How Is Nutrition Different for Older vs. Younger Adults?

There are key differences in nutrition for older and younger adults, due to several factors:

• Nutritional needs change with age and health status
• Older adults choose healthier foods than younger adults (although most are still not getting the recommended serving of five to nine fruits and vegetables a day)
• Many older adults are malnourished

While good nutrition is essential at any age, healthy eating practices may be particularly important for older adults in order to prevent and manage chronic conditions that affect 88% of older adults over age 65.⁴

Nutritional Needs Change with Age and Health Status

As people grow older, their overall intake of food decreases significantly, often due to less physical activity and physiological changes that result in decreased muscle mass.⁵ There is no research, however, that indicates that the requirements for nutrients decrease with age.

"There is some evidence [for] … increased rather than decreased requirements for intake."⁶

For this reason, it is important for older adults to eat quality foods that are high in nutritious value.

Older Adults Choose Healthier Foods Than Younger Adults

National measures of healthy eating habits, such as the Behavioral Risk Factor Surveillance System (BRFSS), the Healthy Eating Index (a summary measure of overall diet quality), and the National Health and Nutrition Examination Survey, confirm trends over the last decade that people age 65 and above have healthier eating habits than younger groups. Compared to younger age groups:

• More people age 50 and above eat the recommended five or more servings of fruits and vegetables a day (about 25-32% of older adults, compared to 20% of people in younger age groups)⁷
• Older people are more likely to eat vegetables than fruit⁸
• Adult women in general (age 18 and above) are more likely than men to get five servings of fruits and vegetables a day (about 28% of women compared to 18% of men)⁹

Many Older Adults Are Malnourished

As we grow older, we decrease our food intake. People age 70 and older need fewer calories because they tend to be less active.¹⁰ In addition, as people age, body composition changes. Skeletal muscle mass decreases and body fat increases.¹¹ However, losing weight without trying can be one of the first symptoms of frailty, which can then lead to other conditions that worsen the quality of life and the health of an individual.

Even healthy older adults tend to decrease their food intake by decreasing meal size and reducing snacks. With the decreasing consumption of energy, there is an accompanying, and more problematic, decline in intake of essential nutrients.

• Nearly 40% of adults age 65 and older have inadequate nutritional intake¹²
• As many as 16% of Americans over the age of 65 consume less than 1,000 calories a day, putting them at severe risk for malnutrition¹³
• Severe weight loss may result in protein-energy malnutrition. If not treated quickly, this condition may not be reversible, resulting in death due to electrolyte imbalance, infection with sepsis (toxins in the blood), low body temperature or heart failure¹⁴

⁴ King, A.C., Rajeski, W.J., and Bunchner, D.M. (1998) "Physical Activity Interventions Targeting Older Adults: A Critical Review and Recommendations." Journal of Aging and Physical Activity 5(1):2-8.

⁵ Wakimoto, P., and Block, G. (2001) "Dietary Intake, Dietary Patterns, and Changes with Age: An Epidemiological Perspective." Journals of Gerontology 56A:65-80.

⁶ Ibid.

⁷ Behavior Risk Factor Surveillance System. "Trends data nationwide grouped by age for 'Not enough fruits and vegetables risk behavior.' " Available at CDC on the World Wide Web: www.cdc.gov/brfss.

⁸ Lin, B. (February 2005) "Nutrition and Health Characteristics of Low-Income Populations Healthy Eating Index." U.S. Department of Agriculture, Economic Research Service. Available at USDA on the World Wide Web: www.ers.usda.gov/publications/aib796/aib796-1/aib796-1.pdf.

⁹ Behavior Risk Factor Surveillance System. "Trends data nationwide grouped by gender for 'Not enough fruits and vegetables' risk behavior." Available at CDC on the World Wide Web: www.cdc.gov/brfss.

¹⁰ Amersbach, G. (Fall 1999) "More Water, More Fiber, Fewer Calories: Reinventing the Food Pyramid for Older Adults." Tufts Nutrition. Available at Tufts on the World Wide Web: http://nutrition.tufts.edu/magazine/1999fall/pyramid.html.

¹¹ Evans, W.J. (2002) "Exercise and Aging," in N. Ruderman et al. (eds) Handbook of Exercise in Diabetes. The American Diabetes Association, p. 567.

¹² Nutrition Screening Initiatives. (2003) "Older Americans not sticking with nutrition programs or statins." Winter 2003(37):1-6.

¹³ Morley, J.E. (June 4, 2004) "As obesity epidemic peaks, our grandparents are starving to death." News release available at Saint Louis University on the World Wide Web: www.slu.edu/readstory/newsinfo/4063.

¹⁴ Morley, J.E. (2003) "Anorexia and weight loss in older persons." Editorial. Journal of Gerontology: Medical Sciences 58A(2):131.