Nutrition plays a significant role in maintaining the health of older adults. Ensuring adequate dietary intake can help enhance quality of life, reduce chronic diseaseriskand increase longevity.1-3
Older Australians are faced with a range of issues that can affect their food intake, including a reduction in appetite. At the sametimethey are faced with age-related changes in body composition and functioning, for example loss of muscle mass and decreased mineral absorption which in turn may increase their nutrient requirements. In the2017-18NationalHealth Survey4, older Australians generally rated themselves as having poorer health than younger people, withonly 37% ofpersonsaged 75 years and over rating their health as being excellent or very good4.In addition,the leading causes ofdeath in Australians aged 65years and overare due tocardiovascular disease,canceror dementia,alllinked to dietand lifestyle.5
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- Physiological Changes
- Body Composition Changes and Protein Intake
- Contribution to RDIs of One Serve of Eggs in Older Australians
- Health Issues
- Conclusion
- Social Media Resources
- Useful Resources
- FAQs
- Video Resources
Food & Nutrition Issues
The2011-2012National Nutrition & Physical Activity Survey (NNPAS)6 provides a snapshot of food and nutrient intakes across Australians of all ages.
Results of the survey, suggest older Australians are:
- More likely to meet vegetable intake recommendations compared to younger adults (6% vs 3%)
- More likely to meet fruit intake recommendations compared to younger adults (30% vs 23%)
- Less likely to meet dairy and alternatives intake recommendations compared to younger adults (3% vs 10%)
- More likely to meet lean meat and alternatives intake recommendations compared to younger adults (29% vs 11%)
Older males (24%) are less likely and older females (39%) more likely to meet grain intake recommendations compared to younger adults (35% younger males and 8% younger females)These results tend to reflect the changes in food group recommendations for this age group (i.e.increased number of dairy serves and decreased number of lean meat and grain serves are recommended for 51-70 and 71+ age groups) but nevertheless highlight where older Australians need to improve their intakes.In addition, those aged 51-70 years were most likely to report being on a special diet, such as a weight loss diet, low fat, salt or sugar or a high fibre diet.
When it comes to individual nutrients, on averageolder Australiansfail to meetthe estimated average requirement (EAR) for protein,vitamin B2 (riboflavin), vitamin B6, calcium, magnesium, selenium andzinc.6Other research studies have suggested that older Australians mayalsobe at risk of vitamin D and vitamin B12 deficiencies.7,8,9Recent researchinAustralianolder adultsfoundthat8% ofhospitalisationsfor falls and almost 8 % ofhospitalisationsfor hip fractures were attributable to vitamin D deficiency, showing thepotential consequences of inadequacy.10
In addition, older adults have the highest risk ofanaemiaaccording to the 2011-12 Australian HealthSurvey11, with rates rapidly increasing after the age of 65 years. Given the higher risk of nutritional deficiencies in older adults, consuming nutrient rich foods becomes an even higher priority.
Physiological Changes
Age-related physiological changes such as decreased immune function, increase in oxidative stress, decreased mineral absorption, decreased gastric acid production and other changes in the gastrointestinal tract canincrease the requirements for vitamins B6, B12, E, C, D, folic acid, zinc, calcium, iron andcarotenoids.12,13Reduced salivary flow, difficulty in swallowing, poor dentition and reduced appetite can also impair the nutritional status of older adults due to decreased foodintake.13 For example, anAustralian study found those with lower chewing ability had lower compliance with dietary guidelines in relation tofibre, sugar, fat andsalt.14Given these physiological changes, older adults may require softer textured, high nutrient content foods to enable them to obtain sufficient nutritional value from the foods they are able to eat.
Body Composition Changes and Protein Intake
Body composition also changes with age, with a particularly notable reduction in skeletal muscle mass (sarcopenia) and other body proteins such as organ tissue, blood cells and immune factors.13
Ensuring adequate protein intake is particularly important to address these changes. The current Australian protein RDI for adults aged 70 years and over (81g protein/ day for men and 57g for women)15 is around 25% higher than the protein needs of younger adults due to increased protein requirements with age.Recommendations to slow theage-relatedloss of skeletal muscle mass were released by the European Society for Clinical Nutrition and Metabolism (ESPEN) in2014.16
In healthy older adults the diet should provide at least 1.0–1.2 g protein/kg body weight/day
- In older adults who are malnourished or at risk of malnutrition due to acute or chronic illness, the diet should provide 1.2–1.5 g protein/kg body weight/day
In conjunction with adequate protein intake, daily physicalactivityor exercise (resistance training, aerobic exercise) should be undertaken by all older people, for as long as possible.
Table 1 shows the contribution of one serve* of eggs towards the vitamin and mineral RDIs for older Australians. Egg consumption data from the Australian Bureau of Statistics shows 17.9% of adults aged 71 years and over consumed eggs and egg dishes on the day prior to theinterview.17 Eggs can play a role in meeting the vitamin and mineral requirements of older adults.
Table 1: Contribution to RDIs of One Serve of Eggs in Older Australians
Nutrient | % RDI 9 for ages 70+ |
Protein | 16-22% |
Long-chain Omega-3s | 71-127% adequate intake (AI) |
Selenium | 41-48% |
Vitamin B12 | 12% |
Iodine | 29% |
Iron | 21% |
Vitamin A | 11-14% |
Folate | 24% |
Vitamin E | 20-28% |
Vitamin D | 54% AI |
Zinc | 7-12% |
Health Issues
Overweight, high blood pressure and high cholesterol are significant health issues that affect older adults and are risk factors for chronic diseases such as Type 2 diabetes and heart disease. Overweight and obesity rates peak in people aged 65-74 years with78% being overweight orobese.4 Type 2 diabetes occurs in 17% of individuals over the age of 75years.18 High blood pressure is also a risk factor for stroke, with 46.2% of those aged 65 years and over diagnosed with high bloodpressure.19 Nearly half of adults aged 55-64 years have high total cholesterollevels.20 To find out more about eggs and cholesterol click here.
Another relevant health issue for older adults is eye health.There is evidence thatgood nutrition includingvitamin A, antioxidants(lutein and zeaxanthin), omega-3 fatsand zincplay a role in maintaining eye health.21-23In particular,mounting21evidenceindicatesa role for omega 3 fatty acids and lutein and zeaxanthin in the prevention of age-related maculardegeneration.24-26Eggs provide bioavailable vitamin A, omega 3 fatty acids, the antioxidants lutein and zeaxanthinandselenium. For further details, refer to ENC’s Eggs and Eye Health statement.
Conclusion
Due to the variety of nutrients found in eggs, they are an ideal food to include in the diets of older adults. They are also economical, easilypreparedand soft in texture which makes them appropriate for people of this age group. Eggs are recommended as part of a healthy eating pattern that also includes adequate amounts of wholegrain breads and cereals, fruits, vegetables, dairy foods, lean meat, fish and poultry and unsaturated fats.
This statement is for healthcare professionals only.
*One serve = 2x60g eggs (104g edible portion)
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