Introduction

The benefits of good nutrition to health maintenance is a important to the elderly as it is to young. Many older adults have special nutrient requirements because aging affects absorption, use and excretion. A combination of macronutrients, vitamins and minerals, fiber and water are essential in providing the nutrients for the elderly.

Macronutrient

• Macronutrient constitutes the majority of an individual diet’s, “supplying energy and the essential nutrients needed for health, maintenance”.
• Macronutrients are nutrients that provide calories or energy. There are three macronutrients which are carbohydrate, protein and fats.
• Each of these macronutrients provides calories and their amount varies:
  • Carbohydrate provides 4 calories per gram
  • Protein provides 4 calories per gram
  • Fat provides 9 calories per gram

Dietary fibre

Dietary fibre constitutes parts of plant that are not digested by the human body. It is found only in plant foods such as fruits, vegetables, nuts and grains. There are two types of fiber. They are soluble and insoluble fiber. Insoluble fiber binds water, so it helps to increase bulk, soften stool and shorten transit time through the intestinal tract.

Health benefits of dietary fiber.

Among the health benefits of dietary fibre include:

• Prevent Constipation
• Lower blood cholesterol level.
  • The body eliminates cholesterol through the excretion of bile acids. Soluble fiber binds bile acids, suggesting that a high fiber diet may result in the excretion of cholesterol.
• Reduces the risk of cardiovascular diseases and some cancers (e.g colon cancer)

Fibre content in selected foods:

Food	Serving Size	Weight (g)	Fibre Content (g)
Guava	1 small slice	60	16.0
Chick peas	½ cup	66	5.6
Peanuts	½ cup	58	4.8
Red gram	½ cup	100	4.0
Mung bean	½ cup	100	4.0
Dhal	½ cup	100	4.0
Pear	1 whole medium sized	166	4.0
Baked beans	½ cup	95	3.8
Apple	1 whole medium sized	138	3.7
Fermented soya bean cake (tempe)	2 small pieces (50g)	50	3.2
Orange	1 whole small sized	120	2.8
Peas (rebus)	½ cup	68	2.8
Potatoes	1 whole medium sized	110	2.6
Banana	1 whole medium sized	100	2.4
Almond	10 nuts	15	2.3
Corn	1 comb medium sized	77	2.2
Tomato	1 whole medium sized	200	2.2
Carrot	½ cup	62	2.0
Prunes	4 pieces	28	2.0
Spinach (bayam)	½ cup	60	1.7
Peas	½ cup	80	1.6
Okra (bendi)	½ cup	64	1.6
Cabbage	½ cup	60	1.4
High fiber bread	1 slice	28	1.3
Barley	2 tablespoon	26	0.8
Oats	2 tablespoon	12	0.2

 

Recommended Nutrient Intakes:

The daily recommendation of fiber intake is 20-30 grams

Vitamins and minerals that are important for the elderly

The elderly have a higher risk of vitamin and mineral deficiencies and are susceptible to several diseases such as gastritis, anemia and bone diseases. It is recommended that elderly should take vitamins and minerals based on the Recommended Nutrient Intakes for Malaysia.

Vitamin A (Retinol)

Vitamin A is needed in the body for the following functions:

• To generate the pigment retina(eyes)
• Proper function for immune system

Sources of vitamin a in food:

 

Food	Serving Size	Retinol Contents ( µg)
Chicken liver	1 whole liver (50g)	8237
Beef liver	1 piece (match box sized- 50g)	4469
Egg	1 whole medium sized (50g)	161
Full cream milk powder	2 tablespoon	56
Black Pomfret (Ikan Bawal Hitam)	1 small sized (90g)	24
Mackerel (Ikan Kembung)	1 medium sized (120g)	16
Skim milk powder	1 tablespoon	4

 

Carotene is a provitamin A that can be converted into Vitamin A (retinol). It is present in plant products, especially in green leafy vegetables, red, yellow and orange fruits.

 

Food Serving	Size	Carotenes Contents ( µg)
Mustard	1 cup (90g)	2374
Spinach	1 cup (50g)	2314
Chinese cabbage	1 cup (80g)	853
Carrot	1 whole medium sized (110g)	2356
Pumpkin	1 cup (140g)	1432
Papaya	1 slice medium sized (160g)	1843
Watermelon	1 slice medium sized (240g)	547
Mango	½ medium sized (240g)	630
Banana	2 pieces medium sized (185g)	289
Bitter gourd	1 cup (125g)	175
Orange	1 whole medium sized (135g)	97
Smooth loofah (ketola air)	1 cup (115g)	12

 

Chronic deficiency of vitamin a can cause:

• Night blindness
• Loss of appetite
• Dry and rough skin
• Lowered resistance to infection
• Dry eyes

Recommended nutrient intakes (RNI):

• Men: ? 60 years : 600 µg RE/day
• Women: ? 60 years : 600µg RE/day

Vitamin C

Vitamin C is needed in the body for the following functions:

• To help the body fight infection
• To reduce risk of diseases
• To aid in the absorption of iron

Vitamin C content in selected foods

 

Food	Serving Size	Vitamin C Contents ( mg)
Papaya	1 slice medium sized (160g)	112.8
Guava	1 whole small sized (60g)	89.3
Cabbage	1 cup (70g)	36.3
Orange	1 whole medium sized (135g)	30.7
Mango	1 whole medium sized (230g)	30.5
Star fruit	1 whole small sized (115g)	26.1
Tomato	2 whole medium sized (110g)	25
Petai	½ cup (60g)	19.5
Lettuce	1 cup (55g)	14.9
Ulam raja	½ cup (17g)	10.9
Indian Pennywort (Pegaga)	½ cup (20g)	10.3
Cucumber	1 cup (136g)	9.4

 

Chronic deficiency of vitamin C can cause:

• Scurvy
• Poor appetite
• Bleeding gums
• Fatigue
• Depression

Recommended Nutrient Intakes (RNI):

• Men: ? 60 years : 70mg/day
• Women: ? 60 years : 70mg/day

Folic Acid

Folic acid is needed in the body for the following functions:

• For the production and maintenance of new cells
• Maintain mood and cognitive function, especially in older people 7

Sources of folic acid in food:

 

Food	Serving Size	Folic Acid Contents ( µg)
Mung beans, dried (kacang hijau kering)	½ cup (100g)	622
Red gram, dried (kacang merah kering)	½ cup (100g)	363
Chicken liver	1 whole (50g)	294
Beef liver	1 piece (match box sized- 50g)	145
Green mustard	1 cup (60g)	112
Spinach, cooked	½ cup (60g)	88
Baked beans	½ cup (120g)	61
Beef kidney	1 piece (match box sized- 50g)	50
Green peas	½ cup (80g)	47.2
String bean (kacang panjang)	1 cup (120g)	39
Egg	1 whole medium sized (50g)	23.5
Lean beef	2 pieces (match box sized- 100g)	8

 

Chronic deficiency of folic acid can cause:

• Anemia
• Weakness
• Fatigue
• Difficulty in concentrating
• Irritability
• Shortness of breath
• Dementia
• Depression

Recommended Nutrient Intakes (RNI):

• Men : ?60 years : 400 µg
• Women: ?60 years : 400 µg

Calcium

Calcium is needed in the body for the following functions:

• To build and maintain teeth and bone health.
• To reduce loss of bone mass
• To help in bone development and repair
• To maintain the calcium homeostasis
• To help in normal blood clotting
• For nerve transmission and regulation of heart muscle function

Sources of calcium in food:

 

Food	Serving Size	Calcium ( mg)
Sardine with bone	2 pieces (130g)	295
Yogurt	1 tube (150ml)	284
Bean curd (tofu)	1 piece (152g)	205
Fresh milk	1 cup (200ml)	204
Kailan	1 cup (60g)	112
Spinach	1 cup (60g)	73
Cheese	1 piece	50
Soybean milk	1 cup (200ml)	38.4
Almond	10 nuts (15g)	32
Anchovy without head	10 pieces	15

*Vitamin D plays a major role in calcium absorption and bone health.

Chronic deficiency of calcium:

• Muscle contraction
• Muscle pain
• Spasms
• Numbness in the hands and feet
• Osteomalacia (soft bones)
• Osteoporosis

Recommended Nutrient Intakes (RNI):

• Men:
  

  ?60 years :	800 mg
  >65 years :	1000 mg

• Women: ?60 years : 1000 mg

Iron

Iron is needed in the body for the following functions:

• To generate red blood cell.
• To transport oxygen in the body.
• Important for brain function especially learning and memory.

Sources of iron in food:

 

Food	Serving Size	Iron ( mg)
Fresh cockles	10 cockles (100g)	13.2
Bitter gourd	1 cup (130g)	7.9
Chickpea	½ cup (100g)	6.9
Fried soya bean curd	1 piece (90g)	6.6
Swamp cabbage ( Kangkung)	1 cup (80g)	4.2
Fern shoots (pucuk paku)	1 cup (85g)	4.1
Rice noodle (Kuih-teow)	1cup (100g)	3.4
Spinach	1 cup (60g)	3.0
Chicken	1 piece medium sized (100g)	2.8
Lean beef meat	2 pieces (match box sized-100g)	2.2
Wholemeal bread	2 slices (50g)	1.6
Raisin	¼ cup (40g)	1.4
Egg	1 whole medium sized (50g)	1.2
Anchovy, whole	10 pieces	0.2

 

Chronic deficiency of iron can cause:

• Skin Pallor
• Weakness
• Fatigue
• Anemia

Recommended Nutrient Intakes (RNI):

• Men : ?60 years : 14 mg
• Women: ?60 years : 11 mg

Zinc

Zinc is needed in the body for the following functions:

• To help in the digestion of carbohydrate, fat and protein.
• To prevent the reduction of taste and smell sensitivity

Sources of zinc in food

 

Food	Serving Size	Zinc (mg)
Liver, kidney (beef, poultry)	2 pieces (match box sized-100g)	4.2 – 6.1
Meat (beef, pork	) 2 pieces (match box sized-100g)	2.9 – 4.7
Seeds, nuts (such as peanut, hazel nut, walnut etc.)	½ cup (100g)	2.9 – 7.8
Poultry	1 piece medium sized (100g)	1.8 – 3.0
Eggs (chicken, duck)	2 whole medium sized (100g)	1.1 – 1.4
Beans, lentils (such as red gram, mug bean, dhal etc.)	½ cup (100g)	1.0 – 2.0
Seafood	3 – 4 small pieces (100g)	0.5 – 5.2
Whole-grain cereals	½ cup (100g)	0.5 – 3.2
Dairy (milk, cheese)	1 glass/ 1 slice	0.4 – 3.1
White bread	2 slices (50g)	0.9
Varieties potatoes	1 whole medium sized (100g)	0.3 – 0.5
Vegetables	1½ cup (100g)	0.1 – 0.8
Fruits	1 whole medium sized (100g)	0 – 0.2

 

Chronic deficiency of zinc can cause:

• Slow healing of wounds
• Loss of taste

Recommended Nutrient Intakes (RNI):

• Men :
  

  ?60 years :	6.7 mg
  ?65 years :	6.2 mg

• Women:
  

  ?60 years :	4.9 mg
  ?65 years :	4.3 mg

Water

Water is needed to enhance the body’s functions. It helps in:

• Digestion, absorption, circulation (blood is 80% water) and excretion (urine is 97% water)
• Regulation of the body temperature as well as lubrication of joints and abdominal viscera.

Water intake is important for the elderly as they tend to have a decreased in thirst sensation. Recommended intake: 6 – 8 glasses/day or 1.5 – 2 L/day

Last Reviewed	:	11 November 2008
Writer	:	Rohida bt. Saleh Hudin
	:	Junidah bt. Raib
	:	Faulina bt. Khamison