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Bulletin #4210, Caregiver Series: Good Nutrition for Older Adults

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Caregiver Series

Good Nutrition for Older Adults

senior shopping at a farmer's marketPrepared by Nellie Hedstrom NS, RD, nutrition specialist, University of Maine Cooperative Extension.

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Loretta turned 73 in August and is living in the small farmhouse that she and her husband bought when they were first married. It has been a full and happy life. But with Loretta’s husband’s death last winter, things have changed. Meals used to be exciting to prepare. They shared mealtimes with each other and often went to eat at the local cafe. Loretta’s health is not as good as it was a few years ago. Her arthritis is bothering her more now that the weather is colder, and the furnace is kept low to save on fuel. What should Loretta do to manage her meals to stay healthy?

Seventy-year-old John lives in a small city in a housing project. The land on which he had built a house and raised a family was sold. The taxes were beyond what he could manage with the income from his Social Security. Eating meals is not the same anymore. John never expected to do any of his own cooking, shopping or cleaning. It’s such a bother to do those things. That was Sadie’s job. What would help John with daily meals?

Problem Signs

New living and social situations can lead to unhealthy patterns among older adults. Eating alone is one of the most common factors behind poor eating patterns. Research shows that poor nutrition results from eating alone, taking multiple medications, smoking and poor dental health. The most common nutritional problems among elderly are high fat and saturated fat diets, and low calorie meals.

A lack of variety in food choices results in a lack of nutrients essential to good health. In some countries, including the United  States, food policy suggests eating a healthy variety of foods every day. The Japanese government recommends people “eat 30 or more different kinds of foods per day.” Studies show that people who have a limited variety of foods often die younger than those who regularly eat foods from the five major food groups: grains, vegetables, fruits, meat and dairy.

Physical changes can also occur as you age. As lean body mass is lost, total water in the body decreases, body fat increases and bones may weaken. To stop these changes, read further to find ways you can eat to stay healthy.

Too Much Fat?

Too much fat in your diet can lead to a higher risk of heart disease, some types of cancer, type 2 diabetes, high blood pressure and obesity, which can cause joint pain and deterioration. Heart disease is the number one cause of death in the United States. Find ways to reduce the total fat, saturated fat and cholesterol in the diet of older adults you care for, especially if they have risk factors for chronic diseases. Here are some questions you might ask them (and yourself):

  • Have you had your blood cholesterol checked?
  • Do you eat high-antioxidant foods?
  • If you smoke, can you stop?
  • Can you increase complex carbohydrates in your diet?
  • Do you eat at least five fruits and vegetables a day?
  • Are you drinking enough water?

Shake the Salt Shaker Syndrome

No one can predict who will develop high blood pressure, another factor leading to increased risk of heart disease, kidney disease and stroke. Some salt in the diet is necessary for normal functioning of the body cells and fluid maintenance. However, when people have too much salt in their diets, there is a greater chance of high blood pressure.

Much of the sodium (salt) in the diets of many Americans comes from snack foods and from salt added to food at the table. Think of ways to reduce salt in your diet or the diet of elders you care for, especially if they are prone to high blood pressure. Here are some suggestions:

  • Learn to eat foods with less salt.
  • Read labels at the store to check the sodium content of each serving.
  • Cook things such as pasta, rice and hot cereal without adding salt.
  • Cut down or leave out the salt you use in your favorite recipes.
  • Substitute herbs and spices for the salt in recipes.
  • Don’t salt your food unless it really needs it.

Brittle Bones Can Be Strengthened

It’s never too late to improve the strength of your bones by eating calcium-rich foods and getting daily exercise. The National Academy of Sciences recommends a daily intake of 1200 mg calcium for adults over the age of 50. The National Institutes of Health recommends a daily intake of 1500 mg calcium for all adults over 65 years. Remember that vitamin D, from food, the sun, or your supplements, is important to keep bones hard and strong. When shopping for food, look for foods that are high in calcium naturally and select foods that have extra calcium added to the them. Research shows that proper nutrition and exercise can reduce the risk of osteoporosis by 50 percent or more. Women are especially prone to this bone disease. Strengthen your bones or those of an older adult you care for with these simple steps:

  • Increase your intake of dairy products, including low-fat milk products, low-fat cheeses and yogurt.
  • Eat dark, green, leafy vegetables, such as broccoli and kale. They are good sources of calcium and antioxidants.
  • If you have trouble digesting milk because your body doesn’t make enough lactase (an enzyme to break down the milk sugar, lactose), choose products with added lactase or use an enzyme supplement.
  • Hard or aged cheeses like cheddar and Swiss contain less lactose and sometimes can be better tolerated. Yogurt products have active cultures and are easier to digest.
  • Enjoy canned fish that includes the bones, such as salmon or sardines. They are good sources of calcium.
  • Regular weight-bearing exercises, such as walking, are necessary to keep bones strong for a lifetime.

Calories Do Count

Another factor that adds to the risk of having chronic disease, such as heart disease, stroke and cancer, is being overweight. Many people in Maine are clinically overweight or obese. About 60 percent of Americans are now overweight or obese. One in five Maine people are obese.

As a person ages, their need for calories decreases. An older person is usually less active physically and needs fewer calories. Since older adults eat less, it is even more important that they choose foods wisely and eat foods that are nutrient-dense.

Some older people need to add weight; this may be as hard as losing weight. Here are some ideas to help in losing or maintaining weight:

  • Find ways to be more physically active—walk, stretch, dance.
  • If you need to lose weight, change your diet to cut calories but choose foods with the vitamins and minerals you need. Try new fruits and vegetables. Select calcium-rich, low-fat dairy products.
  • If you choose a low-calorie diet to lose weight, ask yourself if it’s too expensive. Is it a diet you can follow for a lifetime? Is it unrealistic? Does it limit the variety of foods that you can have?
  • Find ways you can eat out and still maintain a low-calorie diet. Choose restaurants with heart-healthy menu selections. Try vegetarian dishes and broiled entrees instead of fried.

Quick and Easy Options

Managing meals may not be easy, especially if you have never done it, or if you have a disability resulting from an illness. Be prepared for such circumstances. Have a few meals in the freezer that you can pull out and heat in the microwave. There are many to choose from that are healthy and not very expensive. Check the labels. You will find that some are not only low in calories but are also low in fat. Add a salad with a low-fat dressing, a beverage and a low-fat dessert. You can eat well.

Don’t be reluctant to eat out and eat healthily. Many family-style restaurants, ethnic restaurants or even fast-food establishments offer excellent options for the older person who’s not interested in making meals at home. It’s much more fun to eat when you have people to talk to. It’s possible to follow the Food Guide Pyramid even when eating out.

Be creative. Get together with three friends and prepare meals for each other once a week. The fourth week of the month, you can order take-out. You’ll benefit from sharing a special time with friends. Special meals programs, such as Senior Meals, are also options.

Guidelines to Follow

Use the Food Guide Pyramid for Older Adults and the recommended servings as guideline for healthy eating. (See Food Guide below)

The water/liquid group includes the liquids that you consume daily. Eight or more glasses are recommended.

Choose items that are whole grain, including bread, cereal, grains and pasta. Six to 11 servings daily make a sound choice.

The vegetable group is also an important group for building the diet. Include three to five servings of vegetables. Select those that are bright in color.

Deep-colored fruit is a good dessert selection. Everyone needs at least two to three servings each day.

Three servings of low or nonfat dairy products can provide calcium and vitamin D.

Lean meat or alternative meat selections (beans, nuts, eggs) are also necessary for a healthy diet. Two to three servings provide the nutrients you need for the day.

Few needed nutrients are in fat and sugar section at the tip of the pyramid. Limit your intake of these.

Food guide pyramid for older adults.

A Well-Kept Secret: Elderly Alcoholism

A retired man or woman, such as Loretta or John, would be the last person you would think might have a drug or alcohol problem. However, alcohol dependency in people over 60 is much more common than you’d expect.

Many are the “late-onset” drinkers, people who do not begin to drink to excess until after they have reached the “golden years.” This may start after a crisis, such as the loss of a spouse or after retirement.

Changes in body composition and in metabolism rate allow alcohol to have a greater effect on the body than it did when a person was 45. If you know of an older adult who may have an alcohol problem, encourage them to seek help. Older people are actually more successful in treating alcohol problems than their younger counterparts.

Health and Medication

One out of five people in the United States take nonprescription medications daily, and almost half of them don’t follow the label instructions. Thirty-five percent of the patients who are prescribed medications by a doctor leave the office without information on the drug they were prescribed. Follow some rules for safe drug use:

  • Take exactly the amount of drug prescribed by your doctor.
  • Follow the dosage schedule as closely as possible.
  • Be sure you understand all instructions before starting to use a drug.
  • Never take a drug prescribed for a friend or relative. Medicines will not produce the same effects in all people.
  • Inform the health care worker of all reactions to medications.
  • Keep drugs stored in a cool, dry place.
  • Ask for easily opened containers from the pharmacist if an elder has trouble opening the child-proof containers. Remember to keep them out of reach of children.
  • Ask the pharmacist for large print names and instructions.
  • Discard all old medications.
  • Don’t mix one drug with another without the health care worker’s OK. Unless told otherwise, make sure all medication is taken until it is gone.
  • Always eat well-balanced meals, especially if you are on medication for a long period.
  • Don’t ever mix alcohol and drugs. Medications can affect taste. Also, as people age, taste cells decrease in number. Poor oral hygiene and smoking can also affect taste.

Information in this publication is provided purely for educational purposes. No responsibility is assumed for any problems associated with the use of products or services mentioned. No endorsement of products or companies is intended, nor is criticism of unnamed products or companies implied.

© 2004

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