Nutrient deficiencies in older adults
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Nutrients of Concern for Older Adults

Unfortunately, as we grow older our bodies become more vulnerable to nutrient concerns due to the changes associated with aging. These changes can range from physiological to social to everything in-between, and can afflict any of us as we age. Diseases and illnesses, poor eating habits, lack of adequate social contact, and economic hardships are a few of the major reasons that an older adult may face concerns about their nutrition. This article explores some of the most common age-associated nutrient deficiencies and concerns, as well as some of the foods to be aware of if you are trying to increase or decrease your consumption.

Vitamin D

RDA m/f 31-70: 600 IU/day

Also known as calciferol, vitamin D plays a crucial role in bone maintenance (through interactions with calcium) and acts as somewhat of a hormone on cells throughout the body. It may also play a role in blood pressure regulation and heart disease prevention. Certain medications can interfere with vitamin D metabolism, such as barbiturates or laxatives. In addition, because sunlight is one of the primary sources of vitamin D, lack of consistent sun exposure can cause low vitamin D levels.

To obtain more vitamin D in your diet, consider: eggs, fatty fish, and cheese. Also consider consuming foods fortified with vitamin D, such as: milk, yogurt, and breakfast cereals.

Vitamin E

RDA m/f 31-70: 15 mg/day

Vitamin E plays an important role inside the body as an antioxidant. An antioxidant is a substance that reduces the level of oxidative stress in the body. Oxidative stress causes cellular damage, which can lead to diseases such as heart disease and cancer. Vitamin E is also known to play a role in cognitive health.

To obtain more vitamin E in your diet, consider: plant-based oils, such as sunflower or canola, nuts, and plant-based margarine.

Vitamin K

AI m/f 31-70: 120/90 µg/day

Vitamin K plays a crucial role in blood coagulation and an important role in bone mineralization, as well as cell signaling throughout the body. Anticoagulant medications can inhibit vitamin K metabolism, and diets too high in vitamin K can inhibit the actions of anticoagulant medications. People on these medications are advised to maintain a consistent level of vitamin K intake.

To be aware of the amount of vitamin K in your diet, consider: leafy green vegetables, plant-based oils and margarines, and certain fortified foods.

Vitamin A

RDA m/f 31-70: 900/700 µg/day

Vitamin A is essential for vision health, and also functions as an antioxidant in the body. It is also important for overall cellular metabolism. As we age, vitamin A stores increase in the liver (as well as in the circulation) and clearance of the metabolic products of this vitamin is reduced. This can lead to vitamin A toxicity in older people, which can ultimately lead to liver damage.

To be aware of the amount of vitamin A in your diet, consider: eggs, milk, cheese, fish, and fortified foods. Avoid eating too much animal liver as it contains large amounts of vitamin A.

Vitamin B12

RDA m/f 31-70: 2.4 µg/day

Also called cobalamin, vitamin B12 plays an essential role in the body as an enzyme. An enzyme is a substance that is responsible for being a catalyst in a biochemical reaction. Decreased gastric absorption of B12 is what leads to low vitamin B12 levels in the aging population. A severe deficiency of vitamin B12 can lead not only to anemia but also to irreversible neurological symptoms, including loss of mental and physical function.

To obtain more vitamin B12 in your diet, consider: meat and meat products, poultry, fish, eggs, cheese and milk.

Folic Acid

RDA m/f 31-70: 400 µg/day

Folate, the form of folic acid found in body tissues, has a primary role as a coenzyme. Similar to an enzyme, the role of a coenzyme is to assist with biochemical reactions. It is involved in both amino acid metabolism as well as DNA synthesis. Although folate is required in the highest amount by females during pregnancy, decreased absorption during older age can lead to folate deficiency, which can lead to anemia.

To obtain more folate in your diet, consider: green vegetables, nuts, legumes, and certain fruits and fruit juices.

Iron

RDA m/f 31-70: 8 mg/day (18 mg/day for females 31-50)

Iron is found primarily throughout the body in hemoglobin, or the primary protein in red blood cells. It also plays a role in energy production via the TCA cycle and the electron transport chain. Similar to vitamin A, older people are more likely to experience iron toxicity due to the body storing more iron as we age. Iron toxicity can create increased oxidative stress, which will need to be countered with increased antioxidant consumption.

To be aware of the amount of iron in your diet, consider: meat, fish, poultry (animal products), dairy products, and certain plant foods. Avoid eating animal liver as it contains large amounts of iron. Consume more vitamin C to increase iron absorption and reduce oxidative stress.

Calcium

RDA m/f 31-70: 1000 mg/day (1200 mg/day for females 51-70)

Calcium serves a variety of important roles in the body. It is responsible for bone formation, the formation of blood clots, contraction of muscle tissue, and the transduction and transmission of signals. As we age, calcium absorption in the gastrointestinal tract decreases, thus leading to decreased bone mass in many older people. Alternately, too high of a calcium intake can interfere with the absorption of other important nutrients, such as zinc, iron and magnesium.

To be aware of the amount of calcium in your diet, consider: milk, yogurt, cheese, certain types of seafood, and certain (mostly) green vegetables.

Magnesium

RDA m/f 31-70: 420/320 mg/day

The primary role of magnesium in the human body is bone formation. Magnesium forms a “crystal lattice” with calcium and phosphorus to provide the hard nature of bone tissue. Magnesium also plays a role in the stabilization of cell membranes and serves as a part of over 300 enzyme systems. The primary risk of magnesium deficiency due to age is because of decreased magnesium intake rather than decreased metabolism. However, as with many other nutrients, gastrointestinal diseases can reduce magnesium absorption in the GI tract.

To obtain more magnesium in your diet, consider: whole-grains, nuts, legumes, beans, peanut butter, and leafy green vegetables.

Potassium

AI m/f 31-70: 4700 mg/day

Potassium functions as an electrolyte and is important in pH balance of bodily fluids. It also plays a role in smooth, cardiac, and skeletal muscle contraction, as well as has an effect on nerve tissue conductivity. In terms of dietary requirements for older adults, potassium can assist with balancing sodium intake, which is a serious problem for people of all ages. This can greatly influence blood pressure levels caused by high sodium intake. Many older adults do not consume enough potassium in the diet.

To obtain more potassium in your diet, consider: certain fruits, leafy green vegetables, legumes, nuts, seeds, milk and yogurt.

If you are concerned about getting an adequate nutrient intake even in older age, consider that a whole food diet will naturally provide a wide range of important vitamins and minerals. In some cases, however, with impaired digestion or a decreased ability to eat whole foods, supplementation may be warranted and can be prescribed by a doctor or recommended by a trained nutrition professional.

Sources
Brown JE. Nutrition Through the Life Cycle. 5th ed. Stamford, CT: Cengage Learning; 2014.
Gropper S, Smith J, eds. Advanced Nutrition and Human Metabolism. 6th ed. Belmont, CA: Wadsworth Cengage Learning, 2013.

Human Nutrition student working on her Master's, learning to love life through good food and good health.

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