Summary

• In 2014, 10.2 million older adult households in the US faced the threat of hidden hunger, a phenomenon characterized by a deficiency in essential micronutrients 
• Adequate micronutrient status may help to improve health and wellbeing in older populations and slow the progression of non-communicable diseases (NCDs) and other age-related diseases, such as osteoporosis and cardiovascular disease (CVD) 
• Significant healthcare cost savings could be achieved by implementing a long-term preventative strategy to promote healthy aging, and break down the barriers to adequate nutrition for older adults 

Strategies and interventions to diagnose and address hidden hunger in the elderly

The New York Academy of Sciences event, ‘Hidden Hunger: Solutions for America’s aging population’, took place in Washington DC, and welcomed public health officials, healthcare practitioners and scientists from across the globe. Of particular interest at the event was the current status of hidden hunger in the US, and the role that policies can play in encouraging quality health care practices to promote adequate nutrition in the elderly.

What is hidden hunger?

Micronutrient deficiency, often known as ‘hidden hunger’, is a growing problem across the globe. In fact, reports suggest that 1 in 3 of the world’s population is suffering from hidden hunger and its related conditions as a result of inadequate nutrient intake, and subsequent deficiencies in essential vitamins, minerals and other nutrients such as vitamins A, C, D and E, B vitamins, calcium, zinc, magnesium, potassium, omega-3s and others

The challenge, however, is that malnutrition is a key risk factor for NCDs, and can have a significant impact on healthcare costs and the global economy. In the US alone, the costs associated with disease-related malnutrition is estimated at USD 157 billion. While this phenomenon can impact individuals of all ages, older adults are at particular risk of malnutrition as a result of insufficient nutrient intake, with one in five US adults over 50 estimated to be struggling with food insecurity. Indeed, in 2014, 10.2 million older adult households faced the threat of hunger in the United States. This issue is expected to continue, and with the United Nations (UN) projecting that the number of people over 60 will exceed two billion by 2050, it is essential that steps are taken now to manage and address this concern. 

A preventative approach 

While extensive scientific evidence indicates the potential positive health benefits of micronutrients in reducing the risk of age-related chronic disease, there is significantly more to be done to bridge the gap between older adults and adequate nutrition. The problem is further exacerbated by the fact that assessment of micronutrient status is not currently part of the standard healthcare evaluation for older adults. As a result, there is no consistent measure of the level and type of nutrient deficiency that each individual may be facing – not only does this make gauging the degree of malnutrition a significant challenge, it also contributes to inconsistencies in the efficacy of micronutrient fortification and supplementation. Introducing routine screening measures, such as dietary screening tools to characterize the dietary patterns of older adults, is a proactive strategy that could be easily implemented as part of a long-term preventative approach to identify at-risk individuals and more effectively monitor nutritional status. 

Research has also indicated that participation in federal nutrition assistance programs, such as Meals on Wheels America and the Supplemental Nutrition Assistance Program (SNAP), can promote healthy aging in at-risk elderly individuals, while also helping to support greater independence and quality of life. These community-based programs were developed to help mitigate the impact of malnutrition and food insecurity and attenuate healthcare utilization. However, budget cuts have seen these programs significantly scaled back and have, instead, created additional barriers for vulnerable older adults in accessing their support. To help alleviate hunger and improve nutrition in the elderly, it is essential that governments and policy makers the world over consider ways in which such programs can be bolstered to enable more seniors to age well and remain healthy. 

Let’s talk about nutrition

A conversation is also underway within the healthy aging community and beyond surrounding the role that nutrition can play in promoting health in the elderly. A growing body of evidence suggests that increasing intake of key micronutrients, such as vitamins A, C, D and E, B vitamins, calcium, zinc, magnesium, potassium and omega-3s, while reducing consumption of energy-dense refined and processed foods, may be an effective approach to maintaining health as we age and reducing the socio-economic costs and healthcare burden. Implementing strategies that can facilitate better education and awareness on what constitutes a healthy, balanced diet throughout life could be key in improving and supporting the health and independence of the world’s older population.