Nutritional supplements for the elderly

The vast majority of healthy elderly people do not need to take additional nutritional supplements. A balanced daily diet can meet all nutritional needs.； Only in special circumstances such as insufficient nutritional intake or disease-related consumption, targeted supplementation is required under the guidance of a clinical nutrition department or specialist. Do not blindly follow the trend and buy hot-selling products on the market.

Last month, I was doing a follow-up on nutrition for the elderly in the community. I met 72-year-old Aunt Zhang who brought out a whole locker of supplements for me to see: high-protein powder given by her children during the Spring Festival, deep-sea fish oil recommended by my best friend who dances in the square, glycosaminochondroitin from a health lecture, and Ganoderma spore powder that is said to "prevent cancer and anti-aging." There are more than 20 bottles in total. I have to take seven or eight pills before and after meals every day, which is more punctual than taking antihypertensive drugs. As a result, a physical examination some time ago revealed that her blood uric acid was twice the standard and her kidney function was also slightly abnormal. When I asked her, I found out that she was afraid of insufficient nutrition and drank a cup of concentrated protein powder every morning and evening. Elderly people have physiological deterioration of kidney function, and the extra protein cannot be metabolized, which has become a burden.

In fact, if you look at the "Dietary Guidelines for Chinese Residents (2022)", you can see that as long as healthy elderly people over 65 years old can eat 200-300g of cereals and potatoes, half a pound to a pound of fresh fruits and vegetables, about 120g of fish, poultry, meat and eggs, and drink 300-500g of milk, their protein, vitamin and mineral intake will be fully up to standard, and there is no need to take additional supplements at all. Many healthy elderly people in their 90s who I have followed up have never taken any nutritional supplements in their lives. They just eat without being picky and eat a combination of meat and vegetables. They are in better physical condition than those who take supplements every day.

Of course, some people ask, are the fish oil and ammonia sugars that everyone is buying now all IQ taxes? I have discussed this issue several times with my colleagues in cardiology and orthopedics, and the academic community has yet to reach a completely unified conclusion. Let’s talk about fish oil. A 2023 cohort study in the New England Journal of Medicine did show that supplementing high-purity Omega-3 for people at high risk of cardiovascular disease can reduce the risk of major adverse cardiovascular events by 17%. However, another 5-year follow-up study on healthy elderly people found that there was no statistical difference in the incidence of cardiovascular and cerebrovascular diseases between people who continuously consumed ordinary fish oil and those who took a placebo. To put it bluntly, if you have a history of hyperlipidemia or coronary heart disease, it is really useful to buy high-purity foods as directed by your doctor. If you are in good health at ordinary times, the most you eat is to supplement some fat, and you may gain weight. The same goes for ammonia sugar. I met a retired physical education teacher who took ammonia sugar for half a year, and the pain of degenerative arthritis was relieved a lot. My aunt who also had the same symptoms said that it was of no use at all after taking it for three months. The current guidelines of the American Academy of Orthopedic Surgeons do not recommend or object. It clearly states that individual differences are huge. If you take it if it is effective, you can continue to take it. If it is not effective, just stop. There is no need to insist on eating it, which will hurt the stomach.

Oh, by the way, not all elderly people need supplements. Uncle Li, whom I met last week, is 78 years old. His full dentures cannot bite lean meats and crude fiber vegetables. He drinks porridge and steamed pumpkin every day. He has lost six pounds in three months. A nutritional evaluation found that his serum albumin and 25-hydroxyvitamin D are both extremely low. In this case, he must follow the doctor's advice to supplement with short peptide protein powder, multivitamins and vitamin D calcium. In addition, diabetic patients are prone to lack of B vitamins, and patients with chronic kidney disease need to supplement special ketoacid preparations. These have clear clinical indications. You cannot buy them blindly, nor can you generalize that supplements are useless.

What bothers me the most is the people selling supplements at the gate of the community under the banner of "public welfare lectures". They first ask the elderly to get ten eggs for free, and then start talking about their "stem cell nutrient solution" and "longevity factor peptide" for two hours, and they dare to sell more than 3,000 yuan a box. Last time, an uncle bought four boxes and showed them to me. The first two ingredients on the ingredient list were high fructose syrup and water. There were no active ingredients. It tasted sweet when you drank it. Some unscrupulous merchants illegally added glyburide to hypoglycemic supplements. Elderly people are prone to hypoglycemia and the risk is particularly high.

I have been working on nutrition for the elderly for five years, and I have seen too many elderly people who take supplements as life-saving medicines, and I have also seen many children who stock up a cupboard of supplements just to fulfill their filial piety. In fact, there is really no need for this. If you really care about the nutrition of the elderly at home, it is better to cook two more meals a week, with a good mix of meat and vegetables, and go for walks with them in the sun more often, which is more practical than a gift box worth several thousand yuan. If you really need to make up for it, spend dozens of dollars to get an account from the nutrition department for an evaluation. If you really need to make up for what is missing, it will be really good for the elderly.