J.Jpn. Surg. Soc.. 111(6): 353-357, 2010

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Feature topic

POINTS IN NUTRITIONAL MANAGEMENT OF THE ELDERLY

The most important aim of nutritional management in the elderly is to maintain the strength of skeletal muscle and ability to perform activities of daily living (ADL). The total energy expenditure (TEE) decreases with age and accelerates after the age of 65 years. Impaired glucose tolerance becomes progressively more common with advancing age. On the other hand, healthy elderly people have a capacity similar to that of healthy young people to clear and oxidize a triacylglycerol load. Consequently, fat appears to be a more suitable fuel for the elderly than glucose. It is recommended that the elderly have a higher protein intake compared with young adults to maintain skeletal muscle. The TEE of the elderly is 20-25kcal/kg/day, and the recommended daily allowance of protein is 1.0-1.2g/kg/day. Furthermore, the ratio of fat in nonprotein calories should be the same as that for young adults. Eating fruit and vegetables can prevent the development of cancer. However, most elderly individuals do not take the time to prepare and eat fruit and vegetables regularly. Elderly people whose ability to perform ADL is impaired should undergo rehabilitation. Unnecessary rest should be avoided during inpatient rehabilitation. Impairment of the ability to perform ADL due to iatrogenic factors or an inappropriate understanding of the elderly metabolism must be avoided.

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