Before dwelling in detail on the issues of clinical nutrition in elderly and senile patients, there is a need to make an excursion into the evidence-based requirements for the nutrition of practically healthy people over 60 years of age..

Here are the basic principles of gerodietetics:.

•correspondence of the energy value of the diet to the actual energy expenditure of the body;

• preventive focus of nutrition;

•correspondence of the chemical composition of the diet to age-related changes in metabolism and functions of organs and systems;

•Diversity of the food set to ensure a balanced content in the diet of all essential nutrients;

• the use of products and dishes that have a fairly easy digestibility in combination with products that moderately stimulate the secretory and motor functions of the digestive organs, normalizing the composition of the intestinal microflora;

• the right diet with a more even distribution of food in separate meals compared to a young age.

WHO (2002) recommends intakes of essential nutrients for the elderly and aged, as shown in Table. 12.

Individualization of nutrition, taking into account the characteristics of metabolism and the state of individual organs and systems in specific elderly and old people, and long-term eating habits.

Diet.

Important principles of the diet of the elderly and old people are regular meals, the exclusion of long intervals between them, the exclusion of large meals. This ensures normal digestion of food and prevents overstrain of all body systems involved in the absorption of nutrients.. With physiological aging, the functions of the digestive organs are moderately reduced, and the adaptive capabilities are significantly limited, so large food loads may be unbearable for them..

A 4-time diet is recommended: 1st breakfast - 25% of the daily energy value of the diet; 2nd breakfast or afternoon snack - 15-20%; lunch - 30-35%; dinner - 20-25%. At night, it is desirable to consume sour-milk drinks or raw vegetables and fruits.. On the recommendation of doctors, it is possible to include fasting days (cottage cheese, kefir, vegetable, fruit), but not complete fasting. For diseases of the elderly and old people, a 5-time diet is desirable: 1st breakfast - 25%; 2nd breakfast – 15%; lunch - 30%; dinner – 20%; 2nd dinner - 10% of the daily energy value of the diet.

For healthy elderly and old people, there are no prohibited foods and dishes, but only more or less preferred ones.. Passion for any one or group of food products is unacceptable, since even their high nutritional value cannot compensate for the defects of one-sided nutrition..

Physiologically, the transition of older people from the usual diet to strict vegetarianism, eating only raw food, separate meals and other non-traditional methods of human nutrition is not justified.. The preference of certain foods for the elderly and old people is explained by the requirements for their rational nutrition in terms of energy value and the chemical composition of food rations, and the preventive focus of gerodietetics..

medbe. en.