Senior Nutrition

Definition

Senior nutrition is concerned with the special dietary requirements of the elderly. In his book, Earl Mindell's Vitamin Bible for the 21st Century, Earl Mindell, Ph.D, R.Ph (Registered Pharmacist), Master Herbalist, and best-selling author of books about maintaining health through nutrition for the last 20 years, states, "Aging is caused by the degeneration of cells. Our bodies are made up of millions of these cells, each with a life of somewhere around two years or less. But before a cell dies, it reproduces itself. Why then, you might wonder, shouldn't we look the same now as we did ten years ago? The reason for this is that with each successive reproduction, the cell goes through some alteration—basically deterioration. So as our cells change, deteriorate, we grow old. The good news is that deteriorating cells can be rejuvenated if provided with substances that directly nourish them..

Origins

After age 50, adults experience significant reduction in metabolism (chemical action in living cells that provide energy for life's activities and assimilation of new restorative material, or the rate at which the body burns energy) and changes in physiology (body and organ functions during life) that significantly affect their nutritional needs. These changes often call for decreased-calorie diets, but there are many complications that can affect a senior's balance of food intake and energy needs.

Aging causes a decrease in lean tissue mass and an increase in body fat. These changes are significant because an older person utilizes dietary protein less efficiently and may need more than the recommended amount of high-quality protein to maintain lean tissue mass. Complications may also arise because of age-related digestive problems, oral/dental problems, and eating/nutrient problems related to medication. Other complicating factors for the elderly include loneliness, depression, economic concerns, and lack of cooking skills and nutritional knowledge (such as eating too many processed/refined foods devoid of nutritional value). These factors often result in seniors under-consuming the proper foods to meet their energy and nutrient requirements and can lead to weakness, chronic fatigue, and a weakened immune system.

Benefits

Nutritional studies have clearly demonstrated that sound dietary habits adopted by seniors can promote longevity and reverse some of the effects of aging; reduce the risks and severity of illness and disease; increase overall levels of wellness and vitality; and improve quality of life.

The three leading causes of death among adults are heart disease, strokes, and cancer. Diabetes, atherosclerosis, and liver disease are also in the top ten causes of human mortality. All of these diseases have been correlated with dietary habits and alcohol intake, and research has shown that these and many other diseases can be reversed or eliminated through dietary and lifestyle changes. Seniors, who face the most risk from these diseases, can therefore greatly benefit from healthy nutritional practices, especially if they are initiated early in life.

Description

Nearly 90% of Americans above age 65 have one or more degenerative disorders (diseases that develop over time), including heart disease, cancer, arthritis, diabetes, and osteoporosis. Once considered diseases of old age, these conditions are now also being seen as lifestyle-related diseases, which means that changes in habits, including diet, can significantly reduce their risks. For instance, Dr. Dean Ornish, a California cardiologist, demonstrated that heart disease could be reversed by a low-fat vegetarian diet combined with exercise and stress reduction techniques such as meditation and yoga. Furthermore, it has been strongly demonstrated that improper diet is directly correlated with disease and premature aging. Obesity, for example, shortens life expectancy and increases the risk of diabetes, hypertension, and heart disease. For seniors, it is never too late to adopt informed nutritional practices to improve health and chances for longer, healthier life.

Longevity studies (in which researchers attempt to determine the behaviors that contribute to long life in human populations) have shown that moderation is a key component to a life-extending diet. In the longest-living people, stability of overall body weight—where people remain consistently at no more than 5% under their ideal weight or no more than 10–20% overweight—implying moderation of diet, has been found to be very important. Moderation of alcohol intake, meaning no more than two drinks per day, is also important, as is the consistency of eating breakfast every day. As people age, their metabolism slows, making it easier to gain weight and harder to lose weight after it is put on. This factor underscores the importance for seniors to adopt diets that reduce large fluctuations in weight.

In the marketplace of dietary knowledge, the numerous fads and claims can be extremely confusing for the conscientious eater. For instance, there are diets that restrict fats and favor carbohydrates, such as the Ornish diet as mentioned above. Then there are diets that restrict carbohydrates and recommend higher amounts of fats and proteins to be consumed, like the Atkins diet that has been very popular in the mainstream of the early 2000s. The confusion can be compounded by the fact that different people and different age groups, including seniors, have different dietary requirements and tastes.

Within the alternative health care model, there are many diets that have been shown to improve health. These include vegetarianism, veganism, the Ornish diet, macrobiotics, the Mediterranean diet, juicing, the raw food diet, and others. Seniors may not have the time or energy to experiment with various diets until finding a satisfactory one, nor is it advisable that seniors enforce strict guidelines that might take the pleasure and freedom out of eating and preparing food. Nutrition is made easier within the alternative health care model because there are simple principles that can be applied to make any senior's diet more nutritionally sound.

Another healthy diet model for seniors contains a wide variety of fresh fruits and vegetables, whole grains, and legumes (peas, lentils and beans, including soybeans and soy products), and is moderate in the consumption of animal products including meat, eggs, and dairy products. In this diet, the majority of daily calories, or energy, comes from fruits, vegetables, whole grains, legumes, and nuts and seeds—all plant sources. This plant-based diet is naturally high in fiber, which is important for seniors because fiber assists in the digestive process, which is slower and more sensitive in the elderly. Eating fiber also lowers blood cholesterol levels. A sound senior diet also contains adequate protein, derived primarily from vegetable and low-fat animal sources; avoids the intake of saturated fat, which raises cholesterol levels in the blood; and emphasizes the careful intake of healthy fats.

In the alternative health care model, there are general principles that make dietary choices easy and uncomplicated, which in itself is important for the elderly. First, food should be as fresh and in as close to its natural state as available. Fresh and natural food contains the highest amount of life energy, sometimes known as chi or prana, which can be lost when food is overly processed, over-cooked, or stale. Furthermore, fresh food, such as fresh fruits and vegetables, contains no harmful food additives and no added ingredients such as sugar and fat, both of which should be consumed only in moderate amounts by seniors. Fresh and natural foods are also more nutrientdense than processed foods, which means that they contain more vitamins and minerals for the same amount of calories. This is particularly important for seniors, who should strive to maximize the intake of nutrients while maintaining consistent body weight and not consuming more calories than are needed. Foods that contain empty calories—that is, calories without other nutrients, such as foods that are high in sugar or junk foods—should be reduced to very minimal levels in the diet.

More and more health-conscious people have turned to the alternative of juicing fresh vegetables and fruits as a healthy supplement to daily meals because they provide concentrated essential nutrients, vitamins and minerals that the body does not have to first chew and digest. This process requires the purchase of a juicer, the price of which runs from $100 to $500.

Another principle within the alternative health model is a holistic view of the world. Humans are connected to the whole living system of the earth. Food choices that are healthiest for the individual would also be better for the earth; and likewise, keeping the earth's living system healthy improves the health of the human population. It has been estimated that worldwide, 33% of all disease is related to environmental degradation. Thus, organically grown foods are the healthiest choice for consumers. The production of those foods is safest for them and the environment because they contain no toxic chemicals. Healthy fresh organic food choices would also eliminate unnecessary packaging and artificial ingredients. Healthy choices also emphasize locally grown foods, which reduce the loss of nutrients due to transportation and refrigeration. Finally, eating seasonal fruits and vegetables keeps the diet aligned with the natural rhythm of the seasons.

Food can be broken down into the categories of carbohydrates, fats, and proteins. Nutritional science attempts to determine the optimal quantities of each in the diet. Some diets are very rigorous about the measurement of overall calories and exactly how many carbohydrates, fats, and proteins should be included, but general dietary guidelines should suffice for most seniors.

Carbohydrates are a basic energy source found in foods and can provide up to 70% of daily calories in a senior's diet. The simplest carbohydrates are sugars, such as those found in fruits, honey, table sugar, and corn syrup, while complex carbohydrates are found in whole grains and legumes and other plant and animal sources. Small amounts of sugar are not unhealthy, although sugar is no substitute for nutrient-rich foods. A piece of fresh fruit, for instance, would be a far better choice for a sweet tooth than a soft drink. As Dr. Earl Mindell indicates, "The big problem with sugar is that we eat way too much of it and often don't even know it." He implicates sugar in tooth decay and obesity, which can lead to heart disease, diabetes, hypertension, gallstones, back problems, and arthritis. He also points out that its presence in foods tempts one to eat more; and that if calories are reduced without reducing sugar intake, more nutrients than pounds will be lost. Complex carbohydrates are a healthier source of energy and fiber, and whole grains, pastas, breads, beans, cereals, fruits, and vegetables are recommended to supply them in the diet.

Seniors should pay close attention to the amount and type of fat in the diet. The Ornish diet, shown to reverse the effects of heart disease, recommends no more than 10% of all calories coming from fat, and cautions against any saturated fats, or those fats that are present mainly in meat and dairy products as well as in tropical oils like palm and coconut oils, and some nuts and seeds. Some seniors may not need to be this stringent about fats in the diet, but just getting fat content down to 20–30% of total calories will reduce the risks of disease and improve overall health. Generally saturated fats, for seniors, should be greatly reduced and avoided as much as possible. The best fats to consume are generally from such plant sources as olive oil and canola oil, which are the healthiest choices for cooking oils; and occasional use of avocados, nuts, seeds, and nut butters. Clarified butter (ghee) is a substitute for butter, which contains high amounts of saturated fat and should be avoided.

Seniors should also take care to get plenty of essential fatty acids (EFAs) in the diet, particularly omega-3 EFA and omega-6 EFA, important nutrients for the elderly and essential fats for the body. Omega-3 EFA is found in cold-water fish like salmon and mackerel as well as in walnuts, wheat germ, and flaxseed. EFAs can also be obtained in such nutritional supplements as evening primrose oil, wheat germ oil, borage oil, flaxseed oil, and hemp seed oil.

Finally, seniors should take care to avoid the consumption of trans-fatty acids (TFAs). These are artificial fats that are created during industrial cooking processes, and have been widely implicated in heart disease and atherosclerosis. These unhealthy oils are found in margarine, vegetable shortening, and partially hydrogenated oils, which are present in many processed foods. Deep-fried foods should also be avoided, which contribute these unhealthy fats to the diet. By paying close attention to ingredients and then avoiding partially hydrogenated oils, seniors can avoid many unhealthy foods.

Proteins are the basic building blocks used by the body. Americans in general consume more protein than is required, and the excess consumption of red meat, dairy products, and eggs, all high in saturated fats, contributes to the prevalence of many degenerative diseases. Seniors should be careful to not eat too much protein, particularly from meat, dairy, and egg sources. Excess protein in the diet can stress the digestive system, liver, and kidneys, and also contribute to the development of osteoporosis, or weakness of the bones due to calcium loss—a condition afflicting many seniors, particularly women. Two to four ounces (57–113 g) of protein per day is sufficient for most seniors, which would be a piece of lean meat the size of a deck of cards, or a several servings of soy or beans. Healthy sources of protein include legumes, tofu, nuts and seeds, low-fat dairy products, fish, egg whites, and lean meats. Soy products are an excellent addition to the senior diet, providing high-quality and low-fat protein while containing several age-protective nutrients.

Other dietary habits can help seniors optimize nutrition. Sound diets contain a variety of wholesome foods. At least five servings per day of fruits and vegetables are recommended. Variety is important to provide a full range of vitamins and minerals, and helps seniors avoid eating too much of any food that may not be the healthiest. Furthermore, seniors should strive to eat less rather than more at mealtime, and to stop eating while still slightly hungry. Overeating inhibits digestion and causes weight gain, which healthy seniors avoid doing. Regular exercise also contributes to sound nutrition by improving metabolism and digestion and thus the absorption of nutrients by the body. Food choices should not inhibit seniors' autonomy and freedom but enhance them. Food preparation should emphasize taste and the pleasure of eating. Seniors should also drink plenty of fresh clean water as part of their diet. Spring water or filtered water is best, and up to eight glasses per day is recommended. Drinking plenty of water prevents dehydration (which can lead to low blood pressure, heat stroke, nausea, dryness of mouth, vomiting, and constipation); improves digestion; and helps the body flush out impurities. Green tea is a healthy substitute for coffee, as it contains an antioxidant shown to have anti-aging effects as well as less caffeine.

Caffeine is really a drug with many unhealthy side effects. Although it acts quickly on the central nervous system, resulting in almost immediate increased mental clarity and energy, caffeine accumulates in the fat tissues of the body and can lead to nervousness, exhaustion of the adrenal gland, the loss of important vitamins and minerals from the body, and increased acidity in the gastrointestinal tract, caffeine can also dangerously increase heart and blood pressure rates when consumed with decongestants or bronchodilators. It is considered by some doctors to be implicated in hypertensive heart disease. Medical schools and journals have linked excessive caffeine consumption to benign breast disease, prostate problems, cancer of the bladder and lower urinary tract, and heart attack.

Nutritional and Herbal Supplementation

Seniors can inform and avail themselves of the many nutritional and herbal supplements available for specific health problems by consulting alternative physicians—M.D.s, osteopaths, naturopaths, homeopaths, chiropractors—and herbalists for recommendations. They can also consult many books on vitamins, minerals, and nutritional/herbal supplements, and find a great deal of information on this subject on the Internet.

Senior nutrition includes two additional ways in which the elderly can fulfill their nutritional requirements. Although there is ample evidence that a varied and plant-based diet consisting of fresh fruits, vegetables, whole grains, legumes, and moderate amounts of animal products prolongs life expectancy and improves overall health, informed use of nutritional supplements can add extra protection and support for the mature body, and herbal supplements can be safely used to support the treatment of age-related illnesses and as general health tonics.

It should again be noted that there is general acceptance that the best way for seniors to get plenty of nutrients is through a varied diet, because supplements cannot make up for a diet that is not nutritionally balanced in the first place; that nutrients from food sources are more efficiently utilized by the body; that seniors should try to add natural foods to their diets that are high in nutrients known or recommended to help in the treatment of certain disease or degenerative conditions; and that nutritional supplements can then be properly used to supply any extra support or protection that seniors may need.

Generally if a senior is eating a balanced, healthy diet over 1,200 calories a day, vitamin-mineral supplement may be unnecessary. However, some physicians think that much of today's food is grown in soil depleted of nutrients and a high-quality, broad-spectrum multivitamin and mineral supplement, taken once per day, is frequently recommended to seniors to supplement their diets by providing a range of nutrients. It should contain the B vitamins B₆, B₁₂, and folic acid, which may help prevent heart disease, and the minerals zinc and copper, which aid the immune system. Some nutritionists advise that seniors should take a multi vitamin/mineral supplement that provides no more than 100% of the recommended daily allowance (RDA), and caution against taking one nutrient by itself because nutrients interact with each other and single-dose nutrient interaction can be harmful, even toxic, and may actually cause a deficiency of another nutrient.

In addition to a multivitamin, many health professionals, however, advise seniors to add antioxidants to their supplementation routine. These include vitamin A (or beta carotene), vitamin C, vitamin E, and the mineral selenium. Antioxidants may have several positive effects on the body, such as slowing the aging process, reducing the risks of cancer and heart disease, and reducing the risks of illness and infection by supporting the immune system.

Coenzyme Q₁₀ is another antioxidant that is gaining use by the elderly, as it may retard aging, improve the health of the heart and reduce the effects of heart disease, help lower blood pressure, aid in treatment of periodontal disease, help lower blood pressure, and aid in the prevention of toxicity from drugs used to treat many diseases associated with aging.

Essential fatty acids, particularly omega-3, are also recommended for seniors, as, according to Andrew Weil, M.D., author of Spontaneous Healing," they appear to reduce inflammatory changes in the body, protect against abnormal blood clotting, and, possibly, protect against cancer and degenerative changes in cells and tissues."

Calcium supplementation is recommended for the elderly, particularly for women, to strengthen bones and prevent bone loss. Also, the senior stomach may secrete less hydrochloric acid—the enzyme involved in food digestion, which may reduce the amount of calcium that is absorbed. Calcium supplements that are balanced with magnesium have a less constipating effect on the bowels and are better absorbed.

Another nutrient concern is sufficient intake of iron. Many sources of iron need to be eaten to get enough. While the best source or iron is meat, people can also get iron from whole grains, cooked dry beans, and some fruits and vegetables. Vitamin C aids absorption of iron, so such vitamin C foods as citrus fruits, greens, and tomatoes should be included in the same meal with iron.

The supplement glucosamine sulfate, together with chondroitin and MSN, may be useful for seniors with joint problems and pain.

Such natural sources of fiber as psyllium seed husks may be used by those seniors who need added fiber in their diet.

There are many herbs that support vitality and health in old age. In Chinese medicine, ginseng has been the fabled elixir of youth, and astragalus and ginkgo are also recommended to the elderly. Ginkgo has been shown to enhance memory and brain function. Grape seed extract and pine bark extract (pycnogenol) are herbal derivatives that have powerful antioxidant, and thus anti-aging, effects in the body. In the Ayurvedic or traditional East Indian system, ashwaganda and gotu kola are herbs prescribed for their rejuvenating effects on the elderly, and triphala is used to improve digestion and as a mild laxative. Seniors can inform themselves of the many herbs available for specific problems, and also consult alternative physicians and herbalists for recommendations on herbal supplements.

BOOKS

Chopra, Deepak, M.D., and David Simon, M.D. Grow Younger, Live Longer. New York: Harmony Books, 2001.

Kordich, Jay. The Juiceman's Power of Juicing. New York: Warner Books, 1993.

Mindell, Earl, Ph.D, R.Ph. Vitamin Bible for the 21st Century. New York: Warner Books, 1999.

Null, Gary, Ph.D. Gary Null's Ultimate Anti-Aging Program. New York: Kensington Books, 1999.

Walford, Roy, M.D. and Lisa Walford. The Anti-Aging Plan. New York: Four Walls Eight Windows, 1994.

Weil, Andrew, M.D. Eating Well for Optimum Health. New York: Alfred A. Knopf, 2000.

Weil, Andrew, M.D. Spontaneous Healing. New York: Ballantine Books, 1995.

PERIODICALS

Natural Health. <http://www.naturalhealthmag.com.>.

Vegetarian Times. <http://www.vegetariantimes.com.>.

ORGANIZATIONS

Center for Science in the Public Interest. 1875 Connecticut Avenue NW, Suite 300. Washington, D.C. 20009. (202) 332-9110. <http://www.cspinet.org.>.

OTHER

U.S.D.A. Food and Nutrition Information Center. <http://www.nal.usda.gov/fnic>.

Vegetarian Resource Group. <http://www.vrg.org.>.

Douglas Dupler

Ruth Ann Carter