Friday, October 13, 2017

Why Eating Right can Help you Heal

How your body processes and converts food into nutrition

Annually the U.S Department of Agriculture and the U.S. Department of Health and Human Services produce Dietary Guidelines for Americans, which offers advice to promote health and to reduce the risk of chronic diseases through diet and physical activity. One of the basic messages of the Dietary Guidelines is that nutrient needs should be met primarily through consuming foods. In certain cases, fortified foods and dietary supplements may be necessary to provide one or more nutrients that otherwise might be consumed in less than recommended amounts.  Foods that provide an array of nutrients and other compounds, within calorie needs, that have beneficial effects on health. This is of particular importance for the older adult with set food habits, who with aging, tends to reduce the amount of calories consumed. Older adults require a high quality diet with nutrient-dense foods and beverages. This translates into food choices with sufficient calories and concentrated nutrients. All vegetables, fruits, whole grains, fat-free or low-fat milk and milk products, seafood, lean meats and poultry, eggs, beans and peas (legumes), and nuts and seeds that are prepared without added solid fats, sugars, starches, and sodium are nutrient-dense.  We are often feeding smaller appetites that require additional nutrients due to the physiological changes of aging that can impair nutrient absorption and utilization.

Important Nutrient Needs for Older Adults

Protein—Protein is the foundation upon which every living organism is built. The body does not store amino acids (the building blocks of proteins), so an adequate daily intake of protein is needed to supply your body with all the 20 major amino acids.  Adequate intake of dietary protein is extremely important for tissue repair and healing, especially in the older adult.  Illness, surgery, and inadequate food intake can result in protein energy malnutrition that can impair immune function, increase susceptibility to infections, slow wound healing and increase skin breakdown. 

New evidence indicates that eating peanuts and certain tree nuts (i.e., walnuts, almonds, and pistachios), which are high in protein, reduces risk factors for cardiovascular disease when consumed as part of a diet that is nutritionally adequate and within calorie needs. Because nuts and seeds are also high in calories, they should be eaten in small portions and used to replace other protein foods.  They are so energy dense and tasty that it can be easy to eat excessive amounts. Choose unsalted nuts and seeds to help reduce sodium intake. 

In 2003, FDA allowed the first qualified health claim for nuts, suggesting that scientific evidence supports that eating 1.5 ounces per day of most nuts as part of a diet low in saturated fats and cholesterol may reduce the risk for heart disease.  Clinical trials with tree nuts have reported favorable reduction in cholesterol levels, particularly the bad LDL cholesterol that elevates heart disease risk. This effect has been demonstrated consistently in different population groups using different study designs and methods.

Carbohydrates and Fiber — Sufficient carbohydrates are needed to protect protein from being used as an energy source, however it is recommended that carbohydrate intake is limited to whole-grain high fiber unprocessed foods.  The refining of whole grains involves a process that results in the loss of vitamins, minerals, and dietary fiber.  There are three types of carbohydrates - sugar, starch and fiber. Both sugar and starch are turned into sugar and since the body lacks the enzymes needed to digest fiber, it is the only carbohydrate that doesn’t convert to sugar.  

By limiting your daily intake of low fiber highly refined carbohydrates, you also limit your sugar intake.  About 78 million Americans—35 percent of the U.S. adult population over age 18 —have pre-diabetes, which means that blood glucose (sugar) levels are higher than normal, but not high enough to be called diabetes. Carbohydrates in the form of fiber can be found in a variety of fruits, vegetables, and whole grain foods.  Avoid highly refined grains, as these also can be high in solid fats and added sugars (e.g., cookies and cakes).  

Calcium — As people age, a decrease in calcium absorption occurs. When the body does not get enough calcium per day, it draws calcium from your bones.  Bone loss also occurs as part of the normal aging process, particularly in postmenopausal women due to decreased amounts of estrogen.  The elderly population is especially susceptible to osteoporosis (bone loss) and bone fractures. One out of every two women and one in four men over age 50 will have an osteoporosis-related fracture in their lifetime. Many factors increase the risk of developing osteoporosis, including being female, thin, inactive, or of advanced age; smoking cigarettes; drinking excessive amounts of alcohol; and having a family history of osteoporosis. Supplementation with calcium plus vitamin D has been shown to be effective in reducing fractures and falls (which can cause fractures) in institutionalized older adults. Some good sources of calcium include yogurt, milk, cheese, firm tofu, canned salmon with bones, spinach, and rhubarb. 

Vitamin D Vitamin D is generally referred to as ‘the sunshine vitamin’ as it is created by our bodies with sun exposure.  However, recent findings of low Vitamin D levels in many patients lead some to believe that despite getting at least 20 minutes of sunshine daily and adequate intake of foods high in Vitamin D, a daily supplementation is necessary to reach optimum levels.  Additionally, if your body doesn’t have sufficient precursors in your skin to convert to Vitamin D, no amount of sunshine will help and supplementation will be required.  Recent research has shown a possible link between Vitamin D supplementation and lowered risk of dementia, heart failure, diabetic neuropathy, and even cancer.  Adequate vitamin D also can help reduce the risk of bone fractures, especially when taken with calcium supplementation.  Some sources of Vitamin D are vitamin D milk, egg yolk, salmon, tuna fish, and sardines. You can ask for a simple blood test from your healthcare provider to determine your risk for Vitamin D deficiency.

Water Aging adults are more susceptible to dehydration due to inadequate daily intake of fluids. The ability to sense ‘thirst’ is reduced and can significantly decrease optimum fluid intake to cause dehydration.  By the time one senses they are thirsty, the body is already dehydrated to a slight degree so that sensing a feeling of thirstiness is actually a symptom of dehydration.  Because our bodies need water to function normally, when you’re dehydrated you may feel tired, have trouble concentrating or wind up eating more than usual since our bodies often misinterpret thirst as hunger.  Beverages that contain caffeine or alcohol can be dehydrating, so be sure you drink plenty of water to offset your coffee or alcohol consumption.  A minimum of 1500 cc’s / day is recommended for most adults, but there can be lesser requirements for some patients with certain medical conditions (like kidney disease). Be sure to consult your healthcare professional for the amount of fluid you are allowed to consume daily.

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