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各位朋友：

大家好，现在是“每天健康三分钟”时间，我是安阳道简医院医生罗珊珊，今天我给大家讲讲老年人营养管理和饮食原则。

老年人的身体情况有一定特殊性。人上了年纪后，能量需求明显下降，但叶酸、维生素D等营养素的需求反而会增加，尤其这也不能吃，那也不能吃的时候，警惕老年人的营养不良。导致老人营养不良的原因也十分复杂。具体包括以下几方面 ：

1．咀嚼能力下降。老年人口腔问题较多，牙齿过敏、牙周炎、牙根松动、脱落等都会影响进食和消化；

2．消化能力衰退。不少老年人牙齿缺损，消化液分泌和肠胃蠕动减弱，容易出现食欲下降和早饱现象，造成食物摄入量不足和早饱现象；

3．味觉功能衰退。年老后，味觉功能可能比年轻时下降80％，从而导致没有胃口；

4．心情不好。情绪低落，会导致食欲不振、消化功能紊乱；

5．疾病限制营养摄入。比如慢性肾病、肝病会限制蛋白质的摄入；长期用药也会影响食欲和营养素的吸收；行动不便，老年人如果失去自行购物或自制膳食的能力，胃口也会大大降低。

老年人营养管理和饮食原则

1.少量多餐

高龄老人和身体虚弱及体重出现明显下降的老人，应特别注意增加餐次，除三餐外可增加两到三次加餐，保证充足的食物摄入。食量小的老年人，应注意餐前餐时少喝汤水，少吃汤泡饭；

2.制作细软食物

（1）将食物切小切碎，或延长烹调时间。

（2）肉类食物可剁碎成肉糜制作成肉丸食用；鱼虾类可做成鱼片、鱼丸、鱼羹、虾仁等。

（3）坚果、粗杂粮等坚硬食物可碾碎成粉末或细小颗粒食用。

（4）多选嫩叶蔬菜，质地较硬的水果或蔬菜可粉碎榨汁食用；蔬菜可制成馅、碎菜，与其他食物一同制成可口的饭菜（如饺子、包子、蛋羹等），混合食用。

3.足量饮水

老年人身体对缺水的耐受性下降，要主动饮水，每天饮水量达到1500~1700ml。首选温开水。

4.摄入充足的食物

老年人每天应至少摄入12种的食物。采用多种方法增加食欲和进食量，吃好三餐。早餐宜有1～2种以上主食、1个鸡蛋、1杯奶、另有蔬菜或水果。中餐、晚餐宜有2种以上主食，1～2个荤菜、1～2种蔬菜、1个豆制品。饭菜应少盐、少油、少糖、少辛辣，以食物自然味来调味，色香味美、温度适宜。

5.延缓肌肉衰减

骨骼肌肉是身体的重要组成部分，延缓肌肉衰减对维持老年人活动能力和健康状况极为重要。一方面要增加摄入富含优质蛋白的瘦肉、海鱼、豆类等食物，另一方面要进行有氧运动和适当的抗阻运动。

（1）常吃富含优质蛋白的动物性食物，尤其是红肉、鱼类、乳类及大豆制品。

（2）多吃富含不饱和脂肪酸的海产品，如海鱼、海藻等。

（3）注意蔬菜水果等含抗氧化营养素食物的摄取。

（4）增加户外活动时间、多晒太阳，适当增加摄入维生素D含量较高的食物，如动物肝脏、蛋黄等。

（5）适当增加日常身体活动量，减少静坐或卧床。如条件许可，还可以进行拉弹力绳、举沙袋、举哑铃等抗阻运动20～30分钟，每周3次以上。进行活动时应注意量力而行，动作舒缓，避免碰伤、跌倒等事件发生。

最后祝大家生活愉快、身体健康，了解更多心血管科普知识，请关注我们，咱们下期见。

【英文版】

Nutrition management and dietary principles for the elderly

Dear friends, nice to meet you!Now it is time for “Health talk for three minutes every day”,My name is Luo Shanshan, a doctor in the second cardiology department of Anyang Daojian Hospital and Henan Zhonghui Cardiovascular Hospital.Today, I'd like to talk about the nutrition management and dietary principles of the elderly.

The physical condition of the elderly has certain particularity.As people get older, their energy needs decrease significantly,but the demand for nutrients such as folic acid and vitamin D will increase.Especially if the diet of the elderly is restricted, we should be alert to the occurrence of malnutrition. The causes of malnutrition in the elderly are very complex, as follows.

Chewing ability decreased.

There are many oral problems in the elderly, such as tooth allergy, periodontitis, root loosening and shedding, which will affect eating and digestion.

Digestive capacity decline.

Many old people have teeth defect, the secretion of digestive juice and gastrointestinal peristalsis are weakened, leading to the phenomenon of loss of appetite and early satiety, resulting in insufficient food intake and early satiety.

Taste function declined.

In old age, taste function may decrease by 80% compared with young people, resulting in no appetite.In bad mood. Low mood can lead to loss of appetite, digestive dysfunction.

Diseases limit nutrient intake.

For example, chronic kidney disease and liver disease will limit the intake of protein, long-term medication will affect appetite and nutrient absorption,poor mobility, if the elderly lose the ability to go shopping or do self-made meals, appetite will be greatly reduced.

Nutrition management and dietary principles for the elderly

Small and multiple meals

The elderly who are older, frail or with significant weight loss should pay special attention to increasing the number of meals.In addition to three meals, two to three additional meals can be added to ensure adequate food intake. The elderly with small food intake should drink less soup water before meals and eat less boiled rice.

Make soft food

Cut food into small pieces or extend cooking time.

Meat food can be chopped into minced meat to make meatballs, fish and shrimp can be made into fillets, fish balls, fish soup, shrimp, etc.

Nuts, coarse cereals and other hard food can be crushed into powder or small particles to eat.

Choose the tender leaf vegetables. The hard fruits or vegetables can be crushed and squeezed for eating, the vegetables can be made into stuffing and crushed vegetables, or other delicious meals (such as dumplings, steamed buns, egg soup, etc.) together with other foods.

Full dose of water

The old people's tolerance to water shortage is declining, so they should take the initiative to drink water, and the daily drinking amount should reach 1500-1700 ml. Warm boiled water is preferred.

Plenty of food

The elderly should eat at least 12 kinds of food every day. Use a variety of methods to increase appetite and food intake, and eat three meals well everyday. Breakfast should include more than one or two kinds of staple food, one egg, one cup of milk, and other vegetables or fruits. Lunch and dinner should have more than two staple foods, one or two meat dishes, one or two vegetables and one bean product. The food should be less salt, less oil, less sugar, less spicy, seasoned with the natural flavor of food, with full of color, fragrance and taste and suitable temperature.

Delay muscle decay

Skeletal muscle is an important part of the body. Delaying muscle decay is very important to maintain the activity ability and health status of the elderly.On the one hand, we should increase the intake of high-quality protein rich lean meat, sea fish, beans and other food,on the other hand, we should carry out aerobic exercise and appropriate resistance exercise.

Always eat animal food rich in high quality protein, especially red meat, fish, milk and soybean products.

Eat more seafood rich in unsaturated fatty acids, such as sea fish, seaweed, etc.

Pay attention to the intake of antioxidant nutrients such as vegetables and fruits.

Increase outdoor activity time, go out to bask in the sun, and properly increase the intake of food with high vitamin D content, such as animal liver, egg yolk, etc.

You should increase the amount of daily physical activity and reduce the time of sitting or lying in bed.

If conditions permit, you can also pull elastic rope, sandbag, dumbbell and other resistance exercise for 20-30 minutes, more than three times a week. When carrying out activities, you should pay attention to your ability and slow down to avoid bumping, falling or other events.

Finally, I wish you all a happy life and good health!To learn more about cardiovascular disease, please pay attention to us. See you next time.