Research and Innovation to foster the competitiveness of the
European Agri-Food and Seafood sectors Athens 10-11 March 2014
Dietary needs of an ageing population
Antonia Trichopoulou, MD, PhD
Changing demography Increasing life expectancy
About half of the children of children
born after year 2000 will live longer than 100 years
Christensen et al. Lancet 2009
Life span has increased by about 8 years in 3 decades in the economically developed world
mostly because mortality among adults and the elderly
has sharply declined
Main modifications in the daily life of elders : – Retirement, financial difficulties, change in the social environment,
loneliness
– Multi-pathologies
– Limitations in the ability to move
– Oral dental problems with chewing difficulties
– Decrease of appetite, loss of taste, depression
Change of the nutritional needs A decrease of the food intakes
Malnutrition
Limitation of physical activity
Malnutrition
“The cellular imbalance
between the supply of nutrients & energy
and
the body's demand for them to ensure ....maintenance, & specific functions."
WHO
Malnutrition A loss of lean (and fat) mass with consequences on the
general health status and the quality of life
– Increased risk of infection
– Sarcopenia
– Decrease of muscular strenght
– Risk of hip fractures
– Increase of hospitalisation length
– Increased mortality
Prevalence of undernutrition according to Mini
Nutritional Assessment - an international perspective
4507 subjects from 24 datasets - 12 countries, elderly
Kaiser et al. J Am Geriatr Soc 2010;58:1734–1738
Obesity
The Janus Face of nutrition
Undernutrition
Old adults
Source :Cederholm, 2014 Greek Presidency
High level Conference on Nutrition and Physical Activity
Protein intake and the risk of incident frailty in the WHI
• 24417♀ 65-79 y, non-frail
• Protein intake (quintiles)
• 3 year follow-up,
Conclusion:
Higher protein intake,
Lesser risk for frailty
Beasley et al. JAGS 2010
Q1 – 1 g/kg bw, 35 g animal prot
Q5 – 1.2 g/kg bw, 58 g animal prot
Nordic Nutrition Recommendations 2012
Protein recommendation in old adults
... target for protein intake in elderly is 18 E%,
corresponding to 1.2-1.4 g/kg BW/d...
Pedersen&Cederholm Food Nutr Res 2014
Dietary needs of an ageing population ?
The elderly are particularly vulnerable
Basal metabolic rate and physical activity
tend to decline with age, affecting energy requirements
Needs for some nutrients may be reduced or increased
chewing difficulties
compromise their ability to consume many types of foods
The nutritional requirements
for the elderly are not well defined
and
need better documentation
Dietary patterns
may be more relevant
than
specific foods in the etiology
of diet-related diseases
Dietary patterns in elderly Europeans. The EPIC-Elderly study
positively associated with
educational achievement
physical activity
energy intake
negatively associated with
waist-to-hip ratio,
current smoking
greatest at Italy, Spain and Greece
poor in all Northern countries.
Bamia et al British Journal of Nutrition 2005
negatively associated with
educational achievement
physical activity
energy intake
diet not preferred at Italy, Spain, Greece, France
Sweet & fat Dominated Vegetable Based
Diet and overall survival in elderly people
Trichopoulou et al. BMJ 1995
Mediterranean diet was associated with a significant 17% reduction
in overall mortality
Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study
Population 74 607 men and women from EPIC, aged 60 years or older
Exposure Mediterranean diet score (MMDS)
Outcome All-cause mortality
Relative risk 0.92 ( CI 0.88 to 0.96)
Trichopoulou et al British Medical Journal, 2005
Estruch R et al. N Engl J Med 2013
Mediterranean food and extra virgin olive oil or nuts-
the PREDIMED trial
7447 Spanish (55-80 y, 57% female), healthy w. risk factors
3 groups - ~5 years
Med. food + extra virgin olive oil – 1/2 dl/day
Med. food + nuts – 30 g/day
Control diet - Low fat diet
Mortality
For the elderly:new challenges!
Energy balance – avoid obesity and underweight
Exercise regularly – endurance and resistance
MUFA/PUFA/n-3FA before saturated fat
High Q carbs – avoid sugar
High protein intake from white meat/fish/veg
High intake of antioxidants (fruit/veg/wine)
Traditional Mediterranean food
Source :Cederholm, 2014 Greek Presidency
High level Conference on Nutrition and Physical Activity
Merit attention
It has been shown that variants of the
Mediterranean diet are feasible choices even for non-Mediterranean countries
Mediterranean diet has been
consistently shown, in Mediterranean and non-Mediterranean populations, to
promote good health and longevity.
Continue to work in partnership with
all stakeholders
including
industry food producers food processors
retailers, caterers health and consumer NGOs
and academia
Grand mothers
Thank you for your attention
