March 15, 2006
Table of Contents
Food for Thought
Most issues of the SFA newsletter Experience! (formerly named Round-Up) provide a smorgasbord of information on various topics: senior fitness research, health news, wellness tips, safety facts, and more. But every so often we like to cook up a special issue focusing on one specific topic area, and this special issue's entrée is nutrition.
Everyone is familiar with some variation of Anthelme Brillat-Saarin's famous pronouncement: "Tell me what you eat and I will tell you what you are." Here at SFA we also relish Virginia Woolf's perspective: "One cannot think well, love well, sleep well, if one has not dined well."
So, for this special issue of Experience! we're serving up an interesting menu of diet-related news and information. From the world of government to the realm of scientific research, senior nutrition has been on the front burner lately. Below is a taste of what's going on.
Food Programs for the Elderly
The president's new budget proposal calls for eliminating the Commodity Supplemental Food Program (CSFP) and moving the people who use it over to food stamps, according to the Associated Press. A spokesperson for the Agriculture Department said that CSFP is a duplicative program and the department thinks people can be served more efficiently by food stamps and WIC (the Women, Infants and Children program).
Although some new mothers and children participate in CSFP, it mostly benefits poor elderly persons. Each month boxes of food are delivered to churches, senior centers, and other designated locations for distribution. Volunteers often take the packages right to participants' doors. A typical box contains an assortment of nutritious staples such as fruits, vegetables, peanut butter, and cereal.
Tim Robertson, president of the National CSFP Association, questions whether a policy to switch the nearly half-million elderly CSFP participants over to food stamps can be successful. One potential barrier, he notes, is that individuals may find it difficult to enroll and participate in the food stamp program (for example, accurately submitting the required paperwork). Another may be senior citizens' strong sense of personal pride (along with a perceived stigma associated with accepting food stamps).
Agriculture Department figures show that only 28 percent of seniors who are already eligible for food stamps actually participate in the food stamp program.
Under-Nutrition in Community-Dwelling Seniors
Mark Williams, M.D., author of The American Geriatrics Society's Complete Guide to Aging & Health, includes in that publication several key factors regarding malnutrition among older adults who reside in the community setting:
What are some of the circumstances that might contribute to malnutrition in this population?
In some cases, alcohol or drug abuse may play a role in malnutrition. In others, a lack of transportation may make it difficult to shop for groceries. Physical and/or mental impairments may hinder one's ability to prepare nutritious meals at home. Older persons who live alone are often at a disadvantage compared to those who live with others who can provide practical assistance on a ongoing basis.
Of course, malnutrition increases an older person's risks for serious health problems, debilitation, even death. The good news is that it is possible to reverse most -- and maybe all -- of the damage by remedying the nutritional deficiencies that have developed.
For many people, the process of implementing a solution begins with a visit to their physician. He or she will conduct an interview with the patient, complete a physical examination, and more than likely arrange for some laboratory tests. A treatment plan will then be initiated.
Whether it precedes or follows an appointment with the physician, many people will benefit from a home visit by a nurse or occupational therapist. The health care professional will explore the individual's environment and situation, including his or her ability to acquire food, then safely prepare and consume it. Also, an assessment will be made as to whether depression, mental health issues, or other declines in physical health might be hindering the individual's capacity to follow a properly balanced diet.
Home health care professionals can provide advice and education especially tailored to each patient's needs. That may include teaching the individual which foods provide the highest nutritional returns, how to shop more successfully, how best to cook one's foods, and which foods make for healthful snacking. At regular intervals, the patient's body weight should be measured and his or her food intake evaluated. It is beneficial when loved ones and other caregivers can take an active role in promoting and implementing the treatment plan.
Two excellent resources which should not be overlooked, especially for home-alone senior citizens, are Meals on Wheels and congregate meal programs. Meals on Wheels will deliver a nutritious lunch or dinner to one's home. In many communities, transportation for seniors is provided to and from congregate meal sites. Congregate meal services also offer the added benefit of countering social isolation. To find out what types of services are available in your community, a good way to start is by contacting your local Council on Aging office, which should be listed in your telephone directory.
Concerning older persons who are institutionalized or hospitalized, some of the same factors may apply, but there may be differences with respect to the cause and type of under-nutrition and to the interventions undertaken.
Anemia and Falls
A study published by the Journal of the American Geriatrics Society suggests that older men and women with anemia are at increased risk for recurrent falls. Three hundred ninety four subjects from 65 to 88 years of age were followed-up for a three-year period. Those who had more than one fall within six months were considered recurrent fallers. Of the participants without anemia, 19.6 percent experienced recurrent falls, compared to 38.3 percent of the participants with anemia. Researchers believe that anemia may directly compromise skeletal muscle strength.
Upsetting the Apple Cart
Recently the Journal of the American Medical Association (JAMA) has published research that seems to turn conventional nutritional wisdom on its head.
First, there was the report that omega-3 fatty acids (derived from the oils of fatty fish such as sardines, salmon, and tuna) don't appear to offer protection from certain forms of cancer, as previously was widely held.
Then came the news that eating a low-fat diet was not confirmed to lower the risks for developing a number of medical conditions, including colorectal and breast cancer, heart disease, or stroke -- again, as had been previously accepted.
However, this does not mean that we should revert to high-fat diets or omit the omega-3s. The findings noted above -- and in the following item on calcium and vitamin D supplements -- do not actually change current dietary advice. They simply demonstrate how difficult it is to isolate black-and-white, one-size-fits-all solutions in medical research. While the findings were not as strong as expected, the value of following a sensible diet was not called into question.
Although it was not upheld that omega-3 fatty acids possess cancer-fighting properties, they are considered beneficial to one's heart and good for one's general health. Regarding the low-fat diet reports, what the findings suggest is that reducing total dietary fat alone may not be the answer to achieving better health across the board. Persons at increased risk for heart disease or breast or colon cancer may stand to gain the most by consuming less fat over an extended period of time. In general, the types of fats we consume are likely to make an important difference. Therefore, researchers suggest that we fine-tune our approach by avoiding trans fats and saturated fats, but by continuing to include olive oil, vegetable oils, and fish oils in our diets.
Calcium and Vitamin D Supplements
In another surprising twist, a recent study on calcium and vitamin D supplementation in older women found that it provided only limited protection from bone fractures, especially among healthy women. However, the supplements were beneficial to the women who used them most faithfully. Importantly, they also appeared to decrease the risk for hip fracture among women over the age of 60.
Despite the "underwhelming" results of the study, many authorities said they still support the federal guidelines that recommend calcium and vitamin D supplements. Those guidelines have not been changed in the wake of the new findings, but remain as they were before. SFA's long-standing opinion on the subject also has not changed: We advise older adults to consult their personal physician regarding whether or not to use dietary supplements.
Staff of Life
The benefits of a diet plentiful in whole grains -- such as oatmeal, brown rice, whole wheat bread, and bran -- have been studied in middle-aged populations. But a new study, published in the American Journal of Clinical Nutrition, examined subjects up to the age of 98.
Researchers found that older adults whose diets regularly include the vitamins, minerals, antioxidants, and fiber provided by whole grain foods may be at reduced risk for heart attack. Participants who ate more whole grains were less likely to die from heart disease during the following 12-to-15-year period. They had lower odds of developing certain conditions (such as hypertension) that increase the risk for cardiovascular disease and stroke. The results of this study support current recommendations to eat at least three servings of whole grains per day.
American Heart Association Report
Better dietary habits could reduce the high rate of hypertension in the United States, asserts the American Heart Association (AHA) in a recent issue of its journal Hypertension. More than one-fourth of American adults have high blood pressure, and another 31 percent are on the brink of it.
Three steps that clearly appear effective at improving blood pressure are: (1) reducing dietary sodium, (2) ensuring adequate potassium intake, and (3) limiting alcohol consumption. Diet plans that favor whole grains, fruits and vegetables, and low saturated fat choices can compliment those steps. Such diets tend to encourage body fat reduction which, in turn, may help to control or prevent hypertension. The AHA's overall message: Let's keep trying our best to eat healthy.
In some ways, people are all alike and age just doesn't make any difference. As James Beard once said, "Food is our common ground, a universal experience." In fact, most everyone likes to splurge on their favorite dessert now and then. With that in mind, we couldn't think of a better way to conclude a special issue on nutritional matters than with this rich quote from Jim Fiebig:
"Age does not diminish the extreme disappointment of having a scoop of ice cream fall from the cone."
Experience! readers: Thank you for your interest and questions. Due to the high volume of contacts SFA receives, we cannot respond to individual queries or comments. However, the newsletter does address frequently asked questions and topics of vital interest to our members.
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