Nutrition's Role in Elders' Wellness

Jack LaLanne, a fitness and nutrition pioneer, rose to national prominence during the 1960s. Many of your older adult patients will remember him well as the man who, in his 70s, beat Arnold Schwarzenegger in a weight-lifting contest. His long life to the age of 96 lends credibility to his message of balancing physical fitness and nutrition, don’t you think?

LaLanne once said, “Exercise is king, nutrition is queen, put them together and you’ve got a kingdom.” So what holds the keys to the kingdom?

What’s on your plate? The food pyramid you may remember from years ago is long gone. Bread and potatoes no longer form the foundation of a sound diet. It takes nutrients from all food groups together, along with exercise and ample water, to create the foundation for a healthy body. Encourage patients planning for each meal to learn to combine larger quantities of vegetables and grains along with protein and fruit to create a balanced plate. It's important to include dairy as a necessary part of daily intake.

Know the daily requirements. As patients age, the daily requirements for total caloric intake decrease. A 25-year-old woman needs 2,200 calories per day. At 50, the requirement is reduced to 2,000, and at the age of 75 it drops to 1,800. For men, requirements at the same ages are: 2,800, then 2,400, and 2,200, respectively.

Decreasing caloric intake requires greater selectivity and improved nutrition strategies to ensure adequate nutrition with every calorie. It’s important to choose intake wisely to avoid consuming empty calories.

Check the labels. Food labels have come a long way since their inception. Patients need to learn how to read food labels and look for the following five facts: checking total serving size and calories; eliminating trans fats; finding the good fats: polyunsaturated or monounsaturated; looking for the dietary fiber content; and finding whole-grain foods where that specific term is listed in the ingredients.

Got water? Water gets no respect. It’s the most underappreciated nutrient around, yet the body cannot store it for a rainy day. Older adults need to have adequate water intake every day, taken any way it’s appealing, whether with lemon or lime, with bubbles or without. But it shouldn’t be taken with caffeine, which acts as a diuretic, causing greater water loss than the amount of intake.

Fresh fruits and vegetables also provide good quantities of water. Add it all up to total the eight glasses of eight ounces of water per day our mothers told us to drink. It’s still the right prescription for most people. Physicians can make individualized adjustments on recommendations for the daily requirement.

To supplement or not to supplement? Evidence continues to be a bit mixed on this topic. Evidence is most clear in certain deficiency states such as low calcium, vitamin B12, or vitamin D. Most recommendations for older adults also include a daily multivitamin even for those with reasonably good diets.

Is there anyone who truly follows all these golden rules? Certainly not all the time, but those in the Mediterranean area appear to have the best and most balanced approach to nutrition. The Mediterranean diet is not a fad diet but rather it is a lifestyle based on eating abundant fresh fruits, vegetables, monounsaturated olive oil, and grains with limited amounts of red meat and most often protein from fish. Served with a glass of red wine daily and what more could you ask for? So here’s to good nutrition for the ages. Salute!

Good general information and a useful PDF: www.nia.nih.gov/sites/default/files/whats_on_your_plate.pdf.

— Rosemary Laird, MD, MHSA, AGSF, is a geriatrician, medical director of the Health First Aging Institute, and past president of the Florida Geriatrics Society. She is a coauthor of Take Your Oxygen First: Protecting Your Health and Happiness While Caring for Someone With Memory Loss.