Nutrition Can Become More Challenging With Age

Older adulthood can bring an apparent nutritional contradiction: energy needs may decline even though eating well can require more attention. The key is to separate how much dietary energy a person needs from how much nutritional value must fit within that intake. Those are related questions, but they are not the same.

Average energy requirements often decline with age, although the size of that change varies substantially among individuals. Age-related loss of fat-free mass can contribute to lower energy needs, as can declines in resting energy expenditure. That decline in resting expenditure is not uniform and reflects changes in fat-free mass, body composition, and other age-related physiological factors. Physical activity remains another important determinant of energy requirements .¹

Lower energy needs also do not mean the basic adult macronutrient framework is replaced in older adulthood. For generally healthy older adults, the adult AMDRs for carbohydrate, protein, and fat remain the same. Food quality therefore remains important. Older adults should emphasize nutrient-dense foods, allowing more nutritional value to be obtained within the amount of food being eaten. For carbohydrate foods, that can include favoring whole grains and other minimally processed, nutrient-dense choices over refined grain products .^2,3

Meeting nutrient needs can become more difficult for reasons that go beyond calorie requirements. Reduced food intake itself can contribute to nutrient inadequacy, because eating less can reduce the opportunity to obtain needed nutrients. Absorption can matter as well. Some older adults experience malabsorption related to diseases or age-associated gastrointestinal conditions, which can contribute to nutrient deficiency. Malabsorption is not an inevitable consequence of aging; it is particularly relevant when specific health or gastrointestinal problems are present. Practical access to food can create another challenge. Mobility limitations in frail or homebound older adults can make it harder to obtain healthy, varied foods, adding a food-access problem to the nutritional one .^4,5

The nutritional challenge in older adulthood is therefore not simply reduced intake, but achieving adequate nutrient intake within a smaller energy budget. Because calorie needs vary among individuals, the focus shifts from eating more or less food to obtaining sufficient nutrients from the foods that are consumed.