Nutrition for the elderly: preventing neurodegenerative diseases

As life expectancies increase, older people are increasingly faced with age-related health issues. The Agri-food and “Silver Food” manufacturing industries are facing new challenges: how to formulate food products tailored to the special needs and nutritional requirements of elderly consumers that also help towards the prevention of neurodegenerative diseases. A little food for thought...

DEFINITION, CAUSES AND CONSEQUENCES OF NEURODEGENERATIVE DISEASES AMONG THE ELDERLY

Just one definition, but many different diseases

The brain is the hub of our intellectual faculties, and the organ that controls the central nervous system. It is a control centre that receives nerve impulses and controls voluntary and involuntary body movements in return.

By definition, neurodegenerative diseases include pathologies relating to the dysfunction of nervous tissue, and resulting in the progressive damage of the neurons, brain and spinal cord.

Living longer doesn't necessarily mean "ageing well". Neurodegenerative diseases are becoming increasingly commonplace, with behavioural disorders occurring among the elderly.

Consequences for mental health as well as motor function.

As neurons deteriorate, individuals may start experiencing relatively minor symptoms, such as issues with coordination and memory. But over time, the symptoms can gradually worsen. In some cases, patients lose the ability to walk, think or function in society. The clinical presentation of neurodegenerative diseases, giving "the most accurate list of clinically observable characteristics, symptoms and signs of pathologies", includes:

• The impairment of mental capacities leading to dementia. This is the case with Alzheimer's disease or Pick's disease.
• Abnormal motor function, for example with amyotrophic lateral sclerosis (ALS) and Parkinson's disease.
• A combination of mental and motor functions impairment as in Huntington's or Creutzfeldt-Jakob disease.

With no curative treatment available to date, patients may gradually find themselves bedridden, and complications can ultimately result in death. Several situations and diseases can disrupt the physiological balance of the body and contribute to the occurrence of neurodegenerative diseases. As an example, diabetes causing peripheral and/or vegetative neuropathy at an advanced stage.

Further reading: Osteoporosis and nutrition for the elderly.

ETIOLOGY OF NEURODEGENERATIVE DISEASES

Is it all down to genetics?

Some neurodegenerative diseases are caused solely by genetic mutation, such as Huntington’s disease and Charcot–Marie–Tooth disease, although prevalence rates are low.

Infections as the root cause

Bacterial, viral, fungal or parasitic infections can all affect the nervous system. Neurological symptoms can be triggered by an infection itself, or by the body's immune response.

This means that compliance with hygiene regulations during food production by Silver Food manufacturers, and also by the health care personnel and caregivers is essential to avoid contaminating this high-risk group.

Idiopathic causes… are chemicals to blame?

Neurodegenerative diseases are generally idiopathic, meaning they have no identifiable root cause. On a parallel, chemical products (pesticides, heavy metals) and prions have also been identified as the cause of neurodegenerative diseases in some patients.

Important: Studies show that some components have been found to interact with the drug treatments taken by patients in this group. This is why manufacturers must prioritise clean labels in their product formulation.

EPIDEMIOLOGICAL OBSERVATIONS

About a billion people around the world suffer from neurological disorders. According to the Institute for Brain and Spinal Cord (Institut du Cerveau et de la Moëlle-Epinière, ICM), 47.5 million people suffer from dementia, with 7.7 million new cases each year. Alzheimer's disease leads the way, accounting for 60 to 70% of all cases. Neurodegenerative diseases primarily affect patients aged 65 and above. Ageing populations mean that prevalence rates are likely to rise in the years to come.

There is therefore an urgent need for “Silver Food” products. Dietary improvement is one of the easiest and most effective ways of ensuring good health in old age, and of fighting against these diseases.

This is why the agri-food industry has a decisive role to play in developing products specifically designed for the elderly and their nutritional needs, thus helping to prevent neurodegenerative diseases. 

FORMULATING THE RIGHT PRODUCTS FOR SILVER FOOD DIETS AIMED AT PREVENTING NEURODEGENERATIVE DISEASES

Brain health is accumulative over the years

In children, Vitamin B9 helps with neural tube formation. In adolescents, polyunsaturated fatty acids Omega 3 and Omega 6 are essential to memory and learning capacities. In adulthood, Omegas 3 and 6, as well as EPA and DHA, help maintain cardiovascular and brain health. And finally, in the elderly, Omega 3 and Vitamin A are crucial to protecting brain cells.

Which ingredients are the best brain food?

Unsaturated fats

Monounsaturated and polyunsaturated fatty acids contribute to a healthy nervous system. EPA and DHA fats bear health claims and are regulated by the EU COMMISSION REGULATION No 432/2012 of 16 May 2012.

Docosahexaenoic acid (DHA) helps ensure healthy brain function. These claims only apply to food products containing at least 40mg of docosahexaenoic acid (DHA) for every 100g and 100kcal of food. Consumers must also be informed that the benefits of DHA are dependent on a daily intake of 250mg of DHA. Scientific studies show that this essential fatty acid:

• improves learning
• prevents memory issues
• maintains concentration levels
• reduces the risk of developing Alzheimer's disease

Vitamins, minerals and antioxidant compounds

The following nutrients are said to “contribute to the healthy function of the nervous system” as defined in the annex to the EC regulation no 1924/2006:

• Magnesium
• Potassium
• Niacin
• Biotin
• Copper
• Iodine
• Thiamine (Vitamin B1)
• Riboflavin (Vitamin B2)
• Vitamin B6
• Vitamin B12
• Vitamin C

The following nutrients are said to “contribute to the healthy function of the cognitive system” as defined in the annex to the EC regulation no 1924/2006:

• Zinc
• Iron
• Iodine
• Water

These nutrients are also recognised as having brain-boosting properties:

• Pantothenic acid contributes to normal intellectual performance.
• Folates (Vitamin B9) contribute to normal psychological function.
•  Vitamin A and its precursors, such as beta carotene, ensure the body produces retinoic acid, which plays a key role in brain plasticity and new neurone formation, and is therefore beneficial for the elderly and patients living with Alzheimer’s.

Further reading: Nutrition for the elderly: the benefits of dairy ingredients in fighting age-related diseases.

Formulating targeted, innovative products

A holistic approach to food

Preventing neurodegenerative diseases through nutrition goes beyond merely choosing ingredients with health benefit claims. A holistic approach needs to be adopted where the product is also considered for its format, texture and nutritional value. At ARMOR PROTÉINES, our R&D experts always consider the habits and preferences of elderly customers in their recommendations for product formulas!

Individuals with neurological disorders often face difficulties with eating as a result of dementia, such as gripping cutlery (due to tremors) and trouble chewing and swallowing.

This is why brands and R&D formula developers need to adapt product formats to enable the easy handling and gripping of food. Considering product formulas that resemble “Finger Food” type formats may be more suitable for patients with Alzheimer's, for example. “Finger Food” (see food trends 2018) aims to enable people who have become dependent, due to difficulties in the handling of cutlery, to regain their independence by using their fingers to eat.

In addition, for easy chewing and swallowing, the texture of food products also needs to be considered. In cases where liquids are being swallowed the wrong way, solid products are a more favourable option, offering gelled dairy products, dessert creams, etc. On the other hand, if solid foods are being swallowed the wrong way, liquid products may be the way forward for development.

People with neurodegenerative diseases can sometimes lose the concept of time and mealtimes. Treatment protocols therefore suggest increasing food intake via mini snacks in the form of mini formats that patients can have to hand throughout the day. This, however, means exposing food to room temperature. R&D formula developers are therefore faced with the challenge of developing products that are hygenically stable.

In addition, the nutritional quality of the product must be considered, as dementia is often accompanied by loss of memory, reduced awareness of time and space, and loss of appetite. Meal formats often need altering. Products must have high energy and micro-nutritional density for a small volume of food. This contributes to maintaining intellectual facultieswhile preventing protein and energy malnutrition.

Finally, in the design of a new product range, R&D experts could innovate on an organoleptic level. This results from an understanding on how to develop and combine different flavours.

ARMOR PROTÉINES, YOUR PARTNER IN THE PRODUCTION OF DAIRY INGREDIENTS FOR THE FORMULATION OF FOODS FOR THE ELDERLY

Armor Protéines produces dairy ingredients to be incorporated into products that are perfectly tailored to meet the needs of the elderly. These preparations are used to develop food solutions with excellent nutritional and functional properties.

Armor Proteins has several ranges of dairy proteins developed in full compliance with the dietary, health and agri-food industry sectors.

Find out more in our eBook: “Nutrition for the elderly: solutions adapted to the various needs and health requirements among the elderly”.

Find out more:

• Neurological disorders affect millions of people around the world: the WHO's report
• What are neurological disorders?
• Prion diseases - INSERM
• Prion diseases - Institut du cerveau et de la moelle épinière (ICM)
• Fédération pour la recherche sur le cerveau
• Neurodegenerative diseases and food (FRC)
• EBC (European Brain Council)
• FRC (Fédération pour la Recherche sur le Cerveau)
• UNAFTC (Union Nationale des Associations de Familles de Traumatisés Crâniens et cérébro-lésés)
•  "Protein content and methyl donors in maternal diet interact to influence the proliferation rate and cell fate of neural stem cells in rat hippocampus." Amarger V, Lecouillard A, Ancellet L, Grit I, Castellano B, Hulin P and Parnet P. Nutrients 2014, 6, 4200-4217.
• "Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality–a systematic review and dose-response meta-analysis of prospective studies." Dagfinn Aune et al. International Journal of Epidemiology published online 22 Feb. 2017.
• DOI: https://doi.org/10.1093/ije/dyw319
• French national nutrition and health programme (PNNS) http://www.mangerbouger.fr/
• Integrated nutrition and neurobiology laboratory (Bordeaux) http://www6.bordeaux-aquitaine.inra.fr/nutrineuro
• Anses: French national agency for food, environment and workplace safety: https://www.anses.fr/fr
• "Healthy Eating Plate" published by the Harvard School of Public Health: https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/
• https://neurodiscovery.harvard.edu