Is the saying “A slim body in old age cannot be bought with money” true?

Author: Tang Qin, Deputy Secretary-General of the Science Popularization Expert Committee of the Chinese Medical Association, Researcher

Reviewer: Wang Changyuan, Chief Physician, Xuanwu Hospital, Capital Medical University

As the saying goes, "It's worth a thousand bucks to stay thin in old age." Many middle-aged and elderly people are worried that gaining weight will cause various diseases. For the sake of their health, they will deliberately stay thin through various means such as eating less, square dancing, and Tai Chi.

So, are the elderly really healthier the thinner they are? Is there a correct way to evaluate the nutritional health of the elderly? And how can we ensure the nutritional health of the elderly?

1. The thinner the elderly are, the better

Many elderly people believe that "the thinner the better" because they have heard that obesity can lead to many health risks. But in fact, the saying "the thinner the better" is also unscientific.

As we age, we experience a decline in physiological function, redistribution of body fat, and loss of muscle mass. However, being too thin or having too little muscle mass can be an unhealthy condition.

If the elderly are too thin, it may be due to malnutrition, or it may be caused by undetected malignant diseases or problems with the endocrine system. Therefore, if the elderly are too thin or suddenly lose weight, we should pay attention to whether there are any health problems. The reduction in muscle volume reminds us that we need to pay attention to whether the elderly have muscle atrophy and muscle weakness. If so, it means that there may be problems with the elderly's physical health, which needs to be taken seriously and medical treatment should be sought as soon as possible. In addition, a nutritionally balanced diet should include a certain amount of protein intake. If the amount of protein supplementation is insufficient for a long time, the muscle rate will decrease, leading to muscle atrophy or muscle weakness, that is, a reduction in muscle volume.

Therefore, the best health state for the elderly is to be in the normal weight range or slightly overweight and maintain sufficient muscle mass, rather than deliberately making themselves very thin.

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2. How to evaluate the nutritional status of the elderly

Being too fat or too thin in the elderly may mean that their nutritional status is not very healthy. So, how to judge the nutritional status of the elderly? There are two evaluation scales commonly used in geriatric medicine, namely the Simple Nutrition Assessment Scale and the 2002 Nutrition Risk Screening Scale (NRS2002).

1. The Simple Nutrition Assessment Scale is mainly used to assess nutritional status. It is a relatively mature nutrition screening and assessment tool for the elderly and a good tool for detecting the prognosis of malnutrition. The assessment includes anthropometric measurements, overall assessment, dietary questionnaires, and subjective assessments. A total score of ≥24 points indicates good nutrition, 17 to 23.5 points indicates a risk of malnutrition, and <17 points indicates malnutrition.

2. The Nutritional Risk Screening 2002 scale can dynamically assess whether a patient has nutritional risks. The scale includes three aspects: nutritional impairment, disease severity, and age. Based on the above scores, 1 point is added for those aged ≥70 years, and the total score is 0 to 7 points. A score of ≥3 is considered to be at nutritional risk, and an individualized nutrition plan and nutritional intervention should be developed based on the patient's clinical condition.

In professional medical institutions, doctors will make a more professional evaluation of the elderly based on the elderly patient's medical history, medication history, personal eating habits, and blood test results.

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3. Do the elderly need additional nutritional supplements?

Many elderly people will supplement their normal diet with various health products and nutritional supplements, thinking that "only by taking some health products can the body be better." But we must understand the principle of "too much is as bad as too little." As the elderly age, their body functions decline, and excessive intake of nutritional supplements may increase the burden on the body.

Generally speaking, if the elderly have normal digestion and absorption functions, maintain a reasonable and balanced diet, and are not in a stressful state such as illness, then their three meals a day can basically meet the nutritional needs of their body, and additional nutritional supplements are not recommended.

4. How to match the “three meals a day” of the elderly

From a professional perspective, how should we combine three meals a day to ensure a healthy, reasonable and nutritious meal?

Simply put, it is to ensure a balanced diet.

For example: match coarse and fine staple foods, eat refined rice and noodles with various coarse grains; match meat and vegetables, eat meat, eggs and vegetarian dishes; control the amount of acidic food, and appropriately increase the proportion of alkaline food; pay attention to the cold and hot properties of food; pay attention to the balance of various seasonings such as sour, sweet, bitter, spicy and salty.

In addition, the elderly also need to engage in reasonable and moderate exercise to ensure normal digestion and absorption capabilities, so that the body will become healthier and healthier.

Of course, the above suggestions are based on good health. If the elderly have certain diseases, malnutrition risks, etc., they need to combine the advice of professional doctors, formulate a reasonable daily diet plan based on a full assessment and give corresponding additional supplements according to the specific situation.

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In fact, for the elderly, there is no need to pay too much attention to their body fat or thin. As long as they have regular physical examinations, maintain a regular and reasonable diet, have a good attitude, and seek medical treatment in time if they feel unwell, they can have a happy and comfortable old age.

References

[1] Lu Ziye. Healthy diet for the elderly. Beijing: Hualing Publishing House, 2019.