Nutrition in Later Life

Why is nutrition important?

Healthy eating is just as important for seniors as it is for young adults, adolescents and children. While the emphasis is on "healthy", it is also important that eating should be an enjoyable and a sociable activity that you can look forward to.

To have a healthy lifestyle, a good diet should be combined with regular moderate exercise. This can include walking, swimming or dancing. Exercise helps control your appetite and hence your weight, strengthens your heart, blood vessels, lungs and bones, and helps you sleep. Studies on nutrition of Australians indicate that a number of older people have poor diets, including a shortage of intake of fibre, some vitamins and minerals. As a result their health can suffer.

Ageing can also be associated with changes in lifestyle which affects the food we eat. Loneliness, boredom, depression and worrying about the future can lead us to neglect our diet - skipping meals and generally eating poorly. It is important to look at these factors and attempt to improve your diet and, if necessary, ask for outside help. Enquire about the local community services by contacting the local community health centre, council, hospital, or your doctor.

What is a healthy diet?

Nutrition Australia (as The Australian Nutrition Foundation) developed the Healthy Eating Pyramid which enables you to make healthy food choices that will fit in with your individual lifestyle.

SECTION 1: EAT MOST

SECTION 2: EAT MODERATELY

SECTION 3: EAT IN small AMOUNTS

Other foods and flavours

Use less salt

Table salt is sodium chloride. We need some salt in our diet, but we get enough from the salt which occurs naturally in foods such as meat, eggs, milk and vegetables. Most of the salt in the Australian diet comes from the salt added by food manufacturers and caterers. Our high salt diet increases the risk of developing high blood pressure which is common in Australia. About half the Australian population over the age of 60 suffers from high blood pressure.

Use herbs and spices instead of salt to flavour your food and buy reduced salt and low-salt manufactured foods. Avoid or restrict the use of highly salted foods, such as corned beef, bacon and luncheon meats and snack foods such as potato chips.

Other foods

There are many other foods. One important one is water. As we age we don't always feel thirsty when our body needs water. Take regular drinks at least 6 times daily. Fluids may consist of water, tea, coffee, mineral water, soda water, fruit juice or milk.

Other foods include pies and pastries, fried and battered foods and snack food such as chips and chocolate. These belong to the high fat foods and they should be kept for occasional use.

For your desserts choose fruits, yoghurt, custard (including UHT long life ) and ice cream (including the reduced fat and low-fat varieties). Rice with some dried fruit added plus a little sugar and milk always makes an easy dessert.

Special considerations for the older adult

Fragile bones

Osteoporosis, a decrease in the mineral in the bones, is a common disease in older people - especially in women after menopause. Calcium is withdrawn from the bones and therefore they become fragile and the danger of fractures increases. Fractures of the hip, leg and wrist are common problems amongst the elderly.

Once bones lose their calcium it is difficult to replace it, but there is something that you can do to protect against progress of the disease. Exercise, diet and sufficient sunshine combine to protect against the development and progression of osteoporosis. Calcium, fluoride and vitamin D are the key nutrients.

Foods high in calcium are milk (whole or skim) and milk products such as yoghurt and cheese. Fish with soft, edible bones such as canned salmon or sardines are also good sources.

Diets which do not include milk and cheese are almost certain to contain much less than the recommended amount of calcium (1000 mg daily for women over 54 years, and 800 mg for men). Fat modified milks such as skimmer or "Take Care", low-fat yoghurt and skim milk cheeses are alternatives if you need to cut down on your fat intake. Otherwise, advice on a calcium supplement may be necessary - check with your doctor or a dietitian.

Sunshine helps our bodies make their own vitamin D. The vitamin D helps to get the calcium into the bones. A short time in the sun regularly (not in the heat of the day) is sufficient.

If you have skin cancers or you have been advised against going into the sun, or if you are confined indoors, include foods which contain vitamin D and check with your doctor, dietitian or pharmacist about a safe vitamin D supplement (the recommended intake is 5 mg daily). Remember, you can have "too much of a good thing" - don't take more than the prescribed dose. The foods which contain vitamin D are egg yolk, butter, table margarine, whole milk, yoghurt, cheese, malted milk, lamb's fry, liver, tuna, sardines and pilchards.

Arthritis

Healthy eating with a variety of foods is the best dietary recommendation for arthritis. It is also important to maintain a good weight. Being overweight can aggravate pain in weight-bearing joints. Recent research has suggested that fish oils may have some benefit in the treatment of rheumatoid arthritis. Try and eat fish at least once a week but don't use fish oil supplements unless they are prescribed by your doctor.

High blood pressure

About 15% of Australian adults suffer from high blood pressure. The risk of developing high blood pressure increases with age and these people are more likely to suffer from stroke and heart disease.

The high salt intake of Australians is believed to increase the risk of developing high blood pressure. Being overweight and not exercising also increases the risk. Many people who have high blood pressure may have already been advised to avoid salt at the table and in cooking, and to also avoid highly salted foods. In general, Australians are being advised to eat less salt in the hope that this will reduce the number of people developing high blood pressure.

Taste your food before adding salt and try some other flavourings instead of salt (eg. lemon juice, herbs and spices, tomato, onion or garlic). Salt is not fattening, and it does not add joules or calories to the diet, but in some people, salt can be held in the body along with fluid, and this extra fluid causes body weight to increase.

Constipation

To prevent constipation it is important to include foods in your diet that have a high fibre content. Wholegrain cereals, wholemeal bread, fruit, dried fruit, dried peas, beans and lentils are excellent sources of fibre.

Alcohol

Small amounts (1 or 2 standard drinks a day) may add to your enjoyment of meals. Alcohol does not provide protective nutrients such as vitamins and minerals, but it does provide joules or calories - which adds to your total calorie/joule intake for the day. This is why alcohol should not replace the foods in the five food groups.

Healthy teeth and gums

Healthy teeth and gums are a very important factor in being able to enjoy food. Loss of teeth, sore gums and dentures that fit poorly, will make it difficult to chew well. It is important for you to have your teeth checked regularly and if you do have dentures then have them adjusted correctly. It is advisable to visit your dentist whenever you are having difficulty with your teeth, gums or dentures.

Vitamins

A poor diet cannot be made into a good diet just by adding vitamin supplements. If you are convalescing or not eating well, there are a number of ways to still consume a nutritious diet. A milk egg flip, an omelette, a glass of fresh fruit juice or a bowl of vegetable soup are all fairly easily digested foods.

If you do use a vitamin supplement, choose a low dose multivitamin supplement - large doses of vitamins can be dangerous.

Shopping for food

If you are on your own it's a good idea to have a stock of foods available which keep well in your cupboard.

* Canned fruit, canned and UHT fruit juice, canned vegetables, baked beans, bean mixes.

* Rice, spaghetti, macaroni, flour, rolled oats and breakfast cereals.

* Canned, powdered and UHT milk and custard.

* Canned meat, fish, soups, peanut paste.

* Vegetable oil.

Measurements used in this factsheet:

• gm = gram
• mg = milligram (1/1000 of a gram)
• mg = microgram (1/1000 of a milligram)
• ml = millilitre (1/1000 of a litre)
• calorie/joule = measure of energy

For more information Nutrition Australia recommends:

Adding Life to Your Years

Eat less fat

Food for a healthy heart

The fibre in your food

Salt, sodium and you