Age-related decline in bodily functions, organs and tissues of the body, is a natural process and accelerates with each passing decade. This decline causes several challenges that prevent seniors from getting the same quality and quantity of nutrition that they did before. In such a scenario, it is important for seniors to modify their diet, and be constantly mindful of what they are consuming. Such modifications will ensure the senior is getting adequate nutrition which goes a long way in preventing hypertension, type-2 diabetes, cardiovascular conditions, osteoporosis and even some cancers.

Nutritional Challenges brought about by age

Calories: With age, the body needs fewer calories to maintain a healthy weight. Consuming more calories then, leads to weight gain. This is especially true of women who have crossed menopause as decline in estrogen levels causes more fat to be more stored in the belly. Weight-gain leads to fatigue, joint problems, pain, inactivity and indifference to everything including a healthy diet.

Muscle loss: Atrophy of muscles leads to muscle-loss or decline in muscle-strength, a condition called as sarcopenia. Muscle-loss induces pain and hence reduced activity. This reduces the need for more calories. In the process, the elder may compromise on his/her nutrition.

Appetite: With advancing age, the sense of smell and taste start diminishing. This is nature’s way of protecting seniors against overeating and hence weight-gain. The natural outcome of this is that appetite reduces and seniors eat lesser than usual. In the process, the senior does not get adequate nutrition which is required for good health of bones, muscles and organs. Further, some elders become sensitive to pepper, onion, garlic, spicy food and dairy products. The need to cut out such foods from their diet further drives down appetite.

Medical Conditions: Existing medical conditions automatically put restrictions on the diet. While diabetics must watch their sugar or carbohydrate intake, people with hypertension must consume less salt. So also, people with osteoporosis and cholesterol issues must consume a low-fat diet. All these further drive down appetite and self-care when it comes to nutrition. While in reality, people suffering from all such conditions should be eating food rich in fiber, minerals and vitamins, but low on sugar, salt, carbs, saturated-fats and trans-fats. So also, conditions like Parkinson’s makes eating a complete meal a challenge, so the elder or his/her caregiver may compromise on his/her nutrition at times.

Medications: Some of the medications being taken to manage certain health conditions can affect the appetite and also interfere with the absorption of certain vitamins and minerals. While most doctors will advise the patient on how to overcome this situation (generally through supplements), not being aware of the same can compromise the elder’s nutrition.

Oral Health: Loss of teeth, cavities, infections in the mouth and gum issues all lead to anxiety in the elder who starts avoiding food now. This can lead to malnutrition eventually. Even dentures that don’t fit properly can cause elders to skip meals once in a while.

Also Read: South Indian Diet Plan for Heart Patients

Immune System: With age, immunity starts reducing, so the risk of infections, food poisoning, food-borne illness and diarrhea increases. The elder will be advised on foods to avoid or consume in moderation. Not following these guidelines with discipline can increase the risk of illness and subsequent malnutrition.

Thinning skin: With age, skin starts thinning down. This means, the ability of the body to make Vitamin-D from sunshine, reduces. In the process, the elder does not get enough Vitamin-D, so it has to be augmented through diet and supplements.

Less stomach acid: Many elders suffer from atrophic gastritis which cause chronic inflammation of cells in the stomach that produce stomach-acid. As a result, elders have lesser stomach-acid than younger people. This means, they are less capable of absorbing calcium, magnesium, iron and Vitamin B12 from the food, so the same must be taken as supplements. Not being aware of this challenge can cause the elder to be deficient in these nutrients.

Mental health: In case the elder has mental-health issues such as depression or dementia, or still worse Alzheimer’s, having a nutritious meal may not appear like a priority to him/her. When in reality, a nutritious diet can overcome the condition to a good extent or manage symptoms better.

Home Life: With the break-up of the joint-family system, many elderly couples live on their own. Some of them have lost their spouse and are either living alone or in retirement communities (old-age homes). Living or being alone can make some elders indifferent to food, nutrition and the hassle of cooking, while at retirement communities, one may not get adjusted to the food. All this can compromise nutrition over a period of time.

Diet Recommendations

So what should elders be eating or drinking daily for optimum nutrition?

Choice of protein: Adequate protein helps fight muscle-loss or sarcopenia. With advancing age, it is best to limit, or avoid red-meat altogether. Red-meat is rich in saturated fat and low on fiber, and is known to increase the risk of colorectal cancers. A better choice would be lean-meat such as poultry, seafood and fish. Vegetarians could benefit from eggs, low-fat dairy, and a wide range of beans, lentils and legumes.

Quality of carbs: Carbs provide energy and are important for sustenance. However, as mentioned above, elders need lesser calories, so a carb-heavy diet can cause weight-gain over time. It is advisable to eat smaller and more frequent meals as against larger, and fewer meals. Whole-grains like wheat, brown-rice and millets are advisable, while refined flour (maida) must be completely avoided.

Sugar: Refined sugar must be avoided as far as possible, and it’s better to use cane-jaggery, palm-jaggery and sugar-candy for sweetening sweet-dishes as well as milk, coffee and tea. Fruits are a rich source of fiber and innumerable vitamins and minerals. However, they are rich in fructose, so one must avoid splurging or indulging in fruits. A fruit-heavy diet must be avoided. Diabetic elders may have more restrictions and must follow their doctor’s instructions.

Healthy fats: Healthy fats include ghee (clarified butter), olive oil, groundnut oil, mustard oil, canola oil, flaxseed oil and soyabean oil. Butter, cream, cheese, mayonnaise and high-fat versions of paneer (cottage cheese) and yoghurt must be completely avoided. Low-fat versions of paneer and yoghurt are perfectly fine.

Fiber: A good quantum of fiber helps elimination, fights constipation and prevents weight-gain. The fiber must come from a wide variety of fruits and vegetables in different colors, whole grains and whole nuts. The different colors and array of fresh produce ensure you are getting a healthy dose of required minerals and vitamins.

Vitamins and minerals: As above. In addition to fresh produce, lean-meat, low-fat dairy, fish and seafood also provide a certain quantity of vitamins and minerals. All this ensures you have a balanced and nutritious meal.

Beverages: Fresh fruit juice, low-fat milk and a wide range of soups should be the first choice of elders as they replenish lost water along with providing vitamins and minerals. Tea and coffee must be consumed in moderation (2 to 3 glasses a day) as they have a diuretic effect and remove water from the body.

Salt and Spice: As one ages, it is good to tone-down spice in the food as it can lead to acidity, indigestion and GERD (gastro-esophageal reflux disease) which manifests as heart-burn and acid-reflux. Salt must be consumed in moderation as excess sodium can retain water in the body and lead to weight-gain. If the reduced salt and spice in the body makes the food bland, one can increase taste by adding some herbs, grated coconut, lemon juice, nuts and seeds in the dish.

Snacking: Snacks usually imply deep-fried food, refined flours, saturated-fats and trans-fats. It is best to cut down such snacks altogether as they will undo all the good work done by following a healthy diet. If one is habituated to eating snacks, try dry-fruits like almonds, walnuts, pistachios, fresh fruits, and baked vs fried foods, instead.

Water: With age, thirst-receptors which are present all over the body start declining in function. The elder may not feel thirst like before. This increases the risk of dehydration or low water-consumption which creates many health issues. Elders should religiously drink 8 to10 glasses of plain-water a day. Or fewer glasses of water, as long as he/she is consuming enough beverages (listed above).

Also Read: Planning A South Indian Diabetic Friendly Diet

The South Indian diet

All the above restrictions remind us of the South-Indian diet.

• Generally, the South Indian diet is light on red-meat like beef and pork, while mutton and lean meat such as poultry, fish and seafood are more preferred. It is also common to find South-Indians avoiding certain meats on certain days of the week or month for religious or health reasons.
• When it comes to carbs, rice and millets are more preferred than wheat which contains gluten.
• Also, vegetarian South-Indians consume a wide variety of fruits and vegetables.
• Probiotics like yoghurt and its diluted form – buttermilk are consumed all the time, which improves digestion and gut-health.
• Use of cream, butter, cheese and mayonnaise is very rare.
• Soups (rasam) are a daily affair, while tender coconut is a popular beverage in the summer. •Curries like sambar are rich in lentils and fresh vegetables. Even the spices used in rasam and sambhar, such as jeera, ajwain, coriander seeds, methi seeds etc., have their own health benefits.
• Urad dal which has the highest protein content among all lentils, is invariably used in snacks such as idli, dosa and medu-vada.

So if you are an elderly South-Indian, who follows such a diet, no worries, your nutrition is already ensured. People from other parts of India, or the world, can experiment with a South-Indian diet, one or 2 days of the week, to derive its benefits, while they must follow the above guidelines on other days of the week.

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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