Improving nutrition to support healthy ageing: what are the opportunities for intervention?

Abstract

Alongside declining activity levels, energy needs fall in older age and eating less is expected. However, as total food consumption declines, intakes of many nutrients are also likely to fall; while energy requirements may be met, other nutrient needs may not. Although this highlights the importance of nutrient-dense foods and overall diet quality in older age to ensure nutrient intakes are sufficient, maintaining or increasing diet quality may be difficult at a time when food access and preparation are becoming more challenging, and diets may be more monotonous. Poor nutrition, even in developed settings, is common. Older malnourished adults are more likely to have poorer health outcomes, longer hospital stays and increased mortality. Thus, apart from the evident personal costs, the economic burden of disease-related malnutrition is significant, and effective preventive strategies to promote good nutrition among older populations are needed. In particular, there is a need for wider recognition of malnutrition risk among older adults, including implementation of routine screening of nutritional status and early diagnosis. Design of future interventions to support older community-dwelling adults requires a clear understanding of the personal and contextual influences that affect patterns of food choice and consumption, including consideration of the importance of social and psychological factors. In addition, there are opportunities to intervene earlier in the lifecourse; the most effective preventive efforts to promote good nutrition in older age may need to start ahead of age-related changes in physiology and function, including younger adulthood and at the retirement transition.

Keywords: Ageing; Lifecourse; Nutrition; Prevention.

Figure 1

Factors with positive and negative influences on nutritional health, including lack of social interaction, economic factors leading to food insecurity, as well as age-related physiological changes, such as loss of appetite. From Shlisky et al(3).

Figure 2

Hypothetical model of the relationships between themes and potential routes to impact on diet quality in older age. From Bloom et al(37).

Figure 3

Diet quality scores (‘prudent’ dietary pattern(8)) at baseline and 10-year follow-up, according to participation in leisure activities (social and cognitive) at baseline, among older men and women in the Hertfordshire Cohort Study(13). Values are mean (95% confidence interval).