Macronutrient Requirements for Older Adults

Aging affects:
- Body weight decreases (or increases)
- Lean body mass decreases
- Body fat increases

Changes in the body influence nutrient metabolism and the nutrient requirements. Malnutrition is high; especially protein and micronutrient deficencies (vitamins and supplements).

Nutrition needs have to factor in:
- age related biological changes (body changes, illness, etc)
- socioeconomic changes (decrease money, living in nursing home with limited food options, etc)
- decreased food intake (not that hungry, food not appealing)
- sedentary lifestyle
- decrease in energy expenditure (weight gain from lack of exercise)

Nutrition Starting Point: Dietary Reference Intake Guide (DRI)
A fabulous site to utilize is the United States Department of Agriculture

The USDA has links for everyone and all sorts of food and health related topics. To access the DRI Table for people age 51+ please see the following link:

** Please keep in mind that Dietary Reference Intake (DRI) Tables are for HEALTHY people; those with medical conditions may need additional interpretation. **

Energy is physical activity and involuntary activity (respiratory/circulation/body functions). Energy is based on resting, physical activity, and food types. Energy comes from:
* Carbohydrates
* Protein
* Fat

Maintaining Weight
Food eaten = energy expelled

To monitor food intake and energy you can use the EER (Estimated Energy Requirement) tool. The US Department of Health and Human Services has an excellent site:

Please understand that "...older adults require less energy to MAINTAIN their weight, BUT their nutrient needs STAY THE SAME, and in some cases INCREASE." (Bernstein, 2010, pg 46)

A great indicator is to use the MyPyramid for older adults, it is different than the Food Guide Pyramid for younger adults.

The pyramid provides several options for exercise levels and food intake.

So many people want to cut carbs, STOP IT!! Carbs come from starch and fiber (complex carbs) and sugar (simple carbs). Carbohydrates provide energy to the brain and nervous system (incase you didn't know this.....the brain lives on 90% carbs which is why you feel brain-dead when you don't have enough).

Carbs are a VERY IMPORTANT part of the daily diet. Don't believe me? Check out this link and use Google to do some research of your own.

45-65% of daily diet should be carbohydrates

Examples of carbs:
- fruit
- vegetables
- legumes
- grains

See the following link for specifics (I am a huge fan of the Lance Armstrong foundation, they do great research!!):
Dietary fiber is the portion of the plant that we cannot break down (remember that age old saying about Celery being the colon's toothbrush? This is similar). Benefits to fiber:

* Relieves constipation
* Absorbs water, keeping our bodies hydrated longer
* Fiber moves slow through the body, helping the body to absorb nutrients better and manager our sugar intake - this is EXTREMELY BENEFICIAL for people who have Diabetes I or II.
** Appetite suppressant so be careful; people who are already too skinny or have an eating disorder should watch their fiber intake closely.

Recommended Amounts and Food Examples

Women: 50+ Men 50+
14 - 14.4g 17.5 - 18.5g

- Wheat bran
- Whole grain breads
- Cereal
- Vegetables

Fat is very important in the diet; without fat - fat soluble vitamins are not absorbed (Vitamins, A, D, E, K). Fat regulates the body's temperature (keeping you warm or cooling you off), fat acts as an insulator for your internal organs (reduces bruising and damaging), and fat is a hormone regulator. Our body's need fat in order to survive. When people talk about Good cholesterol vs Bad cholesterol here is what they are talking about.....

Good cholesterol makes hormones, retains vitamin D, and makes bile to help with digestion.

Saturated fat: 8-10% daily
(animal fat: butter, cheese, fatty meats)
Polyunsaturated fat 10% daily
(nuts and seeds)
Monounsaturated fat 10-15% daily
(oils: olive & canola)

How many people have seen this at the store.....? I know it's the milk I drink because I think it tastes better - well, that wonderful label (DHA-Omega 3) is beneficial to neurogrowth (brain development and maintenance), cardiovascular benefits, arthritis prevention and cancer fighting properties.

Essential fatty acids include Omega 6 and Omega 3 which come from FAT. Omega 6 comes from nuts and seeds and is the structure of your cells.

Dietary Recommendations:
Men 50+ Women 50+
14g 11g

Omega 3 also comes from nuts and seeds as well as fish and dairy products.
Dietary Recommendations:
Men 50+ Women 50+
.6 - 1.2 % .6 - 1.2%

Average adults eat more than enough protein; however, as we age our appetites decrease and we start to eat less and less food. There are not many studies out; however, the few studies that are out recommend a higher intake of protein as we age.

- 25-30g at EACH meal

Men 50+ Women 50+
56g+/daily 46g +/ daily

Protein combined with weight lifting and exercise has been shown to curb the loss of lean muscle and has even show to help add more lean muscle onto the body. It is recommended to eat protein from animal sources and not supplementation as eating from the source provides better nutrients:
Iron, B12, amino acids, and more nutrients are in meat than supplements.

Water is such a vital part of health. As we get older our thirst mechanism stops, our body stops sweating, and our kidneys are not able to hold onto as much water as before (hence the frequent bathroom trips as we age).

Men 50+ Women 50+
3.7L/day 2.7L/day

We lose fluid through the following avenues:
- Skin
- lungs
- kidneys
- GI tract
- Medications can dehydrate us as well

Water imbalance occurs:
- mental problems
- physical problems (can not get cup to mouth, shaky hands, etc)
- anorexia
- incontinence management (drinking less to pee less)
- hospitalizations
- severe weather changes
- stress

Indicators of dehydration:
- cracked lips - rapid weight loss
- sunken/dry eyes - need help drinking from cup
- trouble swallowing - confusion
- headache/dizzy - lethargy
- muscle weakness - falls

Nutrition is such a huge part of how we live, feel, and sustain our quality of life. Please remember to be empathetic towards others as you may not understand what they are going through. Thank you again for your time!

All information in this post is taken from the following school text book:
Bernstein, M & Schmidt-Luggen, A. "Nutrition for the Older Adult," 2010 by Jones and Bartlett Publishers, LLC

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