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When it comes to health for the ageing population, malnutrition is an often overlooked area.
In fact, malnutrition, which includes under-nutrition as well as over-nutrition, is commonly found in the elderly population and must be addressed to promote the well-being of our senior citizens.
According to the 2015 National Health and Morbidity Survey (NHMS), 4%-11% of Malaysian adults aged 65 years and above were found to be underweight (body mass index, BMI, less than 18.5), a majority of whom were aged 75 and above.
On the other hand, the prevalence of overweight (BMI of 25 to 30), obesity (BMI of 30 and above) and abdominal obesity (waist circumference more than 90cm for men and more than 80cm for women) among Malaysian adults 65 years and above ranged from 27% to 36%, 6% to 17% and 57% to 64% respectively.
Unfortunately, malnutrition among the elderly is also often coupled with diet-related chronic diseases or non-communicable diseases (NCDs) such as diabetes mellitus, hypertension and hypercholesterolaemia.
These chronic conditions, along with body composition changes such as loss of bone density and changes in the digestive system affecting nutrient absorption and digestion, can increase the risk for malnutrition.
Against this backdrop, it is all the more crucial to ensure healthy food consumption and a balanced lifestyle in our golden years.
Nutrition should be given due attention as it plays an important role in helping the elderly tackle or lessen the effects of age-related diseases.
As we age, we need to be more mindful about healthy dietary practices and lifestyle. Here are a few simple ways:
1. Practice a balanced, moderate and varied diet. Use the Malaysian Food Pyramid and My Plate as guides.
The Malaysian Healthy Plate emphasizes that one quarter of your plate should be from the cereals and grains group, another quarter from the meats, fish and legumes group, while half the plate should consist of vegetables and fruits.
2. Consume more whole grains such as unpolished rice, oats and wholemeal bread in your daily diet.
3. Eat plenty and a variety of fruits and vegetables daily.
4. Limit fats, oil, salt and sauces in foods, and sugar in drinks.
5. Drink at least eight glasses of plain water daily.
6. Be physically active and include various types of activities that promote flexibility (stretches), balance (e.g. taichi), strength training (use light weights) and aerobic exercise (e.g. walking).
In addition, the elderly should pay attention to the following six important nutrients essential for a healthier ageing process. They are:
1. Dietary fibre – As an individual approaches senior citizenship, a diet consisting of fibre will aid regular bowel movement and decrease the risk of constipation. This will also reduce the risk of chronic diseases and conditions.
Some examples of foods with fibre are whole grains, legumes, fruits and vegetables. It is recommended to consume a serving of 20g–30g dietary fibre per day.
2. Calcium and vitamin D – Calcium is important for bone health and helps in reducing the risk of skeletal fractures, particularly among the elderly.
On the other hand, vitamin D is said to be associated with reduced risk of chronic diseases such as diabetes mellitus, cancer, cardiovascular disease and metabolic syndrome.
Some examples of foods rich in calcium are milk and milk products, broccoli, kale and sardine.
Good sources of vitamin D are milk and milk products, eggs and sunlight. The recommended consumption is 1,200mg calcium per day and 20μg vitamin D per day.
3. Iron and vitamin B12 – Iron and vitamin B12 are often deficient in older individuals due to poor absorption.
They are important nutrients as iron helps to transport oxygen around the body, while vitamin B12 facilitates red blood cell formation for a healthy brain and nervous system.
Food sources for iron include meats, spinach and beans, while vitamin B12 can be obtained from egg yolks, milk and milk products, and meat and poultry.
It is recommended to have 11-14mg iron per day and 4μg vitamin B12 per day.
4. Water – Without a doubt, water provides vital nutrients for everyone.
Particularly for the elderly, water is important as they are prone to dehydration due to an impaired thirst mechanism. Serious cases of dehydration can lead to hypernatremia (high sodium level in the blood).
Additionally, the elderly also face a tendency to restrict water intake due to urinary incontinence, or the fact that some older persons may not want to be awakened for night-time urination.
Nonetheless, it is recommended to consume eight glasses of water per day.
Besides these important nutrients, the elderly can also include probiotics in their daily diet for gut health. This is beneficial for the elderly as they often experience poor digestion and absorption of nutrients, and a decline in immunity.
Probiotics are good and friendly bacteria for the gut and can be obtained from sources such as cultured milk drinks, yogurt and kimchi.
Meanwhile, most prebiotics are dietary fibre, which serve as food for good gut bacteria and can be obtained from bananas, garlic, leeks, onions and shallots.
In summary, a nutritious and well-balanced diet comprising of a wide range of foods is necessary for a healthy ageing experience.
An active lifestyle that includes daily exercise cannot be avoided to ensure your body remains well-functioning and energetic even while you are advanced in years.