January/February 2001
Healthy eating habits aren't only for the young and growing. In fact, older people need at least the same amounts of vitamins and minerals as they did when they were younger. While the needs remain fairly constant, other challenges enter the nutritional picture for older adults. These include:
Because vitamin and mineral needs remain fairly constant throughout our lives, but calorie needs decrease, older people need to make especially nutritious food choices. Nutrient-dense foods, or foods that give more "bang for the buck," will help people optimally fulfill nutrient needs as they age.
Food quantity, but not quality, changes with age. This challenge in food selection comes at a time in life when many people are less interested in shopping for, preparing or eating food. On what nutrients do older people need to focus? The American Dietetic Association recommends protein, calcium and vitamin D, and vitamin B6.
Older people should consider less expensive protein foods such as eggs, peanut butter, dried beans and peas and dried milk in addition to meat, poultry and fish. Small amounts of protein foods at meals and snacks are typically well-utilized by the body.
Ideas for Sharing Meals
It is not so unusual for a registered dietitian to leave clinical practice, return to school for a Ph.D., then seek a faculty position. Mary Meck Higgins chose those career stops but not in that order. "After I received my Ph.D., I worked as a hospital dietitian for 16 years. Then, after my children were older and the right position opened at K-State, I redirected my career," Higgins said.
It may not have been a traditional path, but Higgins believes her career change to nutrition specialist with K-State Research and Extension is enhanced by earlier experiences. During her roles as a clinical dietitian and as a consulting dietitian in a long-term care facility, Higgins educated many older patients.
"Now, as I specialize in nutrition for older adults, as I write or review resources, I know how older adults respond to materials. I have a good idea of older adults' nutritional habits." Higgins' previous role required her to develop and customize meal plans for older adults according to their health needs and eating habits. "I educated them, but I received feedback from them as well," Higgins said.
Higgins' work and family connected her with Extension long before her current position began in January, 1999. "As a hospital dietitian, I enjoyed doing outreach education and community talks, sometimes working with K-State Research and Extension faculty in presenting programs." Her husband Randy is an entomologist with K-State Research and Extension, and her four children were and are longtime Riley County 4-Hers.
Higgins enjoys the challenge of providing nutrition education resources for the benefit of the large population of older adults in Kansas. "Older adults are often forgotten as an intended audience for nutrition educators," Higgins said.
Many health conditions that affect older people are related to nutrition. "Health conditions help motivate older people to make changes in their nutrition practices," Higgins said. She strives to provide educational resources that promote health and overall good nutrition. Higgins also works to improve knowledge about therapeutic diets for older adults, as part of the management of their health conditions. Currently, she is focusing on increasing awareness of diabetes and its management. Higgins is particularly qualified to address this need, as she is a Certified Diabetes Educator.
With increasing need for nutrition information, Kansans will benefit from Higgins' efforts. While many of the materials she writes address the nutritional needs of older adults with limited resources, the information is applicable to others.
Higgins received notice in January that she and a collaborative team have been granted $300,000 to study food stamp program participation and education needs of rural older Kansans. The funds, which include $100,000 for K-State, will support the development of a training manual and nutrition education campaign in communities within an 18-county area in the north-central Flint Hills region. Other projects she is involved with include collaborating with representatives of various agencies in Kansas and in many other states, all of whom share the common goal of identifying and meeting nutrition education needs of people of all ages, especially older adults.
With no shortage of enthusiasm and a focus on needs to be
addressed, Dr. Mary Higgins clearly has a passion - a heart- for older
adults.
Drug side effects may be severe enough to interfere with good nutrition. For example:
What is the leading cause of unexplained weight loss in older adults? The right answer may surprise you.
Depression is common in older adults because of health problems, loneliness, and medication use. Feelings of anxiety frequently accompany depression in older adults. People with health conditions that have a nutritional concern are more likely to experience depression. Some of these diseases include diabetes, lung diseases, strokes, osteoporosis, cancer and Parkinson's. Medications may cause depressive symptoms, especially blood pressure and sedating drugs.
Widowed and unmarried women who lack social support, experience stressful life events, and have physical health problems are at greatest risk for depression.
Depression is an important risk factor for heart disease and is common following a heart attack.
Symptoms of Depression Although depression is common, its presence and impact on overall health can be overlooked. Suspect depression in older adults if they feel blue and/or lose pleasure and interest in almost all activities for two weeks or longer and four of the following occur nearly daily: sleep problems, lack of energy, weight and appetite changes, feelings of worthlessness or guilt, inability to think or concentrate, very fast or slow movements/thoughts, and continued thoughts of death or suicide. The Geriatric Depression Scale can help identify depression. Versions in English, Spanish, and French may be found at: www.stanford.edu/~yesavage/GDS.html.
Nutrition Food cannot heal depression, but poor food intake makes it harder for the body to heal itself. Lack of interest in buying and cooking food can make meeting nutrient needs a challenge.
Protein, glucose, vitamins such as folic acid and B12, and minerals such as zinc and iron are important in brain function and mood. Successful treatment requires a good supply of these and other nutrients. Caffeine increases feelings of anxiety and needs to be avoided. Alcohol use by older adults may worsen a depressed mood.
Action Plan First, seek treatment for depression! In older adults depression rarely just goes away. Counseling, therapy, or prudent use of medication may save a life. Medications to help depression may cause weight gain, constipation, or vision problems. Some drugs require a special diet. However, the negative side effects are small compared to the benefits for emotional health. Physical activity, especially weight training and aerobic exercise, is effective in treating depression. Healthy eating can make these treatments for depression work better.
Food safety precautions are important for people of all ages. Routine hand washing is one of the most important things anyone can do to guard against food borne illness. Washing hands with warm, soapy water for at least 20 seconds after using the bathroom and before handling food can go a long way toward preventing contamination of food with microorganisms that can cause illness.
Older adults are well advised to take special care in selecting, preparing and storing food. Their immune system may not be as responsive as when they were younger, so even a mild form of food borne illness can have serious effects. They may be at greater risk due to chronic diseases, recovery from surgery or reduced stomach acid. This slowing down of the digestive process permits bacterial growth. Compounding these concerns, older adults may use medications that can negatively affect appetite, nutritional status and, ultimately, the immune system.
Decreased visual acuity makes it difficult for many seniors to read expiration dates on food labels. To combat this problem, consumers may want to write the "to be used by" date on food containers with a dark marker. It is equally important not to rely on smell or taste to judge whether a food is "good," as contamination may not be obvious. A little bacteria may be too much. Frozen and canned foods are safe, reliable staples for seniors.
There are some foods that seniors should avoid eating, particularly if they have health concerns such as diabetes, cancer, immune disorders including HIV, liver diseases or long-term steroid use for asthma and arthritis. These foods include: raw seafood, meat and poultry; unpasteurized milk or cheese; soft cheese such as feta, Brie and Camembert; raw or lightly cooked egg products including salad dressings, dough, batter or egg nog and raw sprouts or unpasteurized juices. It is also recommended to re-heat ready-to-eat foods such as hot dogs and luncheon meats until steaming hot!
Many food handling practices have changed over time. In the past it was common for people to leave food out on the counter or even in the oven between meals. We now know that bacteria grow rapidly at room temperature. To guard against food borne illness, it is important to refrigerate leftovers within two hours of serving.
Thawing meat on the kitchen counter is dangerous. Instead, foods should be defrosted in the refrigerator, microwave or under cold running water.
Many seniors have eaten soft boiled eggs or drunk egg nog made from unpasteurized milk all their lives. The Food and Drug Agency now recommends that egg yolks and whites be cooked until firm to avoid illness from bacterial contamination.
Older adults can be more confident about the safety of their food if they become accustomed to using a food thermometer on a regular basis. Leftovers should be reheated to 1650 F and sauces, soups and gravies should be brought to a boil when reheated. Cooked food that will be refrigerated should be divided into small shallow dishes to make it easier to cool to a safe temperature in a short amount of time to slow bacterial growth.
In two-quart saucepan, mix all ingredients and herbs. Simmer 15 minutes or longer.
Researchers with the U.S. Department of Agriculture have come up with a new Food Guide Pyramid for adults 70 and over. The redesigned pyramid is a new twist on the familiar Food Guide Pyramid. Older adults have special nutritional needs. To help get more nutrients with every bite, the new pyramid makes very specific recommendations—for example, dark green and deep yellow vegetables.
The base of the new pyramid is a reminder to drink no less than
eight glasses of water, milk or juice each day. Other recommendations
include eating fish, increasing fiber and calcium in the diet. The
flag at the top of the pyramid is a reminder that nutrient
supplementation is sometimes necessary.
Living alone doesn't have to mean eating poorly, even for people who don't enjoy cooking. In a single one-hour cooking session, several meals can be prepared for the week to eat or freeze.
Leftovers can often be used for another dish. For example, make spaghetti sauce with lean ground beef or turkey and serve over noodles one day. Add kidney beans, chopped vegetables and chili seasoning for another meal.
Another idea for easy cooking and wholesome eating is to keep a bag of potatoes on hand for days when you just don't feel like cooking. Bake a potato and top with cheese and broccoli or leftover chili.
Powdered, fortified skim milk supplies all the nutrients and lasts longer in the cupboard than a carton of fresh milk lasts in the refrigerator. It can be added to water for a milk beverage or to soups and casseroles, breads and desserts.
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 the microwave. Fresh fruit is convenient, but canned fruits will keep in the cupboard for months and can make a simple snack.
Singles should keep in mind that it is perfectly okay to ask the grocer to divide packages of meat, fresh fruit and vegetables and eggs so that the amount they take home will not spoil before they are ready to eat it.
The main idea is to have some staples on hand so mealtime is a simple fix!
Questions or concerns about this publication? Contact Shelly Burklund, 207 Justin Hall, Manhattan, KS 66506, Phone: (785) 532-1670, FAX: (785) 532-1678