I help people with Nutrition in older people as a medical nutritionist and clinical naturopath. You may even get some health fund rebates.
There is so much information out there that it is easy to become confused about the scientific facts and someone broadcasting promotional material.
When you have problems with your health it is important to get help from a scientifically trained professional. Particularly when you’re not well.
As a mature clinician, over 70, I understand how important it is for us to maximise our nutrition to be as healthy as possible as we age.
Misdiagnosis of nutritional problems in seniors
Most health care practitioners. Including family doctors, have very little or virtually no training in nutrition and seniors’ health. They do not ask questions about what you eat or do tests to find your nutritional levels.
Instead, when looking at your dysfunction or illness they reach for a prescription pad or recommend you for surgery. If there is a nutritional problem, then it means you get a misdiagnosis, and the wrong treatment recommendations.
There is also the issue of costs. If you see a practitioner on government health scheme, they may not have the funds to carry out those tests. If you are going private, you may not have the extra money to have those tests, so you deprioritise them.
The advances in nutritional testing are phenomenal and can give a scientific clear picture what might be happening in your body. The answer they give can make health problems easy to fix rather than having to take unnecessary medications that have side effects.
The difference between macronutrients and micronutrients
Macronutrients include carbohydrates which should be your major source of fuel. Research shows us that carbohydrate plant-based cultures live longer and have less disease. (1)
Lipids (fats) are divided into two groups soft fats (monounsaturated and some medium chain fatty acids from plants) and hard fats (saturated fats). A health body needs monosaturated fats from plants that it can itself convert into the statured fats it needs. If your diet is full of saturated animals then all the nutrition in the world won’t help you because you will develop cardiovascular disease, early senile dementia and Alzheimer’s disease.
We also need a source of 9 to 12 essential amino acids to build our own human proteins. We don’t need to eat protein – we need to build it from the foods that give us amino acids. (2) Telling people to eat proteins is a market phrase and not scientific, because we can’t use any of the proteins that we eat. Biologically we build our own human proteins from amino acids so what we really need are sources of the essential amino acids so those proteins are specific for our own bodies.
Micronutrients include vitamins, minerals, and enzymes activators. They are components that you build your body from, but also signally activators that tell your body to carry out certation biological actions. An imbalance of them, including minerals, causes ill health, illness and rapid aging. (3)
Older people absorb less nutrition
As we age, in our senior years, our organs slow down and may even shrink. This makes them less effective, including your digestive system that absorbs your nutrition.
This leads to common problems like low Iron, vitamins C, B 12, B6, B9, D, E., no matter how many veggies and fruits you may eat. (4) I can also include failure to absorb sufficient, sodium, calcium, magnesium, potassium, zinc etc. (5)
If you live in a care facility it is likely that the food will be mass produced and not as nutritious as if you were able to make it yourself. If you live alone, you might not be bothered to prepare food and choose fast food option that has the wrong nutritional balance.
Eating more isn’t the answer because even if you are overweight you may still be malnourished if you are as deficient in certain nutrients. That deficiency may be like a ticking time bomb ready to go off and make you ill.
The effects of infection on older people’s digestion
Your gut, where you absorb nutrition, is like a finely tuned racing care. It can work well if you take care of it and service and replace the parts that need replacement.
Infection can damage the lining of the stomach, small intestine and large intestine leading to failure to absorb essential micronutrients. Western medicine doesn’t generally understand the effects of infection on the gut for infection.
You have good bacteria (commensal) and bad bacteria in your gut, called the microbiome. When they are in balance you can be well, but infection can lead to overgrowth of bad bacteria that damages the gut lining.
This means you can stop absorbing certain essential micronutrients that you need and those Foods can also be source of prebiotics that help you form probiotics. If you have had antibiotics they have also killed off some of your good bacteria; and as an older person, it becomes harder without expert help for your gut to recover. (6)
The need to test and measure nutrition in older people
The standard blood test at your annual physical or that your doctor orders only measure a smaller amount of nutritional activity and status. It looks for obvious recognisable symptoms of disease.
With the huge advance of laboratory testing we can now measure many more nutritional markers. This data adds considerable knowledge to any illness you may have or problems that will be coming up in the short- or long-term future.
When I see patients, I ask for many of these tests to be done. It’s important to have all the facts possible when I am helping someone.
New tests emerge every few months now and you don’t have to do all of them just some where we think there might be problem. Knowing this information enables you to make changes so either you can get better or prevent future health problems. (7)
Older people getting a better nutritional status
Sometimes clinicians in the interdisciplinary chain clinicians have already done some useful tests for you. Or they have clinical observations that they may share with us that allow us to make your clinical treatment plan.
In doing that I also have to look at whether you have too high a level of macronutrients or micronutrients. If that is the case that excess can block absorption of other nutrients causing a deficiency.
As medical naturopath and nutritionist I am looking for how you can balance your nutritional intake to recover from sickness and create health.
I lead you through the change of what you need to consume and have to do to make that happen fast. Also, as a mental health professional, I create a treatment plan to make it as easy as possible to maintain your treatment plan.
Dr Tracie O’Keefe DCH, Clinical Naturopath & Medical Nutritionist, Naturopath and Orthomolecular Practitioner at the Australian Health & Education Centre. In clinics or by Zoom anywhere in the world. For help with nutrition and your dietary needs: Tel. 0403 398 808.
References
(1) Menzel, J., & Haller, D. (2020). Veganism, aging and longevity: New insight into old concepts. Current Opinion in Clinical Nutrition and Metabolic Care, 23(1), 12–17. https://pubmed.ncbi.nlm.nih.gov/31895244/
(2) Institute of Medicine (US). (2023). Nutrition: Micronutrient intake, imbalances, and interventions. National Center for Biotechnology Information (NCBI). https://www.ncbi.nlm.nih.gov/books/NBK597352/
(3) Gana, W., De Luca, A., Debacq, C., Poitau, F., Poupin, P., Aidoud, A., & Fougère, B. (2020). Trace mineral intake and deficiencies in older adults living in the community and institutions: A systematic review. Nutrients, 12(9), 2889. https://pmc.ncbi.nlm.nih.gov/articles/PMC7230219/
(4) Świątek, Ł., & Pietrzykowska, E. (2019). Analysis of the impact of selected vitamin deficiencies on the risk of disability in older people. Current Opinion in Clinical Nutrition and Metabolic Care, 23(1), 18–24. https://pubmed.ncbi.nlm.nih.gov/31895244/
(5) Gorissen, S. H. M., & Witard, O. C. (2020). Plant proteins: Assessing their nutritional quality and effects on health and physical function. Nutrients, 12(12), 3704. https://pmc.ncbi.nlm.nih.gov/articles/PMC7760812/
(6) Francino, M. P. (2021). Antibiotics as major disruptors of gut microbiota. Current Opinion in Microbiology, 56, 64–69. https://pmc.ncbi.nlm.nih.gov/articles/PMC7732679/ https://doi.org/10.1097/MCO.0000000000000625
(7) Potischman, N., Freudenheim, J. L., & Byers, T. (2019). Biomarkers of nutrition and health: New tools for new approaches. Nutrients, 11(7), 1554. https://pmc.ncbi.nlm.nih.gov/articles/PMC6567133/
