Older Adults

Why is nutrition important for older people?

Nutrition plays a crucial role in maintaining health, functional independence, and quality of life for older people. People who are aged 65 years and older are particularly at risk of not meeting their nutritional requirements so it is important for them to have a balanced diet.​

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A balanced diet can help:

• Maintain muscle mass, so older people can remain active and independent for as long as possible
• Maintain energy levels making daily life easier to manage
• Reduce the risk of infections and illnesses by keeping the immune system healthy
• Reduce the risk of falls
• Promote wound healing

How can a reduced dietary intake occur in older people?

As people get older there are many reasons why they may have a poor appetite and eat and drink less.

Reduced activity: Older people tend to be less active which means they use less energy each day, which in turn can lead to a reduced appetite. Spending some time outdoors in fresh air can help stimulate appetite.

Mental health: Depression and loneliness can lead to a reduced dietary intake. Eating alone at mealtimes can intensity feelings of loneliness and this may have a negative effect on health and wellbeing. Some illnesses such as dementia are more common in older people and can impact dietary intake as appetite reduces, tastes change and swallowing difficulties may develop. Specialist advice from a dietitian may be required. Dementia can cause reduced, taste changes and swallowing difficulties. Specialist advice from a dietitian or speech and language therapist may be required.​

Independence: A lack of independence as people get older can impact their dietary intake. Reliance on others for shopping can lead to someone eating the same foods each week. Being able to see what food options are available can stimulate an interest in food.

Medication: Many older people take a range of medications. Side effects from these can cause a reduced appetite. It is important not to stop taking a medication that has been prescribed, but GP or pharmacists can review medications if it is felt these are impacting food intake.

Specialist diet: As people get older they may develop dental issues such as poor teeth or ill-fitting dentures which can lead to difficulties chewing or swallowing. Management may include restricting certain foods previously enjoyed due to texture and may require a softer diet. Any swallowing difficulties should be discussed with a GP who can refer to a speech and language therapist for a swallowing assessment and specialist advice if required.​

How to help prevent and/or manage undernutrition in older people?

Unplanned weight loss can be a sign of malnutrition/undernutrition. If scales are not available, look out for other signs of weight loss such as clothes becoming loose or rings and jewellery no longer fitting.​ Many older people have tried to follow a healthy diet throughout their lives, but when malnutrition becomes a concern the normal guidelines for healthy eating don’t apply, and it may be necessary to adapt the diet to make sure energy intake is adequate.​

​ Increase energy intake:​

• Switch to full fat dairy products including milk, yoghurts, cheese and spreads​
• Try milky drinks such as hot chocolate, milky coffees, milkshakes or malt based drinks​
• Have a milk based pudding after lunch and evening meal such as custard, rice pudding or semolina​
• Eat little and often: aim for 3 small meals and 2-3 snacks per day
• Fortify foods by adding extra butter, milk, cream and cheese to every-day meals​
• Make the most of opportunities to eat in a social environment such as at community groups or with family and friends as this can encourage eating and drinking​
• Help to increase interest in food if an older person is unable to get to the shops, e.g. looking at supermarket websites​
• Try to base meals and snacks around foods that are preferred and enjoyed rather than aiming for a perfect balance every day. When we are presented with a food we love we are more inclined to eat it! 

Speak to your GP and ask for a referral to a dietitian if you are worried about malnutrition in yourself or someone you care for.

Ways to use Pro-Cal™ powder and/or Pro-Cal shot™ to increase nutritional intake:

Pro-Cal shot is a low volume, high energy oral nutritional supplement that can be taken in small amounts throughout the day to increase energy (calorie) and protein intake. One 120ml bottle of Pro-Cal shot contains 400kcals and 8g protein and it can be used in a variety of ways to increase nutritional intake in older people:​

• Add banana or strawberry flavour Pro-Cal shot to smoothies or milkshakes. Pro-Cal shot neutral flavour can be added to hot chocolate or milky coffees.​
• Boost the nutritional content of soups and puddings by adding neutral flavour Pro-Cal shot ​

Take Pro-Cal shot via a medicine cup in small doses spread throughout the day​ ​ Pro-Cal powder is a neutral tasting high energy powder that can be added to foods and drinks to boost their energy and protein content. Pro-Cal powder provides 100kcals and 2g protein in each 15g serving.​

• Add into yoghurts and puddings​ Sprinkle over moist meals such as mashed potato, casseroles and soups​
• Add to breakfast cereals like Weetabix, Ready Brek or Porridge​ ​

This piece was written in conjunction with a specialist dietitian from the UK.​

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Pro-Cal shot and Pro-Cal powder are Foods for Special Medical Purposes and must be used under medical supervision. Suitable from 3 years of age onwards. ​

Pro-Cal shot contains Milk (Milk Protein, Lactose) and Soya (Soya Lecithin). Pro-Cal powder contains Milk (Milk protein, lactose)

Top Tips to aid dietary intake in older people:

Eat little and often – small meals and snacks are easier to manage

Increase nutritional content of foods by adding extra butter, milk, cream and cheese

Take nutritional supplements as prescribed – these should be treated as importantly as medications. Set an alarm to remind you if required