Nutrition for older people

•Energy (calories)•The major nutrients

•Protein – dispelling the ‘protein myth’•Fat – omega-3 for vegetarians/vegans•Fibre

•Vitamins and minerals to take care about in a care setting

ProteinA comparison of the protein content of meat and vegetarian foods

Meat product Protein content in grams

Vegetarian food Protein content in grams

Small beef burger 10.2 Baked beans, ½ can11.5

Three fish sticks 12.1 Pasta, average serving

 8.5

Kidney beans, average serving

12.4

Peanuts, small packet

6.1

Fat: omega-3

Older people of all ages need omega-3 fat in their diet.

Of course vegetarians don’t eat fish or fish oils so they can’t get omega-3 from them.

Omega-3 fat – why?

•Protection against heart disease (important for people who’ve had a heart attack).

•Can relieve rheumatoid arthritis (swollen and tender joints, grip strength and mobility).

Omega-3 fat – why?

•Eye health

•Preventing mental decline

•Immune function

Omega-3 fat – where?Omega-3 fats 1 daily portion is...

Flaxseed (linseed) oil 1 teaspoon

Ground flaxseeds (linseeds) 1½ tablespoons

Hempseed oil 1 tablespoon

Rapeseed (vegetable) oil 1½ tablespoons

Walnuts 8 halves/28g/1oz

Hempseed 5 tablespoons

Fibre

Can help to prevent:-constipation - heart disease-diabetes - some cancers

But if people have a poor appetite, bulky foods can stop them getting all the nutrients they need.

Fibre

Good sources are wholegrain foods: wholemeal bread, pasta and cereals, brown rice, peas, beans and lentils, and fruits and vegetables.

Shouldn’t need extra bran.

Vitamins and minerals

Older people are less able to digest, absorb, use and excrete vitamins and minerals.

According to a national survey, older people living in institutions may have low intakes or low blood levels of certain vitamins and minerals.

National Diet and Nutrition SurveyNutrient deficiency (or excess) % of older people in

institutions affected

Iron deficiency 40%

Vitamin C deficiency 41%

Vitamin B1 (thiamin) deficiency 14%

Folate deficiency 10%

Vitamin B12 deficiency 9%

Vitamin D deficiency 37%

Vitamin A (retinol) EXCESS 2 to 3%

National Diet and Nutrition Survey

Iron-rich foodsGood sources for vegetarians/vegans

•Fortified breakfast cereals, especially bran flakes (contain 3 times more iron than anything else on this list – see chart that follows)

Iron-rich foodsGood sources for vegetarians/vegans

•Grains: wholemeal bread, spaghetti

•Pulses (peas, beans – including tofu, and lentils)

•Figs – just 3 dried figs supply 29% of daily iron

•Eggs (not for vegans)

•Green veg, especially curly kale

Vitamin C rich foods

Vitamin C is the most common deficiency seen in institutionalised adults (41%).

Also, vitamin C helps the body absorb iron. Fresh fruit juice or a starter containing citrus fruits is a good way to ensure iron from foods is absorbed well.

Vitamin C rich foods

Good sources of vitamin C are:

•Citrus fruits

•Green vegetables

•Peppers

•Tomatoes

•Potatoes (just under the skin)

B vitamins: B1 (thiamin) and folate

B vitamins are water soluble which means they are not stored for long in the body. So try to include some of these foods every day.

Diets containing too little B vitamins can lead to multiple deficiencies within a few months.

B vitamins: thiamin & folate

•B1•Found in wholegrain cereals, nuts, seeds and pulses (peas, all types of beans, including soya, and lentils)

•Folate•Found in green vegetables, especially broccoli, oranges, nuts, wholegrain cereals

B vitamins: vitamin B12

Vitamin B12 is needed every day. Vegetarians get B12 from free-range eggs and dairy.

Vegans get it from B12-fortified foods, such as breakfast cereals, margarines, nutritional yeast (e.g. Marmite) and soya milk.

B12 from fortified foods is better absorbed than the B12 from meat, poultry and fish.

Vitamin AComes in two forms

•Pre-formed (retinol) – from animal foods.

•So-called ‘pro-vitamin’ form (carotenoids). Over 700 of these, including beta-carotene and lycopene (the protective pigment in tomato ketchup!)

Vitamin A

•Carotenoids are found in red, yellow and orange fruits and vegetables (carrots, tomatoes, peaches and apricots).

•And also in green leafy veg: watercress, rocket, spinach and cabbage.

Vitamin AHazards of excessAs we’ve seen in the survey, 2-3% of older people living in institutions get too much pre-formed vitamin A (retinol) – found in animal products. Egg yolks, butter, milk, liver and fish oils are rich sources.

Deficiency is rare. But too much can increase risk of osteoporosis and hip fractures.

Calcium rich foods

Calcium is the most abundant mineral in the body and essential to keep bones and teeth strong.

Calcium rich foods

Good sources for vegetarians are:

•Milk, cheese, yoghurt•Fortified non-dairy versions of the above (for vegans)•Almonds and sesame seed paste (tahini)•Green leafy vegetables (not spinach)•Broccoli•Soya beans (edamame)•Tofu (made with soya beans)

Vitamin D

Like calcium, vitamin D is important for good bone health.

We get most of our vitamin D from summer sunlight on our skin which is converted into vitamin D.

Vitamin D

But good dietary sources for vegetarians are milk, free-range eggs and fortified cereals and margarines.

Dairy-free milks and margarines (such as the ‘Pure’ brand) are fortified with vitamin D and are suitable for vegans.

Older people who do not get outside much are advised to take a vitamin D supplement.