Aging is a natural phenomenon and is controlled by various factors, which may be intrinsic or extrinsic in nature. Extrinsic factors include nutrition. Nutrition plays a very important role in the aging process. Undernutrition or malnutrition fastens the aging process.
As we get older our metabolism and energy requirement decrease. Food intake also decreases with age because of reduced digestion. So, accomplishing energy, vitamin and mineral requirements at an older age is critically important. The diet needs to be well balanced, which can give all the essential nutrients, minerals, and vitamins. The best approach is to have a wide variety of foods, including fruits, vegetables, dairy, and protein-rich foods.
Importance of dairy food in geriatric diet
Healthy muscle and bone mass can be maintained with proper consumption of vitamin D, calcium and phosphorus. These key nutrients of dietary deficiency may lead to sarcopenia in the elderly. Milk and milk products are a good source of these nutrients, so it is beneficial to include these in geriatric nutrition. No fat or low-fat dairy products are a great source of high-quality casein and whey protein, which has excellent muscle-building properties. Whey protein constituents like 3-lactalbumin, 3 lactoglobulin, BSA, lactoferrin, various peptones, and bioactive peptides have a variety of useful roles in various biological processes, thus can be beneficial in managing geriatric health issues associated with improper nutrition or undernutrition.
Reduced-fat dairy products that are significantly lower in energy but rich in calcium, vitamin D and proteins, are a healthy diet option for peoples with sarcopenia. It has been observed that milk proteins (whey and casein) have better muscle-building ability as compared to plant proteins. Therefore, the risk of sarcopenia can be alleviated in the elderly with consumption of milk and dairy products.
In particular, a balanced diet including regular intake of nutrient-rich milk and milk products will reduce muscle degeneration, increase bone density, and reduce the incidence of metabolic and chronic diseases in the elderly population.
Fermented milk products like yoghurt can be incorporated into a healthy geriatric diet. It is produced by fermentation with Lactobacillus delbrueckii, L. bulgaricus and Streptococcus thermophilus bacteria. Yoghurt is easily digestible product with variety of nutrients in bioavailable form, and can be consumed by lactose intolerant people. It improves the intestine health by inhibiting the putrefactive bacterial fermentation and increasing the good intestinal flora.
Probiotics are live microorganism that can play a very important role in geriatric nutrition. Probiotics (usually lactobacilli and bifidobacteria) Culture has been seen to have a health promoting mechanism by improving the gut flora. Probiotic improves digestive health and immune system means protecting them from infectious disease. Probiotics prevents the attachment of harmful or pathogenic bacteria to the intestinal lining. Prebiotic is another useful functional food product made up of fructo-oligosaccharides and inulin, which help in the development of friendly endogenous intestinal bacteria. Both probiotic and prebiotic combined can be extremely helpful in elderly fighting malnutrition, and lactose intolerance to the problem.
Thus, both can improve the health and quality of life in elderly people. After the age of 60 to 65, normal body functions like bowel movements and immune system are challenged, in older peoples. Probiotic and prebiotic are helpful in preventive digestive issues (constipation and diarrhoea) and improves the immune response elderly. Probiotic help in alleviating antibiotic-associated diarrheas in the elderly. Symbiotic is used when probiotics and prebiotics are used together for achieving health benefits.
Geriatric or elderly people need food rich in protein but low in fat and carbohydrate, to compensate for muscle protein breakdown and degeneration. Concentrated or isolated whey and casein protein have different health benefits as compared to when these proteins are consumed as a constituent of whole dairy product. When these proteins are consumed in concentrated or isolated form, they are reduced calories, because of the removal of fat and carbohydrate as compared to whole dairy products such as milk, paneer or yoghurt. Whey protein isolates have less glycaemic index and tendons to release more insulin than other protein rich foods or supplements such as soy, egg, fish protein, ham, gluten, cheese etc.
Elevated blood pressure is a serious health concern in older people. High blood pressure can cause lethality and lead to heat stroke or attack. Continuous high blood pressure may cause renal problems. Dairy and dairy products contain potassium, which can be helpful to control blood pressure. Regular consumption of dairy foods can maintain healthy potassium levels in the body and can prevents them from various cardiovascular and renal disease.
Oxidative stress in elders may cause Alzheimer’s disease and fasten up the aging process due to cellular death. Dairy foods are a rich source of glutathione which is an antioxidant and can help reduce oxidative stress and various health problems associated with it. Dairy products are also a good source of phosphorus, vitamin B2, and vitamin B12 which are essential for cellular regeneration and bone health.
Sarcopenia
Sarcopenia is the consequence of undernutrition or malnutrition in older age. Its incidence rate increases with increasing age. It is observed that the incidence rate is 30% above 60 years and about 50% above 80 years. Sarcopenia occurs when protein degradation is more than protein synthesis. There may be various reasons for decreased muscle mass and strength at older ages including hormonal change, undernutrition, and reduced work out etc. Undernutrition is a critical factor that affects the most.
Limitations of eating dairy food as geriatric diet
Dairy and dairy products are high energy foods, because of their high fat and carbohydrate content present in it, except they are low fat or fat-free eg cheese and paneer. Milk and milk products have little or no fiber food. Fiber needs to be incorporated into the form of fruits and vegetables along with dairy foods as part of the geriatric diet as part of a healthy diet regimen. High fat and protein diets take longer to digest ie food stays longer for intestine, leading to higher water absorption and as a consequence constipation. Lactose intolerant people have problem eating dairy foods, unless they are lactose free or fermented. Heavy consumption of dairy and dairy foods may lead to diarrhoea in the elderly.
Conclusion
The elderly have various challenges like slower metabolism, reduced appetite, limited diet options etc. In such cases, the geriatric diet needs to be well balanced, and healthy with all the essential nutrients to maintain muscle and bone health, and prevent various metabolic and chronic diseases. Dairy and functional dairy foods if incorporated into the diet on a regular basis as well as with healthier fruits, vegetables and grains, can help ours grow older.
Authors
Dr. Dinesh Kumar *
* Veterinary Surgeon (Government of Haryana)
Dr. Rajender Kumar **
* ICAR-NDRI, Karnal, Haryana
Chandni ***
*** Research Scholar, ICAR-NDRI, Karnal, Haryana