Supplements for Older Adults

The human body is a complex network of different systems, all intricate in their design and function. What each system has in common is its need for nourishment, mostly in the form of nutrients, to operate properly.  Antioxidants, vitamins and minerals work synergistically to help the body reach optimal health. Deficiencies in these nutrients can have serious consequences. The immune system, bones, vision, mental clarity, blood pressure, metabolic function and energy are just a few of the health areas influenced by a deficiency in one or more vitamins and minerals. There is no substitute for a healthy, well-balanced diet; however, in today’s fast-paced lifestyles it is important to ensure the body is getting the fuel it needs.

Ideally, consuming foods such as fruits and vegetables can provide antioxidant protection to cells from the damaging free radicals as well as offer other essential vitamins and minerals that help the body perform optimally.  Unfortunately, many foods today are grown in mass quantities in soil that has been nutritionally depleted over many years of use. In a landmark study published in 2004, nutritional data of various vegetables and fruits over a 50-year period were found to have ‘reliable declines’ in protein, calcium, phosphorus, iron, Vitamin B2, and Vitamin C. It was felt this was due to the modern agricultural practices designed to breed new crops that provide larger yields, pest resistance, and climate adaptability.[i]

Combine the nutrient-deficient soil with over-processing and refinement of our foods, then add chemical preservatives and artificial color and flavor enhancers, and there is now a great need to supplement the missing vitamins, minerals, and antioxidants on a daily basis to help combat the inflammation and free radical production that our modern lifestyle generates. [ii]

Because dietary supplements are not FDA regulated as prescription and non-prescription drugs are for standards, safety, and effectiveness, there can be a wide variety of products on the market to choose from.  These can range from poor quality supplements with high amounts of fillers and nonessential ingredients to high quality, isotonic forms that have FDA marketing approval as high quality and easily absorbable. 

Vitamins are divided into two types: fat-soluble and water-soluble. Fat-soluble vitamins (vitamin A, D, E and K) are stored in the fat tissues and liver. They can remain in the body up to six months. When the body requires these, they are transported to the area of requirement within the body with help of special carriers. Water-soluble vitamins (B-vitamins and vitamin C) are not produced nor stored in the body like the fat soluble ones and need to be replenished everyday, whether consumed in our foods or supplementation.

Choosing the right multivitamin supplement is more than just looking at the ingredients. The form in which the supplement is in can make all the difference in the quality of the supplement you are receiving.  A good multivitamin should be easily absorbed and have all of the required daily levels that are essential to maintain good health. 

One multivitamin supplement recommended is ‘isotonic’ which comes as a powdered form to which you add 2 ounces of water to drink.  Isotonic, which means “same pressure,” bears the same chemical resemblance of the body’s blood, plasma and tears. All fluids in the body have a certain concentration, referred to as osmotic pressure (which is isotonic) and allow a consistent maintenance of body tissues. This means that the body has less work to do to in obtaining maximum absorption. The isotonic state of the suspension allows nutrients to pass directly into the small intestine and be rapidly absorbed into the bloodstream. With Isotonix (Nutrametrix) products, little nutritive value is lost, making the absorption of nutrients highly efficient while delivering maximum results.

The Nutrametrix Daily Multivitamin contains all the basic daily dietary needs, and can be with or without iron as recommended by your healthcare professional.  You can then add other Nutrametrix isotonic dietary supplements according to your own personal needs, for instance, for arthritis, allergies and joint pains (antioxidants like OPC-3 and vitamin C), elevated cholesterol (Essential Omega 3 oil with Vitamin E) or nerve conduction/ nerve pain and stress levels (Activated B-complex).  These items can be found online at www.nutrametrix.com/karendoll.  There is a free “Nutri-physical” you can complete online that will help individualize your supplement needs according to your personal needs.  (www.nutrametrix.com/karendoll/nutri-physical).  Before considering any supplemental regimen, be sure to consult your healthcare provider. 

Omega 3 fatty acids have been shown to be effective in fighting inflammation

 in your body as well as in reducing overall cholesterol levels and triglycerides, improving blood flow and blood pressure, and may also help to reduce the occurrence of the more severe outcomes of heart disease. Fatty fish such as salmon, sardines, anchovies and mackerel provide essential omega 3 fatty acids, especially eicosapentaenoic acid (EPA) and docosahexanenoic acid (DHA).   The American Heart Association recommends 1000 mg per day of Omega-3 EPA/DHA for patients with coronary heart disease and 2000 to 4000 mg per day for patients with high triglycerides. For vegetarians or those who have fish allergies, flax seeds or flax seed oil provides an acceptable alternative. 

To achieve this level of supplementation, a high quality Omega-3 oil is recommended daily as you want to know it is tested to be free of fillers and non-essential ingredients, like the Nutrametrix Heart Health Essential Omega-3 with Vitamin E.  NutraMetrix Heart Health Essential Omega III comes from small anchovies and sardines that have a short lifecycle making them an ideal source of fish oil because they are less prone to accumulating environmental toxins that can be found in larger, longer-lived fish.  A good quick way to test any fish oil supplement is to place a capsule in the freezer overnight.  Pure oil will not freeze solid, but those with mostly added fillers will.  If it is firm and inflexible when frozen, it is likely to be more filler ingredients than omega-3 oil.

Another source of inflammation-fighting healthy fats is nuts—particularly almonds, which are rich in fiber, calcium, and vitamin E, and walnuts, which have high amounts of alpha-linolenic acid, a type of omega-3 fat. All nuts, though, are packed with antioxidants, which can help your body fight off and repair the damage caused by inflammation.

Antioxidants are another key supplement necessary for health, especially as we age that will reduce ‘free radical’ formation.  Free radicals are unstable molecules or compounds that react negatively with other molecules creating stress on the body.  This free radical formation is a natural process that occurs daily when the body breaks down certain substances in our environment or food, or comes in contact with pollutants.  Specifically, antioxidants provide the body with a defense against the negative effects of the free radicals, then stabilize and prevent other molecules from turning into unstable free radicals, thereby promoting good health.

Inflammation is part of the body’s immune response; without it, we can't heal. But when it's out of control it can damage the body. Chronic inflammation has been linked to many cardiovascular diseases. Cholesterol gets deposited in the lining of blood vessels and acts as an insult.  Cytokines respond to these insults in the bloodstream, which leads to systemic inflammation. Inflamed blood vessels and growing fatty plaque can cause blockages and blood clots, which then can cause heart attacks.  Foods high in sugar, saturated and trans fats, excess weight, smoking, pollution, chemical preservatives, poor oral health and unhealthy diets in general cause chronic inflammation.   In addition to cardiovascular disease, inflammation is also associated with diseases such as arthritis, autoimmune diseases, allergies, asthma, cancer, and inflammatory bowel diseases.

Three important antioxidants, OPC-3, Vitamin C, and CoQ10, have been found to be beneficial for heart health by reducing inflammation as well as the number of free radicals causing inflammatory damage in our bodies.   Oligomeric proanthocyanidins (OPCs) are bioflavonoids (complex organic plant compounds) found in fruits, vegetables and certain tree barks that provide exceptional nutritional benefits to the human body. Studies have shown OPCs to be up to 20 times more powerful than vitamin C and 50 times more powerful than vitamin E in neutralizing free radicals.  Supplementing with a high quality isotonic OPC, like the Nutrametrix (Isotonix) formulation OPC-3 taken with your daily multivitamin will help fight the free radicals and offer an effective anti-inflammatory.

Vitamin C is an essential water-soluble nutrient that must be replenished on a daily basis. It is important to know that cooking destroys vitamin C activity.  Aside from it’s well known antioxidant properties, vitamin C supports cardiovascular health in a few different ways, i.e. normalizing blood pressure and cholesterol levels, in addition to supporting our immune system and pulmonary health. A lack of vitamin C can cause general fatigue, as it helps moderate healthy iron absorption, transport and storage.  In the typical diet, most vitamin C comes from fresh fruits and vegetables. Peppers, like sweet green and red peppers, hot red and green chili peppers, are especially rich in vitamin C. Other good sources include citrus fruits and juices, brussel sprouts, cauliflower, cabbage, kale, collards, mustard greens, broccoli, spinach and strawberries.

Another powerful antioxidant and vital nutrient to promote energy production within our cells is CoenzymeQ10 (CoQ10).  CoQ10 levels in our body naturally diminish with age, and even faster with poor eating habits, stress or infections.  It is reported that the use of statins (cholesterol-lowering medications) will also reduce the body’s ability to make CoQ10 even further.  It is generally a combination of choosing the right foods containing CoQ10 with additional supplementation daily that will provide the body with the best possible amount of CoQ10 for optimal health.  CoQ10 is naturally found in high levels in organ meats such as liver, kidney, and heart, as well as in beef, sardines, and mackerel. Vegetable sources of CoQ10 include spinach, broccoli, and cauliflower with peanuts and soybeans the best non-animal sources. 

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[i] University of Texas (UT) at Austin’s Department of Chemistry and Biochemistry was published in December 2004 in the Journal of the American College of Nutrition

[ii] See also antioxidants for a definition of free radicals.

Medicare and Medicaid in Assisted Living

Today's seniors enjoy a life expectancy longer than any generation in history. An American who turned 65 in 1998 could expect to live nearly another 18 years beyond their 65th birthday. And while additional years are generally considered an blessing, it is also true that the older one grows, the more likely they will need health care services. Today's seniors, who often consider themselves among the best informed, would do well to learn about three crucial areas that pertain to their future health care needs: the potential that they may need long term care, the cost of long term care and the limited federal and state aid available.

According to a study by the Agency for Health Care Policy and Research, some 42 percent of Americans who reach the age of 70 can expect to utilize some type of long term care during the remainder of their lives. And with the number of people over age 65 expected to grow to 20 percent of the U.S. population by 2030, there is little doubt that demand for long term care services is poised to increase dramatically.

Long term care services have evolved dramatically over the past several years. Where the majority of long term care was once provided only in skilled nursing homes, long term care services today are provided in a wide range of settings, ranging from in-home care to community-based facilities such as adult day care and assisted care facilities to nursing homes. The cost of long term care can be significant, regardless of the setting in which it is provided. The average cost of a nursing home is approximately $60,000 a year, and home care costs can range from $50 to more than $250 a day.

Medicare and Medicaid provide only limited help for nursing home care. Medicare only pays for the first 20 days in a skilled nursing facility - and only after a hospital stay of three days or more. The patient or their family pays the first $99 per day from the 21st day through the 100th day, after which Medicare pays nothing. Medicaid rules vary from state to state, but as former U.S. Senator David Durenburger told the U.S. Senate Special Committee on Aging, Medicaid "dictates that people must effectively impoverish themselves in order to receive government assistance." Medicaid is essentially medical aide for those who have already spent down their assets.

Government won't help much with newer forms of long term care services, either. Though 38 states pay for some assisted living, the programs are miniscule, covering fewer than 100,000 poor people, so waiting lists are long. Medicare covers home care, but just 100 visits in the weeks following a hospital stay. So seniors increasingly are paying their long term care bills out of their own pockets.

Medicaid does not pay for assisted living services in most assisted living, typically they cover the costs of care in Nursing Homes for those who have exhausted their assets. The White House recently authorized Medicare coverage for the treatment of Alzheimer's disease. This means that Medicare beneficiaries can now receive reimbursement for mental health services that were formerly denied because the government rationalized that people with the disease did not respond to mental and physical therapy, this has since been proven incorrect, hence the reversal of their position. Medicare was never intended to cover the costs associated with custodial care, which is room and board, and activities of daily living, and these coverage changes still do not reimburse for this, further Medicare requires a three-day prequalifying hospital stay before they pay for care in a nursing home. Medicare covers certain care procedures, and some limited rehabilitation therapies. The physicians who visit assisted living are normally all Medicare certified providers, so the cost of their visits is often covered by Medicare, subject to the co-payment.

Learning how to read a food label can help you make good nutritional choices

The Food and Drug Administration (FDA) is responsible for assuring that foods sold in the United States are safe, wholesome, and properly labeled. This applies to foods produced domestically, as well as foods imported from foreign countries. The Nutrition Labeling and Education Act (NLEA), which amended the FD&C Act requires most foods to bear nutrition labeling and requires food labels that they are nutrient content claims and certain help messages to comply with specific requirements. It is the responsibility for the food industry to remain current with the legal requirements for food labeling.

The Nutrition Facts panel on any packaged item is the best way to understand exactly what is in the product you are buying.  The front of the package can be very misleading and tells you only what the manufacturer wants you to know about the health claims.  Terms used on packaging, such as “multigrain”, “reduced-fat”, “no additives” and even “natural” can be misleading, as these terms aren’t tightly regulated so manufacturers will use words that make you think you are buying healthy products. Knowing how to read the Nutrition Facts Panel will guide you to better choices for a healthy lifestyle. 

When deciding what is best to buy, compare nutrients and calories in one food to those in another. The information may surprise you. For your heart health, make sure you aren’t eating foods high in carbohydrates, saturated and trans fats, and sodium.

These steps may help simplify what can be a confusing Nutrition Fact label.

1. Check Serving Size and Servings Per Container

This will tell you what is a standardized serving for this product and the nutritional information listed below relates only to this size serving.  It can surprise you to find out that a small package that seems like one serving can be labeled as two servings.  This would mean if you ate the entire container, you would have to double the calories, carbohydrates, fat, sodium and everything else on that label to get an accurate measurement of you are eating. 

2. Carbohydrates count more than calories!

The Total Carbohydrates listed on the label will include sugar, starch, and fiber – all various forms of carbohydrates.  This number can be even more important than the calories, as limiting the carbohydrates you take in will naturally also limit the amount of calories, especially those ‘empty calories’ in the form of sugar and high fructose corn syrup that is commonly added when fat is removed.  For instance, you will be surprised to see that regular plain Greek yogurt will have approximately 8 carbohydrates per serving, while ‘low fat’ plain Greek yogurt will have approximately 12 carbohydrates! What?!?  Manufacturers know that when you take the fat out of a product, it doesn’t taste as good therefore ‘fat-free’ high calorie sugar is added to make it taste better! Even worse, when ‘fruit’ is added, it is generally a sugar-based fruit and the carbohydrate count jumps to 25+grams per serving!  Best to get regular plain yogurt, cottage cheese, etc. and add your own fresh or frozen berries or fruit.

Higher carbohydrate foods that should be limited include most white bread, pasta, rice, and potatoes.  Even the higher fiber breads and pastas, brown rice and sweet potatoes are only slightly better than the white form due to the additional fiber they contain.  They still have a higher amount of carbohydrates that should be limited daily.  The higher the fiber count, the better it is to eat.  Carbohydrates in food are digested and converted into glucose, or sugar, to provide the cells of the body with energy. Excess carbohydrates in your body can lead to weight gain and diabetes.

Mot fruits and vegetables are generally low in carbohydrates, with the exception of apples and bananas.  You would be astonished to know that one medium apple or one medium banana has approximately 25 grams of carbohydrates!  Best to eat fresh melons, berries, peaches, oranges, and pears, etc. and watch the canned fruit as there can be added syrups and juices that add sugary carbohydrates.  Limit the starchy vegetables like peas and corn (read the labels) but don’t hesitate to eat most other vegetables freely.  Did you know that one orange has only 8 grams carbohydrates, yet that small 4 oz. glass of orange juice has nearly 25 grams? Avoid most juices in general as they generally have significant amounts of added sugar (aka carbohydrates).  If you want juice, it would be best to use just a splash for flavor into a glass of water.

In general, when looking at the label and the carbohydrate content, if it has more than 20-30 grams of carbohydrates per serving, then use it in very limited quantities.  Moderation is always best.  As a guideline, keeping your total daily carbohydrate ‘count’ under 100 grams per day will result in controlling the amount of ‘empty’ sugar calories you take in.  Counting your daily carbohydrate intake is much easier than counting thousands of calories, and as long as you choose a variety of colorful fruits and vegetables to eat with your meals and snacks, you will get a well rounded and balanced intake of nutrients.

For those who wish to count the carbohydrates most effectively, you are able to reduce the number of carbs counted by whatever fiber count is shown on the label.  For instance, a label showing 10 grams carbohydrates that also has 3 grams fiber, you need to count only 7 carbs per serving (10-3=7).  Fiber is the only carbohydrate that is not changed by the body to sugar and is eliminated without affecting insulin levels.  Technically, fiber is considered a carbohydrate even though it is not digested and it provides no calories.  Fiber is important for heart health, and getting at least 25 grams of fiber daily is recommended. Most people, however, need a fiber supplement to get these recommended levels. 

3. Look for Saturated and Trans fats

Look for products with the lowest amounts of saturated and trans fats per serving.   For the past years, consumers have been told ‘low fat’ was best and with the added carbohydrates in place of the fat in most products, people have been eating more sugar, more refined carbs and processed foods instead, which has made the world sicker and fatter. 

When reading labels, the amount of Total Fat, Saturated Fat, and Trans Fat is listed, as the law requires it.  No amount of trans fat in the diet is beneficial. Therefore, when a food label indicates "0 grams of trans fat," that's ideal. However, even then a product may still have some trans fat. Manufacturers are allowed to list "0 grams" of trans fat if the product has less than 0.5 grams of trans fat per serving. Some examples are tub margarines or peanut butter. Usually this isn't a problem if you eat one or two servings a day. However, if you were to eat many servings, this amount of trans fat may add up. 

In general, go for the ‘good’ fats, like olive and coconut oil, and don’t hesitate to use higher fat, yet healthy and nutritious foods on occasion, such as avocados, cheese, eggs, nuts, chia seeds and yogurt.  Again, moderation is key to healthy living.

4. Watch your Sodium intake

Sodium (salt) regulates your body’s water levels, which is especially important for those with heart disease and high blood pressure.  Sodium is listed on the label in milligrams. When 1500 milligrams is the general limit for people with heart disease, sodium can add up quickly. That’s equal to little more than ½ teaspoon of salt!  A low-sodium food is defined by the Food and Drug Administration as 140 milligrams or less per serving.  This can be a helpful when deciding if and how a certain product can fit into your healthy eating plan. Most canned foods and highly processed food are high in sodium so best to buy frozen and or fresh produce and unprocessed or low-sodium meats.

5.    Review the Ingredient List

All food products have the ingredients list by weight in decreasing order.  This means the first items listed are the primary ingredients with the remainder of the list showing what is less within.  This can be very helpful in determining more information about the food product. 

  --If there are more preservatives and fillers than identifiable ingredients, this food is likely highly processed and therefore NOT healthy. 

  --If the list contains ‘partially hydrogenated oil’ then it still has trans fat despite a label that may say “0 grams” of trans fat.

  --If sugar or high-fructose corn syrup is listed before the healthy ingredients then likely the calories and carbohydrates are from sugar and low in other nutrients.  Other names for sugar include sucrose, fructose, glucose, maltose, dextrose, high-fructose corn syrup, corn syrup, concentrated fruit juice, honey and maple syrup.

What do I do if there is no Nutrition Facts label?

There are many fresh fruits, vegetables, and other grocery items that do not always come with nutritional labels.  A highly recommended online site that will give you nutritional breakdown of all foods is located at www.calorieking.com.  If you do not use a computer, then seeking a good nutrition book at your local library or bookstore will help you understand which foods are the healthy choices.  As with most lifestyle changes, the more you read and understand the nutritional value of healthy foods, the easier it will become.