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Diet and the elderly; research points to some special needs - part 2

A growing amount of research into the way elderly men and women eat and live is expected to produce new recommendations on the specific nutrient needs of this rapidly growing segment of the American population. Some studies now under way suggest that the elderly have special dietary requirements and that some of them may need more of certain nutrients than they did when younger.

The data are indicating that many elderly Americans, especially women, don't get enough calcium and that some older citizens may have other deficiencies in their day-to-day In one study conducted under a grant from the National Institute on Aging, separate panels of scientists analyzed the information available for six essential nutrients--calcium, vitamin D, iron, folate, thiamine and zinc. The panelists looked at the consumption of the nutrients by the elderly, the dietary requirements of the elderly (as far as they are known), and any known association of inadequate intake with specific diseases. In reporting their findings, however, the panelists stressed that it was difficult to evaluate the nutritional status of elderly people because information about specific needs was lacking.

"Few studies of nutrient requirements have been done on the very old," they reported. "There also is a great need for more effective techniques to detect deficiencies in the elderly." The panels--whose findings were published in a November 1982 supplement issue of The American Journal of Clinical Nutrition--concluded that calcium deficiences are prevalent among many older Americans but that consumption of four other nutrients--folate, thiamine, vitamin D and iron--appeared to be generaly adequate. The panelists also said that consumption of zinc may be less than desirable but that data supporting such as "impression" is too limited to permit a firmer conclusion.

Many researchers believe that a deficiency of dietary calcium is a factor in osteoporosis, a disease that leaves the bones brittle and the individual prone to fractures, a common injury among the elderly. "See "Please Pass That Woman Some More Calcium And Iron" in the September 1984 FDA Consumer.) Of primary concern are women, whose calcium intake is usually less than that of men. Far more elderly women than men suffer from osteoporosis. Generally, bone strenght increases until about the age of 30 to 35. Thereafter, if begins to decline until menopause. Then, following menopause, the amount of bone loss in women tends to accelerate during the next three to seven years, possibly as a result of decreased estrogen levels associated with post-menopause. The panel further noted that as people get older--especially women--they tend to consume fewer calcium-rich foods, such as milk, cheese and other dairy products. The situation is further aggravated, the panelists noted, by reduced physical activity as a person ages. Bone renewal is aided by exercise. Women may face a greater risk from osteoporosis in later life because their bone mass is generally less than that of men to begin with.

The panel concluded that women of all ages need to consume more calcium, and they stressed that it is important for women to develop the habit of eating plenty of calcium-rich foods when young and to continue doing so throughout life.

Vitamin D is needed along with calcium to maintain healthy bones. It can be obtained by exposure to sunlight and by consuming foods fortified with vitamin D, by eating foods in which vitamin D is naturally present (liver, eggs and saltwater fish), and by taking dietary supplements. Absorption of vitamin D declines with age and many older people are less exposed to the sun, the report noted. However, the panel of scientists investigating this nutrient reported that most elderly people in the United States have adequate vitamin D levels, which is related to many foods being fortified with the nutrient as well as to the use of vitamin supplements in this country. Deficiencies, however, may occur among those who are ill, those confined to institutions, those who are heavy alcohol and drug users, and those whose food budgets are limited by small incomes (factors that could lead to deficiencies of other nutrients as well).

Iron, which plays a vital role in transporting oxygen to body cells and in the cells' utilization of oxygen, is generally adequate in the diets of most elderly people, another panel concluded. Inadequate dietary iron can lead to iron deficiency anemia. The body's need for iron is not believed to be any greater in the elderly than in younger adult males, and lower than those for children and menstruating women. The Food and Nutrition Board of the National Academy of Sciences noted in its 1980 report that of all the trace minerals, deficiency of dietary iron probably is the one that poses the greatest nutritional concern, particularly for infants, and children, pregnant women and women of child-bearing age, and older people with low food intakes.