OREGON STATE UNIVERSITY

Malnutrition in Elderly a Major Concern, Needs Attention

07/23/2007

CORVALLIS, Ore. – At an age when proper nutrition is more important than ever, almost half the elderly people in developed countries have an inadequate nutritional intake and increased vulnerability to a range of degenerative diseases – a situation that is both unnecessary and easily preventable.

Due to lifestyle, diet, loss of appetite and other factors associated with aging, millions of American citizens over age 65 are facing malnutrition at a time of their life when adequate, appropriate food and micronutrient intake is critical, researchers from Oregon State University said in a recent report in Pharmacological Research, a professional journal.

Addressing this fundamental – and comparatively easy to fix – problem could be one key to improved quality of life and skyrocketing health care costs in the near future, said Tory Hagen, an associate professor with the Linus Pauling Institute at OSU, and an expert in the metabolic process of aging.

“The elderly population in America is going to double to 70 million people by 2030, and studies have shown that 44 percent of this group has inadequate nutrition,” Hagen said. “This can be directly linked to increased problems with cardiovascular disease and other disease problems. The cost of congestive heart failure alone in the United States is estimated to exceed $18 billion a year.”

The problem, Hagen said, is most easily seen as a decline in nutritional intake at the same time aging systems may need more nutrients than they used to.

There are some socio-economic factors that relate to the poor nutrition, the study said. But more frequently, it is caused by such problems as loss of appetite, smoking, “malabsorption” syndromes, and the nausea, constipation or diarrhea sometimes associated with use of medications. Some people lose interest in cooking. Anorexia is common among the elderly, and is often a consequence of depression. The end result, from whatever cause, is people who get neither the quantity nor quality of food they need.

At the same time their nutritional intake is getting worse, the demands for more or better nutrients may be increasing, Hagen said.

“Cellular antioxidant status and stress response enzymes naturally decline with age, even in healthy individuals,” Hagen said. “There is also an age-related increase in damaging oxidant production, and mitochondrial and nuclear oxidative DNA damage.”

All of these issues can be addressed by an improved diet and possible supplementation if necessary, Hagen said. But people must become more aware that their dietary needs are going up at the same time their interest in food is going down and take steps to address it.

Of particular concern:

• An adequate intake of long-chain omega 3 fatty acids, most commonly found in fatty fish or obtainable through supplements, has been associated with a lower incidence of coronary heart disease and sudden cardiac death. The elderly rarely get adequate levels of these nutrients.

• Most people in the United States, including the elderly, have a dietary intake of vitamin E that is below recommended levels. Trials show that vitamin E derived from food – less clearly than from supplements – in associated with a decreased mortality from coronary heart disease.

• Adequate intake of vitamin C can been associated with lower levels of diabetes, Alzheimer’s disease, blood vessel function, high blood pressure and mortality from stroke. But the elderly may need twice as much of this nutrient to achieve the same blood plasma levels as younger people and often don’t get it.

• Some B vitamins, especially folic acid, have been shown to improve endothelial function and reduce inflammation. Intake of these nutrients in the elderly is not always adequate.

• Although their mechanism of action is still unclear, the polyphenolic compounds found in some foods such as cabbage, broccoli, legumes and fruits reduce both the onset and progression of age-related diseases. A diet rich in fruits and vegetables is often lacking both in the elderly and other populations.

“There’s still a lot we need to learn about exactly how certain components of our diet, or certain micronutrients people can obtain through supplements, may be of value in resisting the problems associated with age,” Hagen said. “But what’s already clear is that these foods and nutrients have very important roles to play, and many elderly people are not getting enough of them.”

Researchers at the University of Paris in France were co-authors on this study. The research has been supported by the National Institutes of Health.