Nutritionist Rose Carr has handy tips and solutions for the common healthy eating challenges you can face as you ageLack of appetite, increased appetite, weight gain or weight loss. As you get older, you may find there are a host of new challenges when it comes to eating well, that you didn’t face before. For anyone aged 65 and over, there are a few changes you can make that can help you deal with some of these challenges – and gain peace of mind that you’re getting the nutrients you need.
Challenge: I’m gaining weight
As you age, the number of kilojoules you need to eat each day decreases, so you may find that without modifying how much you eat and boosting your activity levels, you slowly gain a little weight. The main reason for this is a natural loss of muscle (see Use it or lose it below) which slows your metabolism. Once you hit your 70s, you may need around 1000kJ less (if you’re a woman) or 2200kJ less (if you’re a man) each day compared to your 20s. This will be even less if you start to move less, too. The good news is putting on a little weight as you age is not necessarily a bad thing.
For younger people, a body mass index (BMI) measurement of 25 is the upper limit of the healthy weight range, and as your BMI increases past this point, so do the risks of developing health problems such as heart disease and type 2 diabetes. However, from around age 65 the healthy weight range increases so that a BMI of 27 is the upper limit. The reason for this is that as you get older, carrying a little more weight actually helps your body cope better with, and recover faster from, illness. However, having a BMI that is higher than 27 is still linked with the risks mentioned above and it can also impact how mobile you are, so it’s still important to keep an eye on your weight.
Lose weight and get the nutrients you need
Swap full-fat dairy for reduced-fat versions.
Fill half your plate with vegies, a quarter with protein (red meat, chicken, fish or legumes) and a quarter with carbohydrates (rice, pasta or potato).
Choose lower kilojoule, nutrient-dense snacks. Swap the biscuits with your cup of tea for a piece of fruit, a small tub of yoghurt or a slice of reduced-fat cheese on wholegrain crackers.
Ensure you’re getting out and about and moving to burn more energy throughout the day.
Challenge: I can’t taste my food
If you’re wondering why food doesn’t taste as good as it used to, it might be because, as we age, we lose a significant number of our taste buds. “Older people have around one-third the number of taste buds they had when younger,” says dietitian Julian Jensen. In addition, some medications can also play havoc with our ability to taste our food.
How to add more flavour
Adding herbs and spices such as basil, oregano, garlic, rosemary, coriander, cinnamon, nutmeg and chilli can help bring out the flavours in your meals.
“Relax a little about using salt. Add it in moderation to cooking, rather than using it to ‘top-dress’ your meals — this way you use less and get a better flavour”, says Jensen.
Challenge: I need more nutrients than when I was younger
As your energy needs are less, it may seem helpful that your appetite is also likely to decline with age. However, your need for certain nutrients actually increases, while your ability to absorb nutrients decreases. This puts you at risk of a range of deficiencies. So you should consider adjusting how and what you are eating to make sure you’re getting the most nutritious daily diet.
Once you reach your 50s, you need more
Vitamin B6 – important for releasing energy from the food we eat and the formation of red blood cells. Good sources include wholegrain breads and cereals, legumes, green leafy vegies, fish, shellfish, meat, poultry and nuts.
Vitamin D (for women)– see below.
Calcium (for women) – vital for bone health and healthy functioning of nerves and muscles. Found in dairy foods and calcium-fortified products such as soy milk and cereals.
Once you reach your 70s, you need more
Protein – essential for cell growth, muscle maintenance and energy. Find it in meat, fish, eggs, legumes and dairy.
Riboflavin – important for cell growth and to release energy from the carbohydrates we eat. Good sources include milk, yoghurt, wholegrain breads, eggs and leafy green vegies.
Calcium (for men).
Vitamin D (for men).
Your best food choices
The key to getting enough nutrients in your diet is quality, not quantity.
Eat a rainbow! Aim to use as many different-coloured fruits and vegies as you can, rather than sticking with the same old favourites. This ensures you get a wide variety of vitamins and minerals. You can use fresh, frozen or canned (choose reduced-salt or no-added-salt varieties to keep your sodium intake in check). Including plenty of fruit and veg also adds important fibre and helps to keep you regular.
Aim for 3–4 serves of reduced-fat dairy such as calcium-enriched milk, cheese, yoghurt and custard to help you meet your calcium requirements. Dairy products are great for snacks or adding to main meals.
Have protein foods throughout the day – recent research suggests this is better than having just one high-protein dinner, to help you reach your requirements. Try having a protein-rich food at each meal such as lean meat, fish, poultry, legumes or eggs. Nuts, seeds, dairy and soy products also add protein and other nutrients.
Choose nourishing snacks such as yoghurt, Milo with milk, fresh fruit, or a high-fibre muffin. Make sure you see your GP and/or dietitian if you’ve been on a restrictive diet for a medical condition (such as diabetes), as this may no longer apply.
Challenge: I’m losing weight
If you find you’re losing weight unintentionally, do take it seriously. Firstly, check with your GP that there is no serious cause. Once you have covered that off, focus on increasing your energy intake.
Even if you’re reasonably fit and healthy you may find you experience unintentional weight-loss. This may be due to a decline in your appetite. Reduced appetite may be due to hormonal changes which can lead you to feel full more quickly, changes in taste or smell meaning food is less enjoyable, or certain medications you take that may reduce appetite.
Weight loss can also occur because of poorly-fitting dentures that can make eating more difficult. Furthermore, if you’re living alone, cooking may seem like more of a task so you may resort to quick and easy (but not so nutritious) meals, compared to when you were cooking for the whole family.
Tips for gaining weight
We often eat more when we eat with others so plan to do this on a regular basis. Organise morning teas, lunches or dinners with friends or family each week.
Add healthy fats to your food. Try adding a little more olive oil to salads or mashed vegetables; use avocado or a full-fat margarine (low in saturated fat) on bread or crackers; snack on nuts, seeds or pitted olives marinated in olive oil.
If you can’t eat larger portions, try to eat more frequently and never skip a meal. Remind yourself to eat every three hours.
Keep nutritious, prepared meals in the freezer for when you don’t feel like cooking.
Leave room for your meal by not drinking in the 30 minutes before the meal.
Between meals, drink milk instead of water or tea to add energy, protein, calcium and B vitamins. Juice is another good way to add energy.
Make a ‘super milk’ by adding skim milk powder to your regular milk. You can also add milk powder to porridge, mashed potato or creamy soups.
Challenge: I’m getting dehydrated
As you age you become more susceptible to dehydration. This is because your thirst sensation can weaken so you don’t actually feel like drinking as much. In addition, your kidneys become less able to conserve water so urine is more diluted and you lose more fluid. For people with bladder control problems this can be compounded by wanting to limit fluid intake. For people over 70 especially, becoming dehydrated means you’re more susceptible to health issues such as urinary tract infections, pneumonia, constipation and confusion.
Tips for how to stay hydrated
Count how many drinks you have each day. Aim to drink about 6–8 glasses of fluid each day. It doesn’t just have to be water – try tea, coffee, fruit juice, milk, soup and even jelly.
Remember you need to drink more in hot weather, or when you’re more active. In warmer weather, boost your fluid intake by 2–3 glasses, especially if you’re outside during the day.
Plan your drinks during the day to ensure you’re getting enough. For example, try set up a routine to wake up with a cup of tea or coffee, have juice or water with each main meal and a drink at morning and afternoon tea.
Add a slice of lemon or sprig of mint to a jug of water and keep it handy in the fridge.
Challenge: I’m not getting enough vitamin D
Getting enough vitamin D is critical for the healthy function of many parts of your body. It’s important for muscle strength, bone health and your immune system – just to name a few. As you get older your skin is less efficient at converting sunlight to vitamin D, putting you at greater risk of deficiency. While you get some vitamin D from food, it’s not enough to meet your daily requirements, so getting some sun exposure is essential.
How to get the vitamin D you need
Where you live affects how long you need to be in the sun for your body to process enough vitamin D. It’s also important to balance the risk of vitamin D deficiency with the risk of skin cancer. According to Cancer Council Australia, during summer the majority of people can maintain adequate vitamin D levels from a few minutes of exposure to sunlight on their face, arms and hands before 10am or after 3pm on most days of the week. In winter, in the southern parts of Australia you may need about two to three hours of sunlight to the face, arms and hands spread over a week to maintain adequate vitamin D levels. Try sitting outside while you have a cup of tea or heading out for a walk during the day – even if it’s just for 15 minutes. If you’re concerned, speak with your doctor. They may test your vitamin D levels and, if necessary, recommend you take a supplement.
Use it, or lose it!
Muscle mass naturally declines at a rate of around one to two per cent each year after the age of 50. This process is also known as sarcopaenia. As a result, your metabolism slows and strength and balance is reduced. While you can’t stop sarcopaenia altogether, good nutrition and regular exercise can help maintain as much muscle as possible and slow or delay the decline.
Regular exercise for all adults, including older people, reduces the risk for a wide range of conditions such as heart disease, type 2 diabetes, osteoporosis and depression. Any physical activity is better than none, whether it’s incidental activity such as vacuuming or walking to the letterbox, leisure activities such as playing bowls or dancing, or more structured exercise such as a tai chi class or a walking group. If you’ve been inactive earlier on in life, start slowly and allow yourself to build up your strength and stamina over time, until you’re accomplishing at least 30 minutes of exercise every day.
Top five foods for people over 65
Dairy products (milk, yoghurt and cheese) are packed with many nutrients, including protein, calcium, magnesium, zinc and vitamins A and B12. Include 3–4 serves of dairy each day to meet your calcium needs.
Lean red meat is high in protein, iron and zinc and will help reduce muscle loss. Include it 3–4 times a week.
Oats are full of many essential nutrients, including fibre, to keep you regular and to help to reduce cholesterol levels.
Eggs have 11 different nutrients, including protein, omega-3 fats, vitamins and minerals, such as selenium, iodine, zinc, iron, vitamin A and B vitamins. Up to six eggs a week poses no threat to your cholesterol levels.
Green leafy vegies are full of fibre and packed with antioxidants, vitamins and minerals. Particularly good for your eyes as they contain the antioxidants zeaxanthin and leutin that have been shown to reduce the risk of macular degeneration.
Did you know? Your body may need 2200kJ less in your 70s compared to in your 20s.