Malnutrition: Why the elderly are at a higher risk

Justin Uwera, 27, a graduate from the University of Alberta, Canada, takes care of about six elderly females at her Kanombe home in Kigali. Through donations, she is able to provide them with basics like clothes, health insurance and food. “I developed the idea of starting a home for the elderly during my study sojourn in Canada. Of all things, I give their feeding the most attention since at such a stage they need special nutrition to stay healthy and strong,” she explains. Uwera says five of the elderly women under her care are survivors of the 1994 Rwandan Genocide against the Tutsi and have no relatives. “Before bringing them here they were living in abandoned homes and were weak and malnourished. However that has changed ever since we gave them better housing and diet,” Uwera says, adding that her wish is to have more elderly care homes opened in the country and more funding extended to them. A survey done by Audrey Mutabazi, a dietician with Gasp, a food science consultancy based in Nyarutarama last year, established that 13% of the elderly in Rwanda are malnourished either because of poverty or poor nutrition knowledge. According to the World Health Organisation, 2 billion people will be aged 60 and older by 2050. Between 2000 and 2050, the proportion of the world’s population over 60 years will double from about 11% to 22%. The absolute number of people aged 60 years and over is expected to increase from 605 million to 2 billion over the same period. Challenges, recommendations “Grief, loneliness, failing health, lack of mobility and other factors among old people, might contribute to depression — causing loss of appetite,” Uwera says. Although many people lose appetite for food as they age, a number of them usually resort to drinking alcohol. Mutabazi, however, warns that too much alcohol can interfere with the digestion and absorption of nutrients in an old person. Nutrients might also be lacking if alcohol is substituted for meals. Experts recommend a well-balanced diet for the elderly meaning that they should eat a variety of fruits, vegetables, proteins and whole grains to maintain and improve overall health. Mutabazi says in addition to eating a variety of foods, there are specific things a caregiver can incorporate into their diet to boost health. Douglas Rugaju, a nutritionist with Medplus Clinic Remera, points out that acids have been proven to reduce inflammation, which can cause heart disease, cancer and arthritis. They can be found in flaxseeds and flaxseed oil, walnuts, canola oil, and different types of fish. It is advisable at least some of these foods twice a week. If this is impossible, check with their doctor to see if an Omega 3 supplement would be of benefit. “The need for calcium also increases as people age. This is primarily to preserve bone health. One added benefit of calcium is that it helps to lower blood pressure,” he says. The World Health Organization (WHO) recommends that adults over the age of 50 get at least 1200 milligrams per day of calcium – equal to about four cups of fortified orange juice, dairy milk, or fortified non-dairy milk such as almond or soy. Leafy greens like kale and turnip greens are also great sources of absorbable calcium. Many people find it challenging to consume this much calcium per day by eating and drinking, so check with your loved one’s doctor to see if he or she should take a calcium supplement. Rugaju remarks that for those with hypertension, one of the most important things caregivers can do to help reduce a loved one’s high blood pressure is to prepare foods that are low in sodium. Frozen, processed and restaurant foods are typically high in sodium, and should be avoided or only be a very small part of the diet. Fresh and frozen fruits and vegetables, dry beans, unsalted nuts and nut butters, and grains like brown rice and oats are all foods that are naturally low in sodium, so incorporating them in the diet would be a good. “Incorporate changes gradually, older people are usually skeptical of change. They need to make small changes gradually. As the caregiver, you should reinforce this and make sure that your loved one is incorporating the new foods into their diet,” Rugaju says. Nutrition experts say that setting a good example may go a long way in helping, pointing out that it is important to make eating a social activity, with the caretaker involved eating the same foods as them, this way the dietary changes being made won’t seem so drastic for the elderly. Getting adequate nutrition can be a challenge as one gets older. With age, the number of calories one needs begin to decline. Every calorie consumed must be packed with nutrition in order to hit the mark. Mutabazi says the elderly have a high risk of dehydration. This is because the thirst mechanism changes, the functional capacity of the kidney is reduced and there is a predisposition towards constipation. A minimum of 2 litres or 8 glasses of fluid per day should be taken in the form of water, infusions or broths together with the consumption of foods with high water content. Other aging problems and prevention measures As one ages, their heart rate becomes slightly slower and the heart might become bigger. Your blood vessels and your arteries also become stiffer, causing the heart to work harder to pump blood through them. This can lead to high blood pressure (hypertension) and other cardiovascular problems. With age, bones tend to shrink in size and density — which weakens them and makes them more susceptible to fracture. You might even become a bit shorter. Muscles generally lose strength and flexibility, and you might become less coordinated or have trouble balancing. “Memory also tends to become less efficient with age. It might take longer to learn new things or remember familiar words or names,” says Alfred Gatabarwa, a general practitioner with Abbey Family Clinic. Tips on good life Include physical activity in your daily routine. Try walking, swimming or other activities you enjoy. Regular moderate physical activity can help you maintain a healthy weight, lower blood pressure and lessen the extent of arterial stiffening. Eat a healthy diet. Choose vegetables, fruits, whole grains, high-fiber foods and lean sources of protein, such as fish. Limit foods high in saturated fat and sodium. A healthy diet can help you keep your heart and arteries healthy. Don’t smoke. Smoking contributes to the hardening of your arteries and increases your blood pressure and heart rate. If you smoke or use other tobacco products, asks your doctor to help you quit. Get adequate amounts of calcium. For adults ages 19 to 50 and men ages 51 to 70, medics recommend 1,000 milligrams (mg) of calcium a day. The recommendation increases to 1,200 mg a day for women age 51 and older and men age 71 and older. Dietary sources of calcium include diary products, almonds, broccoli, kale, canned salmon with bones, sardines and soy products, such as tofu. If you find it difficult to get enough calcium from your diet, ask your doctor about calcium supplements. Stay mentally active. Mentally stimulating activities help keep your brain in shape — and might keep memory loss at bay. Do crossword puzzles. Take alternate routes when driving. Learn to play a musical instrument. Be social. Social interaction helps ward off depression and stress, which can contribute to memory loss. Look for opportunities to get together with loved ones, friends and others.