Malnutrition may be associated with the developing world, but many Irish elderly people are malnourished, a conference was told yesterday. The problem can be addressed through diagnosis, but quantifying its extent difficult.
While older people may be malnourished, in most cases they are otherwise well, according to Dr Conor Delahunty of UCC Department of Nutrition. This, however, is not cause for complacency as poor nutrition leads to ill-health and disease, he told an Royal Irish Academy symposium in Dublin on nutrition and elderly people.
The reasons for malnourishment were complex. It could, for example, relate to dentition and ageing of the jaw muscle.
Nutritional research had been preoccupied with what we should eat and how much, yet choice of food and eating habits were determined from acquired food preferences and selections, which had a direct bearing on a person's nutritional status.
It might be better to find out why wine-tasters and perfumers retained their sense of smell and others might lose it 40 years before they reached old age. "There is some evidence that olfactory function [sense of smell] may be sustained by constant use, but the taste function remains robust across the life span. However, changes in olfaction will have a significant influence on both the intensity and quality of flavour perception."
Changes in sensory function could affect food preference and relate to undernourishment. Food choice was also influenced by external factors determining appetite including personality and the environment people lived in, which could change significantly with age.
Older people do not fall into a homogenous group, Dr Delahunty said. This complicated studies of their nutritional status. "The best recommendation might be to explore what sustains some elderly - the winetasters, the gastronomes - and debilitates others to provide insight towards an improved quality of life for all."
Research should concentrate on what determined change in body weight and the role of "energy intake" in diets, according to Dr Barbara Livingstone of the Northern Ireland Centre for Diet and Health. Low energy intake in food and drinks among some women could make it difficult for them to meet micro-nutrient requirements. Many had vitamin and mineral intakes below the recommended amount.
Malnutrition was manifest in lack of body weight or obesity due to under- or over-nutrition, said Ms Ruth Charles, a dietician from Tallaght Hospital. This underlined the need to screen patients as intervention could be effective. This meant fewer hospital stays, reduced health costs and a better quality of life. "You can teach an old dog new tricks, and you can change eating habits with great success."
Traditional Irish diets were "disastrous for vitamin C", Dr John Lavan, a consultant physician of Beaumont Hospital, said. Irish people "stew the guts out of vegetables" and had a reluctance to eat fruit. Also, many elderly people whom he treated for mineral and vitamin deficiency had a false sense of poverty, when in fact they were quite wealthy.
