Malnutrition is something that most of us would associate with developing countries, however in Australia’s elderly population it is more common than most people would think. It is estimated that as many as 10–44% of older Australians are at risk. In residential aged care, Australian studies have shown that the actual prevalence of malnutrition is between 22- 50% (6). 

Ensuring good nutrition in older adults is essential as it supports many aspects of healthy ageing and wellbeing, including:

• Maintenance of muscle mass: Protein
• Normal energy production: Iron, vitamins B1, B5 and B12
• Reduction of tiredness and fatigue: Iron, magnesium, vitamins B2, B3 and B6
• Cognitive function: Iron, zinc and iodine
• Bone health and reduced risk of osteoporosis: Calcium and vitamin D
• Health of the skin and wound healing: Zinc
• Normal cell division: Iron, magnesium, zinc, calcium, vitamins B9 and D.
• Immunity: Zinc, vitamins A, C, D and B12 

Factors that contribute to malnutrition in the elderly

Too little food or a diet that lacks essential nutrients may seem like a straightforward cause of malnutrition. However, there are a combination of physical, social and psychological issues which can cause malnutrition to be increased in elderly populations. These include age-related reductions in taste, smell and appetite. This can make it difficult to enjoy eating meals and maintain regular eating habits. Physical changes as we age can also make it difficult to buy, prepare, cook, and eat food without assistance. Older adults also have an increased need for particular nutrients such as protein, making it even harder to meet their daily requirements. Other factors which make regular healthing eating more difficult include poor dental health, illness, medication side effects, dementia, dietary restrictions, limited income, and reduced social contact (1-3). 

Nutritional deficiencies as a result of malnutrition in the elderly can cause many problems and complications, such as:

• Reduced immune function (recovery from an infection or any acute illness can be delayed and ongoing, causing stress and suffering)
• Poor wound healing
• Muscle atrophy (a loss of muscle mass, strength and function)
• Increased risk of osteoporosis, recurring falls and fractures

People who are malnourished may also have:

• More frequent visits to their GP or medical provider
• Higher hospital admittance rates  
• Greater chances of needing to move into an aged care facility at an earlier stage (compared to someone who is well nourished) (1-3).

How can we enhance elderly nutrition? 

Eating a wide variety of nutrient dense foods is key to meeting elderly nutritional needs. It is crucial to ensure that adequate amounts of protein, energy and essential vitamins and minerals are included as part of the daily diet. However, due to the many barriers older adults face in achieving this, they may need a helping hand from their health professionals, such as a dietician or an occupational therapist. 

Some common tips to help enhance nutrition in the elderly include:

• Eating small, frequent meals and snacks regularly
• Consuming full-cream milks (plant based or dairy varieties) between meals
• Adding calorie dense oils or creams to food when cooking
• Adding nutrient dense small seeds (eg: chia seeds) or ground nut powders to cooked foods
• Using flavour enhancers that serve to make food tastier
• Making sure that the food prepared suits chewing and swallowing ability
• Ensuring nourishing snacks are readily available and easy to access or prepare.

Specialised meal replacements that have been formulated for the elderly are also available and can be a convenient and effective way to help increase nutrient intake (4,5). 

How can oral nutritional supplements help?

Meal replacements that have been formulated to help increase intake of protein, energy, fibre and essential vitamins and minerals can help people easily boost their daily nutrient intake when consumed as a snack in between meals. These supplements are often powders that can be easily blended into water, juice or milks and consumed as part of a varied diet. They are often an ideal solution for elderly people who suffer from low appetite, those who struggle to gain weight or those who have a higher nutrient demand when recovering from illness or surgery. 

It’s always best to speak to your doctor, dietician or pharmacist for help selecting the right product for your individual needs.

Product Highlight:

Fill Up™ is a certified organic meal replacement designed by expert nutrition scientists to help nourish and support elderly Australians. It has been formulated to help meet the body’s demands for energy, protein, fibre and essential vitamins and minerals when these needs are not being met by diet alone. It is an ideal supplement for people with low appetite, those struggling to maintain a healthy weight or those who need increased nutrition after recovering from illness or surgery*. Unlike many other products for elderly nutrition, Fill Up™ contains no artificial sweeteners or added sugar, and it’s also free from artificial colours, flavours and preservatives.

*Consume as part of a varied diet. Not to be used as a total diet replacement.

References: 

1. Dietitians Association of Australia, (2009). Evidence-based practice guidelines for the nutritional management of malnutrition in adult patients across the continuum of care. Nutr & Dietetics;66(3 Suppl): S1–4. 

2. Australian and New Zealand Society for Geriatric Medicine, (2007). Under-nutrition and the older person. Position statement no. 6. Sydney: ANZSGM.

3. Visvanathan R, Macintosh C, Callary M, Penhall R, Horowitz M, Chapman I, (2003). The nutritional status of 250 older Australian recipients of domiciliary care services and its association with outcomes at 12 months. J Am Geriatr Soc;51:1007–11. 

4. Royal Australian College of General Practitioners, (2012). Managing undernutrition in the elderly: Prevention is better than cure, Psych strat;41;9;659-699 

5. Charlton, KE, Nichols, Bowden S, Lambert K, Barone L, Mason M, Milosavljevic M, (2010). Older rehabilitation patients are at high risk of malnutrition: Journal; of Nutrition, Health & Ageing;14;8,622-628

6. Dietitians Association of Australia, (2009). Royal Commission into Aged Care Quality and Safety, viewed 15/10/21, available at: https://dietitiansaustralia.org.au/wp-content/uploads/2019/03/DAA_Royal-Commission-Aged-Care_Mar-2019_Final.pdf