As a doctor caring for seniors I regularly talk to older people about a nutritious diet. A lot of stuff is written about how seniors should eat but unfortunately not much about the difficulties they have following such advice.
For example, drinking of milk. Milk is as good for ageing persons as it is for babies; 250 ml (1 glass) of milk contains 300 mgs of calcium,, 8 gms protein, and only 4 to 5 gms of fats (low fat toned milk), in addition to Vit A, D, some B vitamins; it is low in iron, Vit C and E and B1. Since milk is expensive, most of the amount bought by a family is reserved for the children; those who are addicted to south indian coffee will drink about 50 to 75 ml in their coffee, but chai lovers only consume 5 to 10 ml. Most milk is taken in the form of curds, but at the most, a half cup of the stuff contains just 75 to 100 ml. So an average "milk guzzling" adult consumes, voluntarily, only 150 ml of milk. Contrast this with the daily recommended calcium requirement of 1500 mgs; one has to consume at least 500 ml milk to get just half the daily requirement of calcium! So, addition of a tablet of calcium carbonate yielding 1000 mgs of elemental calcium and Vit D for just 2 to 3 rupees is a cost-effective nutritional supplement. This is well worth it for everyone above 60 yrs, especially women. All this effort is essential to fight the ravages of ageing on bone health. It is surprising how many older people are unaware that milk is as good for them as it is for babies. What if one is lactose intolerant? An alternative is Soy milk which contains less calcium and carbohydrate but equivalent amount of fats and proteins.
Research shows that older people should consume less calories so that they do not become obese, which is not hard to contest, as it is known that obesity contributes to many health problems. That apart, the digestion and metabolism of food, results in formation of oxygen free radicals, those nasty by-products that accelerate ageing. The trouble with a low calorie diet, however, is that nutrients like protein, vitamins, minerals all are sacrificed as well. Seniors need all the nutrients they can get their "mouths" on, so the trick is to eat what are called, nutrient-dense foods. Foods that contain a lot of nutrients in smaller number of calories are known as nutrient-dense foods. Foods that do not come under this category are alcohol, sugar, other refined carbs, and fatty foods; they provide "empty calories", meaning only calories, hardly any nutrients.
Examples of nutrient dense foods good for the elderly can be found at www.whfoods.org by the George Mateljan Foundation.
Elderly require a lot of protein to boost bone matrix, declining serum albumin, and slowing ageing in general. The USPHS recommends 0.85 gm/kg body weight of protein per day, but recently have upgraded it to 1 gm/kg/day. This utopian level is not a big deal for meat eaters because just a small serving of any meat will fetch almost 20 gms of first class high biological value protein. There is hardly any vegetarian food that contains quite as much protein per serving both in quantity and quality, except for soya. Soya is only just getting to be popular and now we can get soya flour, plain or mixed with atta, as well as the nuggets. Unfortunately, soya is not a traditional Indian food, so the Indian recipies for soya are few and far between. Soya has the added advantage of containing plant estrogens, so it could be a good thing for ageing women, but this hopeful thought needs scientific backing. Other vegetarian sources of protein are dhals, including chana (chick peas), rajma, and these are doubly good because of high fibre content. Vegetarians need to ensure that their protein comes from many sources, as vegetable protein from any one source is missing in some essential amino-acid.
Talking of vegetarians, there is the additional concern about adequacy of B12 levels, as this vitamin is present mainly in animal protein; small amounts are also present in milk and eggs, and there is a complex way in which the body conserves and reuses it's stores of Vitamin B12. Hence low levels and related diseases are more due to pathology in the ileum, or lack of intrinsic factor in the stomach, than due to low dietary intake per se. The ageing brain is very vulnerable to low B12 levels, and a reversible form of dementia can occur. Neuropathy and blindness are also likely in deficient states.
Fresh fruits and vegetables are a must for everyone, young and old. Most middle class Indians do not put a great value on fruits because they are expensive and perishable. However, they are invaluable as mineral, vitamin and anti-oxidant and fibre sources. Salads and raw vegetables are not such popular items in the average Indian diet, but should be encouraged, because cooking inactivates so many vitamins.
Ayurveda has a lot to say about ageing and effects of lifestyle, body type and nutrition. I am going to undertake a search of what is known from the Ayurvedic veiwpoint and judge how those concepts are aligned to the allopathic concepts of nutrition.
Eating is also all about tasting and enjoying food. Elderly lose the sense of taste and smell. The "salt" perception declines and "sweet" perception is retained; hence the craving for sweet foods, and the desire to reach for the salt cellar! The answer lies in flavouring foods with herbs such as coriander, spices such as cinnamon, cardamom etc, or the use of enhancers such as monosodium glutamate; reducing the intake of medicines is another way to enhance taste, but may not be always practical.
Perhaps we are just beginning the drive to find the right foods, and the right ways of enticing the elderly palate. Nutritionists, families, general practitioners, and the older persons themselves can all contribute to "eating one's way to healthful old age.......
For example, drinking of milk. Milk is as good for ageing persons as it is for babies; 250 ml (1 glass) of milk contains 300 mgs of calcium,, 8 gms protein, and only 4 to 5 gms of fats (low fat toned milk), in addition to Vit A, D, some B vitamins; it is low in iron, Vit C and E and B1. Since milk is expensive, most of the amount bought by a family is reserved for the children; those who are addicted to south indian coffee will drink about 50 to 75 ml in their coffee, but chai lovers only consume 5 to 10 ml. Most milk is taken in the form of curds, but at the most, a half cup of the stuff contains just 75 to 100 ml. So an average "milk guzzling" adult consumes, voluntarily, only 150 ml of milk. Contrast this with the daily recommended calcium requirement of 1500 mgs; one has to consume at least 500 ml milk to get just half the daily requirement of calcium! So, addition of a tablet of calcium carbonate yielding 1000 mgs of elemental calcium and Vit D for just 2 to 3 rupees is a cost-effective nutritional supplement. This is well worth it for everyone above 60 yrs, especially women. All this effort is essential to fight the ravages of ageing on bone health. It is surprising how many older people are unaware that milk is as good for them as it is for babies. What if one is lactose intolerant? An alternative is Soy milk which contains less calcium and carbohydrate but equivalent amount of fats and proteins.
Research shows that older people should consume less calories so that they do not become obese, which is not hard to contest, as it is known that obesity contributes to many health problems. That apart, the digestion and metabolism of food, results in formation of oxygen free radicals, those nasty by-products that accelerate ageing. The trouble with a low calorie diet, however, is that nutrients like protein, vitamins, minerals all are sacrificed as well. Seniors need all the nutrients they can get their "mouths" on, so the trick is to eat what are called, nutrient-dense foods. Foods that contain a lot of nutrients in smaller number of calories are known as nutrient-dense foods. Foods that do not come under this category are alcohol, sugar, other refined carbs, and fatty foods; they provide "empty calories", meaning only calories, hardly any nutrients.
Examples of nutrient dense foods good for the elderly can be found at www.whfoods.org by the George Mateljan Foundation.
Elderly require a lot of protein to boost bone matrix, declining serum albumin, and slowing ageing in general. The USPHS recommends 0.85 gm/kg body weight of protein per day, but recently have upgraded it to 1 gm/kg/day. This utopian level is not a big deal for meat eaters because just a small serving of any meat will fetch almost 20 gms of first class high biological value protein. There is hardly any vegetarian food that contains quite as much protein per serving both in quantity and quality, except for soya. Soya is only just getting to be popular and now we can get soya flour, plain or mixed with atta, as well as the nuggets. Unfortunately, soya is not a traditional Indian food, so the Indian recipies for soya are few and far between. Soya has the added advantage of containing plant estrogens, so it could be a good thing for ageing women, but this hopeful thought needs scientific backing. Other vegetarian sources of protein are dhals, including chana (chick peas), rajma, and these are doubly good because of high fibre content. Vegetarians need to ensure that their protein comes from many sources, as vegetable protein from any one source is missing in some essential amino-acid.
Talking of vegetarians, there is the additional concern about adequacy of B12 levels, as this vitamin is present mainly in animal protein; small amounts are also present in milk and eggs, and there is a complex way in which the body conserves and reuses it's stores of Vitamin B12. Hence low levels and related diseases are more due to pathology in the ileum, or lack of intrinsic factor in the stomach, than due to low dietary intake per se. The ageing brain is very vulnerable to low B12 levels, and a reversible form of dementia can occur. Neuropathy and blindness are also likely in deficient states.
Fresh fruits and vegetables are a must for everyone, young and old. Most middle class Indians do not put a great value on fruits because they are expensive and perishable. However, they are invaluable as mineral, vitamin and anti-oxidant and fibre sources. Salads and raw vegetables are not such popular items in the average Indian diet, but should be encouraged, because cooking inactivates so many vitamins.
Ayurveda has a lot to say about ageing and effects of lifestyle, body type and nutrition. I am going to undertake a search of what is known from the Ayurvedic veiwpoint and judge how those concepts are aligned to the allopathic concepts of nutrition.
Eating is also all about tasting and enjoying food. Elderly lose the sense of taste and smell. The "salt" perception declines and "sweet" perception is retained; hence the craving for sweet foods, and the desire to reach for the salt cellar! The answer lies in flavouring foods with herbs such as coriander, spices such as cinnamon, cardamom etc, or the use of enhancers such as monosodium glutamate; reducing the intake of medicines is another way to enhance taste, but may not be always practical.
Perhaps we are just beginning the drive to find the right foods, and the right ways of enticing the elderly palate. Nutritionists, families, general practitioners, and the older persons themselves can all contribute to "eating one's way to healthful old age.......
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