Chapter 11. Healthier Older Adults
If you’re an older adult or perhaps playing a vital role in taking care of aging parents or grandparents, there are some nutrition and physical activity considerations to keep in mind. Getting older doesn’t mean that our quality of life or desire to be our best is any different. In fact, we usually become more aware of our health as we age. Healthful habits can help older adults enjoy daily activities, stay mobile, and be independent. Anytime is a good time to start healthy habits, no matter how old we are.
So, if you are a little older…you can still be healthier. Eating a balanced diet of nutrient- packed foods applies to all of us, but for older adults, a healthy eating plan may require a little more planning. If you have health problems or take medication regularly, it may be important to check with your health care provider for advice about changing your diet or physical activity level.
Fiber, more important than ever |
Fats and your heart
We’ve talked about how a healthy diet includes fiber-rich foods, such as fruits, vegetables, and whole grains, that offer many health benefits including protection against heart disease. Another benefit is that fiber promotes regularity. Constipation may affect older adults for many reasons—from taking certain medications to drinking less fluid.
How much fiber do you need? The recommended dietary fiber intake is 14 grams per 1,000 calories consumed. So, the more calories you eat, the more fiber your body needs. Now, figure out your fiber needs from your estimated calorie needs in your Personal Profile.
Good sources of dietary fiber include: cooked dry beans and ready-to-eat bran cereal or shredded wheat; pears and berries; dried prunes, figs, and dates; and cooked green peas, Brussels sprouts, sweet potatoes, and spinach (see appendix B-8). For a 2,000-calorie diet, you will need 2½ cups of vegetables (a source of fiber and other nutrients) each day. Consuming at least 3 or more ounces of whole grains can reduce the risk of several chronic diseases and may help with weight maintenance.
Many of us, especially if we are older, have been told to eat less fat. Fat can impact the health of our heart and arteries in positive and negative ways, depending on the type of fat. All the more reason to stay away from saturated fats, trans fats, and cholesterol. Eating too much saturated and trans fats, the type of fats that are solid at room temperature, may increase the risk of heart disease. Saturated fats can be found in animal-based products such as milk and milk products, butter, meat, and poultry. And eating too much cholesterol, a fatty substance found only in animal-based products, may also increase the risk of heart disease. It’s important to eat less than 10 percent of your calories from saturated fats.
For example, if you aim to eat 2,000 calories per day, your daily allowance of saturated fat would be less than 200 calories or 20 grams—which equals 100% Daily Value (DV) for saturated fat. And, remember, this is a limit, not a goal, meaning you do not need to achieve your DV for saturated fat! Furthermore, you should keep trans fats (often found in cakes, cookies, crackers, pies, and breads) as low as possible, and eat less than 300 milligrams per day (mg/day) of cholesterol.
Maybe you are someone who has an elevated LDL (bad) cholesterol level. Definitely, you should follow your health care provider’s advice. Those of us with elevated cholesterol may be advised to decrease our calories from saturated fat to less than 7 percent of total calories—which is about 16 grams or about 80% DV—and less than 200 mg/day of cholesterol. It’s critical to find out what’s right for a Healthier You.
Now, a few words about making wise fat choices: an immediate change you can make is to eat monounsaturated and polyunsaturated fats found in fish, nuts, and vegetable oils to reduce saturated fat calories in your diet. In fact, to help reduce the risk of heart disease, some evidence suggests eating approximately 2 servings of fish per week (a total of about 8 ounces) for people who have already had a heart attack. It may reduce their risk of death from cardiovascular disease. For more information on fats and using the Nutrition Facts label to help choose them wisely, turn to chapter 8, "Fats, Added Sugars, and Salt,".
Nearly all of us eat too much salt (sodium). As a matter of fact, on average, the more salt we eat, the higher our blood pressure—and most of the salt we eat comes from processed foods, not necessarily from the salt shaker. Surprised? Eating less salt is an important way to reduce the risk of high blood pressure, which may in turn reduce the risk of heart disease, stroke, congestive heart failure, and kidney damage.
Other lifestyle changes may prevent or delay getting high blood pressure. These include eating more foods rich in potassium, losing excess weight, being more physically active, and eating an overall healthy diet.
A diet rich in potassium helps to counterbalance some of sodium’s harmful effects on blood pressure. You may need to consult your health care provider for advice on how much sodium and potassium you should get, but in general, older adults should aim to consume no more than 1,500 mg/day (about 60% DV on the food label) of sodium, and meet the potassium recommendation of (4,700 mg/day) by eating potassium-rich food. When choosing packaged foods, check the sodium content on the Nutrition Facts label. Use the percent Daily Value (% DV) discussed in chapter 8, "Fats, Added Sugars, and Salt," to help limit your sodium intake. Older adults should not exceed about 60% DV for sodium for the day.
Did you know that, every year, an estimated 76 million people in the United States become ill from food that contains harmful bacteria? Older adults are at higher risk. Perhaps, foodborne illness has affected you, and you did not even recognize the common symptoms—an upset stomach, diarrhea, a fever, vomiting, abdominal cramps, and dehydration. It can also result in more severe illness, such as paralysis and meningitis, or even death.
It’s important that older adults, people with weakened immune systems, and individuals with certain chronic illnesses pay extra attention and carefully follow food safety advice. Here are simple steps that you and your family can take to minimize the risk—four key words: clean, separate, cook, and chill. See part IV, "Play it Safe With Food,", for details on each step, as well as proper temperatures to keep food safe when you store it, thaw it, prepare it, cook it, serve it, and save leftovers. Older adults should be particularly careful.
In addition, older adults need to avoid eating or drinking raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs or foods containing raw eggs, raw or undercooked meat and poultry, raw or undercooked fish or shellfish, unpasteurized juices, and raw sprouts.
We’ve talked a lot about the healthy eating plan: getting a variety of fruits, vegetables, whole grains, and fat-free or low-fat milk and equivalent milk products; including lean meats, poultry, fish, legumes (dry beans and peas), eggs, nuts, and seeds; and balancing calorie intake with calorie needs. Each major food group provides a variety of nutrients, so it’s important to include all food groups in your daily eating plan.
For older adults, every day it’s important to eat:
In general, older adults should get enough foods that contain calcium, potassium, fiber, magnesium, and vitamins A, C, D, and E, without eating too many foods high in calories, saturated and trans fats, cholesterol, added sugars, and salt (sodium).
We’ve already talked about some adjustments to make to our diets. Now, let’s quickly review how this fits into your daily calorie needs based on "My Personal Profile," or if you are caring for older adults, take a moment to figure out their range.
For example, a 60-year-old, sedentary woman should aim for 1,600 calories per day, while a 60-year-old, sedentary male should aim for 2,000 calories per day.
When increasing the amount of fruits, vegetables, and legumes you eat, be sure to eat them in place of less nutritious foods, not in addition to them, if weight control is part of your goal. Next, let’s work in some physical activity.
Many older adults may feel that they are too tired to be physically active or that they have earned their rest. However, physical activity is a critical part of a healthy lifestyle, and for older adults, physical activity may take on even more meaning. Continuing to live independently—doing the things that you enjoy—can be linked to being active. Increasing your heartbeat, strengthening your muscles, and increasing your flexibility contribute to physical fitness and the ability to do everyday activities like climbing the stairs, shopping for groceries, and visiting with family and friends.
Older adults may want to consult with their health care provider, if they have certain chronic diseases or are taking medications, before starting vigorous physical activity. Let’s also clear up a misconception—that older adults should not participate in physical activity because of a risk of falls or injury. Actually, the opposite is true. Sedentary older adults have a higher risk of falls and regular physical activity may reduce their risk. Research also shows that regular physical activity can promote psychological well-being and can aid in reducing feelings of mild-to-moderate depression and anxiety. On a day that you’re feeling a bit tired, down, or stressed, consider taking a brisk walk around your neighborhood or at the mall. Start small, have a positive attitude, build up to more vigorous activities, and continue to enjoy all that life has to offer you!
Let’s get into the nitty gritty…for adults ages 65 and older, here’s what science tells us to do:
Moderate activity: Intensity is relative to your level of fitness. For some older adults, moderately-intense physical activities include:
Vigorous activity: For some older adults, vigorously-intense physical activities include:
We’ve talked about this in chapter 10, "Making Physical Activity Part of a Healthier You," because it’s important for all adults regardless of age. But it’s worth repeating. Strength-training exercises are resistance exercises that increase the strength of your muscles, help maintain the integrity of your bones, and may improve your balance, coordination, and mobility. Both strength training and cardio or aerobic activities are important. In particular, strength training helps develop and maintain a healthy skeleton and muscle mass.
A few examples of strength-training exercises are:
What is balance training? Some exercises improve your balance and strength at the same time. If you are at risk of falling, you should include balance exercises as part of your strength-training activities. Some examples include:
Remember: You can do it. It’s time well spent to help give you more time, extra quality years to spend with your family and friends enjoying life!
10 Older adults should meet their vitamin B12 needs by eating foods fortified with vitamin B12, such as fortified cereals, or by taking the crystalline form of vitamin B12 in supplements.
11 For example, an older adult could get adequate daily vitamin D from 3 cups of milk (300 IU), 1 cup of vitamin D-fortified orange juice (100 IU), plus 600 IU from vitamin D supplements.