Dr Paul Clayton 2014


Ensuring older people have enough nutrition can be a challenge. It’s not just a question of preventing deficiency – the real focus should be on making sure they have the optimum range and optimum amount of the nutrients that can reduce the risk of what are termed ‘age-related’ illnesses.

On average, metabolism declines by about 5% per decade – as much as 20% between ages 30 and 70. The result is that older people tend to eat less in order to control their weight and less food means less nutrients.

Additionally the body becomes less efficient at absorbing certain key nutrients (like B12), appetite can decline and there may even be difficulty in digesting some foods.

More importantly, damage to DNA builds up through excessive free radical action. And damage to internal body tissue starts to accumulate though what is called ‘chronic sub-clinical inflammation’ – about which more later.

So if you have an older parent – or are in that age group yourself – here are the most important nutrients to ensure are adequately present in your daily food and nutritional supplements.

We will start with the vitamins and minerals that are most likely to be deficient and how to get them – but they are not necessarily even the most important nutrients! Because we now know the key reason that health declines with age – and how to combat it.

VITAMINS AND MINERALS

Vitamin D
Vitamin D helps the body absorb calcium, and therefore maintain bone density, and therefore prevent osteoporosis – which is an issue for both men and women as they get older. Without sufficient vitamin D, bones can become thin, brittle, or misshapen.

But vitamin D does a lot more – there is good evidence that it helps protect against some chronic diseases, including cancer, rheumatoid arthritis, multiple sclerosis, and autoimmune diseases. Many older people (as many as 70%) are deficient in vitamin D, which is mainly produced by the skin when exposed to sunlight.

Few foods naturally contain vitamin D. Those that do include fatty fish like salmon, sardines, tuna, and eggs. Many experts think that vitamin D is one of the most important vitamins to supplement for older people, since the skin becomes less efficient at producing the vitamin from sunlight as we age. The RDAs for vitamin D are currently under review to be upgraded.

An optimum level for a vitamin D supplement would be 20 micrograms of the D3 form.

Vitamin B12
Vitamin B12 helps keep the body’s nerve and blood cells healthy and helps make normal DNA. B12 also helps prevent a type of anaemia that makes people tired and weak. Older people can’t absorb it from food as well as younger people.

There are several other important B vitamins and they all have different functions, including helping to break down energy from food, keeping the skin, eyes and nervous system healthy, and helping to form red blood cells. People who are B-deficient are at increased risk of anaemia and neurological problems such as memory loss.

The richest source of vitamin B12 is beef liver with fish, meat, poultry, eggs, milk and milk products as good sources. An optimum level for a B12 supplement would be 6 micrograms a day and for vitamins B1 and B2 would be 7.5 milligrams a day.

Magnesium
Magnesium is an essential mineral for maintaining normal muscle and nerve function, keeping a healthy immune system, maintaining normal heart rhythm, and building strong bones. A deficiency in magnesium is associated with muscle loss, cardiovascular disease, diabetes, high blood pressure, anxiety disorders, and osteoporosis.

Good sources of magnesium include dark green vegetables like spinach, also fish, lentils, beans, nuts and seeds. But absorption of magnesium decreases with age and some prescription medications, including diuretics, may also reduce magnesium absorption.

B vitamins Folate/Folic Acid and Betaine
A deficiency of the essential B vitamin Folic Acid (B9) is known to contribute to anaemia. In addition we know that raised levels of a blood protein called homocysteine is strongly associated with a raised risk of heart attack.

Folic acid, together with other B vitamins and especially a lesser known B vitamin called betaine, can reduce homocysteine levels – and therefore the risk of heart troubles.

Good sources of folate – the natural form of folic acid – are leafy green vegetables. An optimum level for a folic acid (B9) supplement would be 200 mcg and of betaine would be 450mg.

Calcium
One in two women and one in five men over the age of 50 will break a bone, mainly because of osteoporosis. Calcium is essential for building and maintaining strong bones and for normal heart function. If you don’t get enough calcium, your body will leach it out of your bones.

However, it’s not enough to take just extra calcium. For the body to USE dietary calcium, it needs both vitamin D and vitamin K – and ideally Omega 3.

Good sources of calcium include dairy products, almonds and leafy green vegetables. The ideal source of calcium is dairy foods, rather than supplements, but these can help. A smoothie made from yogurt, vanilla ice cream and fruit is ideal.

Potassium
Potassium also helps keep bones strong – and has been shown to help reduce high blood pressure and the risk of kidney stones.

Bananas, prunes, plums, and potatoes with their skins on are good sources of potassium.

Fibre
Less than half of older people eat enough fibre – which helps promote healthy digestion by moving foods through the digestive tract.

Good natural sources of fibre include whole grains, nuts, beans, fruits and vegetables, and these all have many other health benefits, including protecting against heart disease.

Vitamins E and C
There is convincing evidence that older people with higher levels of vitamin E have a lower mortality risk. However, vitamin E is fat-soluble and can therefore accumulate. So mega-doses are to be avoided – as with any nutrient. A good supplement level would be about 13 mg per day provided as mixed tocopherols and tocotrienols – which are different types of vitamin E that protect in different ways.

Combine vitamin E with 500mg of vitamin C, as these vitamins work synergistically with each other. Vitamin C is an important antioxidant that helps to fight disease and infections and aids healing.

ANTI-INFLAMMATORY NUTRIENTS FOR THE ELDERLY

Earlier I stated that we now know a key reason that health declines with age. Health researchers have identified what is called ‘chronic sub-clinical inflammation’ as a – possibly the – key cause of age related disease – from cancer to Alzheimer’s to heart disease, diabetes, arthritis and osteoporosis; not to mention ageing of the skin, and indeed the bulk of the ageing process itself.

This type of inflammation is different from external inflammation – which is typically a positive external immune response to a cut or infection. This is an insidious and initially undetectable internal process that causes increasing damage to body tissue over time – ultimately ending in a degenerative disease.

READ MORE on inflammation as a key driver of age-related diseases.

So to stay healthy as you age, you need to reduce the factors that trigger this type of inflammation and increase the level of anti-inflammatory foods and daily supplements.

The two most important anti-inflammatory nutrients are Omega 3 and what are called polyphenols and flavonoids – some of the most active protective ingredients in fruits and vegetables.

Omega-3
These unsaturated fats, found in fish, are associated with reduced symptoms in rheumatoid arthritis, improved brain function (and reduced risk of Alzheimer’s), better heart health and slowing the progression of age-related macular degeneration (AMD), a disease that causes reduced vision in the elderly.

Health researchers recommend at least two, and ideally four, servings of oily fish a week. Wild salmon, tuna, sardines, and mackerel are especially high in omega-3 fats. Since few people will eat four portions of fish a week, a daily Omega 3 supplement should contain at least 500 mg of EPA/DHA (eicosapentaenoic acid and docosahexaenoic acid) – the active fatty acid components of Omega 3.

Polyphenols/Flavonoids
Why does the American Cancer Society now recommend as many as nine portions of fruits and vegetables a day? Because they contain a range of compounds that are cardio-protective, brain-protective and create an internal body environment that is hostile to cancer.

Some of these compounds are polyphenols and flavonoids, many of which give fruits and vegetables their colour. Again, if nine portions are not realistic, older people can get flavonoids in supplement form as green tea extract, grape-seed extract and as lutein, lycopene and beta carotene – all of which have impressive evidence behind them as risk-reducing health supplements.

So the best supplements to protect the elderly should contain much more than the classic vitamins and minerals – they MUST include anti-inflammatory nutrients like Omega 3 and polyphenols/flavonoids.

PLUS PLENTY OF FLUIDS AND EXERCISE

Yes, 8 glasses of fluids a day (which includes tea and coffee). And regular exercise – including walking, gardening, active house-cleaning – amounting to at least 30 minutes for 5 days a week.

A regime like this will put over-60s in the top 1% of healthy seniors on the planet!