In this article I'll talk about the issue of weight loss in the elderly population and common reasons why it happens. I'll also recommend a list of the best high calorie drinks for elderly people to buy.
Weight loss in the elderly population is common and can happen as a result of many factors.
Weight loss can happen quite quickly or over a period of time.
We tend to see more weight loss in the older end of the elderly demographic. Often those aged 75 years and over.
For younger older adults, aged between 50-70 years, or those who just want to gain strength and muscle mass without gaining lots of extra weight, a high protein drink might be more beneficial. These contain a good amount of protein without the added Calories.
(you can see my high protein drink recommendations here)
Often, elderly people who have had a stay in hospital or bout if illness will lose a lot of weight as well as muscle mass and strength.
I'll start by giving my recommended high Calorie drink options. All of the recommendations can be bought from Amazon and I have provided links for each product.
*Please note - weight loss can sometimes be a sign of ill health. It's important to see you doctor if you notice abnormal weight loss to rule out anything underlying health conditions.*
Lets take a look at some pre made high Calorie drink options
All these options are pre made, meaning you purchase them in liquid form ready to drink.
These 200ml bottles of Ensure pack around 300 Calories per bottle with a good amount of protein as well. They come in a variety of flavours. Ensure is a well known brand who have been supplying these nourishment drinks for many years.
Cost: £20.90 for 12 bottles.
Click the link below to view the product on Amazon
Fortisip high Calorie shakes contain 300 Calories per 125ml bottle (with 12 grams of protein). At the time of publishing this link gives a 2 starter pack deal consisting of 12 bottles all together.
Fortisip claim that this product can be used as a meal alternative as it contains all essential vitamins and minerals, however I don't recommend this approach. All these products should be used to supplement your regular diet.
Cost: £22.84 for 12 bottles
Click the link below to view the product on Amazon
This product is advertised as a nutritionally complete drink just like Fortisip. It packs an impressive 500 Calories per 500ml bottle including 34 grams of protein which is great. It also includes all 26 essential vitamins and minerals. Although it's pricer than other options, it has such a high Calorie content you may only need one bottle per day to supplement your normal diet.
They are also 500ml bottles which is much bigger than than the Fortisip and Ensure products listed above.
Cost: £41.99 for 12 bottles
Click the link below to view the product on Amazon
Lets take a look at some powered high Calorie drink options
All these options come as a powder and need to be mixed with either water or milk.
These come as a pack of 16 sachets and can be mixed with milk to give a high Calorie drink containing 265 Calories (with 15 grams of protein). It comes in vanilla, strawberry, banana or chocolate flavour.
They're much cheaper than pre-made bottled options.
Cost: £13.99 for 16 sachets
Click the link below to view the product on Amazon
This product contains 261 Calories when mixed with 200ml of milk. It also contains an array of essential vitamins and minerals. It comes in a 7, 21 or 70 sachet box. I would recommend trying the smaller box first to see if you like the product.
Cost: £11.49 for 7 sachets
Click the link below to view the product on Amazon
This product contains a whopping 500 Calories per serving, including 40 grams of protein. Because it comes in a bag you can manipulate how much you have per serving which can be very useful. For example, having 2 scoops instead of the recommended 4 to make it a 250 Calorie drink with 20 grams of protein.
Don't be put of by the fact that it's a sports nutrition brand. It's just marketing. This product will be excellent for providing the extra Calories you need.
Cost: £9.99 per kilo.
Click the link below to view the product on Amazon
If you want to find out more about weight loss in the elderly and how high Calorie drinks can help then read on.
What causes weight loss in the elderly?
It's important to first clarify what actually causes weight loss before looking at why weight loss is quite common in the elderly population.
Our weight is ultimately governed by the amount of Calories we eat in relation to how many we expend. This simple equation known as Calorie balance is easy to understand in principle but more complex in practise.
In today's digitalised world it's much easier for false narratives around weight loss to become mainstream but ultimately it comes down to overall Calorie intake vs Calorie expenditure.
Therefore if you're losing weight it's because you are eating less Calories than you are burning on a weekly/monthly basis.
There are a LOT of reasons why you might be eating fewer Calories than you once did and a lot of these reasons are specific to the ageing population.
(Caveat: there are a handful of medications and diseases that do affect your metabolism and therefore may disrupt Calorie balance. That's why it's very important to see your doctor if you are experiencing weight loss so that you can rule out any underlying health conditions that might be causing or contributing to your weight loss)
Why do elderly people sometimes lose weight?
There are several reasons why elderly people sometimes lose weight or struggle to maintain their weight.
- Loss of appetite
Loss of appetite is a very common reason for weight loss in the elderly population. Changes in hormones that are often experienced in the elderly can have a significant impact on appetite.
For example, the hormone Ghrelin which helps to regulate hunger is sometimes suppressed in older age meaning elderly people feel less hungry in general.
Changes in taste, smell and vision can play a part in loss of appetite. These senses all play a role in appetite and because the elderly often see a reduction in these senses it can have a knock on affect on appetite. These senses may have a much bigger role in stimulating appetite than is often assumed.
Reductions in these senses may trigger a chain of physiological events that ultimately play a big part in the reduction of appetite in the elderly population.
It's generally accepted that the elderly population are likely to see far more of a reduced sense of smell over taste.
The reduction of taste and smell among the elderly is often not addressed or is largely ignored. The reduction in these senses may not require immediate medical intervention but overtime there's no doubt it can contribute to appetite suppression, weight loss and malnutrition in some older adults.
There are some simple things that you can do to help overcome a reduced sense of smell and taste.
Eating foods with stronger flavours and smells can be a really effective way to help stimulate appetite which will enable you to eat more.
You could also trying using more or different seasonings to enhance the flavour of your meals.
And of course, overcoming that reduced appetite can be done via easy to drink and nice tasting high Calorie drinks.
- Reduced Saliva production
Reduced saliva production is something that can occur with ageing. It's not just a reduction in the flow of saliva but also the quality. Saliva can be less viscous and lubricating which often leads to dry mouth and problems with swallowing.
Reduced salvia production can also make dentures harder to wear and cause poor oral hygiene.
Adequate saliva is also needed for the optimal breakdown of food in the mouth and contributes to the texture and sensation of eating.
- All of these potential side affects from reduced saliva production can cause a reduced intake of nutrients and therefore can lead to either malnutrition or weight loss.
This is something for ageing adults to be aware of.
Extra attention could be placed on ensuring older adults are getting enough water throughout the day.
For those of you who struggle with hydration there are lot's of things you can do to help.
- Use a water bottle with fluid markers to help remind you to drink more
- Add some flavour to your water (such as squash) to encourage you to drink more.
- There's a great product called Jelly drops which are hydration sweets. Each sweet contains the equivalent of 12.5ml of water and can really help boost hydration when combined with regular water consumption.
- Drink a glass of water as soon as you get up. After 6-9 hours of sleeping your body will be dehydrated and so getting some water in straight away will be really beneficial.
Anything you can do to help ensure you are staying hydrated will be really beneficial to lots of your health markers. The importance of hydration goes way beyond just helping you to keep up your appetite.
- Following fad diets for "better health"
I sort of alluded to this point earlier in the article but it's a really valid and pretty common reason why people end up eating less.
Fad diets have never been more prevalent. We've all heard of veganism, Low carb diets and Keto. These diets are rooted in misinformation and fear mongering.
The same goes for the more recent demonisation of certain foods and food groups such as gluten and dairy.
The issue, people hear the false claims about these diets and then radically change their current diet thinking its healthier.
What people don't realise is that there are dangers to eradicating entire food groups or even certain foods from your diet. One of which is potentially lowering your Calorie intake considerably. Another is missing out on key nutrients that are needed for optimal health.
This can great for those who are actively trying to lose weight but not so good for those who are struggling to maintain weight.
A good example of this food fear mongering is plant based milks vs cows milk.
The idea that cows milk is "bad" for you and that plant based milks (such as almond milk) are "good" for you is born out of misinformation.
In fact plant based milks don't even come close to the same nutrient profile that cows milk has.
Plant based milks also have a far lower protein content than cows milk. Because protein is critical to muscle preservation and growth, cutting out cows milk in favour of plant milks can be really problematic.
Anyone who has read my other articles will have probably seen me talk about just how important protein is. You can read my article about protein and great high protein products by clicking HERE.
Be very careful about following diets or diet trends that encourage you to cut out foods.
- Oral hygiene
Discomfort around eating is a common reason why the elderly often eat less. Badly fitting dentures or pain when eating can make eating quite challenging. It's easily enough to stop those with poor oral hygiene from eating enough Calories.
It's not uncommon for elderly people in this situation to try and satisfy their hunger with liquid type foods such as soup. The issue is, often these foods contain fewer calories than whole foods which can result in weight loss over time.
Oral hygiene is really important and so if you're struggling with it just remember you don't have to live with it. Talk to your Doctor and dentist and explain the issues you're having. They are there to help.
- New Illnesses
Unintentional weight loss can be a sign of an undiagnosed illness. Whether your weight loss has happened quite quickly or over a longer period of time it's really important to get yourself checked out by your doctor to rule out anything more serious or get treatment if needed.
This is perhaps one of the more common reasons why elderly people end up losing weight.
Cooking can become very difficult for older adults who are frail and struggle to stand for long periods of time. Lifting heavy pots and pans can also become challenging.
Cooking is something we take for granted in our younger days. It's something most people do multiple times a day.
However, lifting a heavy pot or kettle full of water can be really challenging once there has been a significant loss of strength in the upper body.
Arthritis in the hands and fingers can also make cooking really challenging. Opening packages and lids can become impossible.
Visual impairment can also make cooking very challenging and also very dangerous. Obviously dealing with hot pans and oven trays can be challenging when mobility is reduced and can lead to burns and other injuries.
As a result frail older adults tend to forgo cooking which of course results in a dramatic reduction of Calories and often weight loss.
- Hospital stays or bouts of illness
Hospital stays commonly result in older adults rapidly losing weight. In particular muscle mass and strength.
In fact anecdotally, when my own Grandma was admitted to hospital in her 70's it marked the beginning of her mobility struggles.
She spent the best part of a year in hospital with a rare skin disorder and during her stay did very little physical activity and didn't eat particularly well.
By the time she came out she had lost a significant amount of muscle mass to the point where she couldn't even stand up and walk around without having aids.
This eventuality is pretty common.
Hospital food isn't exactly up to a great standard and what's more the staff are generally so busy if patients don't eat (or struggle to eat) they won't necessarily get much encouragement to do so.
My mum worked as a nurse and recently told me that patents were given a nutritional drink called Fortisips but all too often patients wouldn't drink them because they tasted horrible.
A very scary thing is, hospital stays don't have to be long for significant amounts of muscle, strength and weight to be lost.
This study took 11 healthy older adults (average age of 67) and fed them the recommended daily protein (as part of their dietary intake). They were subjected to 10 days of bed rest and the results showed a significant loss of lower extremity strength.
We same the thing in astronauts operating in zero gravity. Astronauts in orbit dedicate 3 hours of their day doing resistance training to help offset the massive reduction of muscle mass and strength that comes from being outside of Earth's gravitational pull.
One of the Wise Fitness Academy members was recently hospitalised with Covid-19 for 12 days and couldn't walk up her stairs upon returning home. She lost a lot of leg strength after only 12 days of inactivity.
When I was training to become a nutritionist my mentor always said:
"Don't take people grapes when you visit them in hospital, take them a tub of protein powder instead"
This is fantastic advice!
But even better still, high Calorie ready made options which contain lot's of protein as well, do exist. And what's more, lots of them are really tasty. (I will get in onto recommendations later in the article)
- Dementia/age related memory loss
This is a common reason why elderly people end up losing weight. Age related memory loss or dementia can have a significant impact on eating and drinking.
Ageing is associated with some degree of memory loss and of course dementia and Alzheimers disproportionately effects the older adult population.
These issues often have a direct affect on sleep patters and appetite which of course in turn affects eating habits.
The hydrating Jelly drops product I mentioned earlier was born out of a dementia patient who was rushed to hospital suffering from severe dehydration. After extensive research the founder of Jelly drops came to realise the significant problem of dementia patients suffering with chronic dehydration.
Even more subtle age related memory loss can have an impact on appetite.
Having an easy to prepare high Calorie drink can be really useful in these circumstances.
Why are high Calorie drinks so useful for elderly people?
High Calorie drinks help to overcome all the obstacles that the elderly and older adults often encounter when it comes to maintaining weight, muscle mass and strength.
There are several reasons for this.
- Ease of use
Most high Calorie shakes come pre made in liquid form which makes them really really easy to consume. There is no preparation needed and they're really simple to drink. Simply open a bottle and pour it into a glass.
High Calorie drink powders are also available to purchase but often they are marketed specifically to young gym goers who are struggling to put on muscle mass. Don't let that put you off though. A high Calorie drinks powder is perfect for your needs also. The powder form is also cheap and allows you mix other ingredients if you want to.
Lots of the Wise Fitness Academy members use a high Calorie powder and mix in frozen fruit, bananas and peanut butter along with other ingredients. This can make the drink even much tastier and more to your own satisfaction.
- Ease of consumption
Let's face it, if you're just not feeling hungry then it's hard to actively go and eat something. I can actually relate to this on a personal level as someone with a limited appetite. I've always been thin and have always struggled to put on muscle mass and weight.
Drinking a high Calorie shake is just so easy though.
I remember when I first started going to gym and wanted to gain muscles. It was such a chore constantly prepping and eating food all the time. I just didn't want to eat that much. That all changed after I discovered a high Calorie protein powder. I had 2 or 3 shakes a day and it boosted my Calorie intake by about 1200.
Even if you're not hungry it's far more manageable to drink a shake to get the Calories in.
- They're liquid
The fact that these high Calorie drinks come in liquid form helps it overcome some problems. Poor oral hygiene or painful dentures won't be affected and the liquid can also help those who struggle with swallowing.
For those who are really frail and have very limited mobility the use of a straw to drink the shakes can be really helpful.
- They're affordable
These days high Calorie drinks are really affordable and they taste great. You can typically buy a big back of 12 or more pre made high Calorie drink bottles which helps bring the cost down. Keep reading on and I'll show you a variety of recommendations with varying price points.
What's the difference between high Calorie drink and protein shakes?
This is a great question.
In a nutshell, a high Calorie drink will contain a good amount of protein but it ALSO contains more carbs and fat to help bring the Calorie content up.
Remember earlier I talked about Calorie balance determining our weight. Well these Calories come from 3 sources. Carbohydrates, protein and fat. They are known as macro nutrients.
So essentially a high Calorie drink is the same as a protein drink/shake, it just contains more Calories in the form of carbs and fat.
Now for an older adult who is struggling to maintain weight, a high Calorie drink is the way to go. In this circumstance overall Calories are needed to help maintain or even gain weight.
Interestingly, there are no protein drinks/shakes that are marketed towards the older adult population. Instead they are all marketed towards younger gym goers who want a muscly physique. There are however some high Calorie drinks brands that are more marketed towards the older adult population.
So to round this section up:
If you're struggling to gain weight or are losing weight then a high Calorie drink is the way to go.
If you're weight is stable or you're looking to lose weight and add some muscle mass and increase strength then a high protein drink is the best option for you.
Can you JUST drink high Calorie drinks?
There are some products that do have a complete nutritional profile meaning technically you could just have the drink and nothing else.
However, I wouldn't recommend this approach if it can be avoided.
I always advocate what's called a "food first" approach.
High Calorie drinks should ideally be used as a supplement to your more regular diet. And supplement is the keyword here. These high Calorie drinks shouldn't replace all other foods even if they do provide all the nutrients you need.
The food matrix and it's relationship with the human body is infinitely complex. Different foods interact differently when ingested and so relying purely on 1 drink for nourishment probably isn't a good idea.
There are lots of food options that will suit an elderly and or frail person that can be part of a diet along with a high Calorie supplement drink.
Some examples include:
Some of these options are harder to prepare than others which also plays a role in their suitability.
However, there is SO much variety these days that even these examples have options that make them far easier to prep.
Microwavable bags of vegetables are a great example. I actually use these myself just because they're incredibly convenient. The veg is literally portioned out and in a bag ready to be microwaved. The steam cooks the veggies in a few minutes and voila. Simple cut the bag open and serve onto a place. I like to add some sauce such as Salad Cream for added flavour.
Pots of porridge is another example. Instead having big heavy bags or boxes of oats you can buy pre portioned out pots that you just add hot water to or some milk and pop it in the microwave. You don't even have any pots to wash up afterwards.
Can High Calorie drinks prevent muscle and strength loss in the elderly?
Having adequate Calories, including the right amount of protein might help to slow down muscle and strength loss but ultimately physical activity in the form of resistance training is required to preserve and grow muscle mass.
Many elderly people give up on physical activity which only exacerbates issues of mobility and frailty.
It can be tough for elderly people to exercise but it IS possible.
One of our monthly programmes here at the Wise Fitness Academy is a chair based workout specifically for older and more frail adults. Gentle resistance based exercises done regularly will make a HUGE difference to strength and mobility.
What important things should you consider before using high Calorie drinks?
One very important consideration before buying and consuming a high Calorie drink is the vitamin and mineral content.
Some products, including some of the ones I've recommended in this article, are made to be to full meal replacements meaning they generally contain more vitamins and minerals than other products that are just made as a supplements. It's important consider any other sources of vitamins you are taking such as a multivitamin when adding in a high Calorie drink to your diet.
I recommend consulting with your doctor first.
I'll conclude this article by highlighting some of the more important points:
- Calorie balance ultimately determines whether we lose, maintain or gain weight.
- Sudden weight loss can be a sign of ill health and so it's vital you see you doctor if this occurs.
- High Calorie drinks can be VERY helpful for elderly people to get more Calories and nutrients into their diet.
- High protein drinks and high Calorie drinks are different things.
- High Calorie drinks typically come in either powder or liquid form.
- There are MANY reasons why elderly people lose weight.
- High Calorie drinks may help with weight regain or staving off weight loss but physical activity is also required for increased strength and mobility.
best high Calorie drinks for elderly - FAQ
A high Calorie drink normally contains a good amount of protein but ALSO contains carbs and fats to help increase the amount of overall Calories in the drink.
If you're looking to gain weight then a high Calorie drink is the best product for you.
If you're not trying to put on weight or are TRYING to lose weight whilst also trying to build some muscle and strength then a high protein drink will work best for you.
Some high Calorie shakes are nutritionally complete meaning they have all the essential vitamins, minerals and Calories we need HOWEVER I wouldn't recommend only having high Calorie drinks.
You should ideally use high calorie drinks as a supplement to your regular diet. Even if you're only able to eat a little amount of regular food before topping up your diet with a high Calorie drink.
A "food first" approach is always preferable.
One of the major issues about hospital stays is patients losing muscle mass, strength and weight.
Lot's of hospitals actually offer high Calorie drinks already.
Instead of taking a bunch of grapes for your friend of relative, take some high Calorie drinks instead.
Most high Calorie drinks also contain a pretty good amount of protein which is essential for muscle preservation and growth.
However, without regular exercise (specifically resistance training) AS WELL as adequate protein and Calories you probably will still lose some muscle mass.
They generally contain carbs, protein and fat along with vitamins and minerals. They also have some flavouring to make them taste nice.
It's far healthier to try and maintain or even gain weight if you're struggling to eat more regular foods.
At the same time, trying to eat lots of fruit and veg as well as having high Calorie shakes would be better.
A "food first" approach in more desirable but high Calorie shakes can be great for those who are struggling with unwanted weight loss.