It will not take anyone by surprise that the world’s population is getting older—ageing and its impacts have been dominant topics in the last few years and continue to be widely discussed by some of the biggest economies in the world. Compared to the 1950s, when 205 million persons aged 60 or over were living throughout the world, the number tripled to 606 million fifty years later.
According to United Nations’ Economic and Social Commission for Asia and the Pacific (ESCAP), almost two-thirds of the world’s older persons will be living in Asia- Pacific by 2050.
It is also expected that the proportion of the ‘oldest-old’ (those above 80 years of age) will constitute 18 percent of older persons by 2050.
While there is virtually no stopping of this global phenomenon, there are increasing concerns surrounding two critical areas related to ageing: mental decline and physical immobility. In the golden years of life, maintaining independence and preventing disability are fundamental in ensuring good quality of life. In order to achieve this, functional capacity in terms of sight, mental ability and physical mobility need to be maintained.
The Ageing Transition
As we grow older, changes in body composition, organ functions as well as mental and physical performance will occur in all of us. As such, there will be a greater focus on maintaining health and a higher awareness for products offering health benefits.
With lower energy requirements while concurrently having increased requirements for some essential nutrients, the ageing consumer will be looking for nutrient dense food as a product choice. Nutrient density refers to foods that have high levels of essential nutrients per food unit and are therefore deemed high-quality foods. Smaller packaging sizes as well as convenient and healthier single-serve meals will also become more popular, reflecting the changing lifestyle of the ageing population.
Consumers aged above 50 are already reported to be over-represented among buyers of food brands with health benefits and their repeat purchase rates are higher than average. Depending on the product category, their repeat purchase could be as high as about 80 percent. Functional foods and beverages are becoming popular solutions to address age-related complaints like memory loss, impaired mobility, fatigue and declining vision.
Cognitive Health And Then Some
Omega-3s, especially DHA and EPA, are crucial for maintenance
of brain function and can help preserve cognitive functions in the elderly.
Cognition is a combination of mental processes that includes the ability to learn new things, intuition, judgment, language and remembering. When cognition is impaired, a person has trouble with these processes that begin to affect the things he or she can do in everyday life.
Later stage cognitive impairment is also known as dementia. The most common form, Alzheimer’s disease, is characterised by progressive and profound loss of memory, cognitive function and ability to carry out daily functional activities of living. In Japan, it is estimated that two million people suffer from dementia and this number will likely increase as the population ages.
Long chain poly-unsaturated fatty acids (LC-PUFA), in particular omega-3s and specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) constitute the predominant LC-PUFAs in the brain and neural tissues. They are crucial for maintenance of brain function and according to several studies, high blood levels of omega-3s may help preserve cognitive functions in the elderly.
In the Longitudinal Study of Ageing published by the Japanese National Institute for Longevity Sciences, 232 male and 198 female Japanese aged 60-79 were assessed with the mini-mental state examination for cognitive decline. Researchers found that a moderately high level of serum DHA may prevent cognitive decline among community-dwelling elderly Japanese individuals.
In another trial with more than 1,600 individuals between 45 and 70 years, researchers found that omega-3 fatty acids and fish consumption were inversely related to the risk of impaired overall cognitive function and speed.
Depression is extremely common in older adults with mild cognitive impairment and increases the risk of developing dementia. Clinical trials investigating the efficacy of omega-3 supplementation in alleviating depressive symptoms have found positive results in about half of published studies.
In a randomised controlled trial in a group of 50 people over the age of 65 with mild cognitive impairment, researchers found that groups supplemented with high DHA (1.55 g DHA and 0.40 g EPA) per day or high EPA (1.67 g EPA and 0.16 g DHA) per day over six months significantly improved depression scores while the group supplemented with high DHA also had significantly improved verbal fluency.
In addition to omega-3s, there is a fundamental role for B vitamins in neurological and psychological functions. For example, low levels of vitamin B12 have been associated with memory loss and cognitive deficits.
Randomised controlled studies show that supplementation of vitamin B12 and folic acid may improve the cognitive status of older adults: long term supplementation of daily oral 400 μg folic acid and 100 μg vitamin B12 promoted improvement in cognitive functioning after 24 months, particularly in immediate and delayed memory performance.
Vitamin B12 deficiency can also be caused by a lack of intrinsic factors—such as a substance secreted by the stomach cells that binds to vitamin B12 and enables its absorption, or inadequate stomach acid supply, both of which are often observed in elderly people.
The Challenge Of Physical Changes
Human ageing is associated with a significant deterioration of body composition, characterised by an increase in body fat mass and a decrease in lean body mass leading to changes in metabolism. There is a redistribution of body fat from mainly subcutaneous to abdominal fat while the decrease in lean body mass is caused by a reduction in size and strength of skeletal muscle.
Conjugated linoleic acid (CLA) has been proven to improve body composition by reducing body fat mass modestly while maintaining or increasing lean body mass, and is also effective in targeting fat in the midriff area.
A meta-analysis summarised the findings of various clinical trials and concluded that CLA can reduce body fat mass by 90 g per week. This reduction, though of seemingly little consequence at first glance, is still significant when the current trend of weight gain is considered. For example, populations in developed countries gain an average of 0.4 kg per year, (9 g per week). Consequently, these weight gains add up over time and CLA could contribute to prevent the gradual accumulation of fat mass during ageing.
The other compromise to the muscle-skeletal system from ageing is bone density reduction. In particular, women tend to lose bone mass at an accelerated rate after menopause resulting in a higher risk of fractures and other associated complications. Calcium and vitamin D are two key nutrients to support normal bone metabolism and to prevent bone loss. Vitamin D is also vital for the maintenance of normal muscle function and strength to reduce the risk of falls.
In the last few years, multiple studies and surveys have reported the prevalence of vitamin D deficiency in various populations in many countries. Elderly people typically get less exposure to the sun and have reduced capacity for skin synthesis of vitamin D. Therefore, health associations have started to increase the recommendations for vitamin D intake. In order to meet these recommended levels, there is a need for fortified foods or dietary supplements to cover gaps that cannot be met through diet alone.
Maintaining Clear Vision
Just like the body, the eyes and hence sight start to deteriorate over time. Cataracts and age-related macular degeneration (AMD) are the two main causes of vision loss in the elderly. Dietary pigments such as lutein and zeaxanthin belong to the family of carotenoids found in many fruits and vegetables and besides the colouring effect, carotenoids also have many health benefits.
Lutein and zeaxanthin in particular are concentrated in the central part of the retina where they accumulate and form the macular pigment known as the yellow spot. The macula is responsible for central vision which is the ability to see clearly when the eyes are looking straight ahead allowing us to drive, read and see details sharply.
Here lutein and zeaxanthin play a protective role by increasing macular pigment density absorbing harmful blue light and preventing the retina from damage. Electronic screens and lights emitting cold-white light are sources of blue light which causes oxidative stress and inflammation when it reaches the eyes. Lutein also acts as an effective antioxidant protecting important biomolecules and cells against damage induced by free radicals. A high dietary intake of lutein has also been associated with a reduced risk of age-related macular degeneration.
So how much lutein do you need? Studies suggest that 6-10 mg/day of lutein may be beneficial to increase macular pigment density, but actual intake is far below, on average at only 1-2 mg/day in most Western countries.
Besides lutein, a growing body of evidence supports potential benefits of omega-3 fatty acids for eye health, as the retina has one of the highest concentrations of omega-3 fatty acids in the body. Sufficient supply is necessary to maintain and protect visual structures throughout all life stages.
A meta-analysis of studies shows that the consumption of foods rich in omega-3 fatty acids like oily fish is associated with a reduced risk of both early and late AMD. Finally, not forgetting the fundamentals, vitamin A and beta-carotene as a precursor of vitamin A, are also essential for the maintenance of normal vision.
From Prevention To Condition Management
The different types of consumers in their active ageing years vary. On one end of the spectrum are proactive health managers, open and willing to make changes to their lifestyle and diets while on the other end of the continuum are consumers who accept ageing loss as a given and would only medically treat major conditions.
While prevention being better than cure is widely touted as the ideal solution, age-related impairments are a reality. The good news is that science and research in this day and age have given us enough information to know how the right nutrients can benefit the right people at the right time. Government bodies, manufacturers and industry stakeholders all have a part to play in communicating the benefits of better health and lifestyle choices in the hope that this ageing transition can be better managed over time.
Nutrition is key to positively influencing the ageing process as well as maintaining health and well-being throughout a person’s lifetime. In the 20th century, life expectancy has increased by more than 30 years but health expectancy on the other hand still falls short by 8-11 years.
Functional foods and dietary supplements can be an attractive option to help reduce the risk of nutrient deficiencies, enhance quality of life and prevent or manage chronic diseases thus making lifetime vitality happen where one can enjoy more life to years.