Eating for a Longer, Healthier Life

In the United States, people are living longer. It is estimated that by 2060, over 98 million people will live to celebrate their 65th birthday. Why? More studies show that proper diet and exercise can prevent most chronic diseases, thus helping people live longer, healthier lives. As we age, our organ function gradually declines. Aging, however, doesn't have to equate to illness or poor quality of life for everyone. Instead, proper nutrient intake, diet, and exercise are important for a long, healthy life.

As a Clinical Dietitian working with seniors in long-term care, I often see families mistakenly providing foods that don't support their loved ones' needs. I see diabetic residents with cupcakes or cardiac residents with fast food brought in by a family wanting to bring a treat or food for a resident they believe won't eat anything else.

As someone who loves cupcakes and burgers, I would never tell someone they can't have a treat. My motto has always been, "Everything in moderation". However, as we age, nutrition becomes more, not less, important.

The senior community has decreased muscle mass and strength, immunity, bone density/calcium bioavailability, vitamin absorption, ability to regulate fluid balance, and slowed gastric motility. A decrease in total energy expenditure and reduced physical activity results in a reduction of appetite.

Food: Fuel for Life

When someone only eats small amounts, it is essential to provide them with nutrient-dense foods. Consuming nutrient-dense foods can prevent osteoporosis, fractures, and chronic illnesses such as diabetes and heart disease. Seniors should consume:

• 6oz of whole grains and fortified foods such as whole grain bread, oatmeal, certain cereals, brown rice, and pasta.
• 3 cups of dairy fortified with vitamins A and D, including animal or plant-based milk, cheese, and yogurt
• 5 – 6oz of protein from nuts, lean meat, eggs, beans, and poultry, and 8oz of seafood a week
• 2 cups of fruit
• 2 ½ cups of vegetables daily; frozen and fresh is best. If only canned vegetables are available, choose varieties with no added salt or packed in their juice.
• Healthy fats such as olive oil, canola oil, and plant-based margarine with sterols and stanols.

It is important to season foods with different herbs and spices to reduce the need for salt. Solid fats, added sugars, and added salt should be avoided.

Hydration: Water for Life

It is also essential to consume adequate fluids. Water supports our body's function in all activities, including but not limited to transporting nutrients and waste through the body. Dehydration in older adults leads to severe complications such as hypotension, constipation, nausea, vomiting, decreased urinary output, elevated body temperature, urinary tract infections, and increased mental confusion in both men and women.

In older adults, physical limitations in activities of daily living can limit fluid intake. This could mean that the person is continent but must rely on someone to help them to the bathroom, therefore not drinking fluids for fear of being a burden or just fear of not making it in time. Or if a person is on their own and in pain or knows they take a long time to get to the bathroom, they may not drink enough.

A decline in one's mental status, such as depression, can cause dehydration as you neglect to drink liquids.

Seniors' recommended daily fluid needs are- >1500ml of water daily (6 ¼ cups) unless otherwise specified. When a resident has trouble meeting nutrient or fluid needs, I recommend an oral nutrition supplement between meals, such as a Boost or Ensure, and a Glucerna for people with diabetes. This will still provide an opportunity to eat meals. I also like to suggest a multivitamin supplement to optimize nutrition.

I am honored to be a Registered Dietitian for Allied Services. It allows me to provide nutrient-dense meals to each person based on their wants and healthcare needs. In our facilities, I can encourage residents to join activities such as chair exercises, and I can see progress made with the best therapy departments in our area.

While only some seniors have nutritional support available in long-term care or assisted living, National Nutrition Month is an excellent opportunity to learn about the resources available in your community. There are resources available through local non-profits and organizations such as the Commission on Economic Opportunity, The Food Dignity Movement, many food pantries, Friends of the Poor, and Geisinger's Fresh Food Farmacy, as well as local farmer's markets that can help provide nutrient-dense healthy foods at no or a low cost. Some organizations will likely have nutrition information as an additional community resource. Additionally, by speaking with your primary care physician, options may be available to receive an order for a Multivitamin with Minerals or Oral Nutrition Supplements with a copay. I encourage you to look at all available resources provided to this community of older adults.

Cari Snyder, RDN/LDN, Clinical Dietitian, works with patients at Allied Services Meade Street and Center City Skilled Nursing facilities in Wilkes-Barre.