Why do some people age healthier than others?
- Life expectancy is rising at a rapid rate. The global population of people aged over 60 years is expected to double by 2050, which could cause major health and economic implications.1
- A recent instrumental review published in Advances in Nutrition has highlighted the role of nutrition in promoting healthy aging and in improving the prognosis in cases of age-related diseases.2The topic will also be discussed at an upcoming high-profile event in Washington DC in March, ‘Hidden hunger: solutions for America’s aging population’.
- Given that nutrition is a modifiable risk factor for non-communicable diseases (NCDs), a preventative, rather than therapeutic approach, could prove beneficial in helping individuals to live long, healthy lives.
Life expectancy is increasing at a rapid pace across the world. The global population of people aged over 60 years is predicted to double by 2050 to more than 2 billion, which is having serious health and economic implications.3 With the number of people over 80 years old expected to be three times higher in 2050 than it was in 2013, the world is reaching a pivotal health challenge.
A recent important review published in Advances in Nutrition examined the approaches to minimizing age-related frailty and how preventative measures can help to extend the healthy life span by building on modifiable lifestyle factors and nutrition.4 The research also helped to identify key knowledge gaps among healthcare practitioners, and the barriers that public health bodies face in effective implementation. This topic will also be discussed at the upcoming high-profile event, ‘Hidden hunger: solutions for America’s aging population’, which will highlight the role of policies in improving adequate nutrition in the elderly.
The problem with aging
The fact that people today, and in the future, are living longer is generating a burden on individuals and societies across the globe, with an increasing number of people living with non-communicable diseases (NCDs) such as osteoporosis, type 2 diabetes, cardiovascular disease (CVD), age-related macular eye disease (AMD), cognitive decline like Alzheimer’s disease and cancer. This issue is prevalent all over the world, and is particularly widespread in developing countries, where many regions are not adequately equipped to meet the demands of a more elderly demographic, and in developed countries, particularly within population groups with low income and/or who are living in so-called ‘food-deserts’.
Although non-communicable diseases, also known as chronic or nutrition-related diseases, are widely considered to be an inevitable part of aging, they are also becoming increasingly prevalent at younger ages. A growing body of research suggests that this is a consequence of inadequate lifestyle behaviors, rather than a normal function of aging. In fact, the World Health Organization (WHO) estimates that the elimination of major risk factors for chronic diseases, such as poor diet, smoking and lack of exercise, would reduce the risk of CVD, stroke and type 2 diabetes by as much as 80%.5
We are what we eat
Given that the majority of NCDs and other age-related diseases can be prevented with lifestyle modification, there is an opportunity for diet to play a key role in improving the prognosis in cases of age-related diseases. Evidence on calorie restriction in human health is still unclear; long-term randomized studies are generally unfeasible and unethical. While the benefits of calorie restriction have been recognized in other species, the effect in humans is unclear.
However, research has shown that although older people tend to be frailer, they can also be overweight and/or obese and low in muscle mass as the result of longstanding poor, energy-dense diets. It is often difficult for older people to obtain the right amount of nutrients, because many experience changes in taste and smell, loss of appetite, dental and chewing problems and limitations in mobility and access to high quality fresh food. As such, older adults regularly fall below recommended nutrient levels, including calcium, vitamins D and E, dietary fiber and potassium, among others. This can lead to an increased risk of malnutrition – or ‘hidden hunger’ – as they may be suboptimal, or even deficient, in essential micronutrients.
Improving health care plans
One of the challenges with improving the nutritional health of older populations is that medication can often interfere with the absorption of nutrients. For example, long-term use of acid-blocking medications may contribute to vitamin B12 deficiency, which can cause anemia and, in extreme cases, complex neurological complications like dementia and difficulty maintaining balance.6 Supplements and food fortification could therefore offer a convenient, safe and effective option to increase nutritional profiles by correcting inadequate levels. For instance, vitamin B12 supplements may correct deficiency associated with the use of acid-blocking medication.
Similarly, vitamin D supplementation can increase nutrient levels in individuals who receive inadequate sun exposure, while higher intake of vitamin E can help to maintain optimal immune response. A wealth of science-backed research already exists that supports the benefits of adequate and optimal nutrient intake and status, and these findings should be used and applied to those who can benefit from this insight. However, despite the significant body of evidence that highlights that older adults are at higher risk of inadequate consumption of nutrients and nutrient-rich foods, as well as undernutrition, further research is still needed on the optimum requirement for nutrients in this age group.
Building blocks of health
Despite the knowledge gaps that exist in healthy aging research, evidence suggests that incorporating nutritional evaluations and services into preventative care for aging adults could prove beneficial in avoiding and minimizing the effects of age-related conditions. This could be achieved by optimizing nutrition screenings and dietary assessments, as well as re-evaluating how current body mass index (BMI) guidelines are used in older adults. The review concluded that, with regular nutritional screenings as part of a wider healthcare strategy, it could form a solid foundation for developing the right preventative measures in health modulation in later years.
Healthy aging is a lifelong challenge, and requires long-term positive lifestyle behaviors, including adequate nutrition and exercise across the life stages.
For more information on the nutritional considerations for healthy aging, register for the upcoming one-day event on ‘Hidden hunger: solutions for America’s aging population’, hosted by The New York Academy of Sciences in Washington DC, on March 23, 2018: www.nyas.org/hiddenhunger.