Proper Nutrition and The Elderly-Part II
(1/9/16)- The US Departments of Health and Human Services (DHHS) and Agriculture (USDA) have released the eighth edition (2015-2020) of the Dietary Guidelines for Americans. The Dietary Guidelines are an important part of a complex and multifaceted solution to promoting health and preventing diet-related chronic diseases including cardiovascular disease, type 2 diabetes, some cancers, and obesity.
The new dietary guidelines urge Americans to drastically cut back on sugar, and singled out teenage boys and men for eating too much meat, chicken and eggs. Longstanding limits on dietary cholesterol products were removed, including those on eggs.
It is updated every five years and was first issued in 1980. The guideline †affects foods chosen for school lunch programs that feed more than 30 million children each school day. The guideline also affects national food assistance programs like the Special Supplemental Nutrition Program for Women, Infants and children, which have 8 million beneficiaries.
(1/28/14)- We recently received the following e-mail from Kelly Coleman, and we at therubins want to thank her for taking the time to point out the correct link address for the government dietary guidelines, and for recommending the other sites to us.
(5/24/13)- An expert committee, commissioned by the Institute of Medicine undercut the warning that there is a need to restrict the amount of intake of salt in order to stay healthy.
That level of 1,500 milligrams of sodium a day, or a little more than half a teaspoon of salt, were supposed to prevent heart attacks, including anyone over 50, blacks and people with high blood pressure, diabetes or chronic kidney disorder, make up more than half the U.S. population.
The American Heart Association is sticking with the recommendation of 1,500 milligrams or less a day, so which way is the average layman supposed to go?
(1/22/13)-A diet rich in anthocyanins, a class of flavonoids with recognized heart-friendly antioxidant and anti-inflammatory effects, was associated with a 32% drop in the risk of incident MI in a cohort of 93 000 women from the Nurses' Health Study 2 (NHS 2).
At the same time, there was similar drop in MI risk during the 18-year follow-up among those with the highest vs the lowest consumption level of blueberries and strawberries, a major source of anthocyanins in the US diet, NHS 2 investigators report in a study published online January 14, 2013 in Circulation.
(6/4/11)- Hello Nutrition Plate goodbye Food Pyramid!!!!!!
First lady, Michelle Obama, Agriculture Secretary Tom Vilsack and Dr. Regina M. Benjamin, the surgeon general held a press conference in Washington on Thursday to unveil the new design that replaces the food pyramid that had been in place since 1992.
The new design, called MyPlate, is split into four sections, for fruit, vegetables, grains, and protein. A smaller plate sits besides the larger plate and it represents dairy products.
The Agriculture Department has created a Web site, ChooseMyPlate.com that elaborates on the different sections in the plate.
The first part of a new healthy eating campaign will encourage people to fill half their plate with fruit and vegetable. It will urge diners to drink water instead of sugary beverages.
The advertising campaign will cost the government about $2 million over the next year. The Agriculture Department said that it had conducted focus groups with about 4,500 people, including children, to help develop the plate.
(2/12/11)- The latest edition of the U.S. Department of Agriculture's dietary guidelines, which is published every 5 years recommends that we Americans exercise more, skip hamburgers and eat more fish and vegetables.
The agency suggests that people prepare and serve smaller portions at home, and have a slight snack before gorging ourselves at a party.
The USDA said it would release a next-generation food pyramid incorporating the new guidelines in the coming months.
To find the new guidelines go to http://www.dietaryguidelines.gov.
Women who eat a diet that is high in fruits, vegetables and whole grains but low in saturated fats and sugar have a lower risk of premature death or death from cardiovascular disease, research from the Nurse's Health Study reveals. A Western diet heavy on red and processed meats, french fries, sweets and refined grains was linked to a 22% higher risk of death from heart disease, a 21% higher risk of death from all causes and a 16% higher risk of death from cancer.
(1/27/07)- Here we go again, as the Agriculture Department teams up with food retailers and manufacturers try to get more Americans to follow its dietary guide set up in 2005. Mike Johanns the agriculture secretary kicked off a new advertising campaign called "Take a Peak", which will put information about healthy eating in participating supermarkets.
Signs in the stores will remind people to eat healthier by, for example, making sure that half the grains they consume are whole. The displays will also suggest appropriate serving sizes and will feature computers at which shoppers can draw up their own diet plans.
In spite of all their efforts and campaigns, the bottom line is that Americans are more obese than ever, and that the dietary pyramid is not helping the majority of people to "eat healthy."
(8/01/06)-U.S. health officials are ditching the "5 A Day" slogan, and replacing it with "Fruits and Veggies-More Matters", as they try to get us to eat more fruits and vegetables. In order to make the program more understandable to the layman the guidelines will use the "cup" as the measuring device, rather than the term "servings".
The guidelines will also be individualized depending on age, sex and level of physical activity that the individual performs. The new guidelines were published jointly by the Department of Health and the Department of Agriculture.
You can calculate your individual needs by going to www.mypyramid.gov .
Under the old system five servings of fruits and vegetable now equals 2.5 cups of fruits and vegetables. The push towards increased consumption of fruits and vegetables has become more urgent because of the growing body of scientific evidence that shows just how beneficial these food items are for the health and well being of all of us.
Please also keep in mind that the Institute of Medicine, a federal advisory body, recommended in 2004 that the intake of potassium helps to lower blood pressure, and is plentiful in many fruits and vegetables.
According to figures from the CDC, about 90% of Americans do not meet the government's recommendation for fruit and vegetable consumption. The CDC, along with the Produce for Better Health Foundation, a nonprofit group will be in the forefront of promoting the "Fruit and Veggie" campaign starting in March 2007.
Americans need to eat more of certain vegetables, since potatoes, corn and peas make up 40% of the vegetable intake of the average American. Scientists also caution that it is better to eat the actual fruit or vegetable rather than take a pill containing its nutrients.
Frozen vegetables and fruits retain the same nutrients as fresh, especially if they have been flash-frozen immediately after they have been harvested.
(4/30/05)- The Agriculture Department and the Department of Health and Human Services jointly announced the unveiling of the Web site www.mypyramid.gov based on the 2005 Dietary Guidelines for Americans that they published in January 2005. The original pyramid was published in 1992 and it outlined the portions Americans should eat, from the most at the base (grains) to the least at the apex (fats, oils and sugar).
The public-relations firm of Porter Novelli International, a unit of Omnicom Group Inc. under a $2.5 million contract, constructed the new pyramid.
The site is an interactive one that allows you to tailor make your diet plan based on age, gender and activity levels. There are 12 possible plans for you to choose from. The new icon on the site shows an image of a figure climbing steps to reflect the advice that Americans should exercise more. Most older Americans should exercise for a minimum of 30 minutes a day, whether it be walking, swimming etc. For children or people looking to lose weight the minimum time devoted to exercising should be at least 60 minutes per day. To sustain weight loss, up to an hour-and-a half of daily exercise is recommended.
The Guidelines and the USDA's food pyramid are the basis for all federal nutrition programs, including the school lunch program. Posters that will be hung in schools and hospitals will be released shortly with pictures of food and serving sizes based on a 2,000 calorie diet
(3/6/05)- The Agriculture Department and the Department of Health and Human Services jointly announced the new guidelines for proper dieting. The guidelines are set every five years, so that the last time the guidelines were set was in 2000. No funding has been set for promotion of the new guidelines, so it may take a while for the new numbers to reach the public. The Agriculture Department will release a new "food pyramid" of dietary guidelines for the first time since 1992 shortly.
Under the new guidelines total calories and lose weight are two of the more critical components in setting the limits for individuals to try and follow. Exercise becomes one of the more critical elements in setting weight loss objectives rather than just dieting alone. In general the proposals call for less servings of grains a day, but the ingestion of more fruits, vegetables, dairy and fish.
For a person on a 2,200 calories a day diet, the new recommendations call for 7 servings of grains, down from the 9 under the 2000 guidelines. A slice of bread counts as one serving of grain. The guidelines also call for 10 daily servings of fruits and vegetables, up from 7 under the old guidelines.
At least half of the grains people eat should be whole grains, such as whole-wheat bread, preferably in place of foods made from refined grains such as white bread. The 13 member panel that set the guidelines felt that total calories rather than such things as low-carb items is the most important factor in trying to lose weight
The new report specifies that adults should eat at least three cups weekly of dark-green vegetables, such as broccoli or spinach; two cups of orange vegetables such as carrots and squash; three cups of legumes such as lentils and chickpeas; six cups of starchy vegetables such as potatoes, corn and green peas; and seven cups of other vegetables such as tomatoes, onions and lettuce.
The panel also strongly endorsed eating fish at least twice a week. The new recommendations also included the ingestion of at least three servings of dairy a day up from the prior recommendation of two a day serving. The panel also suggested a decrease in the daily salt intake to 2,300 mgs, just 100 mgs less than the prior recommendation of 2,400 mgs per-day.
The report also included the statement that adults do not consume enough vitamins A, C, E, calcium, magnesium, potassium and fiber. Vitamin A is found in carrots and plays a significant role in vision. Vitamin C is found in orange juice and is important in strengthening blood vessels. Vitamin E can be found in almonds and is important in muscle formation. As we all learn from early childhood dairy is important in bone formation, and potassium, which is found in potatoes helps lower blood pressure. Beans can help out with increasing your fibers, which in turn helps with bowel movements.
With the emphasis on whole grain products, whole wheat, oatmeal and brown rice are all products that help in this area. No cap is placed on the amount of trans fat that an individual may consume. Trans fats are often used to make snack and fried foods and margarine.
The emphasis on exercise includes at least 10-push-ups and 5 sit-ups per day, and up to 1 1/2 hrs of walking a day. The updated guidelines help to determine the content of the school-lunch program, and other federal food programs.
(5/29/03)-Most of us are confused in the debate as to whether or not high-fat or low-fat diets are better at controlling weight. The Atkins diet, which emphasizes high-protein, high-fat, and extremely low carbohydrate, has been in the news lately especially with the comments saying that he has been proven correct. Actually this form of dieting was well known before Dr. Atkins brought it into the limelight, since it has been around since the late 1800's.
Under the Atkins diet you cannot eat bread, bagels, cake, cookies, ice-dream, candy, crackers, muffins, pasta, sugary soft drinks, rice, most fruits and many vegetables. Since this means you are consuming less calories you are going to lose weight. This diet allows you to eat almost as much meat, fats, eggs, and cheese as you like.
A diet without carbohydrates causes the body to make substances called ketones what may create a mild nausea which certainly will cut down on your appetite. The question remains however as to how healthy such a diet is for you. Amazingly enough the Atkins diet has not been tested for long-term safety and effectiveness.
The Atkins diet leaves your body shy on some important nutrients, such as vitamin B, and also is negative for vitamins A, C and D, anti-oxidants that slow the effects of aging and calcium. Once again the lack of exercise has to enter into the equation also. If you eat more calories than you expend, you will gain weight. The latest data seems to also indicate that carbohydrate-rich, low-fat diets with only modest amounts of protein may be less effective in achieving and maintaining weight loss. Fat and protein are digested more slowly that carbohydrates and may also delay the return of hunger.
The consensus among the experts in achieving both health and maintaining weight loss now seems to favor a diet that contains about 25 % of calories from fats. These would come primarily from vegetable sources like olive, canola and nut oils, avocados, beans, nut butters, nuts and seeds, along with fish and lean red meats and poultry adding up to about 20 to 25% of calories from protein.
The National Cancer Institute announced that it would launch a publicity campaign that was aimed at getting both men and women to increase their daily consumption of both fruits and vegetables. Although studies have shown that the average male consumes only 3 servings of fruits and vegetables a day, the Institute recommends that a male should eat 9 servings a day. And as far as the ladies go the recommended consumption is for 7 servings a day and for kids it is at least five a day.
We Americans have a long way to go to get up to these recommended levels. Only 23% of adults eat at least 5 daily servings of fruits and vegetables, and only 4% of the males consume 9. About one-third of the population eats only one or two servings a day.
A six-ounce glass of fruit or vegetable juice would count as one serving. A medium sized apple, orange or banana would be one serving. One cup of salad greens would also be considered one serving. For dried fruit like raisins, measure one-fourth cup, which is about the size of an egg would be one serving. One ear of corn or 8 carrot sticks would do the trick for being one serving.
A Harvard School of Public Health of 120,000 nurses or health workers found that those who had very high intakes of fruits and vegetables had the lowest risk for heart disease. In other studies, fruit and vegetable intake has been shown to lower blood pressure. It has also been shown that higher consumption of certain fruits and vegetables has lowered the risk against certain cancers.
There are indications that folic acid, which is found in spinach, oranges and lettuce reduces the risk for colon cancer. Tomato consumption has been shown to lower the risk for prostate-cancer. Research has also shown that people who eat very few fruits and vegetables are at a higher risk for cancer than those who eat at least two or three servings. Most overweight people do not eat very many fruits and vegetables.
The Food and Drug Administration will require manufacturers to add a line to the nutrition label on every box, can and bottle of processed food that will indicate how much of artery damaging trans fat their products contain. Trans fat, or as they are sometimes called, trans fatty acids, are found in vegetable oils that are hydrogenated or partly hydrogenated. Hydrogenation is a process that solidifies the fat to form margarine or shortening. A serving of French fries can have up to 3.6 grams of trans fat. According to Dr. Margo Wootan, a senior scientist for a consumer group, the Center for Science in the Public Interest, said "that the only safe intake of trans fat is zero."
In a report to the FDA from the Institute of Medicine, the medical arm of the National Academy of Sciences it was concluded that trans fat correlated significantly with an increased concentration of L.D.L., or "bad" cholesterol, and a decreased level of H.D.L., or "good " cholesterol. Federal officials have said trans fat will be labeled on a separate line from saturated fat, so that the consumers will know exactly how much they are ingesting.
The American Heart Association's new dietary recommendation for the first time recommended that an individual eat at least 3-ounces of fatty fish like salmon, mackerel or tuna bi-weekly. The results of three recently published studies backed this recommendation to help lower the risk of death from heart disease.
The key factor seems to involve a substance called omega-3 fatty acids which help the heart by preventing fatal disturbances in heart rhythm. Heart rhythm disturbances caused the death of about 250,000 Americans last year. About half of the deaths occurred in people who had no previous symptoms of heart disease.
Dr. Frank B. Hu of the Harvard School of Public Health led one of the studies. The participants are about 85,000 female nurses who have been studied for the last 16 years. Women who ate fish 5 times a week had a 45 % lower risk of dying from heart disease than woman who rarely at fish. For those females who ate fish two to four times a week the risk was lower by about 31%.
In another study being conducted by the Physicians Health Study on 20,000 doctors over the last 17 years, researchers compared the omega-3 fatty acids level in the blood of 94 male doctors who died suddenly with the levels of 184 other men in the group. On average, blood from the men who died suddenly contained a far lower level of omega-3 than did the blood levels of the others in the study.
The third study looked at the effects of giving fish-oil capsules to people who had had heart attacks. Dr. Roberto Marchioli, at the Consorzio Mario Negri Sud in Santa Maria Imbaro Italy found that patients who got the capsules, compared with those given a placebo, had a 42 % reduction in the rate of sudden death.
According to a study done at the University of Iowa under the leadership of Teresa A. Marshall nutrient deficiencies increase with the aging process. This in turn leads to cognitive and immunological decline which according to the study can be reversed through proper nutrition. A simple one-a-day nutrient supplement may be all that is needed to slow or even stem the decline.
The study found that 75% of the individuals involved in the study consumed too little folate, a B vitamin that helps prevent heart disease and stroke. Eighty-three percent did not get enough vitamin D and 63% did not get enough calcium, both of which are essential for bone strength preservation, and also helping to prevent fractures and osteoporosis. The study concluded with the thought that older people should be encouraged to increase the variety of foods they eat, especially nutrient-rich fruits, vegetables and whole grains. It also recommended a daily dosage of nutritional supplements. Dr. Ranjit Kumar Chandra, a pediatrician and immunologist at Memorial University of Newfoundland, led a study that concluded that a nutrient supplement with modest amounts of 18 supplements, minerals and trace elements could improve cognitive function in healthy people over 65.
The October 31st issue of Circulation, a journal of the American Heart Association contained the new dietary recommendations of the AHA. They will also be available on the Web site of the association at http://www.americanheart.org and at heart association offices throughout the country. The new guideline will emphasize common sense and play down the percentages of fat or nutrients in foods.
The new guidelines will recommend a diet rich is fruits, vegetables, legumes, whole grains, low-fat dairy products, fish, lean meats and poultry. Five servings of fruits and vegetables and six servings of grains are recommended daily. A serving of fruit is a medium size piece of fruit or a half-cup of juice, and one of vegetables is half a cup; a serving of grains is a slice of bread or a half-cup of cereal. For the first time the association recommends eating three ounces of fatty fish like tuna, mackerel or salmon bi-weekly. Emphasis is again stressed on the avoidance of saturated fats and trans-fatty acids.
The Agriculture Department held what they deemed "the great nutrition debate" on February 24th, 2000 in Washington. Three of the nations leading nutritionists and diet promoters headlined the debate. Dr, Barry Sears, who is best known as the creator of the Zone diet and Dr. Robert Atkins creator of the Atkins diet were on one side of the debate. Dr. Dean Ornish, the famous dietician-author was on the other side.
The Atkins-Sears side agreed on the dangers of pasta, potatoes and other carbohydrates. The Ornish side argued that pasta and white bread were just fine as long as they were low in fat. Dr. Ornish scoffed at the high-protein diet.
After the debate was over Under Secretary for Food, Nutrition and Consumer Services Shirley Watkins stated " We will stand behind the pyramid". The pyramid calls for:
Before discussing what a proper diet should consist of we will define some often-used phrases that you read about in discussions about diets.
In a unified approach, 5 of the countries leading health organizations endorsed a diet that they feel is best able to deal with counteracting some of our most acute killers (heart disease, stroke, cancer and diabetes). The 5 organizations are: the American Cancer Society, the American Dietetic Association, the American Academy of Pediatrics, the National Institute of Health and the American Heart Association.
Under the Unified Dietary Guidelines, it is proposed that 55% or more of your daily calories come from complex carbohydrates like grain, fruits and vegetables. Cholesterol should be limited to 300 milligrams or less each day. Salt intake should be limited to 6 grams or less per day. The diet was officially published in the July 27, 1999 issue of Circulation, a journal of the American Heart Association.
It is a recognized fact that proper nutrition is a key element to having a healthy body. The problem is that experts disagree as to what proper nutrition consists of, and how it should be achieved. We are not nutritionists but we will present hereafter one of the recommended diets for people over 70 years of age. Dr. Robert M. Russell (Professor of Nutrition and Medicine at Tufts University) developed this diet in co-operation with Dr. Alice Lichtenstein and Helen Rasmussen (U.S Dept. of Agriculture's Human Nutrition Research Center). Remember that it is only a guide, and should be adjusted depending on individual circumstances.
The key to this diet is water. Eight 8-ounce glasses of water (or its nonalcoholic, caffeine-free equivalent) should be drunk on a daily basis. Without this proper intake of water, blood pressure can fall dangerously low, clots may form and block blood vessels, kidney functions may be compromised and constipation may become chronic.
Six or more servings a day of grain based foods like bread, cereal, rice and pasta form the foundation for this diet These fiber rich foods counter high cholesterol, protect against cancer and help maintain a normal blood sugar level. They should be supplemented with extra nutrients such as folic acid and vitamin B-12. Folic acid helps lower blood levels of homocysteine, which in turn aids in the fight against heart disease.
Three or more servings of vegetables and 2 or more servings of fruits are also recommended on a daily basis. They can be sliced, chopped or pureed and can be fresh, canned or frozen. It is best to leave out the syrup, which provide too many sweet calories.
Vegetables in the cabbage family like broccoli, cauliflower, kale and mustard greens are rich in cancer blocking chemicals.
A daily serving of three items from the dairy group is recommended. The servings should be of the low fat or no fat variety.
Two or more servings a day should be from the meat group. It should consist of a variety of fish, dried beans, and lean cuts of meat or poultry.
Liquid oils or trans fatty acid type margarine should be used for cooking the food. Try to avoid salad oil dressing if at all possible. It is now recommended that 400 international units of Vitamin D be consumed per day. It is also recommended that between 1,200-1,400 milligrams of calcium be taken per day. B-12 supplements are also highly recommended.
Many of us are aware of the fact that oftentimes the problem on the dietary front arises when the resident refuses to eat anything at all. Sometimes this may be caused by aspiration in the throat, as diagnosed by a competent medical authority, but sometimes it may be caused by the loss of will power to go on living. This loss of will power may be a temporary occurrence or it may continue for a long period of time. That is why Ensure or some-other type of food enrichment is necessary to keep the resident alive. Frequently the situation may deteriorate to the point wherein the resident must be fed through a tube, attached to a permanent nodule attached to the stomach. We do not judge anyone in how they determine what type of treatment should be afforded to their loved one, but remember to be able to have a choice in this situation you must have a living will or proxy statement available, properly executed and witnessed. See our article on Living Wills.
Please also see: Undernourishment in the Elderly-Part I
See also our article on Recommended Vitamin C and Mineral Supplement Dosages.
FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE "HOW TO SELECT A NURSING HOME".