, added the report, as it is associated with age-related atrophic gastritis and/or use of proton pump inhibitor (PPI) drugs.
Vitamin B6 status is typically lower in older adults compared to younger adults too and is associated with a decline in immune function with advancing age.
Improved B vitamin status is associated with better health outcomes in older adults and consideration should be given to increasing current levels of fortification in order to optimise status, the report recommended.
Ageing consumer market 'a massive opportunity' for the food industry
Over 65s are the fastest growing age group in Ireland, having increased by 19% in the 2016 census to some 630,800 people (13.8% of total population), with expected ongoing increases to a predicted 1.6 million older citizens by 2051.
In Europe as a whole, the population of over 65s is expected to reach almost 150 million by 2050, and the food industry is keen to explore what are the specific needs of what is a rapidly expanding, and often affluent, consumer group.
The number of new products launched that cater to ‘silver surfers’ and ‘baby boomers’, however, pales in comparison to NDP targeting younger cohorts. Meanwhile, with the over-60s often reporting feeling increasingly overlooked and useless as they age, according to a World Health Organisation report, many experts believe the food industry could make better use of older role models in marketing and advertising.
The FSAI report said that in general, dietary intake goals for older adults are similar to those for the general adult population, but particular nutritional issues relating to ageing, such as the need for a more protein-dense diet to prevent frailty, require more specific food-based dietary guidelines.
Other matters associated with advancing age, such as decreased mobility, frailty and possible dependence on residential care, must also be specifically addressed in dietary recommendations. The 10 nutrients examined with a full set of recommendations are protein, carbohydrate, fibre, fat, B vitamins (folate, vitamin B12, vitamin B6 and riboflavin), vitamin C, vitamin D, calcium, iron and zinc.
Key recommendations from the report include:
- Older adults who are obese with weight-related health problems should receive individual intervention to ensure weight reduction undertaken is beneficial and minimises loss of muscle tissue (slow weight loss with physical activity). Lower risk older adults who are overweight are advised to avoid weight-loss diets in order to prevent loss of muscle mass.
- Older adults at risk of ‘low intake’ dehydration need adequate amount of drinks. Women need 1.6ltrs and males 2ltrs per day (unless a clinical condition to require fluid restriction).
- Strong tea should only be consumed between meals and not during meals, as it interferes with absorption of iron and zinc.
- Sense of taste diminishes with age and can lead to increased salt intake; therefore, consumption of salty foods should be avoided and alternatives such as herbs and spices can be used to increase flavour.
- High quality proteins to stimulate muscle protein: Healthy older adults should eat a more protein-dense diet – foods such as meat poultry, fish, dairy and eggs, and, to a lesser extent, beans, peas, lentils and nuts.
- Adequate calorie intake to prevent development of frailty, muscle loss (sarcopenia) and undernutrition.
- Diets should contain high fibre carbohydrates, but low in free sugars. The average intake of carbohydrates are at the lower end of recommended consumption range whilst one third of older people exceed recommended free sugar intake.
- A daily 15 µg vitamin D supplement is now recommended by the Department of Health for all older adults in Ireland. This report provides specific details on the range of dietary intake recommended for vitamin D in older adults, which vary according to ability to obtain some of this vitamin from sunlight exposure.
- Fortified foods are a good source of B vitamins (B12, folate, B6 and riboflavin) and vitamin D; whilst unsweetened orange juice, salads, fruit and vegetables are reliable daily food sources of vitamin C.
- Consumption of salty foods (cured and processed meats, savoury snacks, soups, sauces, some cheeses, anchovies, olives, etc.) and the addition of salt to foods during cooking and at the table should be limited.
- Use of salt substitutes at the table should be discouraged because of the: • Very high potassium content, which is contraindicated in older adults with kidney disease (this is common, as it is associated with ageing)
- Research is needed into the effects of ageing on iron absorption in the gut since poor absorption in the gut may be a more important factor affecting iron status than the amount of iron in the diet.
- Sense of taste diminishes with age, which leads to increased salt intake. Use of salt substitutes at the table should be discouraged because of the very high potassium content, which is contraindicated in older adults with kidney disease (this is common, as it is associated with ageing).
FSAI Chief Executive Dr Pamela Byrne stated that it was important to ensure robust science underpins the development of food-based dietary guidelines that include healthy eating and nutritional recommendations tailored specifically for this cohort.
“This report sets out a number of science-based recommendations that will underpin national guidelines being prepared by the Department of Health, to support optimal nutritional status and health of older adults in Ireland. Due to considerable variations in the ageing process, food-based dietary guidelines are best tailored to functional capacity rather than chronological age,” she said.
Ita Saul, Chair of the FSAI’s Public Health Nutrition Subcommittee, added there is a noticeable difference in functional ability of older adults alive today compared even with 30 years ago, and it is common sense to support older people living healthy productive lives through health strategies based on changing nutritional needs as we all get older.
“On retirement, people in good health can look forward to entering the ‘golden years’ of their third age, filled with many possibilities and interests. The preservation of muscle mass and skeletal strength are both critical to maintaining functional autonomy and independence as we get older. This report looks at the positive role nutritional intake can have in this population group to enable them to live life, and to live it to the full,” she said.