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General Recommendations

Energy needs in the elderly

As we get older, the energy needs get smaller. The reduced energy needs are the consequence of two main factors:

1.       the reduced basal metabolism, which is to a large extent caused by the reduced muscle mass in our body, and to a lesser extent by the reduced basal metabolism activity in all other body tissues, and

2.       to the reduced physical activity. 

Table 1: Energy recommendations for the elderly
Age Basal metabolism Physical Activity

For sports activities or for strenuous activities in our free time (30–60 minutes, 4–5-times per week) 0,3 of PAL1unit should be added per day
kcal/day kcal/day
51-65 1.580 2.050
65 and above 1.410 1.830
51-65 1.270 1.650
65 and above 1.170 1.520

1 PAL = (physical activity level) the average daily energy needs for physical activity as a multiplier of basal metabolism.

Through the entire period of adulthood the energy needs get reduced for approximately 20 %, due to the reduced basal metabolism, as well as due to the reduced physical activity.


Body Mass in the Elderly

Body Mass Index (BMI) is an anthropological measurement, defined as body mass in kilograms, divided by the square of the body height in meters; for instance the BMI of a 172 cm tall person, whose weight is 65 kg , is calculated in the following way:  65/(1,72)2=22

The research shows that it is optimal for an elderly person to have the BMI in the range between 25 and 30.


An important risk factor is also the increased body waist circumference. People with an increased body waist circumference are four times more likely at risk for the development of chronic diseases than those with the normal body waist circumference. Body waist circumference and body weight are frequently closely interlinked.

Waist circumference above 80cm is hazardous for the health of the woman, whereas the circumference above 88cm is considered very hazardous. For men it holds true that the circumference of 94 cm is hazardous, whereas the circumference of 102 cm is very hazardous. Especially dangerous is the slow, but constant increase in the circumference of the waist.

Unsupervised deliberate loss of weight (slimming) can in the elderly lead to muscle loss, to bone fragility and to rapid exhaustion during any disease.


Food Supplements

If the nutrition is balanced and contains also enough fruit and vegetables, as well as the olive oil, which is characteristic for the Mediterranean diet, food supplements are not necessary.


Water and liquids

The recommended daily intake of liquids and water is related to the calorie intake, which is 1 liter of water per 1000 kcal, in an elderly adult the recommendation is even a bit higher. Considering the calorie intake, this means a minimum of 1.5 liters of liquids per day, drinking water and herbal teas are especially recommended, whereas in the case of malnutrition also natural fruit juices with a higher level of sugars are recommended.

Milk and dairy products count as foodstuffs, and are not considered as drinks.

It is important to know, that the percentage of water in our bodies also decreases with age, which means that an elderly person has a smaller "reservoir" and smaller safety boundaries of hydration. At the same time the feeling of thirst gets reduced with age. Both of the above can lead to a mild or also severe form of dehydration. Dehydration in an elderly adult can more frequently cause urinary tract infections, pneumonia, confusion and disorientation as well as bedsores.