By Johannah Uriri-Glover, PhD, MSCR, MNSc, RN, is a clinical associate professor in the Arizona State University College of Nursing & Health Innovation’s Hartford Center for Geriatric Nursing Excellence and the Center for Healthy Outcomes in Aging. Here she answers questions about the body’s changing nutritional needs through the decades.
What nutrition advice do you have for someone who is between the ages of 48 and 57?
As we age, caloric needs decrease. However, nutrient needs remain the same; therefore consume a healthy and well-balanced diet. So reduce caloric intake and eat a high-fiber diet: Eat lots of grains, fresh fruit and vegetables. Include foods high in calcium and vitamin D.
The sense of taste decreases as we age, and people tend to use more salt. Use salt substitutes such as Mrs. Dash.
Limit alcohol to 1 ounce per day.
Obtain annual checkups and receive screenings such as weight and height, body-mass index, lipid measurements, thyroid tests, blood glucose, bone density, and colorectal screening.
What advice for those 58 to 66?
Protein consumption decreases with age, so it is important to get enough protein to maintain energy levels. Additional screening may include vitamin B12, folic acid, iron, total iron binding capacity, total protein, albumin, transferrin, and hematocrit and hemoglobin tests.
Malnutrition becomes a risk factor as we age because of changes in sense of smell and taste, and many people may reduce food intake or eat food that do not have nutrients.
If you could get Boomers to eat include five foods into their weekly meals, what would they be and why?
Lots of whole grains, fruits, vegetables (will reduce fat intake), low-fat or fat-free milk or milk products, and lean meats and other protein sources such as beans.
I would suggest that they limit the intake of saturated trans fats and cholesterol to reduce risk for heart disease; added sugars (they have few nutrients and increase caloric intake); sodium (salt) to reduce the risk for high blood pressure; and alcohol, which provides calories and no nutrients.
At what age do people need to start restricting their calories?
It depends on how active they are. If they are sedentary, then they need to look at reducing their calories. I would suggest that one should begin to think about reducing calories when they are above their desired weight or their waist size enlarges. Follow the U.S. Department of Agriculture food-pyramid guidelines at fnic.nal.usda.gov/dietary-guidance/dietary-guidelines
The USDA recommends 2,200 calories per day for children, teenage girls, active women, sedentary men, and more for pregnant and breastfeeding women. For teenage boys, very active men and women, they recommend 2,800 calories per day. The USDA recommends that sedentary women and older adults get 1,600 calories per day
People can follow the USDA’s food pyramid, but stay at the lower end of the spectrum to account for lower caloric needs at the same time obtaining needed vitamins and minerals.
For example, they recommend 6-11 servings per day of breads, cereals, rice or pasta (which supply B vitamins). Sedentary women and older adults would have 6 servings per day.
Vegetable group: 3-5 servings per day; sedentary women and older adults would have 3 servings per day.
Fruit group: 2-4 servings per day; sedentary women and older adults would have 2 servings.
Milk, yogurt and cheese group: 2-3 servings per day for middle-age and older adults.
Meat, beans, nuts and eggs: 2-3 servings per day; middle-age and older adults would have 5 servings.
At the top of the pyramid it recommended that one use oils, fats and sweets sparingly. For a 1,600-calorie daily intake, they recommend 5 total grams of fat and 6 teaspoons of sugar.
Do Boomers need any vitamin supplements?
If they eat a balanced diet full of fruits and vegetables, they will receive the needed vitamins and minerals. However, because many people do not eat a balanced diet, it is recommended to take a daily multivitamin supplement. Some experts in the field suggest the following supplements: folic acid, vitamin D and vitamin E. Check with your physician or nurse practitioner before starting any dietary supplement.
Supplements may be necessary due to a physiological problem such as osteoporosis, or medications such as antihypertensive medications. If taking the Lasix diuretic, they may need a potassium supplement. Supplements are prescribed by the physician or nurse practitioner.
Many people are using supplements, but they should always let their physician or nurse practitioner know what they are buying over-the-counter. Weight-loss supplements may be harmful to your health.
What are some of your concerns about Boomers and their eating habits?
The rising rates of obesity. Obesity, a major cause of preventable disease and premature death, is increasing among older people.
In 2009-2010, 38 percent of people age 65 and over were obese, compared with 22 percent in 1988-1994. In 2009-2010, 44 percent of people age 65-74 were obese, as were 29 percent of those age 75 and older. (Source: agingstats.gov.)
Nationally, according to the Centers for Disease Control and Prevention, 63 percent of adults are either overweight or obese. Approximately 65 percent of Arizona adults age 18 and over are either overweight (40 percent) or obese (25 percent), and those with lower incomes, less education, and Hispanics are more likely to be obese.
These problems result from the consumption of unhealthy diets. Based on U.S. Census data, the population is also expected to become much older, with nearly one in five U.S. residents 65 and older in 2030.
In 2050, the number of Americans 65 and older is projected to be 88.5 million, more than double its projected population of 40.2 million in 2010. If the rates of obesity continue to rise, there will be more older adults with this problem.
Implications:
Adults: This places individuals at risk for morbidity such as chronic diseases and increased mortality.
Health-care costs will increase due to the increasing numbers of overweight or obese adults. Obesity-related health care costs the nation $147 billion annually, and it cost Arizona approximately $2 billion in 2010.
Why do you think some Boomers hold on to old habits?
Eating is a learned behavior, food is plentiful and many people do not change their eating behaviors as they age.
We learn eating behaviors from our parents and tend to eat what our parents eat. Many Baby Boomers are children or grandchildren of individuals that lived during the Great Depression. Children were told to eat all of the food on their plate (waste not, want not), so they continue to eat well after they are full.
Now we know to eat until we are full. More people are eating out, which may be more convenient, but the problem with eating out is that many places serve large portions and, again, we want eat everything on our plates.
When I present on the topic of healthy aging, I tell middle-age adults to eat until they are full or half of what is served, and take the remainder home to eat at another time. As we age, our need for calories reduces, so we have to reduce the caloric intake but still obtain the needed nutrients from a healthy diet.
A sedentary 40-year-old cannot eat the same number of calories as an active 18-year-old.
Sometimes it is economics, especially if individuals are on a fixed income. It is more expensive to buy healthy foods, such as fresh fruits and vegetables. Fresh fruits and vegetables do not keep long. We have taught our older adult clients how to boil and freeze them so that they will keep longer
What would you say to Boomers to convince them to start now, not wait, to implement good eating habits or good nutrition?
The consequences of being overweight or obese to an individual’s health and well-being range from quality-of-life issues to a host of health conditions, including increased risk for stroke, heart disease, certain cancers, diabetes, osteoarthritis, respiratory problems and other chronic conditions including constipation and malnutrition.
A healthful diet helps reduce risks for many of these health conditions. Although we are living longer, mortality increases as a result of chronic illnesses associated with obesity and poor nutrition.
