Elderly men missing out on proper meals

Mind Your Body of The Straits Times dated 5 May 2011, Thursday.

Elderly men missing out on proper meals

Men are more likely than women to be malnourished and less likely to care about healthy food choices. JONATHAN LIAUTRAKUL reports
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A 57-year-old blue-collared worker tends to skip dinner as he feels it would 'help him lose weight'. An 80-year-old retiree is not bothered about healthy eating because it is 'so convenient eating out'.

These two men, who live with their families, typify the kind of neglect common in the nutrition of older people today.

An informal Mind Your Body poll of 10 seniors on their diets found that four might be at risk of malnutrition. They are usually retired and have families who are out at work, leaving them to eat alone.

Ms Chong Hui Hsien, a senior dietitian at Changi General Hospital, noted that men are more likely than women to not bother about their meals.

She said: 'Males are less likely to have a more balanced diet than females, and they don't seem to care about healthy choices.'

Ms Lim Yen Peng, a senior dietitian at the department of nutrition and dietetics at Tan Tock Seng Hospital (TTSH), said that while most of the respondents have at least three meals daily, it is important to include at least two servings of fruit and more vegetables.

The lack of attention by the elderly to their diet was highlighted recently in a poll done by health-care company Abbott Nutrition last year.

Only 1 per cent of 421 respondents aged 50 years and above had a diet that met the recommended servings of food by the Health Promotion Board.

Dietitians said the root of the problem is ignorance about the kind of nutrients that the elderly need and the physical changes wrought by ageing that make proper meals a challenge.
In an ageing population, untreated malnutrition could pose a growing risk.

It causes fatigue and poor healing of wounds. It increases the risk of infection and injury due to falls, leading to hospitalisation and death.

Mr For Wei Chek, the dietetics manager at Mount Alvernia Hospital, said the elderly tend to have a diet high in refined carbohydrates, such as white rice, which offers little nutritional value.
Often their diets lack vitamins and dietary fibre from fruit, vegetables and wholegrains, protein from fish and meat, minerals like iron from legumes and calcium from dairy products.

An elderly person may not eat enough because changes in hormone levels and gastrointestinal functions, or medication, could take a toll on his appetite. The lack of hunger could be exacerbated by chewing problems or poor dental health.

Ms Chong said: 'The elderly have a reduced sense of taste and smell. This is often results in a reduced interest in food.'

This lack of interest in food is often wrongly attributed to age.

Ms Chong said: 'Many elderly folk and even their family members think it is all right to eat less as one ages.'

Problems with chewing and swallowing can also affect interest in food, said Dr Tan Thai Lian, a senior consultant at the department of geriatric medicine at TTSH.

Then there are the socio-psychological factors. Elderly people who live alone and feel isolated or are mostly confined at home have little motivation to eat.

Ms Lim said: 'They may not be willing to put in so much effort to cook for themselves compared to cooking for their family, and often end up eating very simple and repetitive meals lacking in variety.'

Another problem is that the elderly do not drink enough water because of reduced sensitivity to thirst, said Mr For.

Dr Tan recommends small frequent meals, which are easy to chew and swallow, throughout the day.

Dr Lim Si Ching, a consultant at the department of geriatric medicine at Singapore General Hospital, said family members can pick vegetables and fruits like pumpkins, legumes, papaya and watermelon, which are softer and easier to chew.

'There is no need to totally restrict the intake of salt and sugar as food without flavour will worsen their appetite,' she said.

Finally, families must learn to bear with the eating difficulties faced by the elderly and strengthen familial bonding.

Dr Lim said: 'Social interaction is important in building up the appetites of the elderly. Encourage them to eat more healthily by letting them be present at the same dinner table.'