Elderly Nutrient Requirements Flashcards
Overall considerations for elderly nutrient requirements
Biases: Most studies on nutrient requirements have been carried out on young healthy adults
High heterogeneity of older adults
Different nutrient needs for <50, 51-70 and >70 year-olds
Energy requirements in elderly
Energy requirements ↓ but nutrient needs remain the same or increase
Lower kcal —> requires more nutrient dense diet + diversity
Same requirements in terms of kcal/kg FFM
↓ Energy requirements (↓ muscle mass –> ↓BMR)
Decreased physical activity plays a part
Protein requirements in elderly
No change in recommendation: 0.8 g/kg
Intakes of 1.0–1.5 g protein per kg of body weight per day recommended to improve micronutrient status and reduce frailty
Can be challenging to get enough protein: choose high BV protein and supplements if needed
Water requirements in elderly
Reduced intake proportional to reduced LBM
Physiological changes, medical status and mental status impact water intake
Dehydration is common due to: impaired thirst mechanism, decreased thermoregulation and diuretic meds
Vitamin D requirements
Increased vitamin D requirements > age 70 to 20 mcg (800 IU)
Based on amount to maintain 25(OH)D levels associated with bone health
Difficult to achieve - supplements recommended 1000-2000 IU
Vitamin D synthesis/conversion decreases, reduced sun exposure and poor diet intake
B12 requirements
Crystalline B12
Deficiency symptoms
No change in requirement but recommended change in intake to crystalline supplement form
Changes in GI function ↓ ability to digest animal protein bound B12 due to atrophic gastritis + low stomach acid secretion
Crystalline B12 retains bioavailability in atrophic gastritis and does not decrease with age
Deficiency can lead to changes in mental status, sensory disturbance and disability
Calcium requirements
Increased requirement to account for ↓ Ca absorption adding 200mg/d
For women > 51 and men > 70 years
Few people reach this: ↓ dairy intake –> osteoporosis concerns (HTN, colon cancer)
Increased intake ↓ bone loss and risk of fractures
Iron requirements
Requirements for post-menopausal women decrease to match mens
Deficiency not common but can occur with low meat intake over a long period of time, gastrointestinal bleeding, prolonged malabsorption, or because of medical conditions
Potassium requirements
No change to AI: highest median intake for men and women
Evidence was not sufficiently strong to use blood pressure as an indicator for establishing a potassium chronic disease risk reduction
