Not a personal matter: Favouring group-targeted nutrition for the elderly

06 Oct 2017

Targeted nutritional and lifestyle recommendations for the elderly could greatly improve quality of life – but truly ‘personalised’ nutrition may not be the answer as yet, says Professor of Nutrition and Ageing Lisette de Groot.

Targeted nutritional and lifestyle recommendations for the elderly could greatly improve quality of life – but truly ‘personalised’ nutrition may not be the answer as yet, says Professor of Nutrition and Ageing Lisette de Groot. De Groot will be one of the keynote speakers during the Food Valley Summit Personalized Nutrition: Food for the Elderly on 12 October in Ede, The Netherlands.

De Groot, who works at Wageningen University’s Division of Human Nutrition, said a large number of elderly people fail to meet current recommendations for nutrients that could protect against age-related functional decline. Although it is too early to say for sure, she speculates that sufficient protein, combined with exercise, may have benefits beyond its widely known role in maintaining muscle mass later in life. Likewise, vitamin D may be important for muscle health as well as bone health, and B vitamins could have a role in bone health and cognition, as well as in preventing anaemia.

“I have problems with ‘personalised’ nutrition,” she said. “I would rather see this as group-targeted, more for the general population.”

Health problems related to insufficient nutrient intake are not only about low consumption. They are also linked to age-related physiological changes that result in less effective nutrient use.

“Elderly people are less responsive to protein intake,” said de Groot. “For vitamin D, large amounts can be synthesised in the skin but elderly people can’t do this as efficiently.

“Adherence to guidelines is quite poor. For vitamin D, we know that we often don’t get enough from the diet as people get older, so we need more from the diet, whether from fortified foods or from supplements.”

A shortfall of vitamin B12 also can be exacerbated by changes in the pH levels in the stomach caused by underlying health conditions or medications, which may prevent nutrient absorption.

Even though many elderly people suffer from ailments associated with nutritional inadequacies, de Groot claims the case for personalised recommendations is still weak, as the amount needed to correct the problem falls within population-wide guidance. It is usually somewhere between the Estimated Average Requirement (EAR), which is adequate for half the population, and the Recommended Daily Allowance (RDA), which covers the needs of 97% of the population.

“I could imagine that recommendations could become more targeted when you look at a particular endpoint like looking at vitamin D for muscle health rather than bone health, but even then it’s all within the range of the EAR and RDA,” she said.

Nevertheless, de Groot backs targeted nutrition advice specifically for the elderly, which she says could help reduce frailty by including, for example, higher-than-average recommendations for protein, combined with resistance exercise. And of course, health outcomes would be significantly improved if more people followed current dietary advice, including taking a supplement once they reach the age of 70.

“In the end it’s all about quality of life and remaining functionally in good shape,” she said.

About Lisette de Groot
Lisette de Groot is Professor of Nutrition and Ageing at the Division of Human Nutrition at Wageningen University in The Netherlands. She trained in nutrition, physiology and epidemiology at Wageningen University. Her research interests centre on the role of nutrition in the maintenance of health in old age with a particular focus on nutritional ways to slow down age-related functional decline.