Exploring the need for fortified foods, supplements, and extra protein in the diet of free-living healthy older adults in Ireland

Abstract

This abstract was awarded the student prize for best oral presentation.

Ageing increases the need for some nutrients, especially protein and B vitamins, at a time when energy requirements and food intakes decline. A recent scientific report examining the nutritional vulnerability of older adults (≥65 years) in Ireland highlights the need to ensure high-quality protein foods are consumed at 2 meals/day in amounts that stimulate muscle synthesis (0.4 g/kg body weight (bw))⁽¹⁾ and adequate micronutrient intakes⁽²⁾. This study aims to explore the need for extra food sources of protein, fortified foods and/or supplements by free-living healthy older adults in Ireland. Data on older adults were obtained from secondary analysis of the National Adult Nutrition Survey (n226)⁽³⁾. Using commonly consumed foods (≥5% of consumers) and typical patterns of consumption, 4-day meal patterns were developed ensuring protein food sources at 2 main meals. These patterns aligned with healthy eating guidelines⁽¹⁾ and were developed within energy requirements of males and females (n24) representing height at the 5^th, 50^th, 95^th percentiles in the survey sample, at two physical activity levels (1.2 and 1.4) and at two age points (70 and 80 years). Ideal body weights (BMI 22.5 kg/m² for males, 21.5 kg/m² for females) were calculated from actual height data. The nutritional composition of these meal patterns, excluding fortified foods and supplements, were assessed using Nutritics software and calculating the protein intake g/kg bw at 2 main meals. This analysis was repeated substituting all milk and breakfast cereals with fortified alternatives marketed in Ireland and the inclusion of a daily 15 μg vitamin D supplement. Meal patterns before and after inclusion of fortified foods and a vitamin D supplement were compared using SPSS (version 25). Protein requirements at 2 meals ranged from 19.4 to 29.4 g/meal, which was challenging to meet using protein food sources typically consumed. This was addressed by the addition of an extra dairy portion at the lighter main meal, resulting in a recommendation of 4 rather than 3 dairy foods/day. Inclusion of fortified foods significantly increased the proportion of older adults achieving the Population Reference Intake (PRI) for folate (12–100%), vitamin B6 (58–92%) and iron (25–58%) and marginally increased nutrients (vitamin B₁₂ and riboflavin) that were already above the PRI but had minimal effect on zinc intake. High-fibre cereals were less likely to be fortified with vitamins B6 and B₁₂. While fortified foods significantly increased mean vitamin D intakes (4.33–7.62 μg, P < 0.001), intakes remained inadequate, but this was resolved with the inclusion of a daily 15 μg vitamin D supplement. In conclusion, an extra portion of dairy foods at the lighter main meal provides protein at optimal levels for muscle synthesis. Inclusion of fortified foods and a daily 15 μg vitamin D supplement resolves nutritional shortfalls.