The Importance of a Balanced Diet in the Elderly


Food is one of the great pleasures in life. From a bar of chocolate to a glass of wine snack, or a favourite take away or home-cooked meal, we all have our favourite foods that we like to treat ourselves to from time to time. It can be a good thing to indulge every now and then but it’s important that we eat certain foods in moderation and maintain a well-balanced diet.

Eating healthy as we age is extremely important and it may be the case that our diets have to change as we get older. It helps us to maintain a healthy weight, maintain energy levels, and also to reduce the risk of developing chronic diseases, such as hypertension, diabetes, and heart disease. Eating healthy can also help to manage these diseases if you have already received a diagnosis.

Under nutrition

There are misconceptions that elderly people should adhere to the same low-fat, low-calorie diets recommended for the general population, but this isn’t always the case. The British Nutrition Foundation has recognised that as many as 1 in 7 older people or malnourished. They said “being underweight and/or malnourished increases the risk of disease, delays recovery from illness and adversely affects body function, wellbeing, and clinical outcomes.”

Elderly people who experience weight loss are often recommended to eat what they like. It may also be difficult for your elderly loved one to follow a strict regime of three large meals a day. In this case, it can be useful to encourage them to have smaller, more frequent meals, including snacks, to ensure they have a well-balanced diet with all of the nutrients needed.

Any weight loss in an elderly loved one should be taken seriously as it can often be a sign of ill health or frailty. If your loved one appears to have lost weight it may indicate that they are under-nourished. If this is the case, they should visit their doctor and receive a thorough assessment to determine the cause of loss of appetite or weight loss. It may be caused by a range of issues that are easily treated, such as ulcers, thyroid problems, dementia, or depression.

You should never give your loved one supplements or nutrition drinks without first speaking to their doctor. If they take too much of a supplement, the wrong combination of supplements, or certain supplements in combination with certain medications, there can be unfortunate side effects. High calorie nutrition drinks should not be used as a meal replacement – it’s always better to use regular food to maintain a person’s weight.

Overeating and obesity

A survey conducted by the British Nutrition Foundation suggests that a large proportion of older people are obese or overweight. They identified that 67% of free-living men and 63% of free-living women and 43% of men and 47% of women living in institutions are reported to be obese or overweight. This increases the risk of chronic diseases, such as type 2 diabetes, hypertension, and strokes.

Our mobility often decreases as we age but our diets often don’t change. Reduced mobility or independence can mean that our calorie-intake no longer meets our calorie-demand, and we can subsequently find ourselves gaining excess weight. Furthermore, elderly people may find that they don’t get out as much as they would like or feel less-stimulated and so may eat more. Whatever your loved one’s situation, it’s important that any unhealthy weight gain is addressed to ensure that your loved one is not placing any unnecessary strain on their health.

If this sounds familiar, it is always important to consult their doctor or dietician first, to make sure that any dietary changes still give them all of the necessary nutrients. Overeating and unhealthy weight gain may be addressed by modifying their diet or restricting the consumption of certain foods or food groups, such as a reduced fat intake.  Providing your loved one with more stimulation and physical activity can also help reduce boredom and over-eating. You may want to plan day-trips with them or even consider day care to ensure that they feel fulfilled in their day-to-day life.

Dental and oral health

Diet plays a huge part in maintaining dental and oral health. The British Nutrition Foundation estimates that in the UK, 58% of adults aged 75 years and over have no natural teeth and rely on dentures. People with dentures often eat less fruit and vegetables and may even have reduced intake of nutrients such as vitamin C. The major effect of poor nutrition on teeth is the development of cavities (dental caries) which are affected by a high sugar intake, particularly in the absence of good dental hygiene. Older people are more likely to develop root cavities as they are more likely to have exposed roots due to periodontal disease and gum recession. They may also suffer from tooth decay due to certain medications, such as those with prolonged oral clearance, and high-energy syrup food supplements. As such, dentists commonly recommend that people limit intake of sugar-containing foods and drinks to four or five times a week.

Information sourced from The British Nutrition Foundation

Cardiovascular disease (CVD)

The British Nutrition Foundation states that CVD, including coronary heart disease and strokes, is the main cause of morbidity and mortality for older people. The major risk factors of developing CVD include:

  • Obesity
  • High intake of saturated fatty acids and salt
  • Energy-dense diet
  • Diet low in dietary fibre, whole grain, and fruit and vegetables
  • Hypertension
  • Smoking
  • Diabetes
  • Low levels of physical activity

Certain dietary changes can help lower the risk of developing CVD in old age. They include:

  • Use non-hydrogenated unsaturated fatty acids (monosaturates and polyunsaturates) as the main form of fat
  • Choose wholegrains as the main carbohydrate
  • Eat plenty of fruits and vegetables
  • Take in sufficient Omega-3 fatty acids, primarily from oily fish
  • Reduce salt content
  • Stay active

Staying active

Staying active can help people maintain a healthy body weight, as well as helping them to lose weight or even stimulate their appetite if they find they aren’t eating as much as they used to. The Department of Health recommends that adults, including older adults, should do at least 30 minutes of moderate-intensity physical activity, at least five times a week. For older people, being active at least three days a week is a good goal initially. Longer periods of activity may be needed for weight control.

It’s important to include activities that improve various aspects of fitness, including balance exercises to reduce the risk of falls and non-strenuous strength exercises to maintain good bone and joint health. Physical activity can also be incorporated into activities they love, such as gardening, shopping, or visiting the park or country side. Keeping fit can also provide much needed social interaction as well as maintain mobility, and subsequently independence.

It’s important that your loved one finds an activity appropriate to their fitness level. If your loved one is less mobile or doesn’t get out as often as they would like, you can encourage them to stay active through light walks, easy to do home exercises, or even water-aerobic classes. Aim for at least 10 minutes of exercise at first and gradually increase it. If you are not sure about your loved one’s fitness level, check with their doctor first to ensure that the exercise they do is appropriate to their abilities.

Essential nutrients

Diets with plenty of fruits, vegetables, proteins, and whole grains are often recommended to help maintain and improve overall health. It’s also vital that we get enough essential nutrients. These are important because they play key roles in our metabolism, repairing injuries, as well as often being building blocks for our growth. Two key essential nutrients are Omega-3 fatty acids and calcium.

Omega-3 Fatty Acids

Omega-3 fatty acids are found in foods with a high natural oil content such as flaxseeds and flaxseed oil, walnuts, canola oil, and fish. They can help reduce inflammation, which plays an important role in causing heart disease, cancer, and arthritis. Older people are recommended to eat foods reach in omega-3 fatty acids twice a week. If this isn’t possible their doctor may recommend an Omega 3 supplement.


Calcium plays a key role in bone health. The need for calcium increases as people age, particularly as the risk of osteoporosis rises, a disease which increases bone weakness, increasing the risk of a broken arm. Osteoporosis is a particular concern for women during and post menopause. Calcium can also help lower blood pressure.

The World Health Organisation (WHO) recommends that adults over the age of 50 have at least 1200 milligrams of calcium per day. This is equal to about four cups of fortified orange juice, dairy milk, or almond or soy milk. Absorbable calcium can also be found in high amounts in leafy greens like kale and turnip greens. It can be difficult to consume this much calcium today. If this is the case for you loved one, they should visit their doctor to see if they should take a calcium supplement.

Restrict sodium content

If your loved one is at risk of or has already been diagnosed with hypertension (high blood pressure), limiting the sodium content in their diet can be one of the most important things to reduce their hypertension. Added table salt actually only accounts for a small amount of sodium in food, with high levels of salt being found in frozen, processed, and restaurant foods. To reduce the sodium content in your loved one’s diet, consider the following food stuff:

  • Add flavour to foods with spices and herbs instead of salt
  • Fresh and frozen fruit and vegetables
  • Dry beans
  • Unsalted nuts and nut butters
  • Grains, like brown rice and oats

Stay hydrated

Older people often become dehydrated more quickly as they don’t get thirsty as often and are less likely to drink frequently, even though they still need the same amount of liquids as others. Make sure that you monitor your loved one’s liquid intake and encourage them to drink frequently both whilst you’re with them and when they are alone. You could also monitor their liquid intake by getting them an easy to drink water bottle, such as the Camelbak Eddy 1L water bottle with a built-in straw – you can find it on Amazon here.

If you are concerned that they are not properly hydrated you can also check their urine – this is often the surest sign of level of hydration. If their urine is dark and/or cloudy, they will need to drink more liquids. If you are still concerned that they are dehydrated it can also be useful to visit their doctor or dietician to see how you may increase their liquid intake.


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