By Assoc Prof Dr ZAITUN YASSIN
I HAVE trouble chewing. Food just doesn't taste the same anymore. I don't have a car to go shopping. It's hard to cook for one person. I'm just not that hungry anymore.
Is one of these a reason you are not eating well now? Has age blunted that voracious appetite that used to serve you so well in the past?
The fact is, food provides energy and nutrients that your body needs to stay healthy. These nutrients include proteins, carbohydrates, fats, vitamins, minerals, and water. As you grow older, you may need less energy from what you eat, but you still need just as many of the nutrients in food.
Nutrition experts can recommend what the average older person needs to eat, but you should also check with your doctor, a nutritionist or registered dietitian. This is especially true if you have a health problem that limits what you can eat. They can help you plan meals that will include the healthy foods you need, and what foods to avoid.
Wht the concern?
Nutrition remains important throughout life. Many chronic diseases that develop late in life, such as osteoporosis, can be influenced by earlier poor food habits. Insufficient exercise and calcium intake, especially during adolescence and early adulthood, can significantly increase the risk of osteoporosis, a disease that causes bones to become brittle and crack or break.
But good nutrition in the later years can still help lessen the effects of diseases prevalent among older Malaysians or improve the quality of life in people who have such diseases. They include osteoporosis, obesity, high blood pressure, heart disease, certain cancers, gastrointestinal problems and chronic under-nutrition.
Studies have shown that a good diet in later years helps both in reducing the risk of these diseases and in managing the diseases signs and symptoms. This contributes to a higher quality of life, enabling older people to maintain their independence by continuing to perform basic daily activities, such as bathing, dressing and eating.
Poor nutrition, on the other hand, can prolong recovery from illnesses, increase the costs and incidence of hospitalisation and lead to a poorer quality of life.
What should I eat?
Choose many different healthy foods. Pick those that are lower in fat, especially saturated fat (mostly in foods that come from animals) and cholesterol. Eat or drink only small amounts of sugary or salty foods and alcoholic drinks, if you drink them at all.
Avoid empty calories as much as you can. These are foods like sodas, potato chips and cookies that have a lot of calories, but not many nutrients.
Calories are a way to measure the energy you get from food. If you eat more calories than your body needs, you could gain weight.
If you are not active, choose lower calorie foods and eat the smallest number of servings suggested for each of the five food groups in the Malaysian food guide pyramid. If you are active, you should eat more servings for more calories.
Are you less interested in food?
Does your favourite chicken curry taste different? Does your vegetable soup suddenly seem to need salt? The flavour of food is probably the same as always. With age, your sense of taste and sense of smell may change. This affects how foods taste. They may seem to have lost flavour. You may not be able to smell if foods have gone bad.
You might want to date foods in your refrigerator to keep yourself from eating foods that are no longer fresh. If in doubt, throw it out.
There are other reasons food may not taste the same. Some medicines can change your sense of taste or make you feel less hungry. Maybe you have slowed down a bit, so your body needs fewer calories. Maybe chewing is difficult because your dentures need to be adjusted or your teeth or gums need to be checked. You might want to pick softer foods to eat.
Do I need to drink water?
It's not just water. You need to drink plenty of liquids like water, juice, milk, and soup. Aim for eight eight-ounce glasses a day. You have to replace the fluids you lose every day. But, check with your doctor if he or she has told you to limit how much you drink.
Don't wait until you feel thirsty to start drinking. With age you may lose some of your sense of thirst. In addition, medicines can sometimes cause you to lose fluids. If you are drinking enough, your urine will be pale yellow. If it is a bright or dark yellow, you need to drink more liquids. If the colour still does not change, talk to your health care provider.
Do you have a urinary control problem? If your answer is yes, don't stop drinking a lot of liquid. But, talk to your doctor for help with your urinary control problem.
What about fibre?
Dietary fibre is found in foods that come from plants - fruits, vegetables, beans, nuts, seeds, brown rice, and whole grains, such as oat, barley, wheat, corn and rice bran. It is the part of plant foods that your body cannot digest. Eating more fibre may prevent intestinal problems like constipation and diverticulosis (little pouches that protrude from the intestinal wall). It may also lower cholesterol and blood sugar and help you have regular bowel movements.
Some nutrition experts think adults should eat 20g to 35g of fibre each day. If you are not used to eating a lot of fibre, add extra sources of fibre to your diet slowly to avoid stomach problems. The best source of this fibre is food, rather than dietary supplements.
Should I cut back on salt?
Salt (sodium chloride) is the most common way people get sodium. Sodium is naturally present in most foods, and salt is added to many canned and prepared foods. The body uses sodium to keep the blood, muscles and nerves healthy, but too much is not good. Most people eat a lot more sodium than they need.
Each day you should eat no more than 2,400mg of sodium. This is about one teaspoon of table salt. It includes all the sodium you get in your food and drink, not just what you add when cooking or eating. If your doctor tells you to use less salt, try to cut back on salty foods like processed meats and mustard. Use spices, herbs and lemon juice to add flavour to your food.
What about fat?
Fat in your diet provides energy and certain vitamins. Too much fat, especially saturated fat, can be bad for your heart and blood vessels and can lead to heart disease.
Saturated fats often come from animal sources. They tend to be solid at room temperature, rather than liquid. Also, fat is high in calories. It should make up no more than 30% of your total calories 53g of fat if you are trying to eat 1,600 calories a day.
Do I need to take supplements?
If you are healthy and have a good appetite, you do not need any supplements. However, supplements may be necessary if you do not have an appetite for a prolonged and extended period; if you are losing weight for no apparent reason or are severely underweight; if you are malnourished, if you have impaired digestion; if you are on medications that block the body's use of a nutrient; if you are sick with extra nutritional requirements; or if you had a recent surgery.
If you fall into one of these groups, or decide you want a supplement to improve general health, base you choice on fact, not hype. Check with your doctor, nutritionist or dietitian if you have any doubt. They will assess you and provide you the appropriate advice. Eat well and live well in your golden years.
Assoc Prof Dr Zaitun Yassin is Deputy Dean, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang.
(Published at TheStar February 23, 2003)