On 20th January 2021 the Scientific Advisory Committee on Nutrition (SACN) published their position statement on nutrition and older adults, with a particular focus on those aged over 65 years living in the community. The proportion of older adults in the UK population continues to grow and currently 1 in 5 people are aged 65 years and over.
The SACN working group reviewed research evidence with respect to nutrition and healthy ageing and considered current dietary intakes of older adults (using data from the National Diet and Nutrition survey, NDNS) in relation to current UK recommendations.
Estimated Average Requirements (EARs) for energy are lower for adults aged >65 years and defined in 10 year age bands (2342 kcals, males and 1912 kcals, females aged 65-74 years and 2294 kcals, males and 1840 kcals, females aged >75 years). However the SACN working group highlighted a lack of specific Dietary Reference Values (DRVs), for the majority of macro and micronutrients for older adults aged >65 years.
Dietary intakes and nutritional status of older adults in the UK
The NDNS survey data indicated that adults aged >65 years had intakes of saturated fat, free sugars and salt above the maximum daily recommendations for a healthy diet and failed to meet recommended intakes of fruit and vegetables, fibre and oily fish. This was similar to the dietary intakes for the wider UK adult population.
Whilst protein intakes met the UK Reference Nutrient Intake (RNI) of 0.75g protein per Kg body mass they declined with age and were lowest in the >75 years age group. Mean protein intake was 0.93g per kg body mass for both men and women aged 65-74 years and 0.96 and 0.89g/kg for men and women, respectively, aged > 75 years which was lower than for younger adults aged 19 to 64 years (1.04 and 0.97g per kg body mass for men and women respectively).
Energy levels also declined with age although 87 % of men and 68 % of women aged 65–74 years, and 69 % of men and 58 % of women aged >75 years were living with overweight or obesity.
There was evidence of low micronutrient intakes, particularly in women and older age groups for riboflavin, folate, iron, calcium, zinc selenium and iodine.
Poor vitamin D status was common in all older adult age groups with less than a third taking a vitamin D supplement during the survey period.
Overall for those aged > 75 years, there was evidence of a decline in energy, protein and micronutrient intakes, particularly in women.
Scientific evidence on the role of nutrition and its impact on ageing
The SACN working group also reviewed the current evidence on the role of nutrition and its impact on healthy ageing. Thirty systematic reviews, 15 with meta-analyses, were included. The majority focused on musculoskeletal health outcomes, including sarcopenia (muscle strength, muscle mass, physical performance), frailty and bone health.
The SACN position statement concluded that evidence on dietary patterns, including a Mediterranean dietary pattern, and musculoskeletal outcomes was too mixed to draw conclusions.
The review also highlighted a lack of high-quality evidence in this population group, in particular for major health outcomes such as CVD and cancer, and also in ethnic minority groups. The SACN working group advised that more high quality evidence from RCT and longitudinal studies on nutrition-related outcomes was needed.
The full SACN statement can be read here