#60: 🍽️ Why Do Older Adults Lose Their Appetite?
Untouched meals and a lack of interest in eating by seniors can be a sign of other health issues
Hey Friends,
Last week was a busy one in Lisbon. WebSummit was in town. The air was buzzing with excitement and the amount of side events was overwhelming.
I participated in an in-person panel discussion on “The Future of Healthtech” where we covered patient-centricity and how healthtech is helping this goal become a reality. We also discussed the challenges of healthtech versus medtech and the unique opportunities across different startup ecosystems (Silicon Valley v. Germany v. Portugal).
Thanks to my co-panelists Marta Miraldes, Eco-system builder at Startup Lisboa and Lisboa Unicorn Factory, Fadhil Musa, CEO at DeLox, and moderation by Pedro Rebordão from LISPOLIS. This event was organized by Tec Labs, Lisbon City Council and Startup Portugal.
💬 In this note:
🍽️ Why Do Elderly People Lose Their Appetite?
📚 Vera Wong’s Unsolicited Advice for Murderers
⚡️ Good Burger 2
🍽️ Why Do Older Adults Lose Their Appetite?
Appetite Basics
Appetite for food has three components: hunger, satiation and satiety.
Hunger promotes eating.
Satiation is the feeling of fullness which leads us to stop eating.
Satiety is the fullness that exists (albeit sometimes briefly) until hunger strikes again.
Appetite regulation is complex and like most things in science and health, not completely understood.
It’s controlled by systems in the brain, the digestive system, the endocrine system and sensory nerves.
In response to signals from these different systems, the gut secretes several hormones.
Ghrelin is produced in the stomach in response to fasting to tell the brain you’re hungry.
Peptide-YY is secreted in the colon in response to food intake and suppresses appetite.
Insulin is secreted in the pancreas in response to high blood glucose and suppresses appetite.
Leptin is secreted by fat cells to supress appetite.
The different hormones are released before, during and after eating to control feeding behavior and how much is eaten.
Appetite should remain in balance for your body to meet its needs for energy and nutrients.
However, this balance can all be completely overridden by pleasure signals.
Pushing Appetite to Imbalance
Our world is full of triggers to eat. We walk by a cafe and smell fresh baked bread which can stimulate appetite even if we aren’t hungry.
Seeing a sugary treat can stimulate appetite and cause a person to eat when they don’t actually need to.
The balance in your body can be overridden by what scientists call the hedonic systems.
Mood is a big influence on hedonic systems and mood has a big influence on appetite.
The hedonic system works in mysterious ways, and operates differently for different people.
You may eat when you’re stressed.
You may forget to eat when you’re stressed.
Some people may eat more when they are sad.
People may ignore their appetite because of a desire to lose weight.
Circadian rhythm can also disrupt appetite by causing you to be hungry at the wrong times of day and not hungry at the “mealtime” in your timezone.
All of these factors contribute to appetite.
The risks of decreased appetite
What may come as a surprise is that healthy aging is associated with decreased appetite and energy intake.
This decrease in appetite is generally associated with weight loss after about 70 years of age.
One theory is that as you age, you expel less energy in retirement and you need less calories to support that level of activity.
How and why this happens is poorly understood and it may contribute to malnutrition of older adults along with increased morbidity and mortality.
When a decrease in appetite is more extreme and suddenly results in extreme weight loss then it’s very important to involve a primary care doctor to identify causes and establish a treatment plan.
A 10% loss of body weight has been linked to a higher mortality rate within 6 months of the weight loss.
Why do older adults lose their appetite?
The common causes for changes in an older adult’s appetite can include changing senses, dehydration, reduced hunger, specialized diets and physical impairment.
Dehydration
Adults over 65 have the highest rates of hospital admission for dehydration.
Dehydration can be responsible for a variety of health issues, such as kidney stones, UTIs and even a higher risk of falling.
Adult men should drink ~3.7 liters (15.5 cups) per day of fluids.
Adult women should drink ~2.7 liters (11.5 cups) per day of fluids.
Choose water over other sugary beverages as sugary drinks can actually lead to dehydration.
A standard single-use water bottle, the kind that we’re all familiar with, holds 500mL (16.9oz) or half a liter of water.
To really know how much water you’re drinking, buy a reusable water bottle with the volume labeled on the bottom and set a goal to refill it 4-5 times a day.
Changing Senses
Older adults experience changes in taste and smell, which can lead to a decreased sensitivity to flavor.
Foods that used to taste appetizing may now take bland and flavorless.
These new sensitivities to flavors can lead to reduced appetite.
Specialized Diets
Doctors may recommend a special diet due to health conditions which can eliminate many of an older adult’s favorite foods.
Typical recommended diets for older adults often include a low-sodium or low-carbohydrate diet.
These changes can lead to seniors dreading to eat.
Older adults may also resent being unable to choose their meals or have a say in their dietary choices.
Loneliness or Depression
Depression affects between 10-20% of seniors.
Depression is not a normal condition.
Let me repeat.
Depression is not a normal condition.
Signs of depression can include: sadness, hopelessness and despair, lack of energy or motivation, poor sleeping habits, slower speech or movement, neglecting personal care, memory problems, fixation on death, and feelings of worthlessness.
Additionally, meals are social events and older adults may dislike mealtime because they don’t want to eat alone.
Preparing food for one person is also lonely, sometimes boring and may lead to skipping meals (Even as a younger adult I want to do this!...but hunger wins).
Older adults may also feel that they have lost control over their lives when they become dependent on others, which can lead to depression and loss of appetite.
If you suspect your loved one is experiencing depression, consult a physician right away.
Lack of Routine
Sudden changes to routine or a lack of routine can lead to confusion around meal times and may cause an older adult to skip meals.
Establishing a routine that the older adult looks forward to can help stimulate appetite.
Medications
A change in appetite may follow a medication change because a common side effect of many medications is appetite loss.
If there is a direct relationship between the signs of appetite loss and a recent medication change, contact the prescribing doctor so you can understand the risks and benefits and decide whether or not to continue treatment.
Keeping track of an older adult’s weight and eating habits, along with going to regular health check-ups can ensure that an older adult is getting the nutrition they need.
If you feel that their appetite has decreased, what can you do about it?
Ways to increase appetite in older adults
Encourage snacking
Encourage eating 5 or 6 smaller meals throughout the day that are high in protein and nutrients. It is easier for someone with no appetite to eat small meals rather than large meals
Join them for meals
Eating alone can be boring and lonely. When one eats alone they tend to eat faster than if they are socializing with family and friends. Bringing back the joy of interaction at mealtime might help boost appetite.
Include them in cooking decisions
As people age, they may start to get excluded from decisions that they used to be in charge of. If they know what the meal will be, and participate in cooking, they may find eating more enjoyable.
Engage in regular physical activity
Older adults tend to become more sedentary and this decreases the need for more food to convert into energy. Getting up and going for a walk can help to burn calories and stimulate digestion hormones to boost hunger.
Blend foods or offer easy-to-eat foods
Some elderly people have dental issues (no teeth, dentures, missing teeth) which make chewing difficult to impossible. Blending food into soups or smoothies can help offer a nutritious meal that is easier to eat and enjoy.
If the seniors in your life are struggling to eat during regular meal times or frequently complain about a loss of appetite, take the time to determine the cause of appetite loss. Work together with your doctor, nutritionist and loved one and encourage small changes. With a supportive environment, eating regularly should become less of an issue.
📚 Book of the Week
Vera Wong’s Unsolicited Advice for Murderers by Jesse Q. Sutanto
Rating: ★★★★☆
From the Author that brought us Four Aunties and a Wedding (Nina’s Notes BOTW #32, ★★★☆☆ ) and Dial A for Aunties (Nina’s Notes BOTW #16, ★★★☆☆), Jesse Q. Sutanto brings us another hilarious, fun and lighthearted read about an old lady in a forgotten tea shop who takes it upon herself to solve a murder.
I really liked this book. The writing is quick, easy to read and fun. The situations escalate quickly and are generally outrageous.
The book also reminds me that having a community and a purpose can bring someone a lot of joy. Even if that joy is obstructing justice and going behind the police’s back to solve a murder.
⚡️ Check This Out
Welcome to Good Burger, Home of the Good Burger. Can I take your orrrrrrrderrrr?
Kenan and Kel are back with a sequel to the 1997 teen comedy Good Burger on Paramount+ premiering today, November 22, 2023.
A big corporation wants to give their jobs to robots and the ‘All That’ best buds are going to do something about it.
Edited by Wright Time Publishing