Tips for Elder Nutrition

As people get older, their appetite often shrinks. This is partly due to decreased physical activity (compared to your 20’s, 30’s, or 40’s) and a resting metabolic rate that is a part of natural aging. It can also be due to changing taste buds including a decreased sense of smell and taste. Sometimes if people are losing their sight, it can also change how they feel about food and eating. However, sometimes this decreased appetite is due to other factors such as:

• Depression (unhappy with lifestyle changes, more limitations, new health conditions, loneliness, or change in living situation)
• Health Conditions like Congestive Heart Failure, Chronic Obstructive Pulmonary Disorder, Diabetes, Cancer, Thyroid Disorders, or Gastrointestinal issues (ulcer, constipation)
• Medication side effects, which can suppress appetite
• Dentition changes or poorly fitting dentures can also impact someone’s ability to chew or manage foods comfortably. This could decrease the amount of food they eat. Weight loss can also cause dentures to become loose which then adds to the problem!
• Less desire or ability to cook
• Salivary Gland Dysfunction (a.k.a. Dry Mouth)

 
So…What Can I Do About It?

Check to see if any of the above factors in blue could be affecting you or your loved one. Any unexplained changes to your loved ones’ dietary health, including unexpected weight gain, loss or general malaise (lethargy, fatigue), should be checked out with a physician. These tips are general recommendations and are not a substitute for medical care.

• Eat more frequent, small meals instead of 3 larger ones each day (4-6 little meals is ideal). This cuts down on feeling ‘overly full’, makes you less likely to skip a meal, and helps reduce reflux in some people.
• Focus on quality, not quantity. Larger portions can overwhelm our elders and ‘turn off’ their appetites even more. Instead of giving them more food, make every bite of a smaller meal count. Make sure your meals are full of nutrients and protein. (Suggestions are listed below)
• Be social at meals – it helps people of all ages keep their minds active, young, and encourages greater intake of food. If you or your loved one lives alone, you can try checking out the meal options at senior centers, temples or churches, and community centers. You can also try to schedule “dates” with friends, family or caregivers to minimize dining alone. Try to keep a regular eating schedule. If you have a routine, your body remembers more easily and you will be less likely to ‘forget’ a meal because you were distracted or busy.
• Be aware of medication side effects. If you are on a medication that requires you to take it on an empty stomach early in the day, try to take it as soon as you wake up; this will allow you to have breakfast within a reasonable amount of time. If you are taking a medication that causes dry mouth, you can use oral swabs, rinses, or more frequent brushing to keep your mouth moister.
• If you are able, have health shakes like Ensure (milk based), Boost (milk based), or Orgain (organic and plant based) as either a snack between meals or as one of your several small meals for the day (this means have breakfast, have lunch, have your shake, have dinner). Do NOT use this as a main ‘meal’ replacement!
• If your taste buds are dulling and your sense of smell just isn’t what it used to be, try adding more flavors to your foods (no necessarily salt). Be creative and focus on foods you or your loved one used to enjoy (e.g. loves chicken salad, but now it just tastes like nothing; add in some paprika, chopped shallots/onions, garlic powder, or sweet basil. Find a flavor that makes it more appealing).

• As long as it is okay with your doctor, indulge in fats and treats! Have ice cream when you feel like it. Have a full fat yogurt – don’t worry about your waistline the way you did when you were younger. Have puddings and cheeseburgers! My grandmothers used to talk about their low fat yogurts and their fat free cheeses. I told them, eat the full fat stuff, you need the calories and fats to keep your weight up.
• Make sure to discuss proper nutrition with your loved one. No one likes to feel left out of a conversation, especially when it is about them! You can talk about any causes that are obvious (dentures don’t fit, cataracts is impacting ability to see, etc.) and little things you can do to help. You can tell them some dietary options, and make changes to their schedule or routine to help make things easier. Definitely talk about constipation! If you are backed-up, you don’t usually feel like eating much. Keep those bowels moving!
• Read my section on ‘But I don’t cook anymore’ for suggestions about meal planning.

Some examples of meals you can have include:

Eat these meals at any time of day! If you want eggs and bacon for dinner, go for it! If you want a sandwich for breakfast, no problem!

• Oatmeal with fresh fruit for breakfast – oatmeal is a good source of fiber and protein.

	• Eggs and bacon/sausage or sunny side up eggs on toast
	• Pancakes with butter and a side of bacon/turkey bacon/sausages; or with fruit
• Bran Flakes or another preferred cereal with half a banana and whole milk (or 2% if the whole milk is too rich for your digestive system)
• Greek Yogurt with fresh fruit (banana, strawberries, blueberries, etc.) – Greek yogurt is a good source of protein! You can even make a parfait!  Regular yogurts are fine too, but Greek has more protein and less sodium, but regular yogurt has a lot more calcium!
•  ½ a sandwich (tuna, turkey, egg salad, ham, BLT) with a side salad. By the way, you can eat the whole sandwich if you’re willing and able!
•  Have some veggies and hummus for a snack (cucumber slices, carrot sticks, broccoli florets, cauliflower florets, green beans).  They are rich in fiber and easy to prepare, especially if you use frozen veggies sometimes.
• Chunky chicken and vegetable stew with added rice, noodles, or potatoes. You can put in carrots, celery, broccoli, cauliflower, onions, tomatoes, cut green beans, peas, or whatever you like. I usually do about 3-5 veggies and then add in a starchy food to bulk it up. You can also add in beans for a lovely burst of fiber and protein! If you can’t cook it, have a loved one do it. You can make cooking simpler if you use frozen or canned veggies.
• White or black bean dip or hummus with chips!
	• 4 oz of chicken with roasted butternut squash
• 4 oz of beef with potatoes and steamed broccoli
	• 4 oz of baked fish with spinach and quinoa
• 4 oz of lamb with potatoes and green beans (I love lamb meatballs the most, but any kind of lamb is rich in vitamin B12).
• Try making yogurt smoothies, ice cream smoothies or protein smoothies (use the Ensure as your dairy). Just pick your dairy product (or dairy substitute such as soy milk) and add in a fresh or frozen fruit of choice (peaches, raspberries, blueberries, strawberries, banana, etc.). Now blend it up and enjoy! If you make more than 8 ounces, put some in the fridge for the next day.
• You can have a salad topped with rich nutrients and good fats – such as avocado, walnuts/almonds, slices of chicken, hard boiled eggs, or shrimp.
• Make salad dressings really count! Use good quality oils like olive oil, coconut oil, walnut oil, or avocado oil. A Tbsp goes a long way to add healthy fats to your meal.
• You can eat a half of avocado as a wonderful snack.  Rich in green color, soft to eat with a spoon (when it is ripe) and full of good healthy fats and vitamins.  You can also spread it onto a piece of whole grain toast or crackers if you mash it with a fork beforehand. Once you cut it open, you can eat the half without the large pit first, then when you are ready to have the other half, hit the pit with a knife blade (carefully) and it will come out easily if the avocado is ripe.
	• Whole grain toast with peanut butter or almond butter.  You can even slather on some Nutella chocolate hazelnut spread for an extra sweet treat!  Have ½ a banana or some canned fruit with your toast.
• Instead of Jello, have almost any other snack! Jello has virtually no nutritional benefits and offers very little calories, protein, or nutrients. You can have apple slices, an orange, a clementine, or some grapes. They offer the same sweet satisfaction but offer vitamins and fiber that Jello does not have!

Other Important Tips:

Stay on ahead of constipation – have high fiber foods daily. These foods will help keep your bowels moving and prevent constipation.  The last thing anyone needs is to be constipated or even impacted!! Don’t wait until you’re bound up, keep these things in your daily routine! You can:

• Drink water! It is good for moving your bowels and also for keeping you hydrated. Try to drink between meals so that you have room for foods at meal times.
• Eat Prunes and other dried fruits like apricots and raisins
• Beans, beans, beans! Any kind of bean will do – buy them dried or canned (I prefer boxed or canned, no added salt, BPA free). Add them to soups, stews, salads, make into hummus/dips, etc. Versatile and good for your belly! Just start slowly (have a serving 2x a week at first) and add more into your diet as you become accustomed to the increase in fiber.
• Coconut is a great source of fiber and healthy fats. You can eat coconut flakes or chips, you can drink coconut water which is hydrating and high in potassium, or you can buy coconut flour and add it to your favorite recipes. I use it in smoothies like the one below (1/4 cup has 10g of fiber in it, wow), as a combination flour in baking (like the cake below), or as a part of my breading for fish or chicken.

• Eat some artichokes – they are high in fiber and easy to find frozen, canned or fresh
• Some veggies are good for moving the bowels along. You can try broccoli, cauliflower, leafy greens, and Brussel sprouts.
• Tropical fruits like kiwis, peaches, and ripe/over-ripe bananas help move things along; apples can also be helpful (you can eat them raw in the spring and summer, or bake them in the fall and winter – gives you variety). **Under ripe or green bananas can be constipating!
• Whole grains – oats, bran, barley, brown rice, teff, sorghum all contain a decent amount of fiber. Use these grains instead of white grains such as white rice and white flour breads.
• Coffee works for some people because it is a stimulant and wakes your bowels like it wakes up you!  Don’t have loads of coffee though to resolve constipation, just a cup a day can add to the rest of your healthy dietary habits.
• You can also take a probiotic every day that contains good strains of lactobacillus. Look for specific strains included in the probiotic, look for expiration dates, and quality guarantees. If they are being shipped, be sure they come with ice packs or they can spoil. Probiotics not only keep your gut and intestines healthier, they can boost your immune system from the inside out. I buy mine from Klaire Labs, but there are other high quality ones on the market. Look for those that need to be refrigerated and contain strains lactobacillus such as L. acidophilus, B. longum B. bifidum. You can talk to your doctor about laxative supplements that might be appropriate for you. **Try to avoid foods like cheeses, fried/fatty foods, and junky snacks like chips.

Watch your sodium levels. Too much salt is bad for you – increases blood pressure, can cause swelling or bloating, and if you’re on a restricted salt diet, it can be a major health risk to ignore warnings about how much salt you are eating. People on low salt diets should get 1500 mg or less per day.

• Check food labels to see how many milligrams of sodium. DO NOT USE PERCENT at ALL. It does not apply to you because you’re on a low salt diet.
• You can have up to 1500 mg of sodium per day (low sodium diet). If you have less than 1500, that is okay. Make sure you get at least a little sodium daily because it is important for keeping your body balanced and your heart healthy.
• Make sure to eat potassium (vitamin K) rich foods every day. It helps lower salt levels in your body and can help lower blood pressure a little.
• What foods have potassium?
  Bananas, sweet potatoes, potatoes, greens, spinach, mushrooms, lima beans, peas, tomatoes and tomato products, oranges and orange juice, cantaloupe and honeydew melon, prunes and prune juice, apricots and apricot juice, raisins and dates, halibut, tuna and molasses. You can also have grapefruit and grapefruit juice, BUT talk to your healthcare provider first if you’re taking a cholesterol-lowering drug because it can interfere with effectiveness.
  

Disclaimer:  This is not intended to be a substitute for medical advice.  Always check with your doctor before making any major changes to your diet.  Some people have dietary restrictions due to medications that they take such as blood thinners or must avoid certain foods due to other conditions.