Dietary Guidelines for Older Adults [2020-2025]
Want to learn more about dietary guidelines for older adults? The newest edition of the Dietary Guidelines for Americans, 2020-2025 has been released as of late December 2020! In this article we breakdown the information specific to older adults in these guidelines.
What are the Dietary Guidelines for Americans?
The Dietary Guidelines for Americans (DGA) are a document released by the United States Department of Agriculture (USDA) every five years. The DGAs are meant to serve as guidance for healthy eating patterns throughout the lifecycle.
Are the Dietary Guidelines for Americans for everyone?
The DGAs are targeted towards the average American. The focus is on a healthy diet to promote overall health and minimize risk of disease.
Keep in mind these are guidelines. They are not set-in stone and may not apply to everyone in every situation. Individuals eat in different ways and that’s OK. The DGA is meant to provide a framework and some guidance on how you can eat healthier as you age.
You can find some good information on Frequently Asked Questions here.
The Unique Needs of Older Adults
As you review the dietary guidelines for older adults, keep in mind the unique needs of older adults. And the fact that there is no one-size-fits-all description of an “older adult”.
A healthy, active 65-year-old has very different needs than a frail, bedbound 90-year-old. And those with chronic medical conditions or cancer or those experiencing unintended weight loss have their own needs. And of course, nutrition guidance is completely different for those at end of life.
Dietary Guidelines for Older Adults
OK, so let’s dig in! You can download the 2020-2025 Dietary Guidelines for Americans here.
But keep reading for the “cliff notes” version as the DGAs relate to older adults.
The DGA is 164 pages long. There is chapter dedicated to Older Adults on page 121. The DGAs define an older adult as those ages 60 and older.
Healthy Eating Index Score
Older adults have the highest healthy eating index score of all groups of Americans. The DGAs feature the Healthy Eating Index Score as a way to classify how healthy a population eats. On a scale of 0-100, older adults have a score of 63.
As a general group, older adults can benefit from eating more fruits, vegetables, and dairy foods. For older adults who do not consume dairy, be sure to eat non-dairy foods high in calcium such as calcium fortified beverages, almonds, turnip greens, edamame, kale, bok choi, and broccoli.
Older women in general can also benefit from eating more protein foods.
Healthy Eating Recommendations
The DGAs provide healthy eating recommendations by sharing which types of foods to eat and which types of foods to limit.
Foods to Eat
The DGAs break down recommendations for each food group. The amount varies based on how many calories an individual person requires. Page 125 of the DGAs has a table with information based on calorie needs.
For example, someone requiring 2,000 calories per day should aim for:
- Vegetables: 2 ½ cups
- Fruit: 2 cups
- Grains: 6 ounces (half whole grains)
- Dairy: 3 cups
- Protein: 5 ½ ounces (including meat, eggs, seafood, nuts, and seeds)
- Oils: 27 grams
Eat the foods that best fit your personal preference, culture, traditions, and individual medical conditions. Quality of life is important, so eat foods you enjoy!
Along with eating healthy foods from each of the food groups, drinking plenty of fluid is also important. Many older adults fail to drink enough fluid and experience dehydration. Older adults drink the least number of fluids compared to the other age groups.
In addition to drinking water, fluids can be obtained through fruit or vegetable juice, milk, dairy-free milk alternatives, and foods containing water (ex. soups, fruits, and vegetables).
Alcoholic beverages should be limited to 2 drinks or less for men and 1 drink or less for women.
Foods to Limit
The DGAs recommend limiting added sugars, saturated fat, and sodium. In general, older adults consume too much of all of these. Here are the recommendations per the DGA:
- Added Sugars: Limit 10% of total calories daily
- Saturated Fat: Limit 10% of total calories daily
- Sodium: Limit 2,300 mg daily
Keep in mind when an older adult is experiencing poor appetite, experiencing unintended weight loss, or malnutrition we recommend liberalizing diets. This means not adhering to strict dietary restrictions which could limit calories consumed.
Remember what we said about how each older adult is different?
As a geriatric dietitian I would never tell a 90-year-old to not eat sweets. Those who work with older adults know how important food is in the day of an older adult. And sometimes those 2 cookies they eat every day at 2pm are the best part of their day. Now if that’s all they eat, that’s another conversation!
Quality of life is important. Each individual can make decisions on what food choices are right for them. A caregiver should never impose dietary guidelines on an older adult that goes against their wishes.
Outside of healthy eating recommendations, the DGAs address other considerations for older adults.
The DGAs recognize that protein is an important nutrient to prevent the loss of muscle with aging. A lot of our content on The Geriatric Dietitian surrounds preventing unintended weight loss to preserve muscle mass.
Older adults ages 71 and older consume less protein than older adults ages 60-70. Approximately 50% of women age 71+ don’t get enough protein. And approximately 30% of men age 71+ don’t get enough protein.
Protein needs can be met by eating a variety of protein food types in a variety of dishes throughout the day. Foods high in protein include meats, poultry, eggs, beans, lentils, etc. If you follow a vegan eating pattern, be sure to check out our vegan protein sources chart.
You can learn more about protein at Protein Requirements for Older Adults.
The DGAs recognize that some older adults are unable to adequately absorb vitamin B-12. In most cases older adults can get vitamin B-12 foods through meats and fortified foods. But in some cases, supplementation is needed. You should always talk to your doctor before starting supplements.
Foods high in vitamin B-12 include clams, liver, fortified nutritional yeast, salmon, tuna, fortified cereal, beef, milk, yogurt, eggs, and chicken. Older adults should get half of their vitamin B-12 through fortified foods or supplements (a multivitamin should suffice in those without a clinical deficiency).
You can learn more about vitamin B-12 at 7 Key Nutrients for Senior Nutrition.
Healthy eating is only one part of health. Equally important is regular physical activity. Especially for preventing loss of muscle with aging.
The DGAs address physical activity in older adults. Emphasizing that some is better than nothing and it’s never too late to start. Always speak to your doctor before starting an exercise program.
Physical activity recommendations for older adults are:
- 150-300 minutes of moderate-intensity aerobic exercise per week
- At least 2 days per week include muscle-strengthening exercises
- Include balance training as well
Physical activity in older adults improves quality of life. It can make it easier to complete every day tasks, remain independent in the home, and reduces the risk of falls and fall related injuries.
Finally, the DGAs address topics important for supporting healthy eating and overall health.
They emphasize the importance of enjoying foods and eating with others. Meals are a big part of the day for most older adults.
It’s not just about getting nutrients or calories, it’s about enjoyment.
Some older adults have issues with chewing or swallowing foods. The DGAs address experimenting with foods to find the ones the older adult enjoys the best based on their chewing/swallowing needs. They also emphasize the importance of good dental health.
Additionally, the DGAs address food safety and food security. The guidelines list multiple resources to help older adults to get the foods they need to be heathy.
Here’s my opinion on the new Dietary Guidelines for older adults. I believe the DGAs provide good overall guidance for health eating for the general population. I’m a big fan of fruits and veggies and good nutrition that fuels the body.
However, I don’t think we should get so caught up in healthy eating that we provide foods that an older adult doesn’t want (or won’t eat). Especially in sick, frail older adults. This can cause them to eat less, lose muscle, and increase risk of disability or early death.
So, remember everyone should be treated as the unique individual they are. Older adults have a choice in what they eat. Eating more healthy foods is never a bad thing. But don’t get too caught up that you forget about quality of life.
If you are ever unsure on the unique needs of the older adult in your life, be sure to consult a geriatric dietitian for individual advice. And be sure to eat your fruits and veggies! Be well.
U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.
Dodd, K. 7 Key Nutrients for Senior Nutrition. The Geriatric Dietitian website. https://www.thegeriatricdietitian.com/7-key-nutrients-for-senior-nutrition. Accessed December 2020.