SACN statement on nutrition and older adults living in the community Published January 2021 © Crown copyright 2021 This report is available online at: www.gov.uk/government/publications/sacn- statement-on-nutrition-and-older-adults-living-in-the-community Contents Membership of Scientific Advisory Committee on Nutrition: Older Adults Working Group ......................................................................................................... 7 Membership of Scientific Advisory Committee on Nutrition ................................ 9 Introduction ....................................................................................................... 12 Background ................................................................................................... 12 Terms of reference ........................................................................................ 13 Background ....................................................................................................... 14 Demographics................................................................................................ 14 Factors that impact on people as they age .................................................... 14 Nutrition, health and changes with ageing ..................................................... 15 Appetite ................................................................................................... 15 Smell and taste ........................................................................................ 15 Oral health ............................................................................................... 16 Hydration ................................................................................................. 17 Gastrointestinal health ............................................................................. 17 Anthropometry ......................................................................................... 18 Energy requirements ............................................................................... 18 Cardiovascular health .............................................................................. 19 Type 2 diabetes ....................................................................................... 19 Endocrine function ................................................................................... 19 Eye health ............................................................................................... 20 Immune health ......................................................................................... 20 Skin health ............................................................................................... 21 Cognitive health ....................................................................................... 21 Physical activity ....................................................................................... 22 Musculoskeletal health ............................................................................ 22 Bone health ............................................................................................. 22 Sarcopenia .............................................................................................. 23 Osteoarthritis and joint health .................................................................. 25 Mobility .................................................................................................... 25 Frailty....................................................................................................... 25 UK dietary advice for older adults .................................................................. 26 Current UK government dietary recommendations ....................................... 27 Energy and macronutrients ............................................................................ 27 Micronutrients ................................................................................................ 29 Food-based recommendations ...................................................................... 32 2 Dietary intakes and nutritional status ............................................................. 33 Self-reported health and conditions limiting day-to-day activities .................. 34 Body mass index ........................................................................................... 35 Energy and macronutrient intakes ................................................................. 36 Energy ..................................................................................................... 36 Protein ..................................................................................................... 37 Carbohydrate ........................................................................................... 37 Free sugars ............................................................................................. 38 Dietary fibre ............................................................................................. 38 Total fat ................................................................................................... 38 Saturated fats .......................................................................................... 39 Cis monounsaturated fats ........................................................................ 39 Cis polyunsaturated fats .......................................................................... 39 Salt .......................................................................................................... 39 Energy and macronutrient intakes in people aged 80 years and over ..... 40 Summary ................................................................................................. 40 Micronutrient intakes and status .................................................................... 41 Vitamin A ................................................................................................. 41 Thiamin, niacin and vitamin B6 ................................................................ 42 Riboflavin ................................................................................................. 42 Vitamin B12 ............................................................................................. 42 Folate ...................................................................................................... 43 Vitamin C ................................................................................................. 43 Vitamin D ................................................................................................. 44 Vitamin E ................................................................................................. 44 Iron .......................................................................................................... 44 Calcium ................................................................................................... 45 Magnesium .............................................................................................. 45 Potassium ................................................................................................ 45 Iodine....................................................................................................... 45 Selenium ................................................................................................. 46 Zinc ......................................................................................................... 46 Supplements ........................................................................................... 46 Micronutrient intakes in people aged 80 years and over ......................... 47 Summary ................................................................................................. 47 Consumption of selected foods...................................................................... 48 Energy and nutrient intakes by oral health status .......................................... 49 Trends in nutrient intakes over time and with income .................................... 49 Dietary intakes and nutritional status in people aged 85 and over ................. 50 Overall Summary ........................................................................................... 51 3 Methods ............................................................................................................. 53 Eligibility criteria and literature search ........................................................... 53 Selection of studies ........................................................................................ 54 Data extraction and reporting of study results ............................................... 56 Methods for reviewing evidence .............................................................. 56 Evaluation of the quality of identified evidence ........................................ 57 AMSTAR assessment ............................................................................. 58 Grading of evidence ................................................................................ 58 Limitations of the evidence ............................................................................ 58 Results ............................................................................................................... 60 Mortality ......................................................................................................... 62 Body mass index (BMI) 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