All nutrients are important for the body, but some nutrients are especially important in an aging body. The food and Nutrition Board of the Institute of Medicine issues a table called the Recommended Dietary Allowance (RDA). The RDA is the average daily level of intake sufficient to meet the nutrient requirements of nearly all (97-98%) healthy people. The RDA is broken down by both age and gender. Per the RDA, seniors need more of some nutrients then others and this includes vitamin B-6, calcium, vitamin D, and Vitamin B-12.
The need for vitamin D increases with age. One reason is as we age the skin is unable to make vitamin D as efficiently as it once did. Vitamin D, also known as the “sunshine vitamin”, is produced on the skin when exposed to sunlight. Since seniors tend to spend more time indoors, natural vitamin D production is diminished. Vitamin D deficiency can cause several problems such as fatigue, osteoporosis, cognitive impairment, mood changes, and bone softening.
According to the RDA adults aged 70 years and younger need 600 International Units (IU) of vitamin D per day. Adults older than age 70 need 800 IU of vitamin D per day. Vitamin D helps fight infections, aids in muscle movement, nerve function, cell growth, and reduces inflammation. Vitamin D also promotes the absorption of calcium which is important for bone health.
Very few foods contain vitamin D naturally and the foods that do are not typically consumed regularly. Foods that are high in vitamin D include salmon, sardines, fatty fish skin from cod, tuna, and mackerel, fish liver, and shrimp. Smaller amounts are in beef liver, egg yolks, and mushrooms. Food manufacturers now fortify foods with vitamin D. These products include milk, cereal, yogurt, orange juice, and tofu. Older adults who are unable to get vitamin D through food or sunlight may need to consider a vitamin D3 supplement.
The RDA for calcium is 1,200 milligrams (mg) for men ages 70 and older and 1200mg for women 51 years and older. For younger adults of both genders the RDA is 1000mg. Calcium and vitamin D are both essential nutrients for bone health. Inadequate intake may change bone mineral density, particularly in the elderly, and can lead to fractures. Research has confirmed that calcium is involved in vascular contraction, vasodilation, muscle functions, nerve transmission, intracellular signaling, and hormonal secretion.
It is true that older adults need more calcium, but reality is that the elderly population do not get enough calcium in their diet. Good food sources of calcium include dairy product such as milk, yogurt, cheese, cottage cheese, and ice-cream. Plant-based foods high in calcium include kale, broccoli, turnip greens, Bok choy, and edamame. Fortified food and beverages can also include cereal, milk alternatives, and orange juice.
Natural foods high in calcium, which also contain many other nutrients, should be the primary method of intake. However, if calcium intake is insufficient calcium supplements may be required to correct deficiencies.
Vitamin B-6 needs also increase with age and is a very important vitamin for seniors. The RDA for men older than 50 years old is 1.7 milligrams (mg) daily. For women older than 50 years it is 1.5 mg daily. This is compared to the 1.3 mg daily need for adults under 50 years old. Vitamin B-6 deficiency is rare but research suggests 24-31% of people are at risk for vitamin B-6 deficiency. Inadequate intake can cause anemia, cracks in the corners of the mouth, depression, confusion, and poor immunity.
The richest sources of vitamin B-6 include fish, beef liver, potatoes and other starchy vegetables, bananas, spinach, watermelon, cottage cheese and fortified cereals. Vitamin B-6 is available in multivitamins, in supplements containing other B complex vitamins, and as a stand-alone supplement. If intake is inadequate a supplement may be considered.
The Dietary Guidelines suggests that older adults require more vitamin B-12. This is a result of the aging process and the body not being able to absorb vitamin B-12 as well as it used to. The RDA for adults is 2.4 micrograms (mcg) per day. According to the National Institute of Health (NIH) 10-30% of older people malabsorb food-bound vitamin B-12. It is advised for those older than 50 years to meet the RDA by consuming foods fortified with B12 or a supplement containing B12.
Vitamin B12 helps make DNA and healthy blood cells. It also helps to keep your nerves and brain healthy. Signs of deficiency could include increased tiredness, tingling and numbness in fingers and toes, and confusion. Foods high in vitamin B12 include chicken, beef, fish, dairy products, eggs, tuna, and fortified cereals. Older adults should get half of their vitamin B12 through fortified foods or supplements. A multivitamin should suffice in those without a clinical deficiency. Supplements containing vitamin B-12 may interact with some medications so it is important to discuss any supplements with your medical provider.
The 2020-2025 Dietary Guidelines for Americans notes that “Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. … In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients.” With the elderly requiring increased amounts of the discussed nutrients, supplementation may be necessary. It is important to always work with a healthcare team to determine if supplements are needed.