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NUTRITION
Furthermore, functional impairments of taste, smell
and the gastrointestinal tract may lead to decreased
eating-related pleasure associated with recessive appetite,
thirst and malnutrition. Consequently, this is
associated with a deficient uptake of nutrients and
liquids, which relates especially to the macronutrient
protein and to some vitamins (especially vitamin D)
and trace elements (e.g. zinc, selenium and iodine).
This, in combination with impairments in cellular repair
mechanisms aggravates accumulation of cell
damage and finally leads to loss of cell function. It
is generally assumed that due to these changes the
body’s energy demands decrease, while nutrient demands
remain stable or increase.
Trend one: Development of
demand-adapted food including
new edible material
According to the needs mentioned above, elderly
have to take up nutrient-dense food containing low
energy amounts such as whole grain bread, vegetables
and newly developed foods with optimized nutrient
supply adapted for elderly. In the research association
NutriAct (“Nutritional Intervention for Healthy
Aging: Food Patterns, Behavior, and Products”) joining
academic partners and food companies we test a
dietary regimen suitable for supporting healthy aging
in individuals from above 50 years old 2. This regimen
focusses on locally grown food materials with high
nutrient density and low caloric value that consider
age-related physiological changes such as increased
protein demand for prevention of a later development
of sarcopenia and frailty. Additionally, nutrient-independent
aspects of food uptake are taken into account.
This refers to traditional and local food habits
as well as taste, texture of the food, and time efforts
for preparing the meals. Considering regional food
growth and production, important elements of the
dietary NutriAct pattern are, therefore, an increased
portion of poly-unsaturated fatty acids from rapeseed
oil, increased portion of plant-based protein mainly
originating from regional grown legumes, increased
portion of fibres, and a low glycemic index.
Nutritionists are confronted with the challenge to
adapt dietary recommendations being valid so far only
for adults to demands of the heterogeneous group of
elderly comprising healthy and active people but also
individuals of very high age or with one or more (metabolic)
diseases and being under multiple medication.
According to only recently updated and published reference
values of the German Association for Nutrition
(DGE), elderly should daily eat about 1.0 g of protein
per g body weight (instead of only 0.8 g/g body weight
as recommended for adults) 3. This, in combination
with regular physical activity 4 should prevent or at
least delay occurrence of sarcopenia and frailty. Meat
is a good source of dietary protein with high biological
value since the composition of amino acids is very
similar to humans. However, it has been shown that
high habitual uptake of especially red meat is positively
associated with occurrence of type 2 diabetes 5 and
especially a higher uptake of processed red meat is accompanied
by physiologic formation of nitroso compounds
and lipid peroxides that may lead to colorectal
cancer 6. Intriguingly, an increased portion of protein
in the diet was reported to improve glucose homeostasis
in patients with type 2 diabetes, which was mainly
related to decreased hepatic lipid storage 7. Solving
this dilemma, plant-based protein should be used to
increase protein percentage in the diet. Considering
plant-based protein, especially legume-derived proteins
have the highest biological value and represent
a regionally and traditionally produced protein source.
However, the biological value is much lower than that
from meat or dairy products and, therefore, proteins
of different sources should be combined for complementing
amino acid composition and increasing the
biological value. Looking for alternative protein (nonmeat)
sources, also insect-based protein came into
consideration. However, the biological value as well as
the physiological effects on muscle protein synthesis of
insect-derived protein have not yet been systematically
investigated, but from the available data it can be considered
being similar to meat protein.
Therefore, in the future, we will need even more
food products that are designed according to demands
that are specific to a certain age or lifestyle or physiologic
situation (e.g. pregnancy, growth or illness).
Considering the protein content of food, already now
in several traditional food items (such as bread, pasta
or diced meat) protein content is increased and partly
or completely replaced by plant or insect proteins (see
also 8). This may help e.g. elderly people to increase
protein uptake by eating their traditionally known
food and meals without artificial addition of supplements
or habituation to unknown food and meals.
We expect this trend also to be transferred to other
Vegan cooking is a trend – VeganFach, Cologne (Photo:
Kützemeier)