Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, April 26, 1995 TAG: 9504260010
SECTION: EXTRA PAGE: 8 EDITION: METRO
SOURCE: DEBRA GORDON VIRGINIAN-PILOT STAFF WRITER
DATELINE: LENGTH: Long
That's because such a simple thing as following good nutritional habits as you age can make a dramatic difference in the quality of your later years.
``I can't imagine a better investment in our future than nutrition,'' said Dr. Paul Aravich, associate professor of anatomy and neurobiology at Eastern Virginia Medical School. Aravich lectures fourth-year medical students on the nutritional needs of the elderly.
It's particularly important as this country's population ages. In 1980, about one in 10 persons was 65 or older. By 2030, that number will rise to one in five. And more people will be living longer. In fact, the fastest growing segment of the population now is 85 and older.
And as we age, our nutritional needs change.
Reduced activity and less muscle tissue mean older adults need fewer calories, even as their need for nutrition increases.
Getting the right amount of vitamins and minerals, while eating less, becomes a challenge.
No wonder, then, that health practitioners believe one in four Americans over 65 is malnourished. Or that an Urban Institute report, Hunger Among the Elderly, found as many as 4.9 million elderly, or 16 percent of older Americans, go hungry or worry about how they'll afford their next meal.
The reasons are varied, say the experts, and include poverty, isolation and basic nutritional ignorance.
``Consider an older man who depended on his wife to prepare all his food and meals,'' Aravich said. ``Now, suddenly, he's a widower and has no idea how to prepare a meal.''
The sense of smell tends to decrease with age, which makes food less appealing. Medications that many elderly take can cause loss of appetite, reduced sense of taste and smell, painful swallowing, dry mouth, nausea and vomiting.
And physical disabilities make the daily activities of eating and shopping difficult. A recent study showed that one in five older persons needs help shopping for, buying or cooking food.
One of the biggest contributors to poor nutrition, however, is isolation.
``That isolation and lack of socialization will keep them from having an appetite that would make them feel happy eating their meals,'' said Sidney Brown, nutrition director for the Southeastern Virginia Area-wide Model Program. The program provided meals to about 4,700 people last year through congregate nutritional sites and home-delivered meals.
Once older people get into a nutritional program like SEVAMP's, Brown said, studies show improvement in their nutritional status, and in their mental and physiological states.
Alice Ross, a 65-year-old Norfolk widow, understands the problems of living alone. ``You just don't have a desire to fix a meal,'' she said. So she tries to find healthy, quick foods. She might microwave a bowl of frozen vegetables, for instance.
In the past year, Ross has taken a heightened interest in her nutrition. It started when her doctor said her blood sugar was high. ``I was determined I was not going to take any pills,'' she said, so she asked for a diet.
She used to skip breakfast and then eat continuously from about 2 p.m. on. Now, she eats three well-balanced meals a day, including healthy snacks.
Last fall, Ross took a class in nutrition. On Thursdays, she shares her knowledge in an informal discussion group on nutrition.
That's more interest than some doctors take in their elderly patients' nutritional needs.
``Nutritional deficiencies are frequently not assessed or recognized in the elderly,'' Aravich said. ``So most physicians are not educated effectively in the nutritional health-care needs of the elderly.''
That's dangerous, he noted, because many health problems of older adults could be corrected through proper nutrition.
A vitamin B-12 deficiency, for instance, can lead to senility, paralysis and other neurological problems, all of which can be corrected if diagnosed early. Untreated, the problems can become permanent.
``It's horrible to think about a reversible kind of dementia and paralysis that wouldn't be diagnosed because the physician didn't know about vitamin B-12,'' Aravich said. ``But it's a basic nutritional fact that many are not taught.''
Poor nutrition also can lead to NAIDS - nutritional acquired immune deficiency syndrome. It occurs when people don't get enough protein and are undernourished. Their immune systems begin shutting down, which makes them more vulnerable to disease.
Malnutrition is such a serious issue among the elderly that the Administration on Aging has made it a key part of its blueprint for an aging society, holding regional forums to increase awareness.
``Eight in 10 chronic illnesses are influenced by nutrition,'' said Jean Lloyd, nutrition officer for the Washington, D.C.-based AOA. ``So it's integral to their health and functioning and to keeping people at home and independent.''
So what's an older person to do?
What are the nutritional needs of the 65-year-old? The 85-year-old? The 97-year-old?
No one really knows, Aravich said, because nutrition in the very old hasn't been studied. Current recommended daily allowances (RDAs) are based on three populations: 19 to 24 years; 25 to 50; and 50 and older.
Comparing a 50-year-old with an 80-year-old is like comparing a 3-year-old with a 33-year-old, Aravich said. ``If you look at the RDA for various vitamins, there's quite a bit of controversy as far as what's really needed for the elderly . . . the current recommendation for vitamin A may be too high; but vitamin D recommendations may be too low. And you look at antioxidants like vitamin E and you're not really too sure what the deal is.''
The Department of Agriculture suggests a diet of about 1,600 calories a day for most older adults, including six servings from the bread and grain group; two fruit servings; three vegetable servings; two to three dairy servings; and 5 ounces from the meat group.
Aravich and other nutritional experts recommend increasing calcium servings to five a day to avoid deficiencies.
He warns about eating too much fiber in an effort to avoid constipation, a common problem as we age. High fiber can impair the absorption of calcium, Aravich warns, which can lead to brittle bones.
Nutritionists also suggest lots of liquids. Findings from the Nutritional Research and the Elderly conference held in March in Washington, D.C., showed a simple lack of fluids causes physical ailments and mental disturbances in some older people.
Particularly good are juices like V-8, which contain fiber and water-soluble vitamins, and come in one-serving cans.
The recipe on this page and those on Page 5 address some of seniors' most common dietary needs, including simple preparation; small number of servings; low-cost ingredients; plentiful amounts of fruits, vegetables and calcium; ease of ingestion and digestion; and, of course, good taste.
Recipes for:
Busy-day goulash
Cream of Potato Soup
Chicken vegetable soup
Fresh fruit 'n pudding
Easy baked chicken
by CNB