Dietary Guidelines for Chinese Residents 2022 | Dietary Guidelines for the Elderly

The term “older people” usually refers to those aged 80 and above. Older and frail elderly people often have limited food intake, reduced taste, smell, digestion and absorption ability, and insufficient nutrient intake. Therefore, they need foods with high energy and nutrient density and variety, and should eat more fish, livestock and poultry meat, eggs, dairy products, soy products and other foods with high nutritional value and bioavailability, and at the same time, eat an appropriate amount of vegetables and fruits. Fine cooking, rich and delicious taste, soft texture, adapted to the chewing and swallowing ability of the elderly. According to the specific situation, take a variety of measures to encourage eating and reduce unnecessary food restrictions. Weight loss is a sign of malnutrition and deterioration of the health of the elderly, increasing the risk of illness, weakness and disability. The elderly should monitor their weight regularly. For those who are underweight (BMI < 20kg/m2) or have lost weight significantly recently, a medical nutrition assessment should be conducted to find out the cause as soon as possible and take dietary measures to intervene. If dietary intake is less than 80% of the target amount, timely and reasonable nutrition supplements should be taken under the guidance of doctors and clinical nutritionists, such as special medical foods, fortified foods and nutrient supplements, to improve nutritional status and quality of life. Elderly and frail elderly people need to persist in physical and intellectual activities, which are beneficial to maintain physical and mental health and delay the decline of body functions.

【Core Recommendation】

1. Provide a variety of foods and encourage a variety of eating methods

1. Encourage eating in a variety of ways

(1) Encourage the elderly to eat with their families and participate in food preparation to the best of their ability.

(2) For empty-nest or single elderly people, emphasis should be placed on creating a good social atmosphere and group dining.

(3) For elderly people who cannot eat by themselves, caregivers should assist them in eating.

(4) The temperature of food should be maintained and tableware with good heat preservation properties should be used as much as possible.

2. Ensure adequate food intake

(1) Eat three meals a day well. Breakfast should include 1 egg, 1 cup of milk, and 1-2 staple foods. Lunch and dinner should each include 1-2 staple foods, 1-2 non-vegetarian dishes, 1-2 vegetables, and 1 bean product. Choose 1 or 2 kinds of livestock and poultry meat, fish and shrimp meat to alternate, and you can also pair them with vegetables and bean products.

(2) Eat small meals frequently. The frequency of meals should be three meals and two points, or three meals and three points. Each main meal should account for 20% to 25% of the total energy for the day, and each snack should account for 5% to 10% of the energy.

(3) Eat regularly. Eat regularly according to your daily routine. It is recommended that you have breakfast between 6:30 and 8:30, lunch between 11:30 and 12:30, and dinner between 17:30 and 19:00. It is not recommended to eat within one hour before going to bed.

(4) If elderly people are unable or unwilling to cook for themselves, they can choose to have meals provided or delivered to their homes.

2. Choose foods with soft texture and high energy and nutrient density

Choose appropriate processing methods to make food soft and easy to digest

(1) To cook until soft or mushy, such as making soft rice, thick porridge, or soft pasta.

(2) Cut food into small pieces and cook it for a longer time to ensure it is tender.

(3) Meat can be made into shredded meat, meat slices, minced meat, or meatballs; fish and shrimp can be made into fish fillets, fish balls, fish soup, shrimp meat, etc., making the food easier to chew and digest.

(4) Whole soybeans are difficult to digest and absorb, but they can be processed into bean products such as tofu, soy milk, and dried tofu. Red (green) beans can be boiled soft and made into bean paste, or made into desserts, noodles, and various snacks. Beans can be germinated into bean sprouts for consumption or used to make soup.

(5) Crush hard foods such as nuts and grains into powder or small particles for consumption.

(6) Fruits or vegetables with a harder texture can be crushed and squeezed into juice and eaten immediately after being squeezed. Drink the pulp and juice together. You can also cut the fruit into small pieces and boil them until soft before eating.

(7) Use more cooking methods such as stewing, boiling, steaming, braising, stewing, and roasting, and eat less fried, smoked, roasted, and raw foods.

3. Eat more fish, poultry, meat, eggs, milk, beans, and moderate amounts of vegetables and fruits

(1) Ensure adequate daily intake of fish, poultry, meat, and eggs, including 40-50g of livestock and poultry meat, 40-50g of aquatic products, and 40-50g of eggs.

(2) It is recommended to drink 300~500ml of liquid milk every day. You can also choose yogurt, milk powder or other dairy products.

(3) Regular consumption of soybeans and soy products (such as fermented soybeans, dried tofu, vegetarian chicken, tofu, soy milk, fermented black beans, natto, etc.), with a daily intake of 15g of soybeans or an equivalent amount of soy products.

(4) Try to have vegetables at every meal. 300g of vegetables per day can meet basic needs. You can choose root vegetables with a relatively soft texture (such as yam), eggplants and tomatoes (such as winter melon, tomato, etc.), fungi and algae (such as fungus, mushrooms, etc.), and young leaves of leafy vegetables. Avoid choosing vegetables that contain crude fiber (such as celery, leek, etc.).

(5) Eat fruits every day. Choose fresh fruits that are high in pectin and water and have a softer texture, such as strawberries, kiwis, peaches, bananas, persimmons, watermelons, mangoes, etc.

4. Pay attention to weight loss, conduct regular nutrition screening and assessment, and prevent malnutrition

(1) Monitor your weight regularly, at least twice a month, and it is best to keep your BMI between 20 and 26.9 kg/m2.

(2) If conditions permit, you can also measure grip strength, upper arm circumference, calf circumference, etc. You can also measure body composition to determine changes in body fat, lean tissue mass, bone mass and water content.

(3) For elderly people who are underweight or have recently lost weight, a medical nutrition assessment should be conducted to comprehensively analyze nutrition-related issues and come up with a disease-related nutritional diagnosis.

(4) First, the cause of disease should be ruled out, and then energy intake should be gradually increased to the corresponding recommended level, or slightly higher than the recommended level, based on current health status, energy intake, and physical activity level.

5. Timely and reasonable nutrition supplementation to improve the quality of life

1. Use nutritional supplements properly

(1) When the food intake of elderly and frail people is less than 80% of the target amount, they can use special medical foods reasonably under the guidance of doctors and clinical nutritionists.

(2) When the diet cannot meet the nutritional needs of the elderly, fortified foods can be chosen, such as biscuits, cereals, milk, juice, table salt, etc. that are fortified with nutrients.

(3) Elderly people who have already shown clinical symptoms of nutrient deficiency should choose nutrient supplements suitable for them under the guidance of a doctor or nutritionist.

2. Selection and preparation of easy-to-eat foods for elderly people with swallowing difficulties

(1) Make hard things soft and blend harder foods into powder.

(2) To thicken thin liquids, add thickeners to liquids such as water, beverages, juice, and milk.

(3) Avoid mixing solids and liquids together and avoid eating foods that easily separate into liquid-solid phases.

(4) The food is homogeneous and smooth.

6. Adhere to fitness and intellectual activities to promote physical and mental health

(1) Sit less and move more. Movement is beneficial. Sitting is better than lying in bed, and walking is better than sitting still.

(2) It is recommended that the weekly activity time should be no less than 150 minutes, and the form of activity may vary from person to person.

(3) Increase the amount and duration of activity slowly, do a good job of warming up and recovering after the activity. Pay attention to safety during the activity.

(4) Emphasize the organic combination of balance training, aerobic and resistance activities. Elderly people can first perform balance training and resistance exercises.

(5) Bedridden elderly people should mainly engage in resistance activities to prevent and reduce muscle atrophy.

(6) Persist in mental activities, such as reading, playing chess, playing the piano, playing games, etc., to delay the decline of cognitive function.