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Elderly

During this pandemic, elderly individuals have the highest risk of COVID-19 infection due to old age, comorbidities and impaired immune system. Thus, it is important for us to support their needs to maintain health and improve their protection against COVID-19. Last October 1-7, we celebrated the Elderly Filipino Week with the theme: “Mahalaga sina Lolo at Lola sa Panahon ng Pandemya” which aims to increase public awareness on the different issues experienced by elderly Filipinos.

Due to prolonged lockdowns, poor access to medical services and limited budget for food and other basic needs, we must maximize our resources by choosing those that give the most benefit. In terms of nutrition, choosing nutrient dense foods and applying simple dietary modification can help maintain a good nutritional status and address common digestive problems of elderly individuals.

The following are the natural changes that occur in the body of elderly individuals and nutrition tips to address them.

1. Changes in Body Composition. Body composition changes with aging where muscle mass decreases and fat mass increases. This leads to age-related muscle loss and weakness which may decrease functionality and increased risk of injuries. Muscle loss can be prevented or slowed down by maintaining an active lifestyle and eating adequate amounts of protein from fish and lean poultry or meat. The following are the WHO recommendations for exercise for people age 65 years or older:

● At least 150 minutes of moderate-intensity aerobic activity such as walking or light jogging per week
● Including balance exercises for people with poor mobility to prevent falls
● Including muscle strengthening activities to maintain muscle tone and promote bone strength

2. Changes in Taste and Smell. Elderly individuals may experience dysgeusia or altered taste and hyposmia or decreased sense of smell. This is due to the natural thinning of the cells needed for smell and other factors such as medications, untreated mouth sores, tooth decay, poor oral hygiene and cigarette smoking. Decreased sense of taste or smell can be addressed by:
● Avoid too much taste stimulation from artificial sweeteners or foods with excessive salt which may increase taste threshold
● Eat food while they are warm to aid in better taste sensation
● Eat food slowly so food substances have time to mix with saliva and stimulate taste sensation

3. Oral Changes. Elderly individuals may experience tooth loss, use dentures and have dry mouth leading to difficulties in chewing or swallowing. This can be addressed by eating moisture-rich foods such as soups, stews or dishes with sauces, pureed and chopped foods to make meals easier to eat.

4. Changes in Digestion. Changes in terms of digestion and their nutritional management are the following:

● Decreased hunger sensation - Have a scheduled mealtime or eat with family members or a companion to improve appetite
● Difficulty in swallowing - East thickened liquids or texture modified foods
● Early satiety due to stomach changes - Eat small frequent meals to reach recommended intake
● Insufficient stomach acid and intrinsic factor - This may lead to incomplete digestion and poor absorption of Iron and Vitamin B12. Always include a Vitamin C rich food in the meal to improve iron absorption. Take calcium carbonate supplements at a different time because it tends to affect stomach acid levels.
● Constipation - Drink adequate fluids and fiber rich foods.

In general, by having a balanced and varied diet with a few texture and food type modifications and an active lifestyle, elderly individuals can maintain a good nutritional status, preserve physical health and maintain quality of life. If you or any of your relatives are having feeding problems or nutritional concerns, consult a Registered Nutritionist Dietitian or consult your Doctor for medical assessment and management.

/AET

References:

Panaligan, R. (2021). ‘Mahalaga sina Lolo at Lola sa Panahon ng Pandemya’. Manila Bulletin. Retrieved from https://mb.com.ph/2021/10/01/mahalaga-sina-lolo-at-lola-sa-panahon-ng-pandemya/

Tandang, N. A., Arlan, R. L. C., & Navarro, G. C. (2020). Factors influencing malnutrition in Filipino elderly. Malaysian Journal of Nutrition, 26(3).

Raymond, J. L., & Morrow, K. (2020). Krause and Mahan’s Food and the Nutrition Care Process E-Book. Elsevier Health Sciences.