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FFA Issue 20 - A Recipe for Better Health in the Golden Years

March 2004

First step, measure out the calories, not too much...

With age, changes in body composition decrease calorie needs. Balancing calorie intake to avoid weight gain or losing weight if overweight is increasingly important, as weight increase can become a risk factor for diseases such as diabetes, cardiovascular disease, and arthritis. A reliable way to control calorie intake is by adopting a low-fat diet, as fat is the most calorie-dense nutrient.

and not too few calories...

A very low calorie intake is also not advisable, as it can cause loss of body fat and muscle mass. On average, adults lose 2% of lean muscle mass every year of life and in the long term, muscle loss can result in frailty, disability and loss of independence. A sensible diet (avoiding crash diets for example) along with regular physical activity can prevent loss of muscle mass. The old maxim use it or lose it, is highly appropriate here, as use of the major muscle groups through exercises such as swimming, walking, climbing the stairs, or more active, organised activities and sports, can help slow the loss of muscle and as a result improve strength, balance and body metabolism.

Contrary to popular belief, basic nutrient needs do not decrease with age. In fact, decreased absorption of nutrients with age and medications that interfere with nutrient absorption might result in an increased need for some nutrients. Indeed, higher intakes of some nutrients might be especially beneficial in later life. For example, more antioxidants (to fight free radical damage associated with aging), vitamin D and calcium (to keep the bones strong), folic acid (to retain mental acuity and reduce the incidence of stroke and heart disease) and vitamin B12 (to maintain nerve function) (1).

Remember also that a slight deficiency of some nutrition, may not only impact physical health and wellness, it may also adversely affect a person’s mood and sense of well-being.

As calorie intake is limited, opt as much as possible for nutrient-dense foods that are low in fat and calories. Fortified foods with added vitamins, minerals, antioxidants or other beneficial substances such as omega-3 fatty acids might also be a useful way of boosting the nutrition content of the diet. Though wise food choices are the basis of good nutrition, a multivitamin and mineral supplement or supplementary beverage might be beneficial for some (2). There are a number of studies which found nutritional supplementation improved health status: Correction of vitamin D deficiency for example improved the ability of frail elderly to function independently; B-complex and vitamin C supplements led to desirable increases in body weight; liquid supplements of protein and other nutrients improved the clinical outcomes in older people with hips fractures; correction of marginal thiamine deficiencies led to an increase in appetite and decrease in fatigue; and modest vitamin and mineral supplementation improved immune-system functioning (3).

Constipation is a common problem in old age because of diminishing gut function and inactivity. Adequate fibre and fluid can help combat the problem of constipation and a high-fibre intake also helps lower cholesterol levels and reduce risk of cardiovascular disease and cancer.

Whole grain cereals, fruit, vegetables, lentils, peas and beans are all good sources of fibre. For those who cannot chew, fibre-rich food should be chopped really fine, mashed or blended. As the sensation of thirst can diminish with age, a concerted effort to drink regularly and frequently throughout the day will help ensure that the daily target of 2 litres per days is achieved (2).

New research is proving that exercise and physical activity are safe for people of all ages and physical conditions - everyone can benefit from exercise and physical activity. Scientific experts say that an active lifestyle and exercising regularly can help prevent or delay diseases and disabilities; boost appetite; improve the health of those who have age-related illness; promote strength, balance, flexibility, and endurance – all factors which help an individual stay independent; improve mood, relieve depression and enhance the sense of well being; help older adults enjoy life and improve the quality of their lives.

The National Institute of Aging in the US advises at least 30 minutes of activity a day that makes you breathe harder. Engaging in three 10-minute sessions or one continuous 30-minute bout of exercise is a matter of personal choice, either will generate the same benefits. Strength training is also beneficial, building muscle, increasing metabolism, and helping to keep weight, and blood sugar in check (4).

Sometimes ill health such as arthritis and failing eyesight make shopping and cooking activities more difficult. Grocery deliveries and mobile markets’ might be useful. Also, home-delivered or ready-made meals can help. Eating out is also a good option, bringing the added bonus of social contact with others, and additional variety and choice.

The same dietary guidelines for food eaten at home can also be used when selecting food from street hawkers, restaurants, and take-away food.

Guiding principle in choosing a healthy diet eaten in or outside the home include: plenty of fruit and vegetables, cereals and grains (especially wholegrain) daily; 2-3 serves of lean protein such as lean meat, fish, soya, lentils and beans, eggs, and nuts each day; 2—3 serves of high calcium foods (such as yoghurt; calcium-enriched soya milk and tofu; cheeses such as paneer or hard cheeses; cows, goats or sheep milk) every day; drinking at least 8 cups (equivalent to 2 litres) of fluid daily; and limiting fried and fatty food to 2x/ week. Sweets and other foods high in sugar, fat and calories are also fine from time to time, but the key is to eat them sparingly, in order to stay within daily calorie needs and avoid weight gain.