Diet of community-dwelling older adults – RIVM

Today the results of a long anticipated survey became available, on the diet of community-dwelling older adults, or the Dutch National Food Consumption Survey Older Adults 2010-2012 from the RIVM. The main conclusion? The dietary patterns of older adults above 70 could be improved. Of course this is a rather general remark, and one we all could have guessed, but the report provides useful insights on improvable points. I will definitely use these data in my own research, although it’s a pity that a relatively low amount of older adults with functional disabilities participated in the survey, and the number of participants is relatively low in general, making it difficult to extrapolate these results to the whole elderly population.

You can read the whole report here, but below I listed a couple of interesting findings, regarding my own research topic:

  • One in four Dutch adults over the age of 70 complies with the recommendation to take vitamin D supplements.
  • Compared to people in their fifties and sixties, they consume less meat, sauces and cereal products and drink less alcohol. However, they consume more fruit, sugar, sweets, margarine, spreads and cooking fat.
  • The group of older adults with the greatest functional impairments had a lower intake of energy, protein and various dietary components than well-functioning older adults (note: again, this is what I found in my crude associations)
  • About 9% of the men and 15% of the women were classified as undernourished.
  • About 20% of the men and 60% of the women prepared their own hot meal on a daily basis, whereas more than 40% of the men and 10% of the women never prepared any hot meals. Furthermore, for 39% of the men someone else in the household prepared their hot meal on all days of the week, whereas this was the case for only 3% of the women.
  • Overall, about 63% of both  men and women ate a hot meal daily, prepared by themselves, a partner or through home delivery.
  • Home-delivered hot meals from companies or institutions were rarely consumed: 94% of the men and 97% of the women reported never using these.
  • 0.3% of all the participants follow a energy and/or protein enriched diet.
  • Consumption of fruit was not optimal for this older adult population, with median amounts of about 1.5 pieces of fruit daily whereas two pieces are recommended.
  • The median consumption of vegetables met the recommended vegetable intake, with median consumption of about three serving spoons per day. Unlike for fruit consumption, the recommended vegetable consumption (150 g/day or three serving spoons) is lower for older adults as compared with other adults (200 g/day).
  • For men, median habitual intake of protein was 82 g/day or 1.0 g/kg body weight per day. (note: the current recommendation is at least 0.8g/kg body weight per day. Although it’s not official, experts want to increase this to 1.2-1.5g for older adults).
  • For women, median habitual intake of protein was 70 g/day or 1.0 g/kg body weight per day.
  • Three food groups were responsible for about three quarters of total protein intake. These were ‘Meat and meat products’ (28%), ‘Dairy products’ (25%) and ‘Cereals and cereal products’ (20%).
  • Besides the energy intake, the intake of protein was also significantly lower among persons with a larger BMI (0.96 g/kg) and among those with no undernutrition (1.02 g/kg). Furthermore, the average intake of protein per kg body weight was lower among participants who consumed home-delivered hot meals, and among those who were not able to climb stairs of 15 steps.
  • When protein intake in g/day rather than g/kg body weight /day was considered, differences between subgroups of BMI, consumption of home-delivered hot meals, and undernutrition were small and not statistically significant (data not shown). Apparently, differences in body weight rather than differences in protein intake were relevant for these subgroups. However, persons with an impaired functionality indicated by the inability to climb stairs had a lower mean protein intake in g/day as well as in g/kg body weight compared with persons who were able to climb stairs of 15 steps.
  • They conclude the report with the following statement: Older adults with functional impairments and multimorbidity were not represented adequately in this study. The group of older adults with the greatest functional impairments had a lower intake of energy, protein and various dietary components than well-functioning older adults. This underpins the problem of undernutrition among some older adults. Intake of vitamin D is inadequate for most of these older adults, but even more so for those not going outside daily. Monitoring the diet and supplement use of older adults can contribute to adequate food policies and recommendations. Given the growing population of older adults in the next decades it is recommended not to wait too long to collect new food consumption data. New data collection should be representative of groups of older adults that are most at risk of acquiring nutritional problems.

I’m very grateful for all the people who were involved in the realization of this survey and the report. It’s a really transparent report, with clear data that are easy to interpret. I hope this report will indeed contribute to adequate food policies and recommendations. Now, it’s up to us!