How should an older person who takes many medicines eat?
Food and medicines influence each other: some medicines reduce appetite or cause a dry mouth, and some foods change how medicines work.
In short
- An older person taking many medicines needs a varied, nutrient rich diet and should drink fluids without waiting to feel thirsty.
- Some medicines can change how food tastes, cause a dry mouth or reduce appetite, which makes eating too little more likely.
- Some foods interfere with specific medicines: grapefruit with certain statins, dairy with some antibiotics, or vitamin K with acenocoumarol and warfarin.
- If appetite or weight drops, see the doctor and ask for a medication review; do not change the diet or dose times on your own.
An older person who takes many medicines should eat a varied, nutrient rich diet, stay well hydrated and know which foods can interfere with their treatment. It is not about banning foods across the board, but about knowing which combinations to avoid or space out depending on the specific medicines they take.
In this article we go over the best known interactions, how to fit meals and doses together, and what to do when the person eats very little.
Why does diet matter more when someone takes many medicines?
Because medication can affect how a person eats and food can affect how medication works. MedlinePlus explains that some medicines can change how food tastes, cause a dry mouth or reduce appetite.
Needs also change with age: people usually need fewer calories but the same nutrients, and some need more protein. MedlinePlus also points out that some people lose their sense of thirst as they age, so it is wise to drink fluids throughout the day without waiting to feel thirsty. Living alone, problems chewing or swallowing, or difficulty cooking are other factors that make eating well harder.
Which foods can interfere with medication?
The best known interactions affect specific medicines, not all of them. These are some of those described by official sources:
| Food | Medicines affected | What is recommended |
|---|---|---|
| Grapefruit and grapefruit juice | Some statins (simvastatin, atorvastatin) and some calcium channel blockers (felodipine, nifedipine) | Avoid it if the leaflet or pharmacist says so: it can increase the amount of medicine in the blood |
| Milk and iron supplements | Fluoroquinolone antibiotics (such as ciprofloxacin) and bisphosphonates (such as alendronate) | Space the medicine and these foods about 2 hours apart |
| Vegetables rich in vitamin K (broccoli, cabbage, cauliflower) | Anticoagulants such as acenocoumarol and warfarin | Do not cut them out; keep intake steady and report sudden changes in diet |
| Soya | Levothyroxine | It may reduce absorption |
| Protein | Levodopa (Parkinson’s), in some people | Talk to the neurologist before changing the diet |
The US FDA adds that other fruits such as Seville oranges, pomelos or tangelos may have a similar effect to grapefruit, and that the effect varies with the person, the medicine and the amount. You will find more examples in our article on foods that interfere with medication.
How do you fit meal times and medication times together?
The first step is knowing, for each medicine, whether it should be taken on an empty stomach, with food or apart from certain foods. This information is in the leaflet and the pharmacist can summarise it for you.
- Next to each medicine on the list, note whether it is taken on an empty stomach, with breakfast, with lunch or at bedtime.
- Keep regular meal times, as many doses are organised around them.
- Take medicines with water unless the leaflet says otherwise.
- If the person has difficulty swallowing, do not crush or split tablets without asking first: some must not be altered.
- If meal times change (travel, hospital stays, Ramadan or other situations), ask how to adapt the doses.
What should you do if they eat little, have a dry mouth or lose weight?
Speak to the GP or practice nurse, because loss of appetite or weight in an older person should not be seen as normal and may be linked to medication. Sometimes adjusting a dose, changing the time of a dose or switching a medicine is enough.
- Offer simple but nourishing meals and healthy snacks between meals.
- Eating with others helps: MedlinePlus suggests shared meals when eating is difficult.
- Keep water or other drinks in sight and offer fluids often.
- Check the mouth and dentures: pain when chewing also takes away appetite.
- Physical activity, adapted to each person, can help bring back hunger.
Take to the appointment a list of what they eat on a normal day and another of all their medication. Our list of questions for your doctor may help.
A practical example: Rosa, acenocoumarol and vegetables
Take the case of Rosa, 80, who takes seven medicines, including acenocoumarol, a statin and a blood pressure medicine. After reading that vitamin K interferes with her anticoagulant, she decides to stop eating vegetables. At the same time, as she is hardly hungry, she skips supper and, with it, her evening tablet.
The sensible approach would be for Rosa not to cut out vegetables but to eat them regularly, and to mention her habits at her anticoagulant check. It would also be worth asking the pharmacist whether her statin interacts with grapefruit and talking to the doctor about her poor appetite. Separating the evening dose from supper, if the leaflet allows, would stop a skipped meal also meaning a skipped dose.
How can IMA Health help you?
When each medicine has its own moment in relation to meals, having them prepared by dose avoids confusion. With IMA Health, a specialised pharmacy prepares the medication by the day and time of each dose, so it is clear what goes with breakfast, lunch or supper. IMA coordinates with the pharmacy, handles home delivery and provides personalised follow-up.
Sources
- MedlinePlus: nutrition for older adults (Spanish version)
- Portal del Medicamento, Castile and León regional government: food and medicine interactions (in Spanish)
- FDA: Grapefruit Juice and Some Drugs Don't Mix
This article is for information only and does not replace advice from your doctor or pharmacist.