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Friday, 4 February 2011


Older adults in the UK

The number of older adults in the world is growing both in absolute and relative terms. In 1994, 16 per cent of the UK population was aged over 65. By 2031, this will increase to 23 per cent, and 10 per cent of this figure will be made up of people over 75 years old. The greatest challenge over the coming years will be maintaining the health of this increasing number of older adults.
Deciding what we mean by 'older people' is a little arbitrary. The World Health Organization classifies people aged between 45 and 59 as 'middle age', 60 to 74 as 'elderly' and over 75 as 'old'.
But the nutritional needs of older adults are difficult to neatly categorise into absolute age groups. Dietary needs depend on current health, and while many older people are fit and active, some others who are younger may be frail and require additional care.

Nutrition for generally fit and healthy older adults


Research shows that remaining active can help to maintain both mental and physical health. Keeping up the activities you enjoy doing will help to maintain physical fitness and preserve muscle tissue. Preserving your strength will help to maintain your independence. Remember, activity doesn't necessarily mean joining an exercise class. Gardening, walking to the shops and housework can all count as types of activity too.


Energy requirements can decline with age, particularly if physical activity is limited, but the need for protein, vitamins and minerals remains the same. It's vital that food choices are nutritionally dense, which means you still need to eat a variety of foods to get all the vitamins and minerals you need, but with fewer calories. If you're overweight or obese, it's even more important to be calorie conscious.


Advice to restrict fat intake, particularly cutting saturated fat to improve heart health, remains true for older people who are fit and well. A dietary survey of older people showed most eat too much saturated fat. Above the age of 75, fat restriction is less likely to be beneficial, and isn't appropriate if the person is frail, has suffered weight loss or has a very small appetite. In fact, in these situations additional fat may be used to increase the calories in meals and snacks to aid weight gain. Read our tips for tackling nutritional problems for older people.


Older people can suffer from constipation and bowel problems mainly due to a reduced gut motility and inactivity. To relieve this, try eating high-fibre cereal foods, fruit and vegetables. Raw bran and excessive amounts of very high-fibre foods are not the answer, though; they're too bulky and may interfere with the absorption of certain nutrients. To help the gut work properly, it's also important to drink plenty of fluid, approximately eight medium glasses a day.


Dehydration can make people feel drowsy or confused, it's important to drink, even if this means extra trips to the toilet. The risk of dehydration can be higher in older people because their kidneys don't function as efficiently as those of younger people. Older people are also not as sensitive to the feeling of thirst. Fluid intake doesn't just mean water - it can also include such drinks as tea, coffee, fruit juice and squash.


Generally fit and healthy older people should limit foods and drinks that are rich in sugar, as it can impair dental health and contribute to weight gain when energy intake is too high. But for people who have a poor appetite, or who have lost weight, sugar-rich foods can be a useful source of calories.


Anaemia is common in older adults. Poor absorption of iron, due to changes in the gastrointestinal tract, blood loss and the use of certain drugs - together with a poor dietary intake - may be causal factors. Make sure your iron intake is sufficient by eating red meat and foods from non-meat sources (such as fortified cereals, dried fruit, pulses and green leafy vegetables) every day. Absorption of iron from a meal containing non-meat sources is maximised by consuming foods rich in vitamin C at the same time (such as a glass of fruit juice, fresh fruit or vegetables).


Zinc is needed for a healthy immune system and to support the healing of wounds including pressure ulcers. Rich sources include meat, pulses, wholemeal bread and shellfish.

Calcium and vitamin D

Adequate intake of calcium and vitamin D may help to slow the rate of calcium loss from bones, which starts at the age of 30 and accelerates considerably in later years. Calcium-rich foods (milk and dairy foods) should be eaten every day.
Vitamin D comes mostly from exposing skin to sunlight, although some foods such as oily fish and fortified spreads and breakfast cereals contain vitamin D. As you get older it's advisable to take a vitamin D supplement, as your body isn't able to get enough from the diet and British weather alone.

Vitamin C

Older people may have low vitamin C intakes if not consuming enough fruit and vegetables. This may be because crisp fruit and vegetables are often avoided if their teeth are in poor condition or if they have badly fitting dentures.
Regular check-ups with the dentist can help to ensure that teeth remain healthy, enabling older people to continue to enjoy a variety of foods that will help maintain overall health.

Foods to choose

To meet your nutritional needs, aim to eat a varied diet including regular meals and snacks, and drink enough fluid.
Sometimes older people can no longer eat as much food at a single sitting, so include more nutritious snacks in between meals to boost nutrient intake.
Ideas for quick and nourishing snacks:
  • Sandwiches filled with cooked meat, bacon, tinned fish, cheese or peanut butter. Use different breads for variety and add pickles, relish and sauces.
  • Toast with pilchards, sardines, beans, cheese, ravioli, tinned spaghetti or well-cooked eggs.
  • Crackers or digestive biscuits topped with cheese, toasted crumpets, teacakes, yoghurt, fruit, malt loaf, fruit cake, breakfast cereals or soup.
If it's difficult to get to the shops, keep some basic foods in your store cupboard:
  • Milk: long-life, evaporated or dried milk, and canned milky puddings
  • Meat and fish: cans of corned beef, stewed meat, ham, sardines, salmon and tuna
  • Fruit and vegetables: a variety of canned or frozen fruits and vegetables, beans, pulses, long-life fruit juice, instant mashed potato
  • Drinks: cocoa, malted milk and meal-replacement drinks
  • Cereals: breakfast cereals, crackers, crispbread, oatcakes, rice, pasta and biscuits
  • Other: soups, stock cubes, gravy, honey, jam, pickles and sauces
  • Freezer ideas: frozen meals, bread or rolls, ice cream, fish and meat dishes
The MRC Human Nutrition Research wrote this article in August 2008.