7 Tips for Preventing Malnutrition In Seniors

Our bodies change as they grow older: The metabolism slows down, foods that used to taste good don’t anymore, and the digestive system doesn’t work as well as it used to, either ("Hello, heartburn!"). But eating empty calories—food with little nutritional value—can pack on extra pounds and contribute to a host of health problems, including type 2 diabetes, heart disease, joint issues, constipation, high cholesterol, and depression.

Unfortunately, eating well may not be so easy—or common—among seniors: One recent study found that 60 percent of elderly people cared for in emergency departments were either malnourished or at risk for the condition. Why is this, and what can be done about it?

Causes of Malnutrition in Seniors

Problem: Lack of Resources. "Many [seniors] are living on a fixed income, so the grocery budget is limited. And if they aren’t driving anymore, it may be difficult to purchase fresh food," says Gina Jarman Hill, PhD, RD, LD, an associate professor of nutritional science and director of the Coordinated Program in Dietetics at Texas Christian University in Fort Worth. "Seniors may start relying on processed snacks, which are less nutritious, but have a longer shelf life. Or, [they may] opt for convenience foods, which can be high in sodium and trans fats, and lacking in other important nutrients."

Problem: Medications. Medications can also be a factor in eating right. Loss of appetite is a common side effect. Furthermore, some foods can interfere with the effectiveness of certain meds, and there’s also a lot of confusion about food restrictions, according to Jarman Hill. "I’ve seen elderly people on Coumadin (or similar blood thinning medications) cut out leafy greens [due to concerns about vitamin K from veggies like broccoli and spinach interfering with their effectiveness] and then miss out on the health benefits of these foods by unnecessarily restricting their intake. It’s not that they can’t have broccoli—they just can’t have a lot of it all at once. It’s important to eat these foods with consistency rather than avoiding them completely."

Problem: Dental Issues. According to fellow dietitian Courtney Gravenese, MS, RD teeth—or lack of them—is another common obstacle to healthy eating. "Dental health is a low priority for many seniors. Improperly fit dentures or missing teeth affects their ability to chew and eat a healthy diet," says Gravenese. "Many don’t get to the dentist and settle for eating the same soft food all the time."

Problem: Lack of a Social Life. Finally, there’s the social aspect of eating. Many seniors live alone. "Eating is a social event and when someone feels lonely, she may eat less than if she shared her meals with others," says Jarman Hill. "It’s also not unusual to lose interest in cooking if you’re only cooking for one."

Hidden Malnutrition

Nutrition is easily overlooked when older people have more pressing health concerns. "During a typical office visit, a physician is probably busy addressing other problems. He or she may not inquire about a patient’s eating habits," says Jarman Hill. "Unfortunately, common labs used in patient care won’t catch nutrition problems early."

To complicate the matter further, nutritional deficiencies can look like other health issues and be misdiagnosed. For instance, "Depression, neuropathy, memory loss, and poor appetite can be caused by a vitamin B12 deficiency," Jarman Hill points out. (More than 20 percent of the elderly have a B12, or cobalamin deficiency, according to one Canadian study.) Vitamin B12 helps the body make red blood cells and ensures the nervous system functions properly; poultry, eggs, shellfish, and dairy products are good sources. "Red meat is another good source of this vital nutrient, but many older people forgo it because it’s difficult to chew, hard to cook, or too expensive for their budgets," explains Jarman Hill.

Other symptoms of vitamin B12 deficiency include headache, fatigue, and irregular heartbeat. "If the deficiency is not remedied it can lead to muscle weakness, tingling in the fingers and toes, and more serious problems, including anemia and irreversible neurological issues."

What You Can Do To Help

Ensure your loved ones receive the nutrition they needs by following these tips:

  1. Investigate their refrigerators and cabinets. "Find out what they’re eating and ask questions," says Gravenese.
  2. Invest in a multivitamin/mineral formulated especially for seniors. But don’t overdo it: "Look for a brand that contains 100 percent or less of most recommended vitamins and minerals," Jarman Hill recommends, since getting too much of a nutrient could cause problems. For instance, taking in too much of the B vitamin folic acid could mask a vitamin B12 deficiency. And "Another B vitamin, B6, can be consumed in excessive amounts through fortified foods and high-dose supplements and can cause numbness, especially in fingers," Jarman Hill explains. "Always speak with a doctor before adding supplements to your diet."
  3. If you don’t live close by, enlist the help of a neighbor or friend to check on your parent or loved one and report back to you periodically.
  4. Take advantage of local resources. "The Fort Worth Meals on Wheels program has a team of nutrition experts on hand who help educate and monitor elderly clients. Local municipalities, hospitals and churches may offer similar services for free," says Jarman Hill.
  5. Boost the flavor of foods. With age, sense of taste may decrease. Gravenese recommends seasoning food with fresh herbs, spices, and lemon juice instead of salt.
  6. Limit sources of food with little nutrition such as chips, soda, cookies and alcohol.
  7. Encourage mom or dad to drink plenty of water and get regular exercise. This helps reduce constipation and maintain bone strength.

Seniors really don’t need a special diet, concludes Jarman Hill. "What they do need is nutrient dense calories—food that provides vitamins, minerals, fiber, fat, protein and carbohydrates. Variety, balance and moderation are essential to healthy eating."

For more nutritional information, printable shopping lists, and sample diets, visit the National Institute on Aging’s website

Gina Jarman Hill and Courtney Gravenese reviewed this article.


Phone interview with Gina Jarman Hill, PhD, RD, LD, associate professor of nutritional science and director of the Coordinated Program in Dietetics at Texas Christian University, Fort Worth, TX. 20 October 2014.

Phone interview with Courtney Gravenese, MS, RD. 20 October 2014.

"What’s On Your Plate? Smart Food Choices for Healthy Aging." National Institutes of Health/National Institute on Aging. Accessed October 21, 2014. 

Pereira, Greg F. "Malnutrition Among Cognitively Intact, Noncritically Ill Older Adults in the Emergency Department." Annals of Emergency Medicine. Published online August 12, 2014. Accessed October 17, 2014. 

Kaiser, MJ. “Frequency of Malnutrition in Older Adults: A Multinational Perspective Using the Mini Nutritional Assessment.Journal of American Geriatric Society 58(9);1734-8. doi: 10.1111/j.1532-5415.2010.03016.x Posted September 2010. Accessed October 17, 2014. 

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