Food Becomes You: Nutrition and Aging

by Wendy Gordon

A friend of mine once told me that she planned to resume all her old bad health habits at the age of seventy, because by then "it wouldn't matter anymore." To some degree, she's right.

As Jennifer Anderson, nutrition specialist for Colorado State University Cooperative Extension, states: "A lifetime of eating and lifestyle habits goes into the making of each elderly person." By late middle age, bad habits of your youth have a nasty habit of coming home to roost. On the other hand, if you are lucky enough to have a genetic predisposition to protect you from these consequences, that will manifest itself, also. That doesn't mean good health habits can't prevent further damage or even ameliorate existing problems, but there's only so much a healthy diet can do to clear clogged arteries or repair livers damaged from years of abuse. On the other hand, if Grandma's been eating bacon and eggs for the last eighty years and remains hale and hearty, she may as well continue enjoying them for the rest of her life.

Due to the infinite variations in diet, genetic predisposition and lifestyle, the elderly population is the most diverse in the world, and not as readily categorizable as both health professionals and the popular media would like to believe. Complicating the issue is the way people over fifty are lumped together in many health statistics and most governmental dietary recommendations. Needless to say, there are huge physiological and functional differences between fifty year olds and eighty year olds. For example, middle age is a time when people tend to put on weight, with negative health consequences, so limiting calories is generally good advice. Yet many elderly people actually lose weight, so obtaining sufficient calories becomes a priority in old age. Very few studies have been done on how "normal" parameters change as we age: whether a high cholesterol level at age 25, say, is the same as a high cholesterol level at 55.

Here's a summary of the most common physiological changes associated with aging.

As we age, we tend to lose lean body mass. The most significant manifestation of this is a decrease in basal metabolism, as metabolic rate declines proportionately with the decline in total protein tissue. Not only do adults gain weight more readily towards old age, they tend to gain it more in the midsection, a pattern that seems to increase the chance of heart disease. In addition, the body loses its ability to generate new protein tissue, leading to loss of function in the heart, kidneys, lungs, and liver. Slowed protein synthesis also impairs immune system response and other factors in proper cell growth, making older people more susceptible to infections and cancer. Losing lean body mass poses a challenge, but is not inevitable. This tendency can be, at least partially, counteracted by regular weight-bearing exercise and eating lean sources of high protein food.

Our bone density increases only until approximately age twenty-five, so as we age we also lose bone density. Genetic predisposition plays a large role in osteoporosis and the bad news is bone density loss is less amenable to dietary manipulation than lean body mass. This is especially true for postmenopausal women. Most health professionals routinely recommend that all women over fifty increase their calcium consumption to 1200mg/day. How effective this is in preventing osteoporosis remains controversial, but it certainly can't hurt to take calcium supplements and eat foods high in calcium such as dairy products, almonds and dark green vegetables. As well, there has been increased attention to the importance of vitamin D in bone health, so make sure your calcium supplements contain vitamin D. Also, get some exposure to the sun every day. Many older people do not spend enough time outdoors. Other minerals such as potassium and magnesium also play a role in osteoporosis. Perhaps more important is the exercise component; weight bearing exercise builds bone density, and yoga and Pilates can help retain spine and hip flexibility.

Generally speaking, nutrient absorption does not change as we age. The main exception is vitamin B12, which is not absorbed as efficiently. Severe B12 deficiency takes years to develop, but can mimic Alzheimer's and is frequently misdiagnosed. All animal protein foods are rich in B12, but people completely lacking the absorption enzyme may require occasional B12 injections. Vitamin E and other antioxidants may help prevent Alzheimer's disease. Chronic illness, medications and a monotonous diet often lead to certain deficiencies, especially in iron and zinc. Zinc, vitamins C and E, and the phytochemicals lutein, zeathanthin and betacarotene may slow the onset of age-related macular degeneration. In all these cases, a wide variety of whole, unprocessed foods is largely more effective than supplements.

As we age, our ability to detect thirst lessens. Many elderly people are chronically dehydrated. This leads to constipation, impaired kidney function and fatigue. Elderly individuals should routinely drink five to eight cups of water or juice per day (no, tea and coffee don't count).

As well, we tend to lose sensory acuity as we get older. Reduced smell and taste can lead to lessened or monotonous food intake. This can be exacerbated when elderly people are placed on highly restricted diets. For no seemingly logical reason, food in hospitals, assisted care centers, and nursing homes tends to be bland and tasteless. Unless there is a compelling medical reason not to, elderly people should be encouraged to eat more robust flavors, not less. By the age of seventy, people should be aware of whether or not they are susceptible to high blood pressure caused by excess dietary sodium. If they are, they can perk up the taste of their food by using fresh, unprocessed products, fresh lemon and lime, herbs and pepper. If they are not affected by excess dietary sodium, there is no reason to arbitrarily restrict salt.

Another issue many elderly people deal with is living and eating alone. Preparing meals for one can be an overwhelming and lonely business, often leading to irregular and monotonous eating habits, and over reliance on processed foods. Obviously anything that makes eating less of a lonely proposition helps, whether it be organized senior citizen dining programs, meals on wheels, inviting your elderly aunt over for dinner, or if you are the elderly person yourself, sharing meals with friends. Your co-op deli counter is a great place to buy prepared foods with high nutrient ingredients and robust flavors.

Since the effect of pesticides is cumulative, it is true that health-wise, the younger you are, the more critical it is to begin eating organic foods. While organic food can be pricey (and out of many elderly individuals' budgets) I would encourage everyone to buy organic whenever possible.