The purpose of this research is to discuss the nutritional needs of the aged. This discussion will involve first an examination of the particular problems the aged have in receiving and maintaining a proper diet, what a proper diet, what a proper diet for the aged consists of, and the steps that can be taken to implement better nutrition. There will follow a general look at some specific health problems of the old and how they can be caused or at least aggravated by poor nutrition and how proper diet might help alleviate them. The research will conclude with an analysis of how nutrition, proper or inadequate, should be a lifetime concern.
Recent estimates by the National Institute of Mental Health put the population of the aged at over twenty million, approximately ten percent of the general population in the United States.[1] There has been increasing concern, as the longevity rate continues to rise, and more and more people swell the ranks of the aged, for the ways and means to take care of this group. Not only in housing, medical care, social and financial concerns, but in so basic an area as their daily bread.
There are nutritional problems particularly applicable to the aged which younger, employed groups do not experience, at least to the degree where good nutrition is severely impaired just because of one’s age and inadequate income. It has been recognized that the practice of good dietary habits is dependent on more than just the food itself. “Food is more than just a source of essential nutrients — it can be an enjoyable interlude in an otherwise drab existence. Thus, provision should be made to meet the social as well as the nutritional needs of older people.”[2] It is not enough to hand over a chart on good food to those in need of guidance; the old often cannot prepare their food properly, through physical or other handicaps, and they are often too sick or tired to bother to do more than snack. When, as is often the case, they live alone, the problem is compounded. this, plus an income on a poverty level which offers them the least beneficial kinds of food, and the old can frequently lapse into a case of malnutrition or worse.
In addition, the aged should not be considered some mass block for which one solution will suffice. Members of minority groups have their own special problems. Since food stamps often exclude the purchase of ethnic foods, an aged Japanese, for instance, after a lifetime of ingrained eating habits, is expected to radically change. “Nutrition programs for the elderly have failed to include special dietary and cultural preferences of older Asian-Americans.”[3] This applies also to the Black, the Mexican-American, the American Indian.
Where the aged live has a bearing on the problem also. Approximately nine million of the old are in rural areas and not easily accessible to neighborhood programs, such as meals-on-wheels. It is especially hard for them to shop and to prepare their meals.
Even when the aged live in accessible areas and are not members of a minority, and have adequate income, nutrition in still a problem. Often they are too depressed to eat, or do not feel well enough to bother without some encouragement. Because of dental problems, or relative ease of preparation, the old rely far too often on starches and sweets, foods without bulk or high protein content. Loss os smell, of taste, lack of exercise, all contribute to bad eating habits and poor choice of food.
The following diet for the elderly has been recommended by the Public Health Service: a pint of milk or its equivalent in creamed soups, puddings, milk toast, etc.; one serving of orange, grapefruit, tomato or their juices; one serving of green or yellow vegetables (some raw); one serving of potatoes; one serving of fruit; one serving of whole grain cereal, oatmeal or wheat; and one serving of meat, poultry, seafood, or other protein-rich food.[4]
Most of the foods recommended require a minimum of preparation, but it is important that the elderly be not only educated as to the value of a diet of this nature on a consistent basis, they must be helped in many cases to implement it, and often must be checked up on to insure they continue good nutritional habits.
A young volunteer worker cannot only provide this follow-up service, but provide the necessary social and personal interaction that provides the old person with an incentive for a good nutritional pattern. The fact that an old person, “too tired to eat,” will have more energy once they start eating well is a step in the right direction.
And a proper diet precludes a need for costly and excessive use of vitamins, especially those “designed” to solve the nutritional needs of the aged. The old are particularly vulnerable to claims for miracle drugs. “Older people should be protected from food quackery and unfounded nutritional claims.”[5] Such reliance often interferes with getting the old to et properly.
Although the previously outlined diet is a good general one, individual requirements must be considered, with a particular slant towards the health problems of the old. A major health problem is with the digestive problems of the old. A major health problem is with the digestive system itself. A poor eating pattern can lead to specific digestive troubles, such as constipation. Often a change in mental attitude and facility leads to a change in bowel habits. Misunderstandings as to just what constitutes “regularity” can result in older people aggravating their digestive system through the overuse of artificial laxatives, encouraged as they are by advertisements aimed specifically at them. A good diet can accomplish more, and can accomplish additional benefits to just curing constipation.
”The type of diet that is desirable to develop normal bowel function has many features in common with the prevention of atherosclerosis and its consequent senility, and also with the prevention of cancer of the bowel. The main emphasis should be on devising a diet which contains adequate fluid and lots of bulk.”[6] A good nutritional program can also go a long way to control obesity in the aged with all its side effects, particularly in the cardiovascular system. A high protein diet rather than one rich in fats and carbohydrates is the key, with a careful watch on the caloric content of the foods consumed. The people who reach a legendary age, for instance, in the mountain areas of the Soviet Union were found to consume less than one-quarter of the calories of their counterparts in the cities. They ate meat infrequently, no more than once or twice a week, plenty of cheese and buttermilk, fresh fruits and vegetables — and no coffee, tea, or sugar. They used honey for sweetener, and no liquor, only a wine with a low alcoholic content.[7] This diet is not radically different than the one recommended for U.S. aged.
A good diet can affect the aged’s sexual drive too. Far too often it had been assumed that getting old meant a necessary loss of sexual activity. Obviously, this attitude has a great deal of social and emotional overtones, but a poor diet is often the cause of the aged’s lack of interest in sex. “Nutritional factors may also affect testicular function and, in turn, influence potency. Individuals on a starvation diet will lose normal testicular function; if the diet is continued for a prolonged period of time, testicular damage can occur.”[8]
A lack of calcium in the diet can affect the bones of old people. osteoporosis, or shrinking of bony tissues due to a calcium deficiency, certainly need not be an inevitable result of growing old. The elderly person on a calcium-deficient diet is four or five times as likely to get osteoporosis as one who gets adequate amounts of calcium in his diet.”[9]
Other problems, such as those with the skin and hair, with the circulatory and musculoskeletal systems can benefit from a good diet. When these systems malfunction and require surgery it is important that proper food with the essential nutrients be taken. ” . . . Amino-acid protein is essential to maintain appetite and nutrition in the daily diet of man. It is doubly essential to promote healing following surgery and to insure a smooth convalescence in serious illness at any age and particularly in the chronic illnesses of the aged.”[10] All of the systems in the human body are subject despite the best of care to breakdowns and malfunctions. What a proper diet can do is minimize the ill effects that an operation will have. The undernourished elderly person, alone and sick, who must undergo hospitalization, already has too many strikes against him to insure optimum recovery. A lack of appetite, brought on and aggravated by already established bad eating habits, could prolong the recovery period beyond a reasonable time.
When the operation is a major one, such as for cancer or heart disease, the foundation of a good, nutritious diet could make the difference in whether the elderly survive. Diet, at least at this time, cannot provide the old from being old, despite the vitamin purveyors claim, but it can ease much of the burden that being old brings.
The important message, and not only for the old and those who take care of them, is that diet is only part of the total program the aged must undergo in order to make the most of their remaining years; good nutrition goes hand in hand with a program of reasonable exercise, fulfilling social relationships, the maintenance of an active life, depending on the degree of health the individual already enjoys.
The important note is balance, and this balance cannot suddenly be struck at a late stage in life. Important work is being done in the area of nutrition and just how a lifetime of bad habits contributes to the aging process itself. The still ongoing controversy surrounding saturated fates and whether they contribute to arterial diseases is but one example of how a life of eating bad food can make a difference when old age is reached.
It is known that aging affects the way we absorb nutrients. Studies have indicated that, for instance, losing weight can be as bad, nutritionally, as gaining too much weight. “The unexpected relationship of lighter weight to increase mortality suggest . . . a diminished protein synthesis with age.”[11]
What is gradually being uncovered is that the way we absorb nutrients can affect the way we age. Proper diet is not something that should be corrected only during the last years; how eat all our lives affects how we live our last years.