Most industrial, wealthy, and developed countries have ageing populations; more than 20% of Europeans are aged 65 years and over and this is set to increase over coming decades. As we age, our bodies undergo numerous changes that can impact our overall health and well-being. While much of the focus in public health is understandably on children and pregnant women, there is also growing recognition of the unique needs of older adults.
One significant, yet often overlooked, issue in this population is micronutrient deficiency. Micronutrients — vitamins and minerals — support immune health, cognitive function, bone health, and muscle maintenance, and many metabolic processes. Maintaining an adequate supply of micronutrients is essential to prevent onset and progression of age-related diseases, like osteoporosis. However, older adults also face a unique set of physiological and social challenges that increase their risk of micronutrient deficiencies, even if they eat well.
Physiological Challenges: Absorption and Utilisation
Age-related changes affect all organs, including the intestine, liver, kidneys, and skin, and impede absorption of micronutrients. The stomach produces less (and/or less acidic) gastric acid, gut motility is slower and weaker, microbiota composition changes, and expression of transport proteins, which move nutrients from the gut into the bloodstream, are less efficient. Together, these impact breakdown of foods, release of micronutrients, and their absorption. Hormonal changes, such as those related to menopause in women and declining testosterone in men, also alter metabolic behaviour and nutrient demands increase. Thus, it is not just women who need more calcium and vitamin D to support bone health but also men. Furthermore, older adults often experience a natural decrease in appetite, which leads to reduced food intake and, consequently, lower consumption (intakes) of vitamins and minerals.
Social and Lifestyle Challenges: Barriers to Adequate Nutrition
Beyond biological factors, social and lifestyle issues also contribute to poor micronutrient intakes among older adults. Many older individuals live alone, experience periods of ill-health, or spend time in hospitals or assisted-living with restricted or repetitive menus, any of which can result in less varied and lower-quality diets. Economic constraints, mobility issues, and lack of transportation can limit access to nutrient-dense foods, increasing reliance on processed and less nutritious options. Chronic diseases and medications, such as those for hypertension or diabetes, can interfere with nutrient absorption concentrations or their metabolism. These social challenges, combined with physiological changes, put older adults at increased risk of a range of conditions including reduced cognitive function, muscle loss and bone fractures, deteriorating sight and loss of hearing, infection, and non-communicable disease, such as heart disease.
Public Health and Research Gaps: Measuring Micronutrient Deficiencies
Despite the prevalence of micronutrient deficiencies among older adults, this issue receives relatively little attention compared with the needs of children and pregnant women. Public health initiatives rightly prioritise nutritional needs of these groups due to their immediate impact on growth, development, and infant health (sometimes to the neglect of maternal health). In contrast, micronutrient deficiencies in older adults are often seen as less urgent, despite clear links between these deficiencies and costly health problems, as well as reduced quality of life. There is also a lack of data describing micronutrient intake and status in older adults, which is the starting point for devising any effective public health intervention.
Zero Hidden Hunger EU
The Zero Hidden Hunger EU project (Grant Agreement ID. 101137127) aims to address these issues by raising awareness, delivering scientifically validated evidence, and developing targeted strategies to address micronutrient deficiencies in all vulnerable populations including older adults. Through its efforts, the project hopes to see older adults better supported in maintaining their health and quality of life through adequate nutrition.
Author: Siân Astley
Siân has worked extensively throughout Europe from a variety of disciplines including research, food and biotech industries and the media. She is author of more than 300 popular science articles as well as 27 peer-reviewed papers. She has a particular interest in nutrigenomics, personalised nutrition, sustainable food systems, and co-creation of solutions with stakeholders. In addition to being Secrétaire Générale de EuroFIR AISBL, Siân is an independent science communicator and an editor for Food Chemistry and Editor-in-Chief for Food Chemistry: Molecular Sciences.
