Frailty Matters / AVOID Frailty / Diet and Nutrition

Diet and Nutrition

Good nutrition is essential for cell and tissue repair, for daily activities, and to keep people healthy, happy, and well. As we age, our dietary and nutrition needs change. Being aware of these changes and adjusting your eating habits can help prevent you from developing frailty.

When we talk about “diet,” we’re talking about the quantity and quality of the foods we eat.

“Nutrition,” on the other hand, refers to more than just food and drink. It is the process that involves taking in and using fuel (food and drink) in the body.

The Process

Nutrition is a three part process:

  1. Food and drinks are consumed (eating and drinking)
  2. The body breaks down food and drink into nutrients (digestion)
  3. Nutrients travel through the blood stream to body tissues and organs to be used as energy, and for growth and repair (absorption)

For effective nutrition to occur, people:

  • Must take in food and drink that provide enough energy and key nutrients for growth and repair
  • Must have a digestive system that works properly
  • Need healthy body systems to transport and absorb nutrients to be used by the body

Diet and Nutrition and Frailty: What do We Know?

Maintaining good nutrition can become a challenge as we age.

Malnutrition (undernutrition) occurs when there is a lack of nutrients in your diet. This could be due to a poor diet, not eating enough food or to problems absorbing nutrients from food. It is a factor that increases the risk of frailty.

Why is malnourishment common in seniors?

  • Not hungry
  • Poor sense of smell or taste
  • Medications interfere with digestion and nutrition
  • Mobility issues make shopping and meal preparation hard
  • Financial issues—less money for food
  • Loneliness and grief
  • Dental health issues
  • Illness or disease

The Evidence

Did you know that:

  • 34% of seniors have difficulties meeting their nutritional needs
  • 70% of malnourished patients are living with frailty

A diet lacking in quantity or quality can contribute to being over- or under-weight, decreased bone mass, immune dysfunction, cognitive impairment, functional limitations, and a lowered ability to rebound from illness or surgery. It can also lead to chronic conditions, while existing conditions and their treatments may impair nutritional well-being.

As a result, malnutrition is a factor that increases the risk of frailty.

Food is medicine! As we age, we need more of certain nutrients like Protein, Calcium and Vitamin D to keep our bones and muscles strong well into old age. Use this shopping list to help you choose foods high in nutrition.

Download our shopping list

Vitamin D helps absorb calcium—they work together! Apart from helping your body absorb calcium, vitamin D also plays a role in your nervous, muscle, and immune systems.

How can you adjust your diet and nutrition to help you avoid frailty?

Pay attention to the nutrients in the food and drink you eat—look specifically for protein, calcium, and vitamin D. Aim to ensure you’re eating enough of the right foods and getting proper nutrition.

As we age, our bodies need more protein.

Protein helps to maintain muscle mass and keep us healthy. There are many high quality sources of protein.

For more information, watch Hal Johnson and Joanne McLeod of BodyBreak discuss the importance of getting enough protein, or try their Chili recipe:

Download the Recipe Here!

Animal Products

Animal products provide high quality protein.

  • Chicken
  • Fish
  • Eggs
  • Dairy products

Plant-Based Products

Plant-based sources also have protein, but are not considered high quality because they do not contain all the amino acids.

  • Soy
  • Legumes
  • Spinach
  • Nuts

Vegetarians, take note: for you, getting enough high quality protein takes extra work, education, and planning to ensure you’re getting the right amino acids. It often involves cooking your own food, which can be challenging for older adults at risk for frailty.

How much protein is enough?

Experts recommend 1 to 1.5 grams of protein per kg of body weight.

If someone weighs 175 pounds (80 kg) they should aim for: 80 to 120 grams of quality protein (i.e., a protein that contains all of the essential amino acids in the right amounts) each day.

How to Include More Protein in Your Diet

Protein Calories
Boiled egg (1) 6g 70
Glass of 2% milk (1 cup) 8g 129
Halibut (4oz) 24g 125
Chicken breast (4oz) 35g 184

Having trouble eating enough high quality protein?

Consider supplementing your diet with high protein drinks, puddings or shakes.

Calcium and vitamin D are vital for bone and muscle health

Did you know that calcium is the most abundant mineral in the body? Over 99% of the body’s calcium supply is found in the bones and teeth, where it supports their structure. Calcium is also important for proper muscle function, strong bones, nerve transmission, and hormonal secretion.

Evidence has confirmed that vitamin D and calcium play a vital role in supporting the health of the skeletal system, keeping bones and muscles strong, and helping to prevent osteoporosis.

Calcium is best consumed as part of a healthy diet:

  • Men 51 to 70 years need 1000mg daily
  • Women 51 to 70 years need 1200mg daily
  • All adults 70 years and older need 1200mg daily

Foods Rich in Calcium

  • Milk, yogurt, cheese, and fortified plant-based beverages (e.g., soy drinks)
  • Dark green vegetables (e.g., broccoli, kale, and spinach)
  • Fish with soft bones that are eaten (e.g., canned salmon or sardines)

Vitamin D is best consumed as a dietary supplement

Diet and sunlight provide some Vitamin D. However, more than 75% of Canadians report inadequate Vitamin D intake. Vitamin D deficiency (not getting enough vitamin D to stay healthy) is a common, serious medical condition that significantly affects the health and well-being of older adults, particularly bone health.

Supplementation is recommended:

  • Adults 18 to 70 years need 600 IU daily
  • Adults 70 years and older need 800 IU daily

Vitamin D cannot be absorbed fully by the body without the presence of calcium. It is best to take vitamin D & calcium supplements together.

Foods Naturally Rich in Vitamin D

  • Oily fish (e.g., salmon and oysters)
  • Fish oils (e.g., halibut and cod liver)
  • Egg yolks

Most Likely, You Will Intake Vitamin D from Fortified Foods

  • Cow’s milk
  • Cheese (if made with fortified milk)
  • Yogurt (if made with fortified milk)

Note: Cheese and yogurt can be made with vitamin D-fortified milk, however, they do not contain as much vitamin D as milk alone does.

Vitamin D cannot be absorbed fully by the body without the presence of calcium. It is best to take vitamin D & calcium supplements together.

Did you know that vitamin D receptors have been found in all areas of the body?

Vitamin D and Research

Interest in researching vitamin D has increased in recent years. Research is now ongoing to determine if providing vitamin D can help prevent, treat, or improve the chronic conditions of aging, such as cognitive decline, depression, cardiovascular disease, hypertension, type 2 diabetes, and cancer.

Diet and nutrition and oral health go hand-in-hand. Learn more about how what you eat affects your oral health, and how oral health affects your diet and nutrition.

Citations

Ahmed, T., & Haboubi, N. (2010). Assessment and management of nutrition in older people and its importance to health. Clinical Interventions in Aging, 5, 207-216. doi: 10.2147/cia.s9664

Canadian Malnutrition Task Force. (2019). Eat your medicine. [Online Infographic]. Retrieved from http://www.nutritioncareincanada.ca/sites/default/uploads/files/public-infographic/Public-Infographic_Web.jpg

FatSecret. (2019). Food database and calorie counter: Atlantic and Pacific halibut. [Website]. Retrieved from https://www.fatsecret.com/calories-nutrition/usda/atlantic-and-pacific-halibut?portionid=37112&portionamount=4.000

Health Canada. (10 July, 2019). Vitamin D and calcium: Updated Dietary Reference Intakes. [Website]. Retrieved from https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/vitamins-minerals/vitamin-calcium-updated-dietary-reference-intakes-nutrition.html

Langlois, K. A., Greene-Finestone, L. S., Little, J., Hidiroglou, N., & Whiting, S. J. (March 2010). Vitamin D status of Canadians as measured in the 2007 to 2009 Canadian Health Measures Survey. (Catalogue No. 82-003-XPE). Retrieved from Statistics Canada: https://www150.statcan.gc.ca/n1/pub/82-003-x/2010001/article/11131-eng.pdf

Ledikwe, J. H., Smiciklas-Wright, H., Mitchell, D. C., Jensen, G. L., Friedmann, J. M., & Still, C. D. (2003). Nutritional risk assessment and obesity in rural older adults: A sex difference. American Journal of Clinical Nutrition, 77(3), 551-558. doi: https://doi.org/10.1093/ajcn/77.3.551

Leslie, W., & Hankey, C. (2015). Aging, nutritional status and health. Healthcare, 3(3), 648-658. doi: 10.3390/healthcare3030648

MedlinePlus on behalf of the National Library of Medicine, National Institutes of Health. (2017). Vitamin D deficiency. [Website]. Retrieved from https://medlineplus.gov/vitaminddeficiency.html

Meehan, M., & Penckofer, S. (2014). The role of vitamin D in the aging adult. Journal of Aging and Gerontology, 2(2), 60–71. doi: 10.12974/2309-6128.2014.02.02.1

McNicholl, T., Keller, H., Valaitis, R., Laur, C., Dubin, J. A., Mourtzakis, M., Curtis, L., Nasser, R., & Laporte, M. (May 2017). The More-2-Eat project: Association between measures of frailty and nutritional status in patients at nutritional risk. Presented at the 8th Annual Scientific Meeting of the Canadian Nutrition Society, Montreal, QB. Abstract retrieved from https://cns-scn.ca/sites/default/uploads/files/apnm-2017-0134.pdf

National Health Service. (2017). Overview: Malnutrition. [Website]. Retrieved from https://www.nhs.uk/conditions/malnutrition/

National Institutes of Health, Office of Dietary Supplements. (2019). Vitamin D: Fact sheet for health professionals. [Website]. Retrieved from https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

Ramage-Morin, P. L., & Garriguet, D. (17 July, 2015). Nutritional risk among older Canadians. [Website]. Retrieved from https://www150.statcan.gc.ca/n1/pub/82-003-x/2013003/article/11773-eng.htm

Whiting, S.J., Langlois, K. A., Vatanparast, H., & Greene-Finestone, L. S. (2011). The vitamin D status of Canadians relative to the 2011 Dietary Reference Intakes: An examination in children and adults with and without supplement use. American Journal of Clinical Nutrition, 94(1), 128-135. doi: 10.3945/ajcn.111.013268

These are general health guidelines and should not be considered personal medical advice. Speak to your doctor before taking any new vitamins or supplements. You should consult your health care provider and discuss each element outlined above to ensure that each element of the AVOID Frailty campaign is personally customized for you.