“Oh honey, you are too young to go dancing with our group,” said the 84-year-old woman to her 38-year-old chiropractor.
“You have to be over 65 before you can dance with us.”
This conversation between a chiropractor and her elderly patient that occurred one Saturday night was a surprise to the DC when she was told she wasn’t old enough. Eventually, though, an opportunity arose for her to go dancing with the group. She was amazed to watch the older members out dancing with younger couples.
They remained on the dancefloor from 7 p.m. to midnight, while many of the younger couples were done by 10.
One very special couple, a 93-year- old man with his 81-year-old girlfriend, danced beautifully together the whole night. Sarcopenia? Not in this group of older adults. Most in this group danced three times a week, for four to five hours a night.
Pump up the protein
No matter a person’s age, being active is one key factor to thriving throughout life. Nutrition and diet, which can turn certain genes on or off, are also lifestyle factors every person can control. As a practitioner, you have the ability to optimize your patients’ nutritional and dietary choices by discussing with them nutritional protocols shown to support longevity and the maintenance of muscle mass.
Sarcopenia is the loss of muscle mass that can occur with age. Specific nutrient recommendations to evaluate in the aging population include adequate protein intake and vitamin D. It has been shown that stomach acid production peaks in the early 30s, then slowly decreases with age.
The loss of acidity in some individuals leads to difficulty in breaking down certain foods—especially proteins.
Therefore, digestive evaluation and support with enzymes or betaine hydrochloride should also be considered for elderly patients.
Supplementation can help these individuals increase protein intake without abdominal discomfort.1,2
Generally, the recommend daily total protein intake should be spread out between three main meals with approximately 10 to 15 grams of protein per meal. Most research indicates that 1 gram of protein per kilogram per day is the minimal amount required to maintain muscle mass with an upper limit of 1.5 grams of protein per kilogram per day. 1
Whey protein as a supplement is often considered to have the highest nutritional value of all protein foods, and is shown to augment the muscle, strengthening effects of resistance exercise as well as building muscle mass in the elderly.1-3 If deemed necessary, additional protein between meals, such as in a protein shake can be added.
Serum blood levels of vitamin D have also been shown to decrease with aging. This can have multiple health effects, including bone loss, muscle loss, and lowered immune system response. Vitamin D in the muscle maintains the function of type II (fast twitch) fibers, preserving muscle strength and helping to prevent falls in older individuals.5-10
It is therefore highly recommended to monitor 25-hydroxy vitamin D levels via blood testing in older individuals. The recommended daily allowance (RDA) for vitamin D is currently 600 to 800 international units (IU) per day, although the average practitioner recommendation is 800 to 1,200 IU per day.6-12
Coenzyme Q10 (CoQ10) is another essential nutrient needed for energy production, antioxidant support, and as a natural anti-inflammatory in muscles. At the cellular level, CoQ10 works in the mitochondria in the electron transport chain to produce energy in the form of adenosine triphosphate (ATP).
Supplementing with CoQ10 has benefits for people at any age due to its multiple uses within the body.
Supplementation with CoQ10 has been shown to reduce the inflammatory marker IL-6 in patients with coronary artery disease.13 It has also been shown to improve endothelial function in patients with heart disease.14 From the athlete to the active elderly patient, CoQ10 is an essential nutrient and should be considered as part of a nutritional protocol. At this time there is no RDA for CoQ10; most research has shown 100 to 300 milligrams per day to be a recommended range.
Trace minerals including iron, iodine, zinc, copper, and manganese help to support ligaments, cartilage, and bone health at all ages. This spectrum of trace minerals can be found in a variety of foods, such as raw nuts, beans, nutritional yeast, mushrooms, and a variety of seeds. But, for some active individuals, or for older individuals who may not be eating nutrient-dense foods, supplementing with trace minerals can help provide added support to continue with their activities.
The chart above gives a brief break- down of some suggested supplements for an active individual at any stage in life.
Aging does not have to mean a loss in quality of life and vitality. With the right lifestyle choices—including regular exercise and nutrition—growing older can be fun. Consider the benefits to your aging patients’ health by recommending high-quality whey protein, digestive support, vitamin D, CoQ10, and trace mineral nutritional support.
Georgia Nab, DC, ACN, CWWS, holds a master’s degree in human nutrition and functional medicine, and is certified in applied kinesiology and nutrition. She currently provides chiropractic care, nutrition counseling, and nutrition education training to more than 350 employees at Standard Process’s corporate headquarters. She can be contacted at firstname.lastname@example.org.
1 Morley J., et al. Nutritional recommendations for the management of sacropenia. J Am Med Dir Assoc. 2010;11(6):391-396.
2 Rosenberg I. Sarcopenia: origins and clinical relevance. Journal of Nutrition. 1997;127:5:990- 991.
3 Paddon-Jones D, Sheffield-Moore M, Katsanos CS, et al. Differential stimulation of muscle protein synthesis in elderly humans following iso-caloric ingestion of amino acids or whey protein. Exp Gerontol. 2006;41:215-219.
4 Hays NP, Kim H, Wells AM, et al. Effects of whey and fortified collagen hydrolysate protein supplements on nitrogen balance and body composition in older women. J Am Diet Assoc. 2009;109:1082-1087.
5 Gupta C. Prakash D. Nutraceuticals for geriatrics. J Tradit Comp Med. 2015;5(1):5-14.
6 Perry HM, 3rd, Horowitz M, Morley JE, et al. Longitudinal changes in serum 25- hydroxyvitamin D in older people. Metabolism. 1999;48:1028-1032.
7 Holick MF. The vitamin D deficiency pandemic and consequences for nonskeletal health: Mechanisms of action. Mol Aspects Med.
8 Hamid Z, Riggs A, Spencer T, et al. Vitamin D deficiency in residents of academic long-term care facilities despite having been prescribed vitamin D. J Am Med Dir Assoc. 2007;8:71-75. 9 Morley JE. Vitamin D redux. J Am Med Dir Assoc. 2009;10:591-592.
10 Braddy KK, Imam SN, Palla KR, Lee TA. Vitamin D deficiency/insufficiency practice patterns in a Veterans Health Administration long-term care population: A retrospective analysis. J Am Med Dir Assoc. 2009;10:653-657.
11 Montero-Odasso M, Duque G. Vitamin D in the aging musculoskeletal system: An authentic strength preserving hormone. Mol Aspects Med. 2005;26:203-219.
12 Vitamin D: Fact sheet for Health Professionals. National Institues of Health. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Updated Feb. 2016. Accessed April 2016.
13 Lee BJ, Huang YC, Chen SJ, Lin PT. Coenzyme Q10 supplementation reduces oxidative stress and increases antioxidant enzyme activity in patients with coronary artery disease. [ITAL]Nutrition[/ITAL]. 2012;28:250-255.
14 Dai YL, Luk TH, Yiu KH. Reversal of mitochondrial dysfunction by coenzyme Q10 supplement improves endothelial function in patients with ischaemic left ventricular systolic dysfunction: a randomized controlled trial. [ITAL]Atherosclerosis. [/ITAL] 2011;216:395-401.