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 Nutritional Medicine: Nutritional Programs for the Elderly 
 

The diet of the elderly should contain a variety of foods. This is often a challenge because of past experience, eccentric likes and dislikes, economics, and the state of health of the teeth and oral cavity. Good teeth or dentures are very important to a healthy diet. Sometimes, whole food groups may be omitted because of inability to chew them. If chewing is a problem, more fresh vegetable juices should be drunk; pureed foods, particularly vegetables, and cooled whole-grain cereals will add a lot of nutrition. Even balanced protein-nutrient drinks may be better than not eating. All of these foods add water content to the diet as well.

Sufficient fluids and fiber are crucial to any elder’s diet. Fluids are important to prevent constipation and dry skin. Keeping everything moving in the tissues, circulatory system, and intestinal tract is a vital part of feeling good. Stagnation due to poor flow and dehydration can shut us down physiologically and psychologically. Good flow on all levels is essential to regaining health and staying well. Fluid intake should be enough to produce three to four pints of urine a day. More water, herbal teas, juices, and soups, as well as fresh fruits and vegetables (all water-content foods) will help.

The older body usually uses fewer calories, while the percentage of body fat may rise. Problems of both underweight and overweight occur commonly in the elderly and are often harder to correct at this time of life. At this age, a little (5–10 pounds) excess weight is probably healthier than being underweight. Being too heavy, though, is hard on the bones; in addition, obesity increases the risk of cardiovascular disease and cancer. The three health monitors we do not wish to let rise too much as we age are blood pressure, cholesterol levels, and weight. To maintain weight, it is wise to eat a diet containing the calories required for our ideal weight at ages 25–30. A nutritionist, dietitian, or doctor should be able to help with calculation of these caloric needs.

Remember, though, those calories need to contain nutrients. Some meats and dairy products may be used to obtain appropriate amounts of protein and vitamin B12. Supplemental amino acids with good levels of methionine and lysine are helpful for protein building when protein food intake or energy is low, since they may be more easily utilized as they do not need to go through digestion. It is important to include plenty of fresh fruits and vegetables (raw and steamed, and even vegetable juices and soups), and the whole-grain cereals and legumes. These high-nutrient foods contain some calcium and other nutrients that are helpful to bone health.

Older people who are not currently on a wholesome diet can make a slow transition over one or two months to more natural foods. This means a reduction of refined foods, canned and packaged foods, and devitalized foods. It may be helpful to make these changes gradually, so as to allay the threat of upheaval. Though it is more difficult to change our ways as we age, these positive changes are still possible and very helpful. Remember, if we eat vital foods, we will be vital!

Think of a few people in their 60s, 70s, or 80s. What do you think has led to their degeneration or to their health and vitality? What are you planning for your anti–aging program? Have you already begun?

Avoiding overeating and underactivity is important, because this nondynamic duo can be disastrous. Likewise, a poor appetite can result from lack of exercise with poor utilization and circulation of previously obtained nutrients. Exercise is necessary at all stages of life, and it is no different for the elderly. Not only will it improve the appetite and the desire for better foods, it may significantly improve our attitude toward life. Exercise is a key to bone health, helping prevent osteoporosis. It will also improve other functions—digestion, assimilation, and circulation, as well as muscle tone. Walking, swimming, and dancing are probably the best all-around exercises for older folks, though any may be suitable depending on past history and present condition. If you are not exercising regularly, it is wise to build up endurance slowly to a good active program. It will help in all walks of life.

Often there may not be as much enthusiasm for good nutrition, exercise, and life in general in the elderly. When the body is not working as well, it is not as much fun to take it out for a spin. That is why it is so important to care for ourselves well in earlier years so that we can maintain our vitality and spirit. Creating more support programs for the elderly, plus training programs for those who care for the elderly, will help our society and each of us in our later years.

Loneliness and isolation from family and other loved ones are common for the elderly. Death of a spouse may leave the remaining partner without the enthusiasm or capability to care for him or herself. Encouraging and supporting these folks to attend group or community meals and find new friends can make a big difference. Sharing meals and visiting with relatives may have a special meaning and be a primary encouragement to living. Extended family and local community meetings and meals, especially if they have good food, can be very supportive to many elderly people. Engaging one another in exercise activities, such as walking, hikes, or classes, will help in socializing with peers and boosting morale. Interactive, nurturing therapies, such as counseling or massage, can be very helpful at reducing resistances and enhancing physical energy and flexibility. Our society also needs to learn better how to incorporate this growing age group (in years and in numbers of people) into the functioning community. Connecting our elderly people with the support or care of young children, I believe, is an ideal approach. Young children and elderly people often seem to have a special magic together.

For single people who cook mainly for themselves, here are some suggestions to economize, be practical, and still eat well. Sharing cooking and meals with a friend or two will allow easier preparation, easier shopping, and reduced costs, especially if the friends take turns shopping and cooking. The more people that food is prepared for, the lower the cost per person. If you are cooking just for yourself, buy smaller quantities of food and prepare simpler meals. With many foods, it is wiser to make extra portions, enough for a day or two. Soups, grains, and casseroles will refrigerate well and can be used over two or three days. Meat dishes and other foods can be packaged in individual meal sizes and frozen for later use. If the appetite is not too good, it is still wise to eat regularly, with smaller, nutritious meals. Many quick-fix foods should be on hand; eggs, yogurt, and instant whole-grain cereals are some examples. Nutritional yeast and molasses can be used in blender fruit drinks, with or without milk, a raw egg, and a piece or two of fruit such as banana or pear (if this is supported by the digestion; it’s not perfect food combining).

Prune juice and bran are common laxative foods to help keep the elimination regular and avoid the problem of constipation. A morning or evening drink made with 4–6 ounces of prune juice, 2–4 ounces of water, a quarter or half lemon, and 2 tablespoons of wheat or oat bran should do the trick. Overall, good nutrition is a vital part of any senior’s health plan—one of the best buys in the health insurance market. Maintaining regular activity and exercise is equally important. Drinking plenty of pure water, avoiding processed and chemical foods, and eating lots of fiber foods, such as the fruits, vegetables, and whole grains, are basic nutritional guidelines for staying healthy. Avoiding or minimizing the use of unnecessary pharmaceutical medications and other drugs, such as nicotine, caffeine, and alcohol, is also important. Most of the above suggestions will help to prevent or slow the aging process. Additional antioxidant nutrients are also a good idea. Many of these free-radical scavengers are included in this program (they are further discussed in the Anti-Aging program in Chapter 16).


Important Factors to Good Health for the Elderly

Regular meals
Low-fat, high-fiber diet
Exercise
Nutritional supplements

There are many herbs that may be helpful to aging people, including ginseng root, Gingko biloba, and gotu kola leaf. Ginseng has long been used in the Orient to relieve fatigue and strengthen people. Known as the "longevity" herb, it is used regularly by elderly Chinese men and women to slow the aging process. Ginseng tea bags, powder, or concentrate can be used in hot water to make tea and a couple of cups drunk daily. One or two capsules of powdered ginseng root can be taken twice daily to give a feeling of greater strength. Raw pieces of the hard root can be sucked or chewed, but this is not as potent as the tea. Be aware that excessive use of ginseng root can elevate the blood pressure (as can licorice root) and possibly irritate the gastrointestinal mucosa. The trace mineral germanium has been found to be in high concentration in ginseng. Gingko biloba, another popular oriental herb from the leaves of an ancient tree, has been more recently used in this country to help with circulatory problems, senility, and hearing disorders.

Gotu kola herb is more popular in India, where it also has an ancient tradition. It acts as a brain stimulant, strengthening the memory and other mental powers. Gotu kola can be taken as a tea or in capsules, by itself or with other herbs. In Western medicine, a drug that has been fairly popular among the elderly population (as well as with young men who want to appear alert and quick-witted) is hydergine. It is a cerebral stimulant that improves memory and mental clarity, with very few side effects. It is now used very commonly in people with senility and poor memory.

Among elderly men, prostate enlargement affecting urine flow and possibly leading to prostate surgery is very common. A swelling of the fibromuscular prostate gland can result from such factors as a high-protein, high-fat diet and insufficient activity, both physical and sexual. A diet that is low in chemicals, fried foods, and fats in general and high in fresh foods with good liquid and nutrient content will help things to move better and keep the prostate healthy. Regular exercise and stretching, especially yoga-type inverted positions, and maintaining some sexual activity also offer preventive benefits. Nutrients such as vitamins A, C, and E and other antioxidants, especially zinc, may be helpful in reducing or preventing prostate problems. Herbs such as saw palmetto berries, corn silk tea, parsley, ginger root, marshmallow root, juniper berries, and uva ursi have also been helpful to many men with prostate problems. An encapsulated formula with some of these herbs taken three times daily or a tea drunk two or three times daily could be tried for a month or two. Refer to an herbal text for further information on these and other herbs related to the prostate or the aging process.

Most people in their later years would be helped by an easy-to-digest, well-balanced vitamin and mineral formula for nutritional insurance. There are very few people over 60 who do not have some symptoms of early chronic illness—the body degenerates slowly, blood vessels get clogged, senses may diminish, and digestion and assimilation may weaken. So it is wise to use a nutritional supplement to ensure the best chance for the body to get plenty of what it needs for proper functioning. Many of the nutrients offer some protection against inflammation, regulate blood clotting, improve immune function, and improve fat metabolism by helping the body to handle cholesterol and triglycerides. Several high-quality powdered and encapsulated general formulas, which are easier to digest and assimilate, are available from companies such as Nutricology in San Leandro, California; DeBuren International in Mill Valley, California; Karuna Corporation in Novato, California; and TwinLab, in Ronkonkoma, New York. There are many others; check your local health food store or pharmacy.

As with the other programs, the nutrient ranges in the table here are from minimum needs, which may be obtained through diet and/or a basic daily supplement, to optimum insurance levels, which may require higher-dose formulas or even vitamin injections. For the elderly, because of poor digestive function, a powdered general formula taken a few times daily will improve the chances of absorbing sufficient amounts of many important, though hard-to-assimilate nutrients. Many seniors are also helped by digestive aids such as extra hydrochloric acid prior to meals and pancreatic enzymes in between meals to improve the breakdown of food. Some of the formulas I mentioned above, such as DeBuren’s Optimum I and II, also contain these digestive aids to help the nutrients be better utilized.

(Excerpted from Staying Healthy with Nutrition ISBN: 1587611791)
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 About The Author
Elson Haas MDElson M. Haas, MD is founder & Director of the Preventive Medical Center of Marin (since 1984), an Integrated Health Care Facility in San Rafael, CA and author of many books on Health and Nutrition, including ...more
 
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