Nutrition of the elderly: a challenge between facts and needs

Interactions between nutrition and the ageing process are a fascinating field of research. The assessment of the nutritional status is an important part of medical examination. Generally it is assumed that energy intake and energy expenditure decrease with age. In fact they vary widely and are very different in healthy, in sick or in institutionalized elderly. Nutritional requirements depend on many social and physiological factors in the free-living elderly population. Surveys indicate that dietary requirements are qualitatively grossly comparable to those in middle-aged adults. However the elderly are particularly at risk of marginal deficiencies of vitamins and trace elements. Today the early recognition of malnutrition is an important challenge. Its prevention may influence the evolution of nonspecific intercurrent disease and restore immunocompetence. Another challenge is to promote health by adequate recommendations in order to prevent deficiency diseases and to increase longevity. Some studies suggest that nutrition-based preventive medicine remains useful in the elderly. Caloric restriction, weight loss in case of obesity, decrease in blood lipids, increase in calcium intake which depend mainly of prior nutritional habits may have an effect in the elderly. However, prevention of protein caloric malnutrition is more relevant in the elderly.