March is National Nutrition Month

Earlier this year, the U.S. Department of Health and Human Services and the U.S. Department of Agriculture released the “2015-2020 Dietary Guidelines for Americans,” with updated information about optimal nutrition. The guidelines encourage Americans to eat more fruits and vegetables, whole grains, low-fat dairy products and healthy fats. Also featured are specific recommendations for lowering salt and sugar in the diet. And recognizing the interplay between food and physical activity, the guidelines now include specific exercise recommendations.

Seniors and caregivers should know that the basic nutritional guidelines for adults are about the same, no matter our age. But seniors do have a number of special needs and concerns. The food we eat can raise or lower the risk of many diseases and conditions that become more common as we age, including high blood pressure, osteoporosis, some cancers, heart disease, dementia, diabetes and kidney disease. And the opposite is true: Our bodies’ ability to use the nutrients in food is affected by many common health conditions, as well as by the medications we take to manage those conditions.

Here are 10 common questions seniors ask about nutrition:

Q: How should we adapt our eating as we grow older?
A: If we’ve always practiced healthy eating, most of us can continue on the same course. People with certain health problems may be prescribed a special diet — for example, low-sodium for people with high blood pressure, or a soft diet for people with chewing and swallowing difficulties. As we age, our sense of taste diminishes, so we might prefer to add extra seasoning to our food — not salt, of course.

Q: Is it worse to be overweight or underweight in our later years?
A: Geriatricians continue to study the relationship between age-related conditions and maintaining a healthy weight. Doctors have always worried about seniors who become seriously underweight. But today, more and more seniors are struggling with obesity. As we age, though our need for nutrients does not decrease, we usually require fewer calories for our energy needs. So we need to choose nutrient-rich foods to maintain a healthy weight. Yet many seniors gradually begin subsisting on junk food that has little nutritional value. A senior can be seriously overweight, yet still suffer from malnutrition.

Q: For years, Americans were urged to follow a low-fat diet. Should we continue to limit our fat intake?
A: Today’s seniors have lived through quite an evolution in our understanding of dietary fat! Raised on bacon and eggs for breakfast, cold cuts for lunch and a big steak for dinner, they later followed advice to lower cholesterol by switching to low-fat foods — some of which, it turns out, were just as bad, high in refined carbohydrates and sugars. The American Heart Association (AHA) recently stated that while it’s important to limit unhealthy saturated fat and trans fats, it’s just as important to consume enough of the healthy polyunsaturated and monounsaturated fats that may lower cholesterol and the risk of heart disease and dementia. The AHA offers more information about healthy fats.

Q: I’ve been reading that fish is rich in good fats — they even call it “brain food.” But I’m worried about the mercury content. What should I do?
A: A February 2016 study published by the American Medical Association confirmed that while eating seafood can lead to higher levels of mercury in the brain, this did not lead to a higher risk of dementia. On the contrary, the researchers found that eating seafood at least once a week was linked to a decrease in the plaques and tangles that lead to Alzheimer’s disease. Fish is part of the healthy Mediterranean diet, which you can read about on the website of the Academy of Nutrition and Dietetics.

Q: Do I need dietary supplements?
A: Before purchasing vitamins, health shakes, herbal products or other supplements, your first step should be to ask your healthcare provider about supplements that might benefit you. The supplement industry is huge and largely unregulated, and many companies pitch their marketing at older adults. Certain supplements have been proven to be effective — for example, a special vitamin formula is at present the only treatment for certain types of age-related macular degeneration, and some vitamin supplements are beneficial for seniors who can’t get all the nutrients they need in their food. But remember that a TV infomercial or fancy website doesn’t mean a supplement is beneficial — or safe. Save your health and save your money by talking to your doctor first.

Q: What if a senior I know is having trouble affording nutritious meals?
A: Federal, state and local nutrition programs serve older people living on a limited income. Meals on Wheels-type programs, meal programs through senior centers, the Supplemental Nutrition Assistance Program (SNAP, formerly known as the Food Stamp program) and the Emergency Food Assistance Program are a few of these. Contact your local senior assistance agency to learn about these resources. There are also ways to eat well for less money. For example, frozen and canned vegetables and fruit are, for the most part, just as nutritious as fresh — just don’t select frozen veggies with buttery sauces, canned veggies with a lot of salt added, or fruits packed in syrup.

Q: What if it’s difficult for a senior to go to the store or prepare meals?
A: Health conditions such as arthritis, visual impairment or stroke can make everything harder. And nutrition often suffers when a senior can no longer drive. Meals on Wheels and the other dining options mentioned above can help. If family live nearby, consider making a weeks’ worth of nutritious meals that can be frozen and heated. Families might consider home care for their loved one; an in-home caregiver can prepare meals and take the client on a pleasant outing to the grocery store. Or, it might be time for a move to an assisted living or other supportive living community, where seniors can enjoy healthy meals and companionship. Dining with others piques the appetite, and reduces depression, another cause of appetite loss.
Q: What if a senior has trouble eating and swallowing food?

A: If a person with arthritis, Parkinson’s disease, the effects of a stroke or other health conditions is having trouble eating, an occupational therapist can help them learn adaptive eating methods and the use of adaptive utensils. Seniors who have chewing and swallowing problems due to missing teeth, gum disease or poorly fitted dentures should receive regular dental care. Speech therapists help patients who have trouble swallowing. The person’s healthcare provider or rehabilitation specialist can recommend methods of preparing foods that make them easier to eat and, if necessary, make a recommendation for nutritional replacement drinks.

Q: What if my loved one has Alzheimer’s disease and has trouble eating?

A: People with dementia may experience decreased appetite that quickly leads to malnourishment and dehydration — or, in the early stages of the disease, a person may overeat, forgetting that they had previously eaten and with a diminished ability to tell when they are full. Experts recommend creating a calm mealtime environment, maintaining a routine and offering finger foods and snacks throughout the day. An occupational therapist can recommend the use of adaptive eating tools. Talk to the person’s healthcare provider about strategies and food choices.

Q: Where can I find reliable information about nutrition?

A: It’s best not to start with an internet search! Many companies have set up websites that do not offer valid information, and may be trying to sell you something. Other entities offer nutritional advice that is not backed up by sound science. Here are some good sources of information:

The sponsor of National Nutrition Month, the Academy of Nutrition and Dietetics (www.eatright.org) offers a wealth of nutritional information for consumers, including resources for seniors.
Visit the Health.gov website to read the entire Dietary Guidelines 2015 – 2020.
The National Institute on Aging offers a resource sheet on “Eating Well As You Get Older,” which includes links to nutrition support programs. They also offer a tip sheet on nutrition and dementia for caregivers.

The information in this article is not intended to replace the advice of your healthcare provider. Speak to your doctor and/or a registered dietitian if you have questions about your nutritional needs