VITAMIN D

1. VITAMIN D Function: Essential for bone health. Also linked to the treatment and pathogenesis/progression of several disorders, including cancer, hypertension. multiple sclerosis, rheumatoid arthritis, osteoporosis, muscle weakness and diabetes. Studies have linked vitamin D supplementation to reduced falls risk for those with lower vitamin D levels. Relevance: Older people are less likely to get sufficient sun exposure to make their own vitamin D. Vitamin D is only found in a small range of foods. Deficiency causes bone pain and muscle weakness and increased risk of fractures. Good sources: Sunlight! 30mins of exposure to face and legs/day in summer. Oily fish (sardines in tomato sauce 8µg/100g, pilchards, 14µg/100g, tinned salmon 9.2µg/100g) Fortified breakfast cereals (e.g. bran flakes 1.6µg/40g special k 3.4µg/40g), Fortified margarines (1.2µg/15g), Eggs (1.6µg), Liver (1.1µg/100g). Recommendations: The RNI for people over the age of 65 years is to consume 10µg vitamin D daily for those confined to the indoors. This is difficult to achieve via diet alone. Include fish on the menu twice a week, one of which should be oily. Include liver in the menu once a fortnight. Encourage fortified breakfast cereals. Consider a vitamin D test if your client has a poor intake of these foods and consider supplementation.

2. FLUID Function: Helps to prevent dehydration, reducing incidence of dizziness and confusion, leading to falls, pressure ulcers, UTI, cognitive impairment, constipation, heart disease, kidney stones, postural hypotension, poor oral health. Relevance: The kidneys are less good at concentrating urine as we age, also thirst receptors diminish as we age. Poor mobility/fear of incontinence often means the elderly are reluctant to drink. Good sources: 80% of fluid we take on is from drinks. Tea, coffee, malted drinks, milk, fruit juice, fruit, vegetables, sauces, ice cream, jelly, cereal and milk. Recommendations: For those who are very reluctant-try foods high in fluid, such as jelly and ice cream, or grapes as a snack. Encourage 6-8 drinks throughout the day (minimum 1500-1600mls/day) Consider: availability of their drink of choice, regular drinks rounds, volunteers to encourage drinks, ‘happy hour’ or afternoon teas.