High-Risk Nutrients in the Aging Population

Abstract

Many aging individuals have chronic health concerns, including type 2 diabetes, heart disease, osteoporosis, physical frailty and cognitive decline. As a modifiable risk factor, healthy diet offers tremendous promise for improving health and wellbeing with age. Unfortunately, intakes of several nutrients are inadequate for a large segment of the older population. These "shortfall nutrients" include macronutrients: protein, n-3 fatty acids, dietary fiber; vitamins: vitamins B6, B12, D, E, and carotenoids (vitamin A precursors); and minerals: calcium, magnesium, and potassium. Other nutrients tend to be consumed in excess, increasing risk of obesity, hypertension and related chronic conditions. These include: saturated fats (i.e. fatty meats, processed meat, full fat dairy products), trans fat (i.e. hydrogenated oils, margarine, shortening, many processed baked products, crackers), refined carbohydrate foods (i.e. soft drinks, fruit drinks, white bread and products with white flour, white rice), sodium (salt and sodium compounds in canned and other processed foods, table salt), and phosphorus (cola, processed meats and commercial baked products). Relative to food group intake recommendations, older adults tend to report inadequate intakes of fruit, vegetables, legumes, whole grains, nuts or seeds, fish, lean meat, poultry, and low fat fluid dairy products. Because of lower energy needs, but higher needs for some nutrients, the importance of these nutrient dense food groups is of central importance. Supplements may be needed in the case of nutrient deficiencies, and when health conditions or medications interfere with absorption or effective nutrient utilization of specific nutrients, making it difficult or impossible to obtain adequate intakes from diet alone. Examples of these include vitamin B-12 with atrophic gastritis, use of acid blocking medication, metformin or other interfering medications, and vitamin D for individuals who get inadequate sun exposure, and during the winter months in northern latitudes. For most nutrients, however, increasing intakes of nutrient dense whole foods, while reducing energy dense refined and processed foods, is the best way to optimize metabolism, protect cellular and organ function and maintain health with aging.