Living and Aging Well

Healthy habits mitigate problems tied to aging

Column by Dr. Richard Collins and Susan Buckley
Posted 6/30/15

Aging is a normal, gradual process of physical change over time. However, the inevitable consequences of aging are far more pronounced in some individuals than others. Although some health problems are an unavoidable aspect of aging, many more are …

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Living and Aging Well

Healthy habits mitigate problems tied to aging

Posted

Aging is a normal, gradual process of physical change over time. However, the inevitable consequences of aging are far more pronounced in some individuals than others. Although some health problems are an unavoidable aspect of aging, many more are preventable and can be influenced by three major behaviors: eating a healthy diet, staying physically active and avoiding tobacco. In fact, there is evidence that these three behaviors alone are more influential than genetic factors in fighting age-associated decline.

So what exactly happens in the aging body? Aging is generally associated with a slower metabolism, which leads to accumulation of extra body fat, particularly around the middle. Digestion slows, and the body becomes less efficient at managing the rise in blood sugar after eating. One of the first signs of aging is loss of muscular strength, giving way to stiff joints. Muscle strength remains similar up to age 45 and decreases by 50 percent between the ages of 50 and 80. Gradual loss of lean body mass and reduced energy expenditure lower caloric needs. Energy requirements for the elderly diminish by about 100 kcal/day per decade in general. However, nutrient needs do not drop, and in some cases they increase. As a result, packing more nutrition into fewer calories becomes a challenge for older adults. For this reason, focusing on quality food choices becomes paramount.

National surveys show a decline in energy intake with age, accompanied by a similar decline in protein and key vitamin and mineral intake after the age of 50. While adults are not easily categorized, certain nutrients require greater attention as people age. Which vitamins and minerals are critical depends on the health status of the individual but most often, vitamin D and some of the B vitamins are marginalized in older adults, followed by calcium and iron. Studies confirm this. Inadequate dietary intakes of energy, folate, vitamin D, vitamin B6, calcium, iron and zinc have been reported in community-dwelling adults over 60 years old. There is a reduction in energy requirements with increasing age, whereas there are increased requirements for a number of nutrients, such as protein, riboflavin, B-6, B-12, calcium and vitamin D.

Vitamin deficiencies, particularly vitamin B12, B6 and folate, are associated with cognitive impairment. Protein needs go up as well. Protein helps older individuals maintain muscle. Muscle is the absolute centerpiece for being healthy, vital and independent as we grow older. Muscle keeps us strong and mobile. It’s where most of our calories are burned, so having more muscle means burning more calories, which makes it easier to stay trim. Muscle also helps us appear younger. What makes us look older more than anything else is losing muscle and gaining body fat as we age.

As we age, we naturally lose muscle mass and strength due to a trifecta of reduced muscle response to protein intake, changing hormones and for some, less physical activity. Called sarcopenia, this gradual loss of muscle mass has been credited with a litany of health problems, including insulin resistance, low bone mineral content and density, falls and fractures — even death. Plus, the greater your muscle mass, the more apt you’ll be to stick with the health-boosting physical activities you enjoyed in your younger years.

Most people (especially older people) start the day with a carbohydrate-rich, protein-poor breakfast, such as cereal or a bagel. Higher protein breakfasts help older adults remain stronger and healthier. Getting approximately 25-30 grams of protein at each meal is the goal.

Breakfast:

Cottage cheese, one cup = 30 grams

Greek yogurt, six ounces plain = 18 grams

Eggbeaters, half cup = 12 grams

Whey protein shake = 20-30 grams

Two tablespoons whey mixed into oatmeal = 20 grams

Most individuals over age 50 have a reduced ability to absorb naturally occurring vitamin B12 as well, and must therefore consume it in fortified foods or supplements. The major causes of vitamin B12 deficiency are atrophic gastritis and pernicious anemia. Atrophic gastritis (inflammation of the stomach lining) affects nutrient bioavailability and is a problem that increases with age; research indicates that 40 percent to 50 percent of individuals over age 80 have the condition. Consequently, a significant portion of older people are at risk of impaired absorption of vitamin B12, folic acid and other vitamins and minerals.

Constipation is another common problem. Since constipation may affect up to 20 percent of people over age 65, foods rich in dietary fiber become increasingly important for older adults. Additional causes of constipation among this age group may include side effects of medications and lack of appropriate hydration. Low fiber intake may also contribute to other gastrointestinal diseases common among older adults, including diverticulosis. Adequate fluid intake not only eases constipation; it also helps avert dehydration, a serious threat to the elderly. Severe dehydration in the elderly can lead to cognitive impairment and functional decline. Making sure to drink six to eight glasses of water and fluids a day is essential.

Dr. Richard Collins and Susan Buckley are members of the health-care team at South Denver Cardiology Associates. Collins, known as “The Cooking Cardiologist,” is board-certified in cardiology and internal medicine. Buckley is a registered dietitian and certified diabetes educator.

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