Keeping healthy in old age
My bedtime reading this week has been the Ministry of Health's updated 156-page Food and Nutrition Guidelines for Healthy Older People, which is primarily aimed at health practitioners. I will give you the highlights, but for the full version visit health.govt.nz/publications, where there is also a pamphlet you can download, which contains more user-friendly information.
Good nutrition is even more important for good health as we age. It can help to:
The nutritional status of older people is affected by many factors:
Some of these factors are irreversible (such as sarcopenia), but some are modifiable. Targeting these modifiable factors (perhaps by enrolling in some basic cooking classes or getting your dentist to check the fitting of your dentures) may result in an improvement in the general state of your health, as well as your enjoyment of food and life.
The updated guidelines recommend that people over the age of 65 maintain a healthy body weight by eating well and by daily physical activity.
They should also eat well by including a variety of nutritious foods from each of the four major food groups each day:
An area deserving special mention is bone health in older people. Strong, healthy bones require adequate calcium, vitamin D and regular weight-bearing activity, such as walking. A lack of any or all of these can easily lead to osteoporosis and fractures.
Many older people do not consume enough calcium each day. The recommended daily amount is about 700mg for women over 65, and 800mg for men. Calcium is found primarily in milk and other dairy products, but there are also reasonable quantities in bread, vegetables, canned fish with bones (such as salmon or sardines), legumes, nuts, tofu and dried fruit.
Vitamin D unfortunately is not readily available in food. Small amounts can be found in oily fish, eggs and liver, but most of our vitamin D is obtained from exposure to sunlight.
As older people don't absorb vitamin D as easily as younger people do, and are often immobile or house-bound due to chronic illness, they are often at risk of vitamin D deficiency.
In summer, exposing the skin on your face and arms to sunlight for at least 30 minutes will be beneficial, but this is unlikely to be enough over the winter months.
If you are living in a residential home, or are concerned about your vitamin D or calcium intake, talk to your GP, who will be able to give you dietary advice and suggest supplements if required.
Cathy Stephenson is a GP, medical forensic examiner and mother of three. If you have a question, write c/o Features Editor, The Dominion Post, PO Box 3740, Wellington 6140, or email email@example.com
The Dominion Post