Eating well as we age: How our diets should shift

Having a poor diet can damage a person mentally and physically, so good nutrition is essential at every age, but it's especially important for seniors, whose bodies are not as good at absorbing nutrients as they once were and who are at a higher risk for chronic conditions such as high blood pressure, diabetes, osteoporosis and heart disease.

"As we age, there are nutritional needs that shift," says registered dietitian Andrew Wade, co-owner of Case Specific Nutrition, a counseling service. As a result, certain foods and proper hydration become even more important.

Protein and B12

Among the trickiest changes to navigate is the increased need for protein. To prevent the loss of muscle mass and strength that occurs naturally with age, an older person requires roughly 50% more protein than a young adult, Wade said. The amino acids in protein also power up the body's immune functions, decreasing one's chance of getting sick.

But because people in their 70s or 80s typically move less throughout the day, and their metabolism slows down, they might not feel hungry, so it's difficult to consume enough. 

Vitamin B12 levels are also a concern because deficiencies can lead to a reduction of red blood cells. This can cause not only anemia,  but also neurological problems such as numbness or tingling in the hands and feet, vision problems and confusion. Along with age, certain medications can decrease absorption of vitamin B12.

Complicating factors  

Our digestive system slows as we age. So it's essential for seniors to get more fiber, says Wade. "It feeds gut bacteria and keeps things moving."

But even getting to that point can be difficult because older adults may have more trouble chewing or swallowing food because of dental issues or the loss of control of mouth and throat muscles following a stroke or conditions such as Parkinson's disease.

Seniors also are more apt to become dehydrated because they often just don't feel thirsty or fear incontinence; a UCLA School of Nursing study published in 2019 found that up to 40% of elderly people may be chronically underhydrated.

Also, our taste receptors start to break down as we age, resulting in diminished taste for most seniors. That can make food bland and unappetizing.

Some people develop problems gripping utensils, so assistance may be needed to cut food into small pieces. Also consider purchasing curved utensils or ones with fat handles made to solve such problems.

For those with chewing or swallowing issues, texture is key. Softer foods such as cottage cheese, milkshakes, smoothies, cereal and milk, oatmeal or mashed potatoes are good options, along with berries and fruit. So are eggs, which have the added benefit of providing protein.

"There's a lot going on," says Laura Ali, a registered dietitian and culinary nutritionist and author of "Mind Diet for Two," a cookbook focused on "brain healthy" foods.

Clues and conversations 

So how do you know if a senior you care about  is eating well??

For starters, it's important to have frequent and respectful conversations.

Simple questions — "How is your appetite?" or "What's in the fridge?"  — can give important clues.

To help with hydration, Ali recommends a refillable water bottle with time markers placed next to a chair or bed for easy access if the senior has mobility issues, or keeping a lightweight pitcher and cup handy. If they don't like plain water, add some fruit juice for flavor, or a squeeze of lime or lemon.

Small, consistent sips throughout the day are better than trying to chug several ounces in one (uncomfortable) fell swoop.

Providing ready access to fruits and vegetables with high water content, such as watermelon, cucumbers, lettuce and tomatoes, also can prevent dehydration, along with liquid foods such as soups and broths, Wade said.

Counting calories 

If you or a senior you care about is undereating, Ali says one solution is to figure out ways to concentrate calories and protein into smaller amounts of food. Adding a bit of powdered milk to a glass of milk or plate of scrambled eggs is a great way to add protein to a meal without changing taste. Five or six small meals throughout the day may work better than three squares. Regular exercise can also boost appetite.

Another strategy is  to start the day with one of the body's main sources of energy: carbohydrates. A simple breakfast of toast or a belVita breakfast biscuit is easy to digest and will get the appetite going, says Wade. If savory is your style, add a little peanut butter; if it's sweet, pair the toast with some jam.

Nutritional shakes like Ensure are easy to criticize because they have very little protein and a lot of sugar, notes Wade, but they are a source of calories that are intentionally filling. 

"It's not right for everybody," Wade said, but it can be  "a tool in the toolbox."

When it comes to adding protein, both animal sources (lean meats, fish, poultry, eggs, dairy) and plant sources (tofu, lentils, chickpeas, beans, quinoa) will work their magic. Vitamin B12 is also found naturally in foods like meat, eggs and dairy products, and seafood; good sources of fiber include beans, whole grains, brown rice and popcorn.