Ageing is associated with an increased risk of chronic disease, disability and death. The financial burden alone to society for caring for an ageing population is substantial.
The need to shift priorities to increase our attention on ways to prevent chronic illnesses associated with ageing is paramount. Individually, people must put increased efforts into establishing healthy lifestyle practices, including consuming a more healthful diet. Making smarter and healthier food purchasing decisions will be more and more important.
Ageing affects everybody in different ways, but there are three main contributions to healthy ageing: genetics and family history; lifestyle practices and exercise; and diet and nutrition. The first of these three factors is immutable, but the remaining two can be modified to improve health.
An important part of keeping older people healthy is the prevention of these prevalent chronic disease conditions and their associated complications. Part of living a healthy lifestyle is practicing good health behaviours, including getting proper nutrition.
A prominent theory of ageing and chronic disease has been the ‘free radical theory’ in which a lifelong accumulation of cellular damage due to free radicals leads to an increased risk of disease and disability.
It has been thought, therefore, that diets rich in antioxidants, such as vitamin E and vitamin C and many bioactive polyphenol compounds found in fruits and vegetables, will help combat free radical damage and improve health.
This theory is consistent and strongly associated with better health outcomes, and may have positive effects on cancer, heart disease and neurodegenerative diseases.
Plant Polyphenols & Catechins
Many of the plant-based antioxidant components are being identified and isolated for use in supplements. As research mounts, additional benefits of these components are being identified.
The curcuminoid polyphenols, which are the primary polyphenols in the rhizome (underground stem) of the turmeric plant (curcuma longa) and are responsible for its yellow colour, have potent antioxidant, anti-inflammatory, and anticancer properties.
These properties have led to investigations in curcumin’s impact in preventing cognitive decline relating to Alzheimer’s disease. Green tea polyphenols have been shown to have powerful antioxidant, anti-inflammatory, and anticancer benefits. The most famous of these is epigallocatechin-3-gallate (EGCG).
EGCG is found in high concentrations in green tea. As a member of the catechin family of compounds, it has antioxidant properties, but it also has other biochemical effects in cells. The majority of emphasis on the health promoting effects of EGCG has been related to its potential anti-cancer activities, particularly related to hormone-sensitive cancers.
Grape seed extract (GSE) is a concentrated source of polyphenols. These resemble the catechins of green tea in basic molecular structure with the exception that components in grape seed extract reach a larger molecular size.
Lutein and zeaxanthin are members of the carotenoid family of compounds and are found abundantly in green leafy vegetables. These carotenoids have healthful properties and are found in high concentrations in the macula of the eye, which is responsible for central vision.
Macular degeneration is a common problem in the elderly and is among the four leading eye diseases found in this population. Supplementation of patients with early signs of macular degeneration with lutein and zeaxanthin has been shown to be beneficial.
In addition, consumption of diets rich in lutein and zeaxanthin have been found in a recent meta-analysis to be associated with a reduction in the risk of developing late stage macular degeneration.
Lycopene is also a member of the carotenoid family and is responsible for the red to pink colour found in tomatoes and watermelon and some other fruits and vegetables. Epidemiologic, animal and cell culture evidence support a role for lycopene in cancer prevention.
Plant sterols and stanols are found naturally in small amounts in many plant-based foods. These compounds have cholesterol-lowering properties resulting from the inhibition of cholesterol absorption, and manufacturers have started using them as food fortificants to help lower blood cholesterol and reduce the risk of heart disease.
Since dyslipidemia is an important risk factor for heart disease and a common condition in older people, it would be prudent for this population to consider using plant stanol/sterol-enriched food products as part of a healthy diet.
Omega-3 Fatty Acids
Omega-3 (n-3) fatty acids are found in fish oil and in some plants, such as flaxseed. N-3 fatty acids are known to have anti-inflammatory effects and lower blood triglycerides, and have been suggested to have a positive effect in patients suffering from recent myocardial infarction (heart attack) or heart failure.
The Japan EPA Lipid Intervention Study (JELIS) found a 19 percent reduction in the risk of coronary heart disease and a significant reduction in recurrent stroke after long-term use of pure eicosapentaenoic acid (EPA) in Japanese patients with hypercholesterolemia. Higher circulating long-chain omega-3 fatty acids have also been shown to be associated with a lower risk of congestive heart failure in a prospective cohort study.
Omega-3 intake may also play a role in cancer development. For example, a recent study found that higher omega-3 intake was associated with a decrease in breast cancer risk in obese Mexican women. Currently, an ongoing study, called Vitamin D and Omega-3 Trial (VITAL), is studying the effects of these compounds in a large randomised, double-blind, placebo-controlled study of primary cancer and cardiovascular disease prevention.
Another interesting finding concerning omega-3 fatty acids is that female health professionals consuming higher intakes of EPA and DHA had a lower incidence of age-related macular degeneration.
Glucosamine, Chondroitin Quercetin & Collagen
Arthritis refers to an inflammation of the joints. The most common type of arthritis is osteoarthritis, often called ‘wear-and tear’ arthritis, which may manifest as morning stiffness and pain in the hips and knees. During movement, the cartilage that surrounds the ends of bones in joints is subject to breaking down and must be repaired.
Cartilage is composed of type II collagen. Glucosamine and chondroitin are two molecules that are found in cartilage and oral consumption of these building blocks of cartilage are believed by many to be beneficial in reducing pain and protecting bone cartilage.
Dietary fibre can be classified into either soluble fibre or insoluble fibre. These two types of fibre have different effects metabolically due to their different chemical properties.
Soluble dietary fibre, such as those found in peas and soybeans, are soluble in water and have a gelling effect in the intestine and can thereby slow down the digestion of carbohydrates and flatten out the postprandial blood glucose curve.
This metabolic effect of soluble fibre can be of benefit to help control blood glucose levels in diabetes. Insoluble dietary fibre is not water soluble and relatively indigestible, tending to increase the dry matter content of the stool and aiding in the prevention of constipation.
Prebiotics & Probiotics
The large intestine is normally filled with a large array of different bacteria, which are believed to play an important role in maintaining health. It is believed that large populations of friendly bacteria aid in keeping the growth of unfriendly pathogenic bacteria and yeast at bay.
An imbalance (dysbiosis) of intestinal bacteria can be caused by antibiotic treatment and result in disease, including antibiotic-induced diarrheal disease. Therefore, it is believed that supplying the body with good bacteria (probiotics), such as those from the lactobacillis and bifidobacterium families, can help restore the correct bacterial balance.
Prebotics are non-digestible food carbohydrates that can enter the large intestine and act as nutritional supplements to stimulate the growth of certain intestinal bacteria.
Coenzyme Q10 is a vitamin-like compound that plays an important role in aerobic respiration in the mitochondria of the cell and is involved in the generation of ATP, which is used as an energy source by the cell.
Coenzyme Q10 is also a powerful antioxidant that can reduce oxidative stress. Supplementation with coenzyme Q10 has also been found to have an anti-inflammatory effect by reducing the inflammatory marker IL-6 in patients with coronary artery disease.
In addition to the initial selection of product ingredients that are in-tune with various cultural, ethnic or medical concerns of older adults, a number of technical issues often arise in the attempt to manufacture and market a novel fortified food product.
These issues include things such as possible chemical interactions between nutrient ingredients, as well as issues related to final product acceptance, including product stability, taste and texture concerns, and product shelf-life.
In the development of new fortified products specifically targeted to the ageing market, manufacturers should take into consideration that ageing is associated with some notable physiological changes, including the loss of taste.
Therefore, the incorporation of flavour enhancers and textual considerations should be carefully addressed in premix development for these products. Taste is paramount for a product to be successful. Therefore, it is especially important to pay close attention to flavour intensity, masking any off notes, and the addition of colorants.
Products can be flavoured with herbs and spices, and a number of other ingredients can be included in a premix or finished product to intensify product colour or enhance texture to increase product appeal.
Additionally, as consumers age ‘healthfully’, many are more likely to be taking medications to address certain health conditions, so formulators need to consider potential interactions with common medicines.
For example, within the juice category, the interaction between grapefruit juice and some immunosuppressant drugs (statins) used to lower blood cholesterol, and calcium-channel blockers used to treat high blood pressure would suggest that more attention should be placed on fortifying other types of juice applications for this population.
Half of the world’s oldest populations are found in only five countries: China, India, the US, Japan and Russia. Therefore, older adults are not only an important market opportunity in the US and Europe, but also in Asia and the rest of the developing world.
Currently, of the 600 million older persons in the world, 370 million of them live in developing countries. By 2020, 70 percent of the world’s one billion elderly persons will live in developing countries. Fortified products directed to the older adult market could be developed for various demographic subgroups within this population and offer opportunities for manufacturers.
Additionally, as people grow older, they need fewer calories but more nutrients to maintain proper health. Generally speaking, people burn fewer calories during physical activity when they age, but even the most active ageing body gradually loses lean muscle tissue, and less muscle translates to a lower calorie requirement.
At the same time, however, their appetites decrease while, as previously noted, their needs for several nutrients goes up—or at least remains the same—in order to enable the body to run at peak efficiency as the years pass. To fill these nutrient gaps, fortified food or beverage products will continue to grow in popularity and will become a mainstay with any consumer that embraces the concept of healthy ageing.