Food and Drug Interactions That Older Adults Need to Monitor

As a chef-turned-registered dietician, Michael Williams, Cura Vice President, Nutrition and Wellness, DBA, MBD, RD, CDN, believes that food and nutrition go hand-in-hand, according to recent interview with Pharmacy Times. Having good nutrition is especially important for older adults who have increased disease and medication risks.

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“As we age, our nutritional needs change due to decreased activity level, usually a change in hormone production, and also an increased risk of chronic disease,” Williams said.

Older adults should adapt their diet by decreasing calorie intake (because activity goes down) and eating higher amounts of low-calorie, nutrient rich foods—especially protein—to combat age-related loss of lean muscle mass, Williams said. Good sources of protein include the basics: seafood, dairy, poultry, and eggs. Older adults should also consume plant-based sources of protein that include beans, legumes, and soy, he added.

Nutrition affects everything about the body, Williams declared. While he’s a firm believer in getting vital nutrients from the source—that is from food—supplements can be beneficial if food isn’t enough to satisfy all nutritional requirements. He recommends talking with a physician or dietician prior to starting a supplement because it could interact with another medication.

But it’s not just supplements that can interact with medications, older populations need to be aware of medication risk associated with diet. For instance, warfarin is an anticoagulant—sometimes referred to as a blood thinner¹—for heart conditions that can negatively interact with vitamin K-rich foods (leafy greens, avocados, and grapefruits).

“Based on the medication that [patients] are taking, it could have the counter effect of what we want the medication to ultimately do,” Williams said.

But he affirms that foods rich in vitamin K are still healthy for those who do not take an anticoagulant class of drugs. Another example is tyramine, a monoamine that is naturally produced in the body and commonly found in cheeses and red wine. Although tyramine regulates blood pressure, large amounts of tyramine-rich food can cause patients on a monoamine oxidase inhibitor (MAOI) to have a dangerous skyrocket in blood pressure, Williams said.

“We need to make sure we're having those conversations with the physician, with the pharmacist, with the registered dietician…There may be some diet and lifestyle changes that have to be made,” Williams said.

Notwithstanding, proper nutrition may mitigate the need for certain medications. He considers a heart healthy diet that is lower in cholesterol, fat, red meat, and higher in lean protein, could possibly reduce the need for certain cardiac medications. Although he is not an expert on diabetes, Williams suggests that certain dietary habits may also make this condition more manageable, even if it does not totally eliminate the need for medication.

Older adults deserve good food, Williams said. Yet they are disproportionately affected by food insecurity, according to Feeding America’s The State of Senior Hunger in America in 2020 report. Food insecurity is defined as not relying on or having enough food to live an active and healthy life.²

Williams said the leading causes of food insecurity among older adults are lack of funding and living below the poverty line, but it could also be issues related to worsening memory—which could result in forgetting to eat—or lack of access for a variety of reasons.

Williams saw his grandmother’s mobility worsen to the point that she could no longer access food by going to the store, so his parents delivered her food every night.

“If [my parents] weren't around, [my grandmother] probably wouldn't have been eating,” he said.

It can be difficult for older adults to not have the functional independence of their youth, liberties such as going to the grocery store alone or driving places. This can have also negative repercussions on mental health that lead to disorders such as depression, Williams said. And malnutrition is a common issue that can impact the mental wellbeing of older adults.

“There's a huge aging population out there and it's just going to keep getting bigger,” Williams said. “We're all aging…we're going to get there at some point,” which is why he added that it is crucial for older adults to have access to fresh and well-balanced meals.

“Really, it’s the right thing to do,” Williams said.

References

1. RxList. Warfarin. Drug Description. August 25, 2021.. Accessed on May 11, 2023. https://www.rxlist.com/warfarin/generic-drug.htm
2. National Council on Aging. Get the Facts on Food Insecurity and Older Adults. News Release. April 15, 2022. Accessed on May 8, 2023. https://ncoa.org/article/what-is-food-insecurity-get-the-facts