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Healthy Eating For Seniors
The Aging Adult
As you get older, you go through a number of cellular, physiological, and psychological changes. While many elderly individuals exhibit a decline in organ function and in metabolic activities, a number of them show no decline in functional status with age. This distinction has led to distinguishing "successful" aging from "usual" aging. The "usual aging" may reflect a lifetime of poor health habits, including poor dietary patterns, smoking, drinking, limited exercise, and other stress related factors rather than aging alone. In other words, you can help yourself age "successfully" if you look after a number of things.

As you grow older, your body becomes less forgiving, and you will have to make more of an effort to eat well and stay fit. Ideally, you've been practicing healthy eating habits throughout your life. But most of us don't live in an ideal world, and often we don't pay attention to our health until we reach middle age and beyond. But middle age is still a good time to start thinking about how to stay healthy in your later years. Your nutritional needs are pretty much the same at 40, 50, 60 and beyond as they were when you were younger--with some minor variations.
Dietary Requirements
A 10-year study of the elderly indicated that current weight, rather than age, determined energy intake in both men & women. Intake of protein, as well as fat, carbohydrate and cholesterol, decreased slightly but not significantly with age. The study suggests that changes in lifestyle over time, rather than age per se, resulted in the dietary changes observed in this healthy elderly population.

Thus, as you age you need fewer calories, but exactly how much you should eat still depends on how active you are. Since you are eating less food to maintain a healthy weight, you have to be more careful about choosing low-fat and nutrient-rich foods. As the years pass and you lose lean body mass (muscle), your metabolic rate slows down and you burn calories more slowly. Exercise is the best way to maintain lean body mass and speed up your metabolic rate.

As for vitamin and mineral requirement, even healthy elderly people may exhibit deficiencies for vitamin B6--resulting from lower intake and higher requirements; vitamin B12 and folate -- due to low intakes and malabsorption; vitamin D -- as a result of reduced exposure to sunlight, low intakes, age related decreased synthesis; and zinc -- resulting from low intake associated with low energy intakes.
Eat more fibre and calcium
Fibre is more important than ever to prevent constipation and gastrointestinal diseases such as diverticulosis (formation of pouches in the lining of the large intestine that can cause spasm or cramping).

At around age 40, calcium and other minerals start to move out of bones faster than they can be replaced. In women at menopause, the drop in estrogen (which helps bones hold on to calcium) causes greater bone loss than in men. The Ministry of Health suggest that menopausal women take 1200 mg of calcium daily and if you already have osteoporosis, the amount should be increased to 1500 mg. The National Institute of Health in the United States recommends a daily calcium intake for post-menopausal women of 1500 mg, regardless of onset of osteoporosis. To help counter the loss, women and men too--should make sure to get plenty of calcium in their diet every day. Calcium may also help to keep blood pressure low and play a role in preventing colon cancer. Calcium supplements up to 1,000 milligrams a day are recommended for people who is not getting enough of the mineral from their diet. If you take supplements, calcium carbonate and calcium citrate are the ones experts frequently recommend. Supplements derived from bone meal oyster shells, dolomite or other natural sources may contain large quantities of lead and are not recommended. Ensure that you are getting enough vitamin D (synthesized by the body when exposed to sunlight although this ability is diminished in the elderly) to aid the absorption of calcium.

Antioxidant vitamins E, C and beta carotene (a form of vitamin A) have prompted considerable discussion about their health-promoting benefits. The oxidation of lipoproteins play an important role in the development of atherosclerosis. There is some evidence that vitamin E, and possibly the other two vitamins, can retard the process. The position of the American Heart Association is to not recommend these vitamins as supplements until their value has been demonstrated in clinical studies. They currently suggest that individuals eat a variety of foods that will provide a rich natural source of these vitamins.
Causes of Nutritional Problems
Many things contribute to the risk of malnutrition in older adults. For example, chronic diseases may lead to physical limitations, as from arthritis, or to cognitive limitations, as from Alzheimer's disease. Such conditions can make shopping for, preparing, and consuming food difficult without assistance. Dental problems may incline some seniors to avoid eating foods that must be chewed well—skin on fruits and certain meats, for example. Changes in the senses of smell and taste—which can result from aging itself or from drug therapy—can cause decreases in food consumption or disinterest in, even aversion to, formerly preferred foods. By age 75, people have only half as many taste buds as they did at 30. In addition, loneliness, depression and the financial restrictions of living on a fixed income can interfere with an older person's ability to buy and prepare good food. Since food is often associated with family and social events, preparing food and eating alone can be difficult for older people who have reached a stage in life where many of their loved ones have either died or moved away. For many, a loss of appetite follows the loss of companionship. Older men who have lost their wives (who did the cooking) may be at special risk.

Taking medicine also affect nutritional status in other ways. The gastrointestinal side effects of some medications can interfere with the desire to eat. Anti-inflammatory drugs used in the treatment of arthritis, for instance, can cause stomach upset. Some medicines also affect the absorption or metabolism of nutrients: laxatives that contain mineral oil can decrease the absorption of certain vitamins, for example. Senior citizens are the most frequent users of both prescription and over-the-counter medicine, and many of them take at least several medicine daily. Medication-related nutritional problems are thus more likely among senior citizens than among younger persons.
The following tips may help provide better meals for an elderly person:
  • Obtain dental care as soon as possible. Lack of teeth and dental decay make chewing difficult, contribute to poor nutrition and also give food an abnormal taste. Bone loss makes dentures hard to fit, and many elderly people who have dentures do not wear them because they are uncomfortable.
  • If chewing is a problem, try softer foods that are well-cooked or chopped.
  • Four or five smaller meals might be easier for an older person to handle than three larger ones.
  • Add a little more spice or sugar to foods to enhance their flavor.
  • Due to the importance of getting enough calcium, ensure that you focus on high calcium foods. If milk is unacceptable, try fish with bones like ikan bilis or sardines, tofu, cooked beans or even low-fat ice cream. Take a supplement if you know you are not consuming enough calcium.
The Ministry of Community Development list public and private programs which offer meals for people 60 years of age and older at senior centers throughout the island. These programs provide social interactions that may be just as beneficial to an elderly person as the meals. For more information, visit: www.gov.sg/mcds.

One way for seniors to pack a lot of good nutrition into a little meal is to have it in a drink such as milo, horlicks or ovaltine. Add a couple of spoonfuls of milk powder to boost the protein, calcium and calorie content. Have 3-4 wholewheat crackers and a piece of fruit like papaya, mango or banana to round off the mini meal.

Adequate hydration is a chronic problem for many seniors. Decreased thirst sensation is common with aging, and some medications affect a body's ability to regulate fluid balance. Dehydration worsens symptoms of kidney dysfunction and constipation. To combat this problem, seniors are advised to drink at least 8 glasses of fluids a day.
Common Problems and Suggested Solutions
Flatulence or gas
Burning sensation, heartburn

  • Eat smaller, more frequent meals.
Belching or bloating
  • Avoid alcohol, carbonated beverages and high fat foods such as some sweets, meats, oils and margarine, and coconut milk. 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 & 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 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-fibre, low sugar 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.

Sample Meal Plan
Breakfast 1 cup cooked oatmeal with 1 tbsp. wheat germ
1 banana
Snack 1 bowl bean curd w/syrup
6 oz pure fruit juice
Lunch 1 bowl chicken mushroom noodle soup
½ cup stir-fried spinach
Glass of water
Snack 1 sardine bun
Tea
Dinner 3 oz steamed fish
½ bowl of watercress soup (includes ½ cup of watercress)
1 bowl of rice
Water
Snack 3-4 whole wheat crackers
Cup of milo/horlicks/ovaltine with added milk powder
Nutritional analysis:
1880 calories, 18% protein, 25% fat, 59% carbohydrate, 25 grams fibre


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