THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Thursday, March 30, 1995 TAG: 9503290036
SECTION: FLAVOR PAGE: F1 EDITION: FINAL
SERIES: SPECIAL NUTRITION SERIES
PART 5: THE ELDERLY
It's National Nutrition Month. Each Thursday in March, Flavor has
presented special stories on nutrition issues that affect you and your
family. This is the last in the series.
SOURCE: BY DEBRA GORDON, STAFF WRITER
LENGTH: Long : 207 lines
THE FOUNTAIN of youth - or at least wellness - may be found in a bunch of broccoli. Or a pound of kale. Or a dozen oranges.
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, 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 stated.
Learning proper diets
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 at Tidewater Community College. On Thursdays, she shares her knowledge in an informal discussion group on nutrition at the Norfolk Senior Center.
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 (AoA) 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 many unknowns
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.''
Contrary to what most Americans think, being a bit heavy is a good thing as we age, Aravich said.
``If we look at body weight as a predictor of mortality, and look at the overweight and obese elderly versus the underweight elderly,'' Aravich said, ``it's the underweight that are at far greater risk for morbidity and mortality.''
That's not to say older adults should feast on cakes and candies. They still need to follow recommended nutritional requirements.
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 earlier this month 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. MEMO: RATE YOUR NUTRITIONAL I.Q.
HERE'S A checklist from the Nutrition Screening Initiative to
determine your nutritional health if you are a senior citizen:
For each ``yes,'' score the number noted:
I have an illness or condition that made me change the kind and/or
amount of food I eat. (2)
I eat fewer than two meals a day. (3)
I eat few fruits or vegetables, or milk products. (2)
I have three or more drinks of beer, liquor or wine almost every
day.(2)
I have tooth or mouth problems that make it hard for me to eat. (2)
I don't always have enough money to buy the food I need. (4)
I eat alone most of the time. (1)
I take three or more different prescribed or over-the-counter drugs a
day. (1)
Without wanting to, I have lost or gained 10 pounds in the last six
months. (2)
I am not always physically able to shop, cook and/or feed myself.
(2)
NUTRITION SCORE
0-2: Good! Recheck your nutritional score in six months.
3 to 5: Your are at moderate nutritional risk. See what can be done to
improve your eating habits and lifestyle. Contact SEVAMP, a senior
citizens center or your health department. Recheck your nutritional
score in three months.
6 or more: You are at high nutritional risk. Bring this checklist the
next time you see your doctor, dietitian or other health or social
service professional. Talk with him about problems you may have. Ask for
help to improve your nutritional health.
- Debra Gordon
ILLUSTRATION: Color Illustration
SAM HUNDLEY/Staff
Experts say older adults should have two or three servings of fruit
and dairy products each day.
LOCAL RESOURCES
SEVAMP, the Southeastern Virginia Area-wide Model Program, runs
congregate meal services at 24 sites in Hampton Roads.
The sites provide at least one nutritionally balanced meal five
days a week for people 60 and older and their spouses, as well as
social interaction.
For the location of the meal site nearest you, call SEVAMP
nutritional services at 461-9481.
SEVAMP's home-delivered meal service is determined on the basis
of eligibility. For a free eligibility screening, contact SEVAMP's
intake specialist in Chesapeake, Norfolk, Portsmouth and Virginia
Beach at 461-9481; in Suffolk, 934-1661; in Franklin, 569-8206; in
Isle of Wight, 357-4050; and in Southhampton, 653-2105.
Depending on your income, you may be eligible for food stamps.
Call your local Social Services department for more information.
DIET DILEMMA
Of the 10 leading causes of death among the elderly, eight are
related to diet and nutrition.
85 percent of older people today have a chronic condition or disease
related to nutrition.
An estimated one in four elderly Americans doesn't get enough to
eat, or the proper nutrition.
Between 35 percent and 50 percent of older residents in long-term
care facilities are malnourished.
As many as 65 percent of the elders in hospitals may be
malnourished.
Source: Administration on Aging
by CNB