A Review of Nutritional Requirements of Adults Aged ≥65 Years in the UK

Abstract

Appropriate dietary choices in later life may reduce the risk of chronic diseases and rate of functional decline, however, there is little well-evidenced age-specific nutritional guidance in the UK for older adults, making it challenging to provide nutritional advice. Therefore, the aim of this critical review was to propose evidence-based nutritional recommendations for older adults (aged ≥65 y). Nutrients with important physiological functions in older adults were selected for inclusion in the recommendations. For these nutrients: 1) recommendations from the UK Scientific Advisory Committee for Nutrition (SACN) reports were reviewed and guidance retained if recent and age-specific, and 2) a literature search conducted where SACN guidance was not sufficient to set or confirm recommendations for older adults, searching Web of Science up to March 2020. Data extracted from a total of 190 selected publications provided evidence to support age-specific UK recommendations for protein (1.2 g·kg−1·d−1), calcium (1000 mg·d−1), folate (400 μg·d−1), vitamin B-12 (2.4 μg·d−1), and fluid (1.6 L·d−1 women, 2.0 L·d−1 men) for those ≥65 y. UK recommendations for carbohydrates, free sugars, dietary fiber, dietary fat and fatty acids, sodium, and alcohol for the general population are likely appropriate for older adults. Insufficient evidence was identified to confirm or change recommendations for all other selected nutrients. In general, significant gaps in current nutritional research among older adults existed, which should be addressed to support delivery of tailored nutritional guidance to this age group to promote healthy aging.

Is protein the forgotten ingredient: Effects of higher compared to lower protein diets on cardiometabolic risk factors. A systematic review and meta-analysis of randomised controlled trials

“…The effects of dietary protein on human health are determined by several factors, including quantity, quality (animal protein/plant protein) and source; animal (red and white meat, fish, eggs and dairy) or plant-based (nuts, legumes, grains). In terms of quantity, current European and US dietary recommendations for protein intake generally advise at least 0.8 g/kg body weight (BW)/day for adults [2,3] and growing evidence suggests an even higher intake for elderly (1.0-1.2 g/kg BW/day) [4][5][6]. When expressed in percentage of the total energy intake (energy-percent (E%)), the Nordic Nutrition Recommendations established a desirable daily protein intake of 10-20 E% for adults [7].…”

Nutritional concerns later in life

“…Nutritional recommendations should account for these alterations, not only for reducing risk of diseases such as osteoporosis (vitamin D), megaloblastic anaemia (vitamin B12), sarcopenia (protein) but also for the preservation of functional health and quality of life into old age. Because age-specific evidence to derive nutritional requirements for older adults is often lacking (16) , requirements of older adults are often considered the same as for the rest of the older populations for most nutrients (17) . Therefore, a recent critical review of a total of 190 papers was conducted in the UK to propose evidence-based nutritional recommendations for the 65+ population segment, particularly for most nutrients with important physiological functions in older adults.…”

“…Recommended intakes of vitamin B12 have been collated within the EURRECCA network of excellence, demonstrating a range of 1⋅5-3⋅0 μg daily (RDA's for adults and elderly (29) ). In the UK, the proposed recommendation amounts to 2⋅4 μg daily, along with the food-based advice to consume foods fortified with vitamin B12, such as breakfast cereals or yeast extract or animal products including lean meat, fish, poultry, eggs and dairy (16) .…”

“…Despite repeated calls that for optimising muscle health it should be recommended that older individuals consume ≥1⋅2 g protein/kg daily (39) or even higher (40,41) the debate on changing the current protein recommendations beyond the RDA of 0⋅8 g/kg body mass (42) is still ongoing. Yet, Dorrington et al (16) propose to change the current UK protein recommendation for adults ≥65 years (0⋅75 g/kg daily) to 1⋅2 g/kg daily acknowledging the likely benefits of particularly animal protein for muscle mass and function, and potentially for frailty and disability. The food-based dietary advice which comes with this recommendation is to have with each meal a portion of lean meat, poultry, fish, eggs, dairy or legumes (16) .…”

Influence of Age and Individual Differences on Mouthfeel Perception of Whey Protein-Fortified Products: A Review

“…Energy requirements are considered to decline with age due to body composition changes and reduced physical activity [6]. However, protein needs are considered to increase with age (as outlined in Section 2), but, as with most other nutrients, recommendations typically remain the same as those suggested for adults generally [7][8][9] (for a recent review on nutritional recommendations in older adults see Dorrington et al [10]). Additionally, there are adverse effects associated with the ageing process, which is considered to be a multidimensional process, including physical, psychological and social changes, all of which are potential risk factors for malnutrition (Table 1) [11].…”