Improving dietary resilience and better integration of nutrition in the health care system can promote healthy aging and may significantly reduce financial and societal burden. This was the key finding of a paper called Nutritional Considerations for Healthy Aging and Reduction in Age-Related Chronic Disease.
The paper – published in Advances in Nutrition – reports that by 2050, the number of persons aged 80 years old and over will reach 392 million, about three times the 2013 population. An increasingly large portion of the population will be vulnerable to nutritional frailty, a state commonly seen in older adults, characterized by sudden significant weight-loss and loss of muscle mass and strength, or an essential loss of physiologic reserves, making the person susceptible to disability.
Nutritional Assessment Model
While increasing numbers of older adults are obese, many are also susceptible to nutritional frailty and, as a result, age-related diseases including sarcopenia, cognitive decline, and infectious disease. The review concludes that exploring dietary resilience, defined as a conceptual model to describe material, physical, psychological and social factors that influence food purchase, preparation and consumption, is needed to better understand older adults’ access to meal quality and mealtime experience.
“A nutritional assessment model that takes into consideration the effect of aging on muscle mass, weight loss and nutrient absorption is crucial to overall wellness in our elderly population,” said Gilles Bergeron, Ph.D., executive director, The Sackler Institute for Nutrition Science at the New York Academy of Sciences, New York, N.Y. “However, nutrition recommendations are usually based on that of a typical healthy adult, and fail to consider the effect of aging on muscle mass, weight loss, and nutrient absorption and utilization.”
A recent model to frame food intake included the addition of more randomized clinical trials that include older adults with disease and medication. This will help to identify their specific nutrient needs, biomarkers to understand the impact of advancing age on protein requirements, skeletal muscle turnover, and a re-evaluation of how BMI guidelines are used.
“Much greater emphasis needs to be placed on prioritizing research that will fill the knowledge gaps and provide the kind of data needed by health and nutrition experts if we’re going to address this problem,” added Simin Nikbin Meydani, D.V.M., Ph.D., director of the Nutritional Immunology Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Mass. “There also needs to be more education about on-going nutritional needs for those involved with elder-care – not only in a clinical setting, but also for family members who are responsible for aging adults.”
Tips To Stay Healthy
Here are five suggestions – offered by Paul Erwin, professor and department head of public health in the College of Education, Health, and Human Sciences – that may help you live a longer, healthier life. Keep up with clinical prevention. Stay up to date on immunizations, screening exams for specific types of cancer – colorectal cancer screening for men and women, and breast and cervical cancer screening for women – and screening blood tests for conditions such as diabetes and HIV.
Be physically active. Current recommendations call for 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise or a combination of moderate and vigorous activity. If you are not into running, swimming, or yoga, try mowing the lawn with a push mower rather than a riding lawn mower. Park at the far end of the parking lot rather than the spot closest to the door. Take the stairs up to the second floor rather than riding the elevator.
Achieve good nutrition. Eating well can be both enjoyable and affordable, but it requires a level of thoughtfulness about foods of all types. What we eat is much more important than how much we eat. Be mindful about what you eat. Stay tobacco-free. This is the most important preventable cause of early disease and death. Model this good behavior for family, friends, and co-workers. If you currently use tobacco, make an effort to quit. Pursue balance. Practice and pursue harmony and balance in life – between work and play, between rest and activity, and across the spectrum of mind, body, and spirit.
Some Common Beliefs About Food And Health
Here’s the medical lowdown on a couple of widely held notions about food and health.
Fish is brain food. “Many long-term studies have found a correlation between improved cognition and the consumption of fish high in omega-3 fatty acids such as DHA,” says Annette Frain, a registered dietitian at Wake Forest Baptist Medical Center in Winston-Salem, N.C. and the medical program coordinator at Wake Forest Baptist’s Weight Management Center. “This isn’t a speedy fix – you’re not going to get a higher score on your test or do a better job on your project at work because you ate fish last night. It’s rather the build-up over time. So the sooner you start, the better off you’ll be in the long run.”
The best seafood sources of these omega-3s that promote optimal brain function are fatty and oil-rich fish such as salmon, albacore tuna, mackerel, sardines and herring. Flounder and tilapia appear more frequently on our plates and are good for you as well but just not as good. “They aren’t as potent in terms of omega-3s, and they’re often breaded and fried, which only adds calories,” said Frain. “Grilling is the best way to prepare fish.”
The Acne-Food Connection
Eating chocolate does not cause acne. “I remember hearing that when I was growing up and I still hear it when I see patients, especially teenagers,” said Sarah Taylor, M.D., a dermatologist at Wake Forest Baptist. “But it’s not true. Chocolate has been studied, and there’s no hard evidence it has anything to do with acne.”
Acne occurs when the skin’s pores become clogged with excess oil produced by hair follicles. This allows dirt, bacteria and dead skin cells to build up in the pores and form the lesions and blemishes of acne. What triggers this isn’t clear. Hormonal changes can prompt the overproduction of oil, and heredity can be a factor. But eating chocolate is not and that goes for pizza, potato chips, French fries and cheeseburgers, too.
Research, however, has identified one acne-food connection. “Non-organic dairy products can make acne worse, because the cows are treated with growth hormones,” Taylor said. “So we’ll tell patients that when they’re having yogurt, cheese, milk or ice cream to make sure it’s organic if they want to help their acne out.”
Eating carrots does not exactly improve vision. “Carrots are a good source of vitamin A, which is one of the nutrients necessary for good ocular health,” says Craig Greven, M.D., chair of ophthalmology at Wake Forest Baptist. “But they won’t improve your eyesight.” Their vision-friendly reputation notwithstanding, carrots are far from the only way to get vitamin A. Dairy products, eggs, fish and liver are prime sources, as are a number of fruits – peaches, mangoes, tomatoes – and vegetables – spinach, kale, broccoli, peas, red bell peppers – that also provide other nutrients and antioxidants that contribute to good vision. “In general, a balanced diet, and really anything that leads to a healthy lifestyle, is good for your eyes,” Greven said. “But there’s not one specific perfect eye food.”
Spicy foods do not cause ulcers – and Jalapenos and habaneros aren’t to blame. Ulcers are sores on the inside lining of the stomach, esophagus or small intestine that develop when acid is able to penetrate the layer of mucus that normally protects the digestive tract. But spicy foods have nothing to do with that. Stress and alcohol also can be added to the list of things that don’t cause ulcers.
“About 75 percent of all ulcers are caused by bacteria called Helicobacter pylori,” says Joel Bruggen, M.D., a gastroenterologist at Wake Forest Baptist. “Most of the others are caused by the use of aspirin and other non-steroidal, anti-inflammatory medications. Stomach ulcers can produce a burning pain in your stomach, and if you have a pain in your stomach after eating spicy food you might think you have an ulcer, or a doctor might even tell you have an ulcer, but you probably don’t.”
Golden Years And Good Health
People with no major heart disease risk factors in middle age live longer and stay healthy far longer than others, according to a 40-year study reported in the American Heart Association’s journal Circulation. “Good cardiovascular health in middle age delays the onset of many types of disease so that people live longer and spend a much smaller proportion of their lives with chronic illness,” said Norrina Allen, Ph.D., M.P.H., assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago.
In the first study to analyze the impact of cardiovascular health in middle age on the duration of illness later in life, researchers examined data from the Chicago Health Association study, which did initial health assessments in the late 1960s/early 1970s and has followed participants on an ongoing basis using Medicare health records. Researchers determined how many participants had favorable factors: non-smokers, free of diabetes and normal weight, blood pressure, and cholesterol levels; versus those with elevated risk factors or high risk factors.
Comparing those who had two or more high-risk factors in middle age among the 17,939 participants who reached age 65 without a chronic illness, researchers found that those with all favorable factors: lived an average of 3.9 years longer; survived 4.5 years longer before developing a chronic illness; spent 22 percent fewer of their senior years with a chronic illness – 39 percent vs. 50 percent; and saved almost $18,000 in Medicare costs.
“Health professionals need to let young adults know that maintaining or adopting a heart-healthy lifestyle makes it more likely that you’ll live longer and still be healthy enough to do the things you love to do when you’re older,” Allen said.
Consider The Risk Factors
Looking solely at heart disease in 18,714 participants who reached age 65 without having a heart attack, stroke or congestive heart failure, those with all favorable risk factors: lived 6.9 years longer without heart disease; and spent 46.5 percent fewer of their senior years with heart disease.
At the start of the study, when their average age was 44, only 5.6 percent of participants had all favorable factors. That data is even grimmer than a 2011-2012 national survey suggesting only 8.9 percent of U.S. adults age 40-59 had five or more “ideal” health factors, according to The American Heart Association’s Heart Disease and Stroke Statistics 2017 Update.
“We need to think about cardiovascular health at all stages of life,” she said. “The small proportion of participants with favorable levels in their 40s is a call for all of us to maintain or adopt healthy lifestyles earlier in life. But risk factors and their effects accumulate over time, so even if you have risks it’s never too late to reduce their impact on your later health by exercising, eating right, and treating your high blood pressure, cholesterol and diabetes.”