Senior Nutrition: Eating Well As You Age

Healthy eating is important no matter what age you are, but older adults have unique nutritional needs. Aging brings about physical, social and emotional changes that can make senior nutrition a challenge. 

Many people over the age of 65 have malnutrition, whether they don’t eat enough of the nutrients the body needs or consume too many. This can lead to health complications including weakness, frailty, obesity and diabetes. A nutritious diet consisting of a variety of food is essential to help you stay healthy and feel your best. 

Why Is Nutrition Important for Older Adults?

As we age, the body’s metabolism slows in response to reduced physical activity. Older adults require fewer calories to get through the day. It’s important to adjust eating habits to reflect this shift, ensuring the ones you do eat are wholesome and rich in nutrients. 

Seniors who continue eating the same amount of food as they used to may take in too many calories and gain weight. Other adults may experience reduced appetite that makes it hard to get the appropriate nutrition. Illness, side effects from medication and difficulty chewing, swallowing or digesting food can also negatively impact food intake. 

It's important for older adults to have a healthy diet that includes a wide range of vitamins, minerals, proteins, carbohydrates and other nutrients. A lack of nutrition can affect the heart, bones, muscles and nervous system, causing a range of health risks and leading to conditions such as heart disease, osteoporosis, diabetes and cancer. 

Malnutrition in Seniors

Malnutrition occurs when the body doesn't have the nutrients it needs to function properly. Older adults are at risk for both undernutrition and overnutrition. 

Undernutrition

Undernutrition occurs when the body doesn’t take in enough of the dietary energy and protein it requires, leading to unintentional loss of weight, body mass and fat. An estimated 10% of older adults who live in their own home and more than 35% of those in senior living communities experience undernutrition. Many seniors skip at least one meal a day. 

Older adults need a variety of nutrients for proper health, such as calcium and vitamin D for bone health, protein for muscle function and vitamin B-12 for cognitive function. Some effects of undernutrition include: 

• Weakness or fatigue 
• Frailty 
• Increased risk of falls 
• Anemia 
• Increased risk of infections 
• Difficulty recovering from illness 
• Longer hospital stays 
• Increased mortality 
• Poor quality of life 
• Cachexia or wasting 

Overnutrition

One-third of people over the age of 65 suffer from overnutrition.¹ This occurs when older adults are less physically active and take in more calories than they need, or when certain nutrients are eaten in excess amounts.

Diets high in saturated fats, processed foods, whole-fat dairy products, refined carbohydrates and sodium can lead to overnutrition.

Some effects of overnutrition include: 

• Obesity 
• Cardiovascular disease 
• Arthritis 
• Diabetes 
• Lack of nutrients the body needs for overall health 

Why Are Older Adults at Risk of Malnutrition?

Physiological, emotional and environmental changes can impact appetite or the ability to eat a healthy diet. Here are some factors that may make it challenging for seniors to get adequate nutrients.  

Oral and Digestive Issues

Gum disease, cavities, mouth infections and loss of teeth are common in older adults,³ making it difficult to chew or swallow food. Other problems that can impair appetite include: 

• Side effects from medication including decreased saliva production and dry mouth  
• Feeling of fullness from bloating or constipation  
• Slower gastric emptying, which keeps food in the stomach for longer  

Diminished Taste and Smell

Older adults may find their ability to taste and smell isn't as sensitive as it used to be.⁴ Our senses play a big part in stimulating appetite, and food that seems to taste bland or not have a delicious aroma may not be as enticing to eat. 

Illness

Senior nutrition can also be affected by chronic conditions or side effects of medication including pain, discomfort, nausea, weakness, hand tremors, arthritis and difficulties with manual dexterity. Feeling unwell can reduce appetite and make it hard to prepare food or eat. 

Affordability

According to Meals on Wheels, nearly 9.5 million seniors are threatened by hunger.⁵ Fixed or reduced incomes can affect how much food older adults can buy or the variety and quality of food they consume, especially if they have other expenses, such as medications. 

• 4 million are marginally food insecure, meaning they are worried about having enough food. 
• 3.3 million are food insecure. While they may not have a reduced food intake, they do have reduced quality, variety or desirability of diet. 
• 2.2 million are very low food secure and have disrupted eating patterns and reduced food intake. 

Emotional or Psychological Factors

Some seniors may find that life events impact their eating habits, such as the loss of a partner, close friend or family. One in four seniors live alone, and one in five report feeling lonely, according to Meals on Wheels.⁶ Social isolation and depression can make people less motivated to cook for themselves, especially when they must eat alone. 

Additional Barriers to Senior Nutrition

There are other factors that affect the eating habits of older adults. 

• Retirement can result in a lack of routine and less predictable mealtimes.   
• Care of an ill spouse may mean some seniors take less time to care for themselves. 
• Health issues such as dementia, frailty, pain or mobility can make it difficult to grocery shop or cook. 
• Lack of cooking skills means those who aren’t used to cooking for themselves may be limited in the kinds of meals they prepare.  

What Foods Are Good for Seniors?

The United States Department of Agriculture (USDA) and Department of Health and Human Services developed national dietary guidelines to help Americans choose what kinds of foods to eat for optimal health.⁷ Older adults should consume a variety of these wholesome foods.  

Vegetables and Fruit

A diet high in brightly colored fruits and vegetables provides an array of nutrients and fiber. Choose fresh or frozen fruits and vegetables or canned products that are low in sugar and salt. 

Grains

Whole grain pasta and cereals, whole wheat bread, oats and brown rice are excellent sources of vitamins and fiber. Whole grains provide more nutrition than refined products. 

Milk and Dairy

Milk, cheese and yogurt provide essential protein and calcium. Select fat-free or low-fat dairy products. Soy and rice milks that are enriched with vitamin D are also good options. 

Meat and Alternatives

Protein is important for energy and to build and repair tissue. Seniors should consume protein-rich foods, such as seafood, eggs, lean meats, poultry, nuts, seeds, beans and soy products. 

Oils and Fats

Fats are needed to give you energy, keep you warm and help with the absorption of certain vitamins, but it's also important to choose healthy unsaturated fats in moderation.⁸ 

Studies show that replacing saturated fats with unsaturated fats may lower risk of heart disease when consumed within recommended dietary guidelines.⁹ Unsaturated fats are found in avocado, fatty fish, most nuts, seeds and plant-based canola, olive, safflower, sunflower and peanut oils. 

Special Considerations for Senior Nutrition

There are some nutrients older adults often don’t get enough of and should make an effort to include in their diet. 

Calcium

Seniors should consume plenty of calcium-rich foods such as milk and dairy products, dark green leafy vegetables, canned salmon with bones and soybeans. Women in particular need calcium to maintain bone health and reduce the risk of osteoporosis.¹⁰ Calcium also helps to keep muscles, blood vessels and the nervous system healthy and functioning. 

Vitamin D

Studies show that older people who don’t appear to have malnutrition can still be deficient in vitamin D.¹¹ Fatty fish, fish liver oils, fortified cereals, fortified milk and milk products are all sources of vitamin D. 

This nutrient helps the body absorb calcium and is essential for bone health. It also helps manage blood pressure and hormones and improves functioning of the immune and nervous systems. 

Potassium

Potassium is also essential for senior nutrition. It helps the heart, muscle and nervous system to function properly, builds proteins and balances acids and bases in the body.¹² 

Many fruits and vegetables contain potassium, including citrus, bananas, cantaloupes, prunes, broccoli, peas, potatoes and squash. Meat, fish, dairy products and nuts are also excellent choices. If you like dried fruit, you might opt for dried apricots, since they contain more potassium than fresh apricots. 

Vitamin B-12

Vitamin B-12 is found in meat, fish, poultry, milk and fortified cereals and is important for the production of red blood cells and healthy nerve function. Older adults tend to have difficulty absorbing vitamin B-12 that occurs naturally in foods and may need to take supplements.¹³ Synthetic B-12, which is in foods fortified with vitamin D, such as cereal and some dairy products, is more easily absorbed.  

Magnesium

The body’s ability to absorb magnesium decreases with age.¹⁴ Chronic diseases and some medication can also affect magnesium levels. This mineral regulates blood pressure and blood glucose and is important for muscle and nerve function. 

Magnesium is found in green leafy vegetables, whole grains, legumes, seeds and fortified cereals. Dry roasted almonds or cashews, spinach, plain yogurt, black beans, brown rice and shredded wheat cereal are all excellent sources. 

Dietary Fiber

Fiber helps the body digest food and encourages more frequent bowel movements to help remove waste. It may also help reduce the risk of heart disease.¹⁵ 

Fiber is found in fruit, vegetables, whole grain breads and cereals, beans, nuts, seeds, peas and lentils. For extra fiber, consume fresh fruits and vegetables instead of drinking juice and leave the skin on where possible. Be sure to add fiber into your diet gradually to avoid constipation. 

Foods to Watch for in a Healthy Senior Diet

Consuming too many calories can lead to overnutrition. Older adults should make sure they're eating nutritious foods and avoiding those containing excess sodium, sugar and fats.¹⁶ 

Sodium

While we need sodium to balance fluids and for healthy muscle and nervous systems, too much sodium increases the risk of high blood pressure, heart disease, stroke and kidney disease. According to the CDC, seniors should limit sodium to less than 2,300 mg per day.¹⁷ Use salt sparingly when cooking and season foods with herbs and spices instead. Watch for sodium content in processed foods. 

Sugar

Avoid foods that are full of calories but have little nutritional value, such as cake, cookies, candy, soda and alcohol. Sugar adds empty calories, so be cautious of using too many sweeteners such as honey and syrup at the table and check ingredient labels for added sugar. Glucose, sucrose, fructose, dextrose, corn syrup, molasses and organic cane sugar are all added sugars, even if some sound natural and healthy. Seniors should be careful not to consume more than 50 grams of added sugar per day.¹⁸ 

Saturated and Trans Fats

Fat gives the body energy and helps with vitamin absorption, but some are unhealthy. Saturated and trans fats can raise cholesterol levels and increase risk of heart disease and stroke. Watch for saturated fat in animal products such as butter, fatty meats and dairy products.

Foods such as cakes, cookies, snack foods, pizza and burgers can also contain high amounts of saturated fat. 

Older adults should limit intake of saturated fat to 10% of daily calories by choosing lean cuts of meat, removing skin from poultry, consuming low-fat dairy products, cooking with olive or canola oil and eating more vegetables and whole grains. 

Trans fats are present in some processed desserts, microwave popcorn, frozen pizza, hard margarine and coffee creamer. Avoid trans fats as much as possible. 

How Much Food Should an Older Adult Eat?

Healthy eating for seniors involves consuming the right foods, but also the recommended amounts. This may vary depending on cultural or personal preferences. For example, vegetarians prefer not to include meat in their diets. 

The USDA has designed three eating patterns and recommends different quantities from food groups based on the style of eating. The amounts indicated below are based on a 2,000-calorie diet, but the number of calories you need depends on your age, sex, weight, height and how physically active you are.¹⁹ 

Healthy U.S.-Style Eating Pattern

A Healthy U.S.-Style Eating Pattern consists of nutrient-rich foods commonly consumed by Americans, including fruits, vegetables, grains, dairy, seafood, meat, nuts and seeds. 

The recommended daily guidelines for the Healthy U.S.-Style Eating Pattern are: 

• Vegetables: 2.5 cups 
• Fruit: 2 cups 
• Grains: 6 ounces 
• Dairy (low-fat or fat-free): 3 cups  
• Protein: 5.5 ounces 
• Oils: 5 to 7 teaspoons 

MyPlate, a tool developed by the USDA and the Center for Nutrition Policy and Promotion, provides a visual representation of these guidelines to help you plan your portions of foods.²⁰ 

For example, one-half of the plate contains vegetables and fruit and one-quarter of the plate contains grains. Meat, nuts and seeds comprise the remainder of the plate, with a serving of dairy on the side. 

Healthy Mediterranean-Style Eating Pattern

Compared with the Healthy U.S.-Style Eating Pattern, a Mediterranean-style diet emphasizes fish, fruits, vegetables, beans, nuts, olive oil and whole grains. It involves moderate consumption of dairy and limited amounts of red meat. 

This eating pattern is based on traditional diets in countries such as Greece and Italy and is recommended by the American Heart Association to reduce the risk of heart disease, stroke, obesity, diabetes, high cholesterol and high blood pressure.²¹ 

The recommended daily guidelines for the Healthy Mediterranean-Style Eating Pattern are: 

• Vegetables: 2.5 cups 
• Fruit: 2 cups 
• Grains: 6 ounces 
• Dairy (low-fat or fat-free): 3 cups  
• Protein: 5.5 ounces 
• Oils: 5 to 7 teaspoons 

Because a Mediterranean-style diet contains fewer dairy products, those following this eating pattern may not consume as much calcium and vitamin D as in a Healthy U.S.-Style Eating Pattern. 

Healthy Vegetarian Eating Pattern

A healthy vegetarian diet can replace meat, poultry and seafood with soy products, eggs, beans, peas, nuts and seeds. There are different types of vegetarian diets. Some include eggs, dairy or fish. A vegan diet includes only plant-based foods. 

Reducing the amount of meat you consume can improve your health by reducing the risk of obesity, heart disease and diabetes. Vegetarians usually consume fewer calories than non-vegetarians and more fiber, potassium and vitamin C.²² 

These daily guidelines are based on a vegetarian eating pattern that includes eggs and dairy. 

• Vegetables: 2.5 cups 
• Fruit: 2 cups 
• Grains: 6 ounces 
• Protein: 3.5 ounces 
• Dairy (low-fat or fat-free): 3 cups  
• Oils: 5 to 7 teaspoons 

Seniors who follow more restrictive vegetarian diets should make sure they find alternate ways to consume the appropriate nutrients, such as vitamin B-12, which is in dairy and eggs; vitamin D, found in fatty fish and egg yolks; and iron, which is in meat. 

Hydration

Adults tend to have less water in their bodies as they age. Our sense of thirst also diminishes as we get older.²³ 

Dehydration can lead to hospitalization among seniors, so it’s important for older adults to drink plenty of fluids. Choose water, low-fat milk, 100% juice, soup, fruits and vegetables. 

Water helps with digestion, absorbing nutrients, removing waste, getting blood to the muscles and lubricating joints. Signs of dehydration include dry mouth, dizziness, fatigue and muscle cramps. If it persists, it can affect cognition, mobility and heart rate.  

Senior Nutrition Programs 

There are national and state benefit programs in place to assist seniors who have trouble meeting nutritional needs because of income or mobility. Some organizations also offer resources that provide meal planning ideas and cooking tips. 

Meals on Wheels America

Meals on Wheels supports seniors by providing meal delivery to their homes.²⁴ There are more than 5,000 Meals on Wheels programs throughout the country, each designed to meet the needs of the community. Visit www.mealsonwheelsamerica.org to find a program near you or call 1-888-998-6325. 

Supplemental Nutrition Assistance Program (SNAP)

SNAP is a nutrition program that supplements the food budget of eligible applicants to help buy food. To get SNAP benefits, you must apply in the state in which you currently live and meet certain requirements, including resource and income limits. For more information, contact your local SNAP office.²⁵ 

Senior Farmers' Market Nutrition Program

Low-income seniors may receive healthy products from farmers' markets, roadside stands and community agriculture programs. The Senior Farmers' Market Nutrition Program is administered through state agencies in certain states.²⁶ 

Feeding America

Feeding America has a network of food banks, food pantries and meal programs throughout the United States, providing free food and confidential services. This includes: 

• Mobile Pantry Program, providing high-need households with pre-packed boxes of food including meat and produce.  
• Senior Grocery Program, providing low-income seniors with balanced meals they can prepare at home. 

Programs may not be available in all states. Contact your local food bank to see what resources are in your community.²⁷ 

Benefits Check Up Tool

The National Council on Aging has an online tool designed to help connect seniors to nutrition programs they may be eligible for, including cash benefits and meal assistance.²⁸ 

National Hunger Hotline

If you need food assistance, call the USDA National Hunger Hotline at 1-866-3-HUNGRY, between 7:00 AM and 10:00 PM Eastern Time. A representative can help you find resources such as meal sites, food banks and other social services.²⁹ 

American Heart Association

The American Heart Association has online resources to help seniors make heart-healthy food choices, plan meals, grocery shop and cook.³⁰