As we age, we often lose our ability to taste and smell, as well as having more difficulty chewing. All this can cause a decrease in appetite.

If we also consider other psychological and social changes that occur with old age, such as living alone, feeling depressed or losing purchasing power, there is a greater risk of compromising the quality and quantity of food ingested.

Other changes at the physiological level that accompany aging, such as the decrease in the elasticity of the stomach walls, bacterial overgrowth, other common diseases such as atrophic gastritis and even the use of medications, can also compromise the intake and absorption of nutrients.

Thus, the risk of malnutrition increases with age.

What is malnutrition?

The different international institutions specialized in nutrition (such as the European Society for Clinical Nutrition and Metabolism (ESPEN), describe malnutrition (or malnutrition) in elderly people as imbalances in caloric intake and nutritional deficiencies developed from some disease (with or without inflammation ) also covers situations of hunger for other socio-economic or psychological reasons.

In numbers, the number of people with malnutrition in Europe represents 2.1% of those living independently, and those at risk of malnutrition rise to 26.5%. As expected, the number of elderly people with malnutrition who have help at home is lower (8%) than those who are in homes or hospitals (22% and almost 29% respectively).

Malnutrition makes us sick

Malnutrition in the elderly has serious consequences. Fundamentally, it weakens the immune system, increases cognitive deterioration and promotes serious chronic diseases (osteoporosis, sarcopenia or frailty, among others). In fact, in one study, we observed that elderly people who are not frail, when they are at risk of malnutrition, are more likely to develop frailty compared to well-nourished ones.

Malnutrition appears to weaken a person’s functional capacity and increases the risk of addiction, preventing him from doing what is important to him.

There are differences in nutrient intake between non-frail older adults who are well nourished and those at risk of malnutrition. This could be giving us a clue about the nutrients that cause us to lose functional capacity and develop frailty as we age.

Specifically, health deteriorates with a higher consumption of alcohol and a lower consumption of proteins and other nutrients such as vitamin D or magnesium, involved in protein synthesis, muscle maintenance and the immune system.

Furthermore, if we don’t eat well, the intake of other substances involved in inflammation and oxidation processes, such as vitamin C or omega-3, is reduced. And also others involved in circulation, such as the B group vitamins. According to other studies, all these nutrients seem to be equally involved in sarcopenia -muscle loss- and in frailty, so that they may be the cornerstone of different syndromes that affect us at as we age.

More protein and exercise

One of the main treatments for malnutrition is to ensure that we eat enough and a variety of foods, both in terms of energy, protein and other nutrients. However, exercise can also be helpful. Physical activity increases muscle mass, decreases inflammation and can also increase your appetite. Therefore, it is very important to understand how nutrition and exercise interact, as it can help to understand what happens with aging.

Some of our research has looked at the influence of certain nutrients on the effects of multicomponent exercise on body fat or bone health. Specifically, an increase in alcohol and vitamin A consumption could interfere with the bone health of these people who train. On the contrary, polyunsaturated fatty acids and vitamin D facilitate bone improvement after a training period.

However, much remains to be investigated about this diet-exercise tandem and about the intervention possibilities that open up from these results.

What should the elderly eat?

Firstly, alcohol should be avoided and ensure that protein sources such as meat, fish or eggs appear at every meal, which can help to achieve the recommended protein intake. Not forgetting legumes which, in addition to providing protein, help cover the recommendations for other vitamins and minerals.

In addition, it is important to encourage the consumption of blue fish and the use of healthy fats, such as olive oil, to help reduce a possible inflammatory state.

Without forgetting that change or even training can make a difference, and that institutions must be involved in the prevention of malnutrition and the problems derived from it.

This article was published in ‘The conversation’.