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A Senior's Guide To Good Nutrition

[source]

by Suzanne Havala, M.S., R.D.

Topics in this article:

• Introduction to Diet and Aging

• Do Seniors Have Special Nutritional Needs?

• Who Should Be Concerned About Their Diet?

• Should I Take Supplements?

• How Can My Diet Help Me?

• Constipation

• Gas and Heartburn

• Chewing and Swallowing Problems

• What If I Have to Follow a Special Diet?

• What If I Have No Appetite?

• Common Problems and Suggested Solutions

• How Can I Make Preparing Meals a Little Easier?

• Handy Hints for Quick Meals

• Does Eating Well Have To Be Expensive?

• What Food Assistance Programs are Available for Seniors?

• Summing It All Up

• Sample Meal Plan

• Recipe Suggestions

Introduction to Diet and Aging

Relatively little is known about how the nutritional needs of older people differ from those who are younger. Although many people enjoy a generally healthy and vital old age, age-related health problems do increase with advancing years and often have an effect on eating habits.

The science of gerontology, or the study of normal aging, is still quite new, and science is giving us new insights into aspects of aging that in the past have been accepted as "normal." While there is a similar pattern of changes that takes place among all humans as they age, these changes can occur at different rates in different individuals. We do not know how much of this difference is due to genetic make-up, and how much is due to lifestyle factors such as diet.

There is abundant evidence to show that an optimal level of nutrition can extend the lifespan and improve the quality of life. A large body of research examining the health of vegetarians, who typically consume a diet that is lower in calories, saturated fat, and protein, and higher in fiber and phytochemicals than nonvegetarians, shows that vegetarians suffer from less heart disease, obesity, high blood pressure, diabetes, and some forms of cancer. Vegetarians also tend to live longer than nonvegetarians.

Good eating habits throughout life can help to promote physical and mental well-being. For older people, eating right can help to minimize the symptoms of age-related changes that, for some, can cause discomfort or inconvenience. Although the aging process affects some people differently from others, everyone can benefit from eating a well-planned vegetarian diet.

Do Seniors Have Special Nutritional Needs?

Very little is known about how the aging process affects the body's ability to digest, absorb, and retain nutrients such as protein, vitamins, and minerals. Therefore, little is known about how the nutritional needs of older people differ from those of younger adults. Recommended nutrient intakes for seniors are currently extrapolated from those of younger adults.

One point that is generally agreed upon, however, is that older people tend to take in less energy, or calories, than younger people. This may be due, in part, to a natural decline in the rate of metabolism as people age. It may also reflect a decrease in physical activity. If the total intake of food decreases, it follows that intakes of protein, carbohydrate, fat, vitamins, and minerals also decrease. If calorie intake is too low, then intakes of necessary nutrients may also be low.

Many other factors can affect the nutritional needs of older people and how successfully they meet those needs, including their access to food. For instance, some of the changes that take place as people age can affect the kinds of foods they can tolerate, and some can affect their ability to shop for or prepare food. As people age, problems such as high blood pressure or diabetes become more common, necessitating certain dietary modifications. Digestive system problems become more common, and some people may have trouble chewing or swallowing.

Generally, current dietary recommendations for adults also apply to older people. These are summarized in the following chart:

1. Limit:

• sweets

• regular coffee and tea

• greasy or fatty foods

• alcohol

• oil, margarine, and "junk" foods

• other added fat

• salt

2. Eat plenty of:

• fruits

• whole grain breads and cereals

• vegetables

3. Drink plenty of fluids, especially water

Who Should Be Concerned About Their Diet?

Young or old, it pays to eat well and understand some nutrition basics. For starters, since food intake usually declines with age, it may be increasingly important for older people to make sure that what they do eat is nutritious. There may be less room in the diet for sweets and other "empty calorie" foods, which provide little in the way of nutrition in exchange for the calories they contribute to the diet. Eat fewer snack chips and commercially made cakes and cookies, and do your best to limit soft drinks, candy, and alcohol.

A sensible program of exercise, such as walking, may also be wise. People who are physically active have an easier time controlling their weight while still taking in more calories than those who are sedentary. The higher the calorie intake, the more likely a person is to obtain all the nutrients he or she needs.

A simple way to assess your own diet is to keep a written log or diary of everything that is eaten over a period of a few days to two weeks. Include some details about how foods were prepared, and be sure to make a note about portion sizes. Then compare the results to the general guidelines above. Write down ideas for improvement in areas that need some attention.

Should I Take Supplements?

With few exceptions, vitamin and mineral supplements are rarely necessary for people who eat a varied diet and enough food to meet their energy needs. In fact, taking large doses of some vitamins and minerals may cause imbalances in body stores of others, and some are toxic at high levels. Your best bet is to get the nutrients you need from whole foods, without the use of a supplement, unless otherwise directed by your dietitian or physician.

How Can My Diet Help Me?

Digestive system problems are the most frequent source of discomfort for older people. Sometimes these problems cause people to avoid foods that would otherwise be a healthy addition to the diet. For instance, flatulence or intestinal gas may prompt some individuals to forgo certain vegetables such as cabbage or beans, which are good sources of vitamins, minerals, and fiber. In other cases, adding more of certain types of foods can reduce the severity of some problems. Let's take a look at how a well-planned diet can help with a variety of common complaints.

Constipation

Constipation can result from not drinking enough fluids and by eating a diet that is too low in fiber or bulk. Certain medications, including antacids made with aluminum hydroxide or calcium carbonate, can also cause this problem, and it can be made worse by the habitual use of laxatives.

There are several things that people can do to prevent constipation from. Including a liberal amount of whole grain breads and cereals in the diet, as well as plenty of vegetables and fruits, is a start. Eating dried fruits such as prunes or figs, or drinking prune juice, may also help, since they have a natural laxative effect for many people. Drinking plenty of fluids is very important, and water is the best choice. Most people should drink six to eight glasses of water or other fluids each day. 

Foods that are high in fat, such as many sweets, meats and high fat dairy products, oils and margarine, or fried foods should be limited. These foods are very calorie dense and may displace foods that would otherwise provide needed fiber in the diet. Decreasing the consumption of fatty foods may also lessen the need for antacids. Don't forget, too, that a regular routine of exercise is effective in promoting good muscle tone and preventing constipation.

Gas and Heartburn

Many people experience general abdominal discomfort after eating, which may include belching, intestinal gas or flatulence, bloating, or burning sensations. These complaints have many causes, including overeating, eating too many high-fat foods, alcohol, or carbonated beverages, swallowing too much air when eating, lying down to rest immediately after eating, and taking certain drugs or aspirin. Switching to a diet that is high in fiber may also cause some flatulence at the start, although it usually lessens as the body adapts to the increased fiber intake.

One way to help relieve problems such as these is to eat smaller, more frequent meals over the course of the day instead of eating one or two larger meals. Avoiding fatty foods, alcohol, and carbonated beverages is a good idea, too. It may also be helpful to eat slowly and to chew food thoroughly before swallowing. If heartburn is a problem, avoid reclining immediately after meals, or if you do so, keep the back elevated to at least 30 degrees so that you are not lying flat on your back. Regular exercise can also help to minimize trouble with intestinal gas.

Chewing and Swallowing Problems

These may occur for a variety of reasons. For people who have trouble chewing foods, it may be helpful to cut food into small pieces and to allow extra time to chew food at a comfortable, unhurried pace. Cooking some fruits and vegetables may also be helpful and necessary for some. Poorly fitting dentures should be checked by a dentist and possibly replaced.

Drinking plenty of fluids can alleviate some swallowing problems if the throat or mouth is dry, which may be caused by certain medications or may simply be related to commonly-occurring changes that accompany the aging process. Lozenges or hard candies may be helpful in keeping the mouth moist. It may be necessary to ask your physician about whether or not a particular medication may be contributing to the problem.

What If I Have to Follow a Special Diet?

The older people get, the more likely it is that they will develop medical problems that require a special, or therapeutic, diet. People who develop diabetes, high blood pressure, and heart disease, for instance, may have special considerations in meal planning. Most conditions, however, benefit from a diet that is high in fiber from whole grains, fruits, and vegetables, and low in animal products. 

Well-planned vegetarian diets can help to control blood sugar levels. By limiting fat, salt, and sugar, vegetarian diets can also be useful in controlling high blood pressure, heart disease, and other conditions. However, since individuals vary in their needs, those who must follow a special diet should consult a registered dietitian for more detailed recommendations and help with meal planning.

Many people also wonder if diet can help to treat conditions such as arthritis and osteoporosis. At present, no conclusive evidence exists to recommend one kind of diet over another for the treatment of arthritis. However, a lowfat vegetarian diet may be helpful in promoting normal weight, which, in turn, may help reduce or prevent some symptoms of arthritis.

The risk for osteoporosis is influenced by many factors, including diet. Diets that are excessively high in protein and sodium can accelerate the loss of calcium from bones. Vegetarian diets tend to be moderate in protein content and, when care is taken to avoid processed foods, they can be lower in sodium as well. Including plenty of greens and other vegetables in the diet will help to ensure an adequate intake of calcium.

One of the most common surgical procedures for older people is cataract surgery, and there is a considerable amount of research being conducted presently on the relationships between diet and the incidence of cataracts and macular degeneration.

What If I Have No Appetite?

Depression because of changes in living conditions, loss of companions, certain medications, and complications in preparing meals can all result in a loss of interest in food. Sometimes eating smaller, more frequent "mini-meals" can help. It may also be a good idea to seek out meals in a social context. For instance, local vegetarian societies may have regular organized potluck dinners or restaurant outings that provide an opportunity to make new friends and enjoy a meal in the company of others.

Some common nutrition-related problems that older people encounter, and suggestions for dealing with them, are summarized in the following chart:

Common Problems and Suggested Solutions

How Can I Make Preparing Meals a Little Easier?

Some older people may find meal planning is more burdensome if shopping or preparing meals is difficult. Arthritis, for instance, or impaired hearing or poor eyesight may make it hard to drive to the grocery store, to read food labels or package instructions, or to open bottles and handle cooking utensils. It may also be difficult to maintain the motivation to cook for only one or two people.

For all these reasons, it may be necessary for meals to be simple, quick, and convenient to prepare. Ready-to-eat, whole grain breakfast cereals are a nutritious meal or snack anytime, as are quick-cooking hot cereals like oatmeal, which can be cooked in a microwave oven. Fresh fruit is also convenient, but canned fruits, packed in their own juice or water, will keep for months in the cupboard and can also make a simple snack. Whole grain breads, bagels, and lowfat muffins can be kept in the freezer and individual servings taken out as needed. Other good freezer and cupboard staples include bags of mixed, plain frozen vegetables, whole grain crackers, peanut butter, canned beans such as pinto beans or black-eyed peas, and jars of vegetable salads such as three-bean or beet salad.

It also makes sense, for those who are able to do more extensive cooking, to fix enough of a recipe so that some can be frozen in small batches to be reheated at a later date. For example, bean chili, vegetable lasagna, some casseroles, whole grain cookies, lowfat muffins, or pancakes all freeze well and can be stored in small containers that can be reheated in a conventional or microwave oven.

Handy Hints for Quick Meals

Does Eating Well Have To Be Expensive? 

For many elderly people, a limited income or limited access to transportation to a grocery store can complicate meal planning. So, good planning can not only be efficient, it can also be economically helpful as well. Foods prepared from scratch at home are usually less expensive than packaged mixes and frozen entrees, for example, and the cook has more control over what ingredients are used, also. For example, salt or fat in a recipe can be reduced when food is prepared at home, or whole wheat flour can be substituted for refined white flour.

Wise food choices can help save money. Buying in bulk, whether an item is on special or not, can be cheaper than buying small containers of food, although storage space must be available. If a person has access to food outlet stores, substantial savings can be had on things such as baked goods or breads. If freezer space is available, trips to an outlet can be less frequent. Coupon clipping, especially for brands that are usually purchased anyway, can save as much as 10% off food bills. Many stores offer double or triple the face value of the coupon. On the other hand, store brands of certain items can be much cheaper than name brands, even after coupon discounts, and often with little detectable difference in quality. Paper goods, canned goods, jams and jellies, and breakfast cereals are just a few examples of items which may have store brand or generic options.

There are certain food items that tend to be relatively costly and also should be limited for health reasons for most people. Sweets, especially prepared desserts such as cakes, pies, and cookies, and junk foods such as chips and other fried snacks, snack cakes, and some candies can be fairly expensive. High-fat dairy foods such as cheese and ice cream are relatively expensive, and for non vegetarians, meat is typically the costliest item on the grocery list.

Desserts can be prepared at home, with alterations in the recipe to make them more nutritious, and money can be saved. Junk food snacks can be replaced with less expensive snacks such as air-popped plain popcorn, mixtures of dry cereals, bagels, whole grain muffins, or seasonal fresh fruit. If cheese is eaten, buy small quantities and use it sparingly. Add a sprinkling of grated cheese to salads or on top of a casserole or sandwich, rather than using it as a more prominent ingredient. Meatless meals, incorporating mixtures of vegetables, whole grains, and legumes such as canned or rehydrated beans and lentils, are economical and healthful, not to mention delicious.

What Food Assistance Programs are Available for Seniors?

Food assistance programs, such as food stamps, can increase buying power for people who are eligible. Food delivery programs, such as Meals-on-Wheels, are also available for people who are housebound or have difficulty getting around or preparing meals. Congregate meal programs are available in some areas, where older people can meet in a central location to enjoy a meal in the company of others, and transportation is frequently provided to the meal site.

It is usually necessary to ask if vegetarian meal options can be made available, and the ability of food service personnel to accommodate the vegetarian's needs may vary from site to site or city to city. If there is difficulty in obtaining vegetarian meal options, contact the local vegetarian society. They may be able to refer the problem to a local dietitian-member for assistance. Find out if others are interested in lowfat vegetarian meal options. Quantity recipes are available from the Vegetarian Resource Group and other organizations, and these can be provided to food service directors or dietitians who may be able to incorporate them into menus.

Meal delivery programs may be organized by community nonprofit organizations or health and social service agencies such as hospitals, churches, nursing homes, and visiting nurses associations. To determine who is eligible, call these organizations directly. Otherwise, people can be referred by another family member, a physician, a visiting nurse, or a social worker.

Grocery delivery service is also available at stores in some communities. For people who have trouble finding transportation to the grocery store, or for those with physical limitations, a list can be phoned in to a local grocery store and someone will deliver the purchases to the home.

Summing It All Up

A well-planned vegetarian diet is health-supporting for all ages. While age-related changes affect different people in different ways, a good diet can help to overcome or reduce symptoms of certain problems that may become more common with age.

Sample Meal Plan

Recipe Suggestions

Recipe Suggestions from Simply Vegan 

• Blended Delight (p. 18)

• Apple Raisin Spice Muffins (p. 20)*

• Banana Muffins (p. 21)*

• Corn Bread (p. 21)*

• Oatmeal Medley (p. 22)

• Cindy's Light and Fluffy Pancakes (p. 23)*

• Garbanzo Spread (p. 28)

• Peanut Butter and Fruit (p. 29)

• Popcorn Treat (p. 34)

• Mini Pizzas (p. 34)

• Apple Celery Salad (p. 41)

• Easy Pasta Salad (p. 44)

• Quick Pea Soup (p. 47)*

• Creamy Lentil Soup (p. 49)*

• Tomato/Zucchini Stir-Fry (p. 57)

• Vegetable Medley (p. 58)

• Mexican-Style Chickpeas (p. 73)

• Bean Tacos (p. 83)

• Pumpkin Casserole (p. 83)*

• Hearty Macaroni Dinner (p. 87)

• Broccoli Pasta Dish (p. 88)

• Ginger Cookies (p. 109)*

• Chocolate Pudding (p. 108)

• Karen's Creamy Rice Pudding (p. 115)

* indicates items which can be prepared ahead and frozen

Suzanne Havala is a nutrition advisor for The Vegetarian Resource Group.

Reprinted from Meatless Menu Alternatives for Seniors-The Vegetarian Resource Group.