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 under stand 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
Flatulence or gas Eat smaller, more frequent
Burning
sensation, meals.
heartburn
Belching or bloating Avoid alcohol,
carbonated beverages,
and high fat foods such as some
sweets, meats, oils
and margarine,
and high-fat dairy foods.
Eat slowly and chew foods well.
Avoid lying down after meals.
If you do, keep head and back
elevated at
a 30-degree angle.
Consider reducing aspirin intake
Ask physician
to check medications.
Difficulty chewing See dentist if problem is
poorly
fitting dentures. Cut food into
small pieces and chew food at a
comfortable, unhurried pace.
Cook some vegetables and fruits
to soften.
Difficulty swallowing Ask physician to check medications.
Drink plenty of water. Use lozenges
or hard candies to keep throat moist.
Constipation
Eat liberal amounts of whole grains
as well as vegetables and fruits.
Try dried fruits such as prunes
or figs, or drink prune juice.
Drink 6 to 8 glasses of fluid,
especially water, each day.
Limit greasy or fatty foods such as
high-fat dairy foods, oils and
margarine,
fried foods, high fat
sweets and meats.
Limit use of antacids.
Get into a regular routine of
exercise, such as walking.
High blood sugar Limit sweets and alcohol.
See a registered dietitian
for
help with planning a high-fiber,
high-carbohydrate diet.
High blood pressure Limit salty foods.
See a registered dietitian for
help
in planning a heart-healthy diet.
Heart disease See a registered
dietitian for help in
planning a diet low in saturated fat.
Loss of appetite Eat small, frequent meals or snacks.
Also, see "Handy Hints for Quick Meals."
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.
A summary of some handy hints for quick meals follows:
Handy Hints for
Quick Meals
Cupboard staples Ready-to-eat, whole grain
breakfast
cereals; quick-cooking
whole grain cereals such as
oatmeal; canned fruit
packed in
own juice; whole-grain crackers;
nut butters; canned beans
such as
pintos or black-eyed peas; jars of
vegetable salads such as beets
or
three-bean; low-sodium vegetarian
soups; aseptically-packaged
(long-life)containers of soy milk;
popcorn; dried fruit.
Freezer
staples Frozen fruit pieces such as
strawberries or raspberries; whole
grain breads or muffins (to take
out as needed); bags or boxes of
plain,
mixed frozen vegetables;
fruit juice concentrate.
Make-aheads
Bean chili; vegetable lasagna;
(to be frozen in small vegetable and bean
soups; whole
batches and reheated grain-and-vegetable casseroles;
at a
later date) whole grain cookies, lowfat
muffins, or pancakes.
Also
keep on hand Flour tortillas; salsa and
chutneys; fresh fruit.
Shopping
tips Split bags of fresh vegetables,
such as carrots, celery, and
onions,
or heads of lettuce, with
a friend to reduce the amount of
spoiled food
that has to be thrown
away.
Shop with a list, and keep a list
on-going at home.
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 nonvegetarians, 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
Breakfast 6 oz. orange juice
1 cup cooked oatmeal with
1/4 cup chopped raisins and dates
6 oz. soymilk
Snack 1 banana
1 slice whole grain toast with
2 teaspoons peanut butter
Lunch 1
cup vegetarian chili * (* see recipe source below)
1/2 fresh green pepper,
sliced
1 corn muffin *
water
Snack 2 bagel halves with apple
butter
6 oz. soymilk
Dinner 1-1/2 cups spinach salad with onions,
mushrooms, and cherry tomatoes
2 tablespoons no-oil dressing
1 cup
cooked spaghetti topped with
1/2 cup tomato-basil sauce
Chunk of Italian
bread
2 chilled, canned peach halves
water
Snack 3 cups
plain popcorn
6 oz. apple juice
14% fat 14% protein 72% carbohydrate 30
grams of fiber
Recipe Suggestions
Recipe Suggestions from Simply
Vegan (available for $13 from The Vegetarian Resource Group, PO Box 1463, Baltimore,
MD 21203)
· 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.