Nutrition Guidelines for the Elderly 2024 Latest Edition

Ensure adequate food intake > high-quality protein intake > micronutrient supplementation > dietary taboos for chronic diseases.

A while ago, I followed Dr. Zhang from the community nutrition department to do a home-based nutrition screening for the elderly. I met 68-year-old Aunt Li, who has been suffering from diabetes for 12 years. Before, she strictly followed the old saying and only ate half a bowl of multigrain rice every day. She did not dare to touch pork, beef, mutton, and only dared to eat egg whites. As a result, during that time, she was out of breath when climbing two floors. She fell when going out to buy groceries. When she went to the hospital, her serum albumin was only 32g/L, and she had developed mild sarcopenia. The plan that Dr. Zhang gave her completely broke her previous understanding: add one or two lean pork or steamed fish to each meal, eat one whole egg every day, replace the staple food with half grains and half white rice, and add half a box of sugar-free yogurt between meals. During the follow-up visit last month, her albumin had returned to 37g/L, she was walking with much strength, and her blood sugar was more stable than before - after all, she was prone to hypoglycemia from hunger in the past, which was more likely to cause blood sugar fluctuations.

Speaking of which, we have to mention the current controversy in the nutrition community about "light diet for the elderly". The two mainstream views are clearly listed in the 2024 version of the guidelines: the traditional direction of chronic disease prevention and control is to insist on daily salt not exceeding 5g, cooking oil not exceeding 25g, and strictly controlling the intake of added sugar to avoid aggravating the burden of chronic diseases such as high blood pressure and hyperlipidemia.； However, recent research on sarcopenia and malnutrition in the elderly has suggested that as long as there are no serious heart failure, renal insufficiency or other problems, salt can be relaxed to 6-7g, and cooking oil to 30g is no problem. After all, many elderly people have degraded taste and cannot swallow meals that are too bland. The risk of reduced immunity and sarcopenia caused by long-term insufficient intake is much more harmful than eating 1g more salt. The final recommendations given by the guide are also very flexible: "Adjust according to the elderly's willingness to eat, and give priority to ensuring that they can eat and eat enough." There is no deadlock value at all.

Oh, by the way, everyone has been struggling with the egg yolk issue for more than ten years. The 2024 edition has also updated clinical data: healthy elderly people eating 2 whole eggs a day will not have a significant impact on blood lipids. Even elderly people with high blood lipids and coronary heart disease are safe to eat 1 whole egg a day without deliberately throwing away the yolks. After all, the lecithin and vitamin D in the egg yolk are nutrients that are particularly scarce for the elderly, so it would be a pity to throw them away. I met a 76-year-old man before. He heard from a health lecture that egg yolks raised cholesterol. He had not eaten egg yolks for three years. As a result, his physical examination revealed that he was severely deficient in vitamin D. He slipped and fell in the winter and fractured his femoral neck. The gain outweighed the gain.

If your old man has good teeth and no serious underlying diseases, you don’t need to specially change his diet. As long as you remember to eat more fish, poultry, eggs, milk, and soy products every day, drink enough 1500ml of water every day, and go out to bask in the sun more, you don’t need to force him to eat whole grains he doesn’t like. If he feels gastric reflux and bloating after eating whole grains, there will be no problem at all if he eats white rice and white noodles. If you are an elderly person over 80 years old, even if you have diabetes, you don’t need to control your staple food too strictly. The risk of hypoglycemia for elderly people is much greater than the risk of high blood sugar. It’s okay to eat until you are six to seven times full at each meal. If you feel hungry, you can add a small cake or a few soda crackers. As long as you don’t eat too much at one time. Oh, and there is a special case. If the elderly have renal insufficiency, their protein intake must strictly follow the doctor's requirements. They cannot increase the amount casually. Don't copy the above statement.

There are also elderly people with poor swallowing function who are prone to choking and coughing. Don’t feed white porridge every day. White porridge has no nutrients except carbohydrates. If you drink it for a long time, you will definitely be malnourished. It is best to break up lean meat, blanched green leafy vegetables, and eggs and add them to porridge or rice cereal. If you find it troublesome, you can also buy homogenized meals from regular manufacturers, which are much more nutritious than mixing them by yourself.

I have been working in the field of community nutrition for almost 5 years, and I have seen too many elderly people being deceived by messy health rumors. Either they dare not eat this or that and become so skinny, or they buy a bunch of protein powder and fish oil and pile them all over the table, but they don't eat. In fact, the core of the 2024 version of the guide is "people-oriented". Don't ask the elderly to meet the dietary standards of young people, and don't be obsessed with nutritional values. As long as the elderly like to eat, can eat, do not feel uncomfortable after eating, and have stable physical examination indicators, it is better than anything else. When you go home for dinner in the evening, it is better to ask the elderly at home what they want to eat recently, which is much more useful than forcing them to eat so-called "healthy foods".