Guyana Chronicle
May 6, 2001

NUTRITION and health are closely linked at all stages of life. Nutrition contributes to our mental and physical growth, our immune response, and our risk of chronic disease development. Society places great emphasis on the nutritional health of infants, children, adolescents and adults, but how much attention do we give to nutrition in later life?

The following article will highlight how small improvements in food choices can lead to big gains in long-term health.

Over the years, the body feels and functions differently. In later life, we usually begin to experience more aches and pains, become more forgetful, and gradually lose strength and agility. Other serious problems creep up such as decreased bone density; obesity, which is a risk for heart disease, cancer and diabetes; underweight; high blood pressure; and gastrointestinal disturbances (e.g. nausea, vomiting, diarrhoea and constipation).

However, these changes need not interfere with our ability to function daily. Adopting a healthy lifestyle, which includes eating wisely and staying physically active, may not prevent all age-related disabilities but they can certainly impact on some of the problems mentioned above. For those enjoying the golden years of life, following these basic nutritional and lifestyle guidelines can greatly increase health and happiness.

Keep bones healthy

As people reach middle age, they begin to lose minerals from their bones. If a lot of minerals are lost, a disease called osteoporosis may develop. In osteoporosis, bones become brittle and therefore break easily and take longer than normal to heal. Osteoporosis can be prevented and delayed through diet and lifestyle, specifically the intake of adequate amounts of calcium and vitamin D, and participating in daily physical activity.

Calcium is necessary for building and strengthening bones. Good sources of calcium are dairy products such as cheese, milk, and yoghurt (choose low fat); tinned fish such as sardines; dark green leafy vegetables such as callaloo, pakchoi and spinach; dried beans; tofu prepared with added calcium; nuts, and calcium fortified foods such breads, cereals and some fruit juices.

In order to absorb calcium, the body needs Vitamin D. The body can make its own vitamin D from exposure to sunlight. Foods like sardines, egg yolk, liver, margarine and fortified milk are good sources of vitamin D.

Drink plenty of water Daily recommended fluid intake in people, whose fluid intake is not restricted for health reasons, is eight glasses per day.

It may be pure, undiluted water, or it may take the form of alternatives such as juice, soup, milk or decaffeinated tea or coffee. Beverages such as coffee, black tea and soft drinks are not good alternatives to water because the caffeine they contain actually causes dehydration through frequent urination.

Some people have restrictions on their water intake due to blood pressure or specific medications. Those people should ask their doctor what would be an appropriate amount of water to drink each day.

Be active Physical exercise is beneficial at any age. It helps to strengthen muscle and bone, keep the heart and lungs healthy, control blood pressure, blood cholesterol and blood sugar, and maintain a comfortable weight by burning up excess stored energy.

Being physically active also improves sleep quality and increases the appetite. The natural high that physical exercise induces and the reduction in aches and pains it can cause, are particularly important for older people. At least 30 minutes should be devoted to physical exercise every day. This can be done all at once or divided into three 10-minute sessions.

There are many different types of exercise. Individuals should choose the form that is best suited to them. Walking is a popular for of exercise in older people, as is gardening, housework and yard work. Simple choices, such as taking the stairs instead of the elevator, can increase one's daily level of exercise.

Remember to drink at least two glasses of water before starting physical exercise and to sip water while exercising. You should also wear comfortable clothing and well-fitting shoes.

Prevent overweight Weight control tends to get more difficult with age. As people get older and reduce the amount of physical activity they do, their basal metabolic rate drops, which means that they burn calories less quickly.

Although older people should eat fewer calories to compensate for this change, most do not; they continue to eat the same amount or more than they did in their younger days, leading to weight gain.

People of all ages, including those in later life, can maintain a desirable body weight by making certain changes to their diet and eating habits. Rather than taking infrequent, large meals, it is healthier to eat small portions regularly. Skipping meals is not a good idea; it can lead to snacking habits, which often results in overeating.

If you do get hungry and occasionally need a snack, choose low-calorie, healthy foods like fresh fruits, plain biscuits or crackers. Choose low fat milk, and eat less sweets and sweetened foods. When eating meats such as beef or pork, always choose lean cuts. Remove the skin from chicken. When cooking, bake rather than fry foods, and use as little butter, balancing the calories that you put into your body and the calories your body uses.

Prevent underweight For some older people, unintentional weight loss, rather than unwanted weight gain, is a problem. The weight loss is usually a result of decreasing eating, which occurs for a variety of physical and social reasons.

Some older people develop teeth or gum trouble, making eating painful or difficult and leading them to eat less. To avoid weight loss, meals can be prepared in a form that is easier to eat: chopped, pureed, creamed, crushed or moistened. Others may have Alzheimer's disease or other conditions which make then forget to take their meals on time. In this case, some assistance may be necessary.

Older people often experience dietary restrictions, such as a limit on sugary or spicy food, due to medication regimes or gastric problems. Some may find that food served without sugar or spice is less palatable and therefore may eat less. Sugar substitutes, herbs and spices may be used to improve food flavour and boost appetite.

The small income of some older people limits the amount of food they can buy and the traveling they can do to and from food stores. These people may need help with getting their food supplies. Lastly, many older people are used to eating as a social event and may be less inclined to eat if they are on their own. For these people, eating with friends or in a group may improve not only appetite, but also the quality of mealtime.

Use less salt As we age, our taste buds become less sensitive, making food seem more and more bland. In order to compensate for this decrease in flavour, older people tend to add a lot of salt to their food. Although it may make food more palatable for salt sensitive persons, high salt intake can lead to high blood pressure, and then to heart disease and stroke.

Using alternative herbs and spices seasonings, such as lemon grass (fever grass), ginger, mint, onion, garlic and escallion can satisfy the desire for stronger flavours without the dangers that increased salt intake brings.

Eat a variety of foods Since no single food will provide all the nutrients that we need at any age, eating a variety of foods from the six food groups is the best way to ensure that we get enough of all the nutrients we need. These should be selected daily on the basis of a balanced diet.

As we age, our intake of vitamins, minerals and fibre becomes more important. Fruits and vegetables, rich in all of these and also low in fat and calories, are an essential part of the older person's diet. In addition, a high intake of fruits and vegetables has been proven to decrease the risk of certain types of cancer. Older people should aim for the following number of daily servings from each of the six food groups:

* 1-2 servings from the Food from Animals group. Foods in this group include: beef, pork, poultry, fish (fresh canned, dried or pickled), milk, yoghurt, eggs, cheese, liver and kidney.

* 7-9 servings from the Staples/Cereals group. Foods in this group include: bread, corn, cornmeal, flour, rice, pasta, green banana, yam, potato, dasheen, coco, cassava.

* 2-3 servings from Fruits group. Foods in this group include: mango, citrus fruit, pawpaw, watermelon, pineapple, sweetsop.

* 3-4 servings from Dark Green Leafy, Yellow and Other Vegetables group. Foods in this group include: callaloo, pakchoi, cabbage, string-beans, carrot, pumpkin, cho-cho, cucumber, tomato.

* 1-2 servings from Legumes and Nuts group. Foods in this group include: red peas, gungo peas, cow peas, black-eye peas, other dried peas and beans, peanuts, cashew nuts, sesame seeds, pumpkin seeds.

* 4-6 servings from Fats and Oils group. Foods in this group include: cooking and salad oils, butter, margarine, shortening, coconut cream/milk, meat fats, nuts, avocado pear, Jamaican ackee.

Avoid constipation Constipation, the slow movement of food through the intestines, is a common problem among older people. Eating lots of fibre (found in whole grain breads and cereals, peas and beans, ground provisions, leafy vegetables, fruits and nuts), drinking lots of fluids and exercising regularly, are excellent ways to remain regular and avoid constipation. Water helps rid the body of waste and soften stools. Fibre gives bulk, making the stool more easily excreted from the body.

Keep an eye on your medications Older people are major users of over-the-counter and prescription medications, both of which can affect nutrition.

Anorexia (loss of appetite) is a common side effect of many medications. This should be monitored closely as it can lead to dangerous weight loss.

Constipation can lead to abuse of laxatives. Other side effects to some medications include diarrhoea, nausea, vomiting, dry mouth, and altered taste sensations. Some medications decrease the availability of certain nutrients.

If you or an older person in your care experience any of these problems, speak with your doctor, nurse or dietitian/nutritionist about the medication's effects and how to remain healthy despite them.

Eating a balanced diet, drinking enough fluids and using herbs and spices to improve the flavour of foods, may offset some of these medication-induced problems.

Paying special attention to the nutritional health of older people in our society is an important responsibility. Simple dietary and lifestyle changes can lead not only to longer life, but also to healthier, more enjoyable years in later life. (NYAN NEWS)