What Healthy Nutrition Guidelines Should I Follow?

“To eat is human; to digest, divine,” the 1909 Nettleton Cookbook, one of America’s earliest cookbooks, says - and many of us, unfortunately, may agree as we experience our bodies slow down with age and have a harder time digesting food. Because digestion, metabolism, and other systems ease into a more relaxed pace as the years go by, it becomes more important than ever to infuse ourselves with nutrition that is mindful of our changing needs.

The United States Department of Agriculture (USDA), along with the Department of Health and Human Services, releases Dietary Guidelines for Americans that help set parameters for healthy eating. The 2015-2020 Guidelines are illustrated for the senior population in a redesigned MyPlate for Older Adults, an icon illustrating the foods that constitute a healthy plate. The key takeaways of this Plate, and major organizations’ consensus on nutrition for seniors, are the following:

• Fruits and veggies reign supreme (> 50% of MyPlate) + the importance of fiber: Fruits and veggies make up over half of MyPlate and are high in essential nutrients and fiber, which older adults need more of. As the digestive system slows down, constipation may become more common. To combat this, fiber-rich foods help move food down the digestive tract and aid with proper digestion. Examples of fiber-rich foods, in addition to fruits and veggies, are whole-grain cereals, breads, pastas; brown rice and bread; and beans and peas.
• Grains make up a significant portion (almost 25%): At almost a quarter of MyPlate, grains are also an important source of fiber as well as B vitamins. Examples: whole wheat bread/couscous, barley, brown rice, oats/rolled oats/oatmeal, muesli, quinoa, fortified foods.
• Protein makes up the final large portion of MyPlate (almost 25%): ...and they come in many forms, including certain dairy products. As we age, we need more protein than when we were younger to help preserve muscle mass, especially as activity levels tend to decrease. In addition, protein-rich foods become even more critical when older adults face stressful situations such as trying to lose weight or dealing with illness and hospitalization. During these times, our aging bodies don’t process protein as efficiently and also need more of it to maintain health and strength. Examples of protein-rich foods: nuts, beans, fish, lean meat, eggs, milk, cheese, and yogurt.
• A small daily portion of dairy can be valuable: Milk, cheese, and yogurt provide protein, calcium, and other important nutrients. 1% dairy products and nonfat powdered milk are better than full-fat versions. Dairy is a good source of calcium, which is essential in older adults as bone loss occurs with age. Bone loss can lead to osteoporosis, and brittle bones contribute to fractures and possible disability. Make sure to add Vitamin D along with calcium for bone health, as Vitamin D helps the body absorb the calcium that builds bones (a lot of milk is Vitamin D-fortified).
• Omega-3 and healthy oils are necessary: They provide fatty acids and fat-soluble vitamins; reduce the risk of a slew of undesirable conditions (heart disease, cancer, rheumatoid arthritis, Alzheimer’s, the progression of macular degeneration); and keep the brain alert. Polyunsaturated and monounsaturated fats are best. Avoid trans and saturated fats, which can be found in foods such as stick margarine, vegetable shortening, and some fried foods (yes, the yummy stuff). Examples of sources of good fats: nuts, seeds, avocados, olive oil, vegetable oils, soybeans, and fish.

These food groups on MyPlate Plan are based on the USDA’s Healthy U.S.-Style Eating Pattern, which adapts to the types and amounts of foods Americans usually consume. To see the illustrated MyPlate for Older Adults, go to: https://hnrca.tufts.edu/myplate/. To personalize MyPlate for yourself, you can access The MyPlate Plan, which shows what and how much to eat based on your age, sex, height, weight, and activity levels: https://www.choosemyplate.gov/MyPlatePlan

In addition to the Dietary Guidelines’ U.S.-Style Eating Pattern, there are two additional Food Patterns with the same nutrient standards. These two Food Patterns might align better with your personal or cultural preferences:

• Vegetarian Eating Pattern: Food group amounts are modified here to adapt to a vegetarian lifestyle. There are more soy products, legumes, nuts and seeds, and whole grains while meat, poultry, and seafood are eliminated. Further substituting dairy into fortified plant-based substitutes (i.e. soymilk) can turn this Pattern vegan. This Pattern is higher in calcium and fiber but lower in Vitamin D when compared to the U.S.-Style Pattern. The USDA provides a table with various calorie levels (depending on your individual calorie needs) to show how much of each type of food you should eat daily: https://health.gov/dietaryguidelines/2015/guidelines/appendix-5/. See further pointers on vegetarian eating: https://www.choosemyplate.gov/ten-tips-healthy-eating-for-vegetarians
• Mediterranean-Style Eating Pattern: If more fruits and seafood (and less dairy) are more your style, it makes sense to follow the Mediterranean-Style more closely. Compared to the U.S.-Style Pattern, this Pattern has lower levels of calcium and Vitamin D due to less dairy intake. See https://health.gov/dietaryguidelines/2015/guidelines/appendix-4/

In addition to trying to align your eating as closely as possible to these Food Patterns, most major organizations agree on the following pointers:

• Don’t forget to hydrate: The body’s ability to conserve water slows down with age, and it may not signal the need for hydration as effectively - that is, you may not feel thirsty when you need hydration. Sip on liquids often throughout the day - it doesn’t need to be only water, if you find that boring! Examples of hydrating liquids: water, soups, tea, coffee, and juices, including those from fruits and vegetables.
• Food is good in many forms: fresh, frozen, canned, dried: Choose the low-sodium or low-sugar options if available; food does not necessarily need to be fresh to contribute to good nutrition, and stewed or canned fruits and vegetables may be easier to eat and digest for those with chewing and swallowing difficulties.
• Salt is a no-no: Salt has been found to contribute to chronic diseases such as high blood pressure; substitute it, and add more flavor, with various herbs and spices. Increasing potassium along with reducing sodium (salt) may lower the risk of high blood pressure. Good sources of potassium are fruits, vegetables, and beans.
• Beware of empty calories: Our appetites may decrease as we age, and activity levels decrease. Combine this with the slowdown in our basal metabolic rate, and this means that we need fewer calories while still having the same nutrient needs than before (and even more of some nutrients, such as Vitamin D). This highlights the importance of ensuring that the foods we consume are nutrient-dense, and not just empty calories. Examples of foods with lots of calories but few nutrients are, again, the “fun” foods: chips, candy, baked goods, soda, and alcohol. Nutrient-dense foods are fruits, vegetables, and fish.
• Supplement if needed: Some of us might have difficulty consuming the recommended amounts of nutrients in a day, in which case it’s a good idea to consult a physician on taking supplements to help meet our nutritional needs. Some key nutrients that are usually lacking in older adults and can be supplemented are: Vitamin D and calcium, B vitamins, and potassium. However, remember that the closer you can get to a good diet and exercise routine, the fewer supplements you will need to meet your nutritional needs. Be careful, too, as supplements may interact with medications you take.
• Keep active: MyPlate emphasizes the need for physical activity with the walking, swimming, and biking symbols positioned on its placemat. Moderate physical activity, combined with mindful nutrition, is the key for staying healthy and lowers the risk for many diseases. Exercise, too, can help counteract the decrease in appetite by making you hungrier!

These may be a lot of things to consider and remember, but the MyPlate graphic simplifies and summarizes the main points. Additionally, eating well doesn’t have to be boring, calculating, or another burden to add: make meals pleasant by turning them into a social event, and remember to treat yourself once in awhile to your favorite foods, even if they aren’t exactly MyPlate quality. After all, what is life without the occasional slice of decadent chocolate cake (or a deep fried funnel cake...or greasy french fries)?

Bibliography

• https://www.ncoa.org/economic-security/benefits/food-and-nutrition/senior-nutrition/
• https://www.washingtonpost.com/national/health-science/for-older-adults-a-protein-rich-diet-is-important-for-health/2019/01/18/886926ce-1a78-11e9-88fe-f9f77a3bcb6c_story.html?noredirect=on&utm_term=.b6ef42264223
• https://www.nia.nih.gov/health/choosing-healthy-meals-you-get-older
• https://health.usnews.com/wellness/articles/2016-05-25/myplate-for-older-adults-adjusts-eating-guidelines
• https://www.silversneakers.com/blog/supplements-older-adults-need-know/
• https://www.webmd.com/healthy-aging/features/missing-nutrients#1
• https://www.eatright.org/health/wellness/healthy-aging/special-nutrient-needs-of-older-adults
• https://www.seniorliving.org/health/nutrition/ (eat slower)
• https://www.aging.com/elderly-nutrition-101-10-foods-to-keep-you-healthy/
• https://www.who.int/dietphysicalactivity/factsheet_olderadults/en/
• https://medlineplus.gov/nutritionforolderadults.html
• https://www.aplaceformom.com/blog/seniors-nutritional-needs/
• https://www.aplaceformom.com/planning-and-advice/articles/nutrition
• https://www.healthline.com/health/healthy-eating-for-seniors#agerelated-changes
• https://health.gov/dietaryguidelines/2015/guidelines/chapter-1/a-closer-look-inside-healthy-eating-patterns/

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