Arthur Baguma
8 November 2009
Kampala — AT 80 years, Mzee Kiwanuka is literally living like a baby. With all his teeth gone, he no longer enjoys beef, his favourite delicacy. His appetite and taste for food has also drastically taken a slump. He is battling old age in isolation.
According to dieticians, these are some of the realities of life that come with old age and could deny one access to the vital nutrients needed to keep healthy.
Statistics show that the number of the elderly is growing worldwide, both in absolute and relative terms.
Yet the greatest challenge over the coming years will be maintaining the health of this increasing number of older adults.
According to research conducted by Brany Fred Lukwago, the product researcher and development at the Uganda Industrial Research Institute, 33.3% of the elderly in Uganda are malnourished.
The research shows there were about three million elderly people in 2002 and this was expected to double by 2010.
The research under the theme, Nutritional Status and Fractional Ability of the elderly aged 60-90 years, cited poverty and lack of mobility to do daily activities, and diseases like eye problems, back pain, joint pains and lack of knowledge on nutrition, as the major cause of malnutrition among the elderly.
"They (elderly) don't know what to eat. And sometimes they forego meals and give food to the children under their care.
They cannot do certain activities like cooking, walk to the shops or well to fetch water. This means they are more vulnerable to malnutrition," Lukwago says.
Lukwago urges the Government to set up centres to look after the elderly, just like it is done in the developed world.
The Government, he advises, should project more funding and also empower the elderly to engage in simple income-generating activities like rearing chicken and goats.
The World Health Organisation classifies people aged between 45 and 59 as middle age, 60 to 74 as elderly and over 75 as old.
Dr Hanifa Bachou, the head of the Nutrition Department at Mulago Hospital, says nutritional needs of older adults are difficult to neatly categorise into absolute age groups.
According to Dr Bachou, there are many factors that influence nutritional status in older adults: some naturally occur during the ageing process, such as a reduced ability to absorb nutrients efficiently, or a sore mouth due to dentures and disease-specific conditions such as cancer, which place greater nutritional demands on people.
She adds that some drugs that interact with nutrients and prevent absorption, for example aspirin, can interfere with the absorption of Vitamin C.
Prof. Joyce Kikafunda, a nutrition expert at Makerere University, notes that continuing to enjoy food and eating a diet that maintains nutritional status is key to coping with illness among the elderly.
Poor nutrition has been shown to increase the risk of infections, bed sores, chest infections and poor wound healing in the elderly.
Lukwago says human nutrition research shows that the ability to taste flavours declines as people grow older. Food can often taste bland to the older people.
To increase the elderly's appetite, Kikafunda advises the use of herbs and spices, tomatoes and lemon juice to flavour food, but avoid using too much salt.
"You can also choose foods with a strong taste. Go for strong-flavoured meats, sauces, dressings, mustards and pickles to arouse their (elderly) interest," she says.
Give them extra care
If you are responsible for looking after an older relative or friend who needs a lot of assistance, here are some suggestions that might be useful to ensure they eat well.
Offer to do shopping for them.
lMake a batch of stew, pasta sauce or other dishes and freeze them in portions such that they are ready to heat and eat.
lMake sure they have plenty of store cupboard items that are easy to prepare such as tinned vegetables and fish, pasta and rice, dried fruit and nuts and frozen foods.
How to stimulate their appetite
If an elderly person under your care is unable to eat much, try small appetising meals and calorie-rich snacks in-between meals to boost their nutrient intake. You could also try out the following to increase their calorie intake:
Fats and sugars provide energy and help food to taste good, so use these generously. Add extra cheese to sauce or grate on potatoes, add butter or margarine to vegetables or enrich full-fat milk by adding powder milk. Try using sugar or honey on breakfast cereals.
Eat pudding once or twice a day, such as yoghurt, milky puddings, ice cream, trifle, cake, fruit pie, sponge puddings with custard and desserts.
Cakes, biscuits, chocolate and crisps provide extra energy when eaten with meals, but ensure they do not spoil one's appetite for more nourishing foods.
Enriched nourishment drinks, available in pharmacies and supermarkets, may be taken between meals to increase the elderly's calorie intake.
However, these should not replace meals.
Alcohol in small amounts can stimulate the appetite. However, one should consult their doctor, especially if they are on medication.
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