Veganism for the Over 60s

Introduction
A vegan diet can provide a nutritionally adequate diet at all times of life. General nutritional studies on elderly people have revealed that intakes of various vitamins and minerals, e.g. vitamin C, folate, riboflavin, vitamin D, iron, potassium and fibre, are lower than desirable. Although no studies have been carried out specifically on the nutritional status of elderly vegans, vegan diets generally contain the above mentioned nutrients in levels similar to, or higher than, the general population. There is a lack of data for deriving specific dietary requirements for the elderly due to the diversity of this population group. The requirements of each individual will depend on eating habits, health and activity levels.
General Guidelines
Choose a varied diet and strive for a minimum of 5 daily servings of fruits and vegetables, complementing them with generous portions of grains and legumes. A nutritionally balanced diet helps to maintain and boost the immune response - focus on whole grains, green leafy vegetables and vegetable oils - such as safflower, sunflower and rapeseed.
Detailed below are nutrients that dietitians and nutritionists have pinpointed as being of main concern in the elderly population. The term 'elderly' generally refers to men and women of pensionable age. The term 'very elderly' is often used for those over 75 years of age.
Vitamin D
Vitamin D is very important to keep bones healthy. Although it can be found in margarine and breakfast cereals (D3 is animal-derived; D2 is vegan). Conseqently, the main source of vitamin D is from exposure of the skin to sunlight. Low levels have been recorded where individuals have spent long periods in residential homes and hospitals, with little exposure to sunlight (1). Therefore, try to sit out in the summer - even if you only uncover your hands, face and neck for short (but regular) sessions. Use a sunscreen cream to keep your skin from burning. Even sitting in light shade will help your skin manufacture vitamin!
Iron
The elderly may be at risk of poor iron status but there is no data to quantify specific requirements. Iron from plant sources (non-haem iron) is absorbed less efficiently than iron from animal sources (haem iron). However, vitamin C (e.g. from citrus fruits and fruit juices) greatly enhances the absorption of non-haem iron from foods whereas tannins (e.g. found in tea), phytate and fibre inhibit absorption. Studies have shown that the iron status of vegans is usually normal and iron deficiency is no more common than in the general population (2).
Calcium
The desirable calcium intake for the elderly is a source of continuing debate. The COMA (Committee on Medical Aspects of Food Policy 1987) panel felt that there was no conclusive evidence that a high calcium intake in the elderly would prevent bone loss - although members suggested it might be prudent for those at risk of osteoporosis (porous or fragile bones) to consume a high calcium diet. However, there does not appear to be a direct link between an older adult's bone density and their current calcium intake (2). Nevertheless vegans should ensure they consume calcium-containing foods such as almonds, tofu (made with calcium sulphate), fortified soya milk, bread, green vegetables and pulses. Calcium absorption is more efficient in the presence of vitamin D.
Zinc
Zinc deficiency has been associated with delayed wound healing, decreased taste acuity and anorexia in old age. Vegan diets usually contain less zinc than non-vegan diets. However, the healthy elderly have been shown to be in zinc balance despite an apparent low dietary intake (4), suggesting that there is at least some degree of adaptation. Plant foods rich in this mineral include nuts, seeds and wholegrain cereals.
Potassium
Potassium is present in nearly all foods. Foods high in potassium include wholegrain cereals, fruit, nuts and vegetables. Potassium depletion has been recorded in diets high in refined foods and excess sugar intake.
Folate (Folic Acid)
Folate deficiency is more common in the elderly (1) due to poor intake. In the general elderly population sources of folate, such as vegetables and fruit, are frequently avoided. Vegans, however, generally meet or exceed recommended intakes.
Riboflavin (Vitamin B2)
The Manual of Dietetics (3) states "Riboflavin deficiency is rarely reported in Western countries but is common in countries with low intakes of meat and dairy products. Those most likely to be at risk in the UK are vegans." However, there have been no reports of riboflavin deficiency in vegans. Vegan sources of riboflavin include yeast extract, wheat bran, peas, whole cereals, pulses, nuts, mushrooms and avocados.
Vitamin B12
Research has shown that vitamin B12 deficiency is rare in vegans and when it does occur it is more likely to be as a result of malabsorption rather than dietary deficiency. There is no evidence for an increased requirement for this vitamin in old age.
Vitamin B12 is produced by bacteria in the human gut but distal to the site where it can be absorbed. Therefore it is recommended that this vitamin is included in the diet. For vegans, B12 fortified foods include yeast extracts, some vegetable stocks, TVP, certain soya milks and margarines, and some breakfast cereals.
Fibre
Fibre is important for providing bulk to enable food to pass through the gut easily. Constipation is a common problem in the elderly which is often due to a low fibre diet. However, vegan diets are generally rich in fibre ensuring the digestive system stays healthy, active and regular. Transit time in the elderly is no different than for the younger population. Good sources of fibre include fruits, dark leafy vegetables, grains and legumes.
Fluid
Some elderly people may have a fading sense of thirst which can lead to dehydration. Dehydration can cause mental confusion, headaches and irritability and so it is important that fluid intake is checked. Recommendations are for a minimum 6-8 glasses of water or liquids per day. For those concerned about nocturnal incontinence, extra fluids can be taken earlier in the day. Aim to eat a varied wholefood diet and choose foods from the following food groups on a daily basis
Cereals
Barley, rice, wheat (bread, pasta), oats, shredded wheat, millet, corn, bulgur, cous cous
Pulses
Beans, peas, lentils (cooked or sprouted)
Nuts & Seeds
All types of nuts, nut butters (peanut butter, cashew nut butter, etc), pumpkin, sunflower and sesame seeds and tahini (sesame seed spread). Also, sprouted seeds such as alfalfa and mustard.
Vegetables (cooked and/or raw)
Deep yellow & dark green leafy vegetables including carrots, green peppers, broccoli, spinach, endive and kale. Other vegetables include bean sprouts, potatoes, tomatoes, lettuce, cabbage, sweetcorn, celery, onions, cucumbers, beetroot, marrows, courgettes and cauliflower
Fruits(fresh, dried & tinned)
Bananas, oranges, tangerines, grapefruit, apples, mangoes, cherries, grapes, apricots, pear, paw paws, kiwis, berries, currants, lemons and plums.
Some Vegan Sources of Key Nutrients
Protein
Whole grains (e.g. whole wheat flour and bread, brown rice), nuts (e.g. hazels, cashews, brazils, almonds, cob nuts), seeds (sunflower, sesame, pumpkin), pulses (e.g. peas, beans, lentils), soya flour, soya milk, tofu.
Carbohydrate
Whole grains (e.g. wheat, oats, barley, rice), whole wheat bread, pasta and other flour products, lentils, beans, potatoes, dried and fresh fruit.
Fats
Nuts and seeds, nut and seed oils, vegan margarine, avocados. Two polyunsaturated fatty acids not made by the body are the essential fatty acids linoleic acid (omega 6 group) and alpha linolenic acid (omega 3 group). Good sources of these fatty acids include:
Linoleic acid - safflower, sunflower, corn, evening primrose & soya oils
Alpha-linolenic acid - linseed, pumpkin seed, walnut, soya & rapeseed oils
Vitamins
A Carrots, spinach, pumpkins, tomatoes, dark green leafy vegetables, vegan margarines
B Nuts, whole grains, oats, muesli, pulses, yeast extract (e.g. Marmite), leafy green vegetables, potatoes, mushrooms and dried fruit
B12 Fortified yeast extracts (e.g. Marmite) and soya milks (e.g. Plamil), vegan margarines, packeted 'veggie burger' mixes, some cereals (e.g.Kellogg's Fruit & Fibre, Frosties, Common Sense Oat Bran Flakes). Possibly: fermented foods (e.g. tamari, miso and tempeh, sea vegetables (e.g. hijiki, wakame and spirulina).
C Citrus fruits (e.g. oranges, lemons, grapefruit), red and blackcurrants, berries, green vegetables and potatoes
D Sunlight, some soya milks (e.g. Plamil) and vegan margarines
E Nuts, seeds, whole grains and flours, vegetable oils
Folate Wheatgerm, raw or lightly-cooked green leafy vegetables (e.g. watercress, broccoli, spinach), yeast, yeast extracts, nuts, peas, runner beans, oranges, dates, avocados, whole grains.
Minerals
Calcium Molasses, seeds, nuts, carob, pulses, miso (fermented soya bean curd), parsley, figs (dried), sea vegetables, grains, fortified soya milk (several varieties are fortified with calcium)
Iron Seeds, nuts, pulses, miso, grains, dried fruit, molasses, sea vegetables, parsley, green leafy vegetables, using cast-iron cookware
Zinc Wheatgerm, whole grains, nuts, pulses, tofu, soya protein, miso, peas, parsley, bean sprouts
Exercise and Lifestyle
Exercise is important to improve/maintain strength, suppleness, balance, stamina and memory. It helps protect against heart disease, osteoporosis and many other chronic conditions. Try and mix aerobic exercise - e.g. walking and swimming, with simple activities that strengthen muscle - e.g. lifting and carrying. As we age we lose important muscle tissue and muscle strength. Research shows it is never too late to rebuild and strengthen muscle with the right kind of activity and exercise. Muscle mass also determines our basal metabolism which directly affects the appetite. More muscle means a heartier appetite which translates into more nutrients for our bodies (5).
Research shows without doubt that good nutrition together with an active lifestyle, can have a beneficial effect on the health of almost all older people and is the best way to retard and even reverse the process of ageing.
Heart disease is the UK's number one health concern and ageing makes us even more susceptible, partly because our cholesterol count and blood pressure tend to increase. Eating healthily can reduce the risk. Good heart-healthy choices include oats and other wholegrains, dried peas, beans and lentils.
Medical Problems
The above information is only relevant to relatively healthy individuals; nutritional requirements will be altered by disease and therapeutic drugs. The Vegan Society is not able to deal with medical problems. If you have a health problem, we suggest you contact your local GP or request a copy of our Healthcare Professionals list which contains a list of GPs and alternative practitioners who you can contact who are sympathetic to the vegan diet and lifestyle.
References
(1) Department of Health Dietary Reference Values for Food Energy and Nutrients for the UK. Report on health and social subjects No 41. London HMSO 1991.
(2) Langley G (1995) Vegan Nutrition.
(3) Thomas B (1994) Manual of Dietetic Practice 2nd edition Black Well Scientific Publications Elderly people 287-297.
(4) Bunker VW, Clayton BE (1989) Research review: Studies in the nutrition of elderly people with particular reference to essential trace elements. Age and Ageing 18, 422-9.
(5) Nutrition and Elderly People (1992) National Dairy Council Nutrition Service General guidelines for the elderly population.