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An appetite for life: nutrition in the elderly

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Being a witness to the slow decline of a person who nourished you with stories and advice, with knowledge gained from a lifetime of experience and a hindsight that could only have come from mistakes made and lessons learned. Knowing that now it is your strength that they need to carry on.

Malnutrition in the elderly is a problem that is present but unrecognised in all nations, developed and developing. (1A)

There are many factors which may contribute to the elderly not getting the nutrition they need, factors that include physiological, mental and environmental changes associated with the ageing process:

•    Alterations in smell and taste (2A)
•    Poor appetite (3A)
•    Poor dental health e.g. difficulty chewing (2A,3A)
•    Social isolation – 64% of malnourished elderly patients in a study were widowed and 39.6% were living alone (3B)
•    Depression (3C)
•    Decline in cognitive and functional status (1B)
•    Chronic diseases (1B)
•    Poverty (1B)

These factors may contribute to an insufficient intake of food and nutrients, leading to malnutrtion in the elderly.

It is the consequences of poor nourishment that are the most concerning.

Undernourished elderly have longer periods of illness, longer hospital stays, higher rates of infection, delayed wound healing, reduced appetite, reduced quality of life and increased mortality rates. (3D) 55% of elderly hospitalised patients are undernourished or malnourished on admission. (3E)

Nutrition plays a major role in immune function (4A)

Nutrition also plays a huge role in immune function. Ageing is associated with a decline in immune function, which increases susceptibility to infectious disease, degenerative diseases and cancer.  (5A) This decline in immune function is compounded by poor nutrition. (4B,6A)  Deficiency in both macronutrients (protein, energy) and micronutrients (vitamins and minerals) can cause immune function impairment (6B) that leads to secondary health complications, e.g. S. Aureus  after influenza infection, or upper respiratory tract infections. (6C)

How do we give the elderly the strength to carry on?
Getting them to eat proper, nutritionally balanced meals may seem like the obvious answer, but the reality is not that simple. Due to the factors mentioned above, many elderly people just don’t have the energy, the will or the ability to feed themselves properly. This is where proper nutritional supplementation can play a huge role.

Nutrition supplementation helps to enhance the immune system of the elderly, (4C)  and may contribute significantly to the health and wellbeing of older individuals, and to their ability to recover from illness. (2B) Meal supplements are easy to prepare and, in most cases, tasty alternatives that contain the minerals, vitamins and nutrients the elderly need. Some of these products also contain probiotics like Lactobacillus paracasei that increase the healthy bacteria in the gut of the elderly and enhance their immune system. (6D,7A,8A)

Caring for a parent or grandparent means giving strength as well as support. Nestlé Nutren Optimum is a complete nutritional supplement designed to respond to the immune challenges of elderly people. Nutren Optimum is a meal in a glass that contains vitamins, nutrients and strength-building protein, as well as pre- and probiotics known to enhance immunity and aid digestive health, that gives them the strength to carry on. Two glasses of Nutren Optimum a day can improve immune function and decrease infections by 41% in the elderly. (9A)

Nestlé Nutren Optimum is available at retailers and pharmacies countrywide. For delicious recipes using Nestlé Nutren Optimum, or for more information about the product, visit www.nutren.co.za   


References:
1. Kagansky N, Berner Y, Koren-Morag N, Perelman L, Kobler H, Levy S. Poor nutritional habits are predictors of poor outcome in very old hospitalized patients. Am J Clin Nutr 2005;82:784-791.
2. Forster S, Gariballa S. Age as a determinant of nutritional status: A cross sectional study. Nutr J 2005;4:28.
3. Feldblum I, German L, Castel H, Harman-Boehm I, Bilenko N, Eisinger M, et al. Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status. Nutr J 2007;6:37.
4. Lesourd B, Mazari L. Nutrition and immunity in the elderly. Proceed Nutr Soc 1999;58:685-695.
5. Srinivasan V, Maestroni GJM, Cardinali DP, Esquifino AI, Perumal SRP, Miller SC. Melatonin, immune function and aging. Immunity & Aging 2005;2:17.
6. Pae M, Meydani SN, Wu D. The Role of Nutrition in Enhancing Immunity in Aging.  Ageing Dis 2012;3(1):91-129.
7. Forssten SD, Salazar N, López P, Nikkilä J, Ouwehand AC, Patterson A, et al. Influence of a Probiotic Milk Drink, Containing Lactobacillus Paracasei  Lpc-37, on Immune Function and Gut Microbiota in Elderly subjects. Eur J Food Res Rev 2011;1(3):159-172.
8. Crittenden R, Saarela M, Mättö J, Ouwehand AC, Salminen S, Pelto L, et al. Lactobacillus paracasei  subsp. paracasei F19: Survival, Ecology and Safety in the Human Intestinal Tract – A survey of Feeding Studies within the PROBDEMO project. Microb Ecol Health Dis 2002;(Suppl 3):22-26.
9. Bunout D, Barrera G, Hirsch S, Gattas V, de la Maza MP, Haschke F, et al. Effects of a nutritional supplement on the immune response and cytokine production in free-living Chilean elderly. J Parenter Enteral Nutr 2004,28(5):348-354.

 
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