Aging is a natural phenomenon and controlled by various factors, which may be intrinsic or extrinsic in nature. Extrinsic factors include nutrition. Nutrition plays a very critical role in the aging process. Undernutrition or malnutrition fasten 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 requirement at older age is critically important. The diet needs to be well balanced, which can give all the essential vital nutrients, minerals, and vitamins. The best approach is that the diet should contain wide variety of foods, including fruit, vegetables, dairy, and protein-rich foods.
Importance of dairy food in geriatric diet
Healthy muscle and bone mass can be maintained with the proper consumption of vitamin D, calcium and phosphorus. The dietary deficiency of these key vital nutrients may lead to sarcopenia in the elderly. Milk and milk products are a good source of these nutrients therefore, 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 α ‐ lactalbumin, β‐ lactoglobulin, BSA, lactoferrin, various peptones, and bioactive peptides has a variety of useful roles in various biological process, thus can be beneficial in management of geriatric health issues associated with improper nutrition or undernutrition.
Reduced-fat dairy products which are significantly low in energy but rich in calcium, vitamin D and proteins, is a healthy diet option for peoples with sarcopenia. It has been observed that milk proteins (whey and casein) have better muscle-building capacity as compared to plant proteins. Therefore, the risk of sarcopenia can be alleviated in elders with the 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 intestinal health by inhibiting the putrefactive bacterial fermentation and increasing the good intestinal flora.
Probiotics are live microorganisms that can play a very important role in geriatric nutrition. Probiotics (usually lactobacilli and bifidobacteria) culture has been seen to have health promoting mechanism by improving the gut flora. Probiotic improves digestive health and immune system ie protect them from infectious disease. Probiotics prevents the attachment of harmful or pathogenic bacteria to the intestinal lining. Prebiotic are another useful functional food product made up of fructo-oligosaccharides and inulin, which help in the growth of friendly endogenous intestinal bacteria. Both probiotic and prebiotic jointly may be extremely helpful in elderly in fighting malnutrition, and problem of lactose intolerance.
Thus, both can improve the health and quality of life in elderly people. After the age of 60 to 65, normal body functions like bowl movements and immune system are challenged, in older peoples. Probiotic and prebiotic are helpful in preventive digestive issues (constipation and diarrhea) and improves the immune response in the elderly. Probiotic help in alleviating antibiotic-associated diarrheas in elderly. Symbiotic is used when probiotics and prebiotics are used together for achieving health benefits.
Geriatric or elder people food need to be rich in protein but less in fat and carbohydrate, to compensate the 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 the constituent of whole dairy product. When these proteins are consumed in concentrated or isolated form, they have reduced calories, because of removed fat and carbohydrate as compared to whole dairy product such as milk, paneer or yoghurt. Whey protein isolates have less glycaemic index and tends to release more insulin as compared to other protein rich food or supplements such as soy, egg, fish protein, ham, gluten, cheese etc.
Elevated blood pressure is a serious health concern in elder people. High blood pressure can be lethal and may lead to heat stroke or attack. Continuous high blood pressure may cause renal problem. Dairy and dairy products contain potassium, which can be helpful to control blood pressure. Regular consumption of dairy food can maintain the healthy potassium level in body of elders and can prevent them from various cardiovascular and renal disease.
Oxidative stress in elders may cause Alzheimer’s disease and may fasten up the aging process due to cellular death. Dairy foods are a rich source of glutathione which is an antioxidant and can be beneficial to reduce oxidative stress and various health problem 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 is a consequence of undernutrition or malnutrition in older age. Its incidence rate increases with increasing age. It is observed that incidence rate is 30% above 60 years and around 50% above 80 years. Sarcopenia occurs when protein degradation is more than protein synthesis. There may be various reasons for reduction of muscle mass and strength at older age including hormonal change, undernutrition, and reduced work out etc. Undernutrition is a critical factor which effects the most.
Limitations of eating dairy food as geriatric diet
Dairy and dairy products are high energy foods, because of high fat and carbohydrate content present in it, unless they are low fat or fat-free eg cheese and paneer. Milk and milk products are less or no fiber food. Fiber needs to be incorporated in the form of fruit and vegetables along with dairy foods in geriatric diet as part of healthy diet regime. High fat and protein food take more time to digest ie food stay for more time in intestine, leads 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 diarrhea in elders.
The elderly have various challenges like slower metabolism, reduced appetite, limited diet option etc. In such cases, the geriatric diet needs to be well balanced, and healthy with all the essential vital nutrients to maintain muscle and bone health, and to prevent various metabolic and chronic disease. Dairy and functional dairy foods if incorporated in diet on regular basis along with healthier fruit, vegetables and grains, can help our elderly to age better.
Dr. Dinesh Kumar *
* Veterinary Surgeon (Government of Haryana)
Dr. Rajender Kumar **
* ICAR-NDRI, Karnal, Haryana
*** Research Scholar, ICAR-NDRI, Karnal, Haryana