… continued from part 3 … Move your body

As we age we lose muscle which makes us less steady on our feet and more likely to fall. It can be a vicious cycle: you fall – you’re afraid of falling again so you’re less active – you lose muscle strength so you’re more likely to fall.

Less muscle also reduces our basal metabolic rate (BMR) – the rate we burn energy. The lower the BMR, the easier it is to gain fat. And the fat tends to go on around our stomach and internal organs, increasing the risk of diabetes, heart disease and high blood pressure. Not to mention ruining the look of our best clothes! We tend to accept this as a normal part of aging but researchers have observed that people who keep vigorously active throughout their life have a similar body composition and physiological function to younger adults. Even if you have been a couch potato, all is not lost. One study found that while people who had been physically active all their lives were about 60% less likely to have heart disease, even those lazy-bones who didn’t start serious exercise until after age 40 still had 55% less risk than those who stayed stuck in front of the television!

Regular exercise such as walking from the far side of the car park to the shops, taking the stairs instead of the lift, cycling with the grandchildren, swimming, dancing, golf, pilates and gardening have fantastic anti-aging effects. It helps reduce high blood pressure, increases the good HDL cholesterol that takes fat away from the arteries, gets the bowel moving, keeps joints mobile which helps with arthritis, keeps calcium in the bones so they stay strong, keeps muscles strong so you are less likely to fall, allows you to enjoy more food without gaining weight and gives a boost of endorphins – the body’s natural mood improver.

Be careful about the supplements you take

As our activity slows with age, we need less food but just as many nutrients – sometimes more. As well as vitamin D and B12, the B vitamins, especially B6 and folate are vital for a healthy brain, heart and immune system. Older people can also be low in calcium, zinc, potassium and magnesium.

Does this mean we need to rush for the supplements? It’s true that we need higher levels of nutrients to protect against degenerative conditions and disease than to simply avoid a deficiency. But food is always better and safer than a pill. Food provides all the nutrients we need – the ones we have discovered and those we don’t yet know about – in the perfect package for peak absorption. Supplements are sometimes in a different form from what occurs naturally so may not be as effective. Large doses of vitamins, minerals and so-called ‘natural’ herbal remedies can have potent, drug-like effects, especially in older bodies which are less able to handle it. They can also interfere with medication. For example, taking fish oil or high doses of vitamin E (over 400 IU) with aspirin or warfarin may cause excessive bleeding as they both reduce clotting. Taking just one vitamin or mineral can cause a deficiency in another e.g. zinc and copper. A multivitamin minimises this risk and many people take one as a form of nutritional insurance. But popping a multi-vitamin with your hot chips and jam sandwich doesn’t make a balanced diet!

An expert panel, set up by the National Institutes of Health, analyzed the research and concluded that there was a proven health benefit of supplements in just three cases: calcium and vitamin D to reduce bone fractures in post-menopausal women; vitamins C, E, beta-carotene, zinc and copper to reduce the risk of blindness in people with early signs of macular degeneration; and folic acid to prevent birth defects (not usually an issue for the over-65’s!)

Always let your doctor know if you are taking nutritional supplements, especially if you are on medication

… one more in this series tommorrow …

Let’s start where we finished off yesterday – with a glass of wine! As we age our sense of taste and smell isn’t so great and a glass of wine with dinner may be just what we need to enjoy our meal. It also encourages us to sit down to a ‘proper’ meal – wine just doesn’t go well with tea and toast! We lose tastebuds as we age and food just doesn’t taste the same. To add some flavour, it’s tempting to add extra sugar or salt. Some people get into the habit of shaking the salt shaker for a certain time without even tasting the food. One nursing home was having trouble with the amount of salt their residents were lavishing on their food. So they covered some of the salt shaker holes with tape. For the same amount of shaking they got less salt! Too much salt speeds up calcium loss from the bones, sends up blood pressure and makes us more prone to dehydration. Try using more herbs and spices for both flavour and a few extra antioxidants.

Some medications, pain, depression, mild zinc deficiency, poor oral hygiene, gum disease and poorly fitting dentures can all make eating more of a chore than a pleasure. Try these ideas to help. Go for a pre-meal walk to stimulate appetite. Set the table attractively. Eat small, frequent meals. On your plate use lots of colour (from vegetables, not artificial colours) and try different textures – crispy roast veges and salad with a casserole rather than sloppy mashed potato. Stimulate your tastebuds by eating individual foods rather than piling them all on your fork in one uniform taste. Chew food well – just like your mother told you! It extracts more flavour.

Digestion

About one-third of people over 65 suffer deterioration of their stomach lining which means it doesn’t make so much hydrochloric acid, pepsin (a digestive enzyme) and intrinsic factor. This reduces how much vitamin B12, folate, iron and calcium they can absorb. Vitamin B12 deficiency seriously affects the nervous system and can lead to dementia. B12 comes mostly from animal foods. To get the recommended 2-3mcg a day include some lean meat, salmon, tuna, oysters or liver.

Constipation is common in older people, especially those who are inactive. Some try to solve the problem with laxatives (not a good idea long term) and others by taking copious amounts of unprocessed bran. The odd bran muffin makes a yummy morning tea but too many will bind up vitally important minerals such as calcium, iron and zinc. One study found that eating two tablespoons of wheat bran three times a day halved the amount of calcium absorbed.

Our gut contains many ‘friendly’ bacteria that enhance the immune system and make us more resistant to food poisoning and tummy bugs. But as we head into our 70’s there are less of these ‘friendly’ bacteria around. Eating yoghurt or fermented dairy drinks will add a few ‘friendly’ bacteria back into your gut. Check the use-by date to buy the freshest yoghurt as the bugs die off over time. To help these bacteria survive the perilous journey through your stomach, eat foods with resistant starch such as rolled oats, nuts, seeds, lentils, baked beans or cold rice or pasta. You may find yourself sitting on the toilet a bit more often but straining will be a thing of the past!

These foods are great for keeping your gut in top working order:

• Banana or berry yoghurt smoothie
• Porridge or muesli topped with yoghurt
• Baked beans on grainy toast
• Pasta or rice salad
• Stir-fry beef with lots of vegetables on rice
• Fruit salad with yoghurt
• Sushi
• Lean mince cooked with red lentils, vegetables and a jar of pasta sauce.

Remember to add in a little exercise, plenty of water and lots of smiles! … more tommorrow (part 4)…

… continued from part 1 …

Think like a pot plant! That’s the message a dietitian colleague of mine tells older people – water yourself well and get out into the sunlight.

Getting some sun

Just half an hour of activity outside each day is enough not only to keep reasonably fit and toned but also to allow our skin to make its own vitamin D. Older people have about one-quarter the ability to produce vitamin D compared to younger people so it is important to get some sun exposure each day. It’s the sun that causes the skin to make vitamin D. Vitamin D helps carry calcium into the bones to keep them strong. It’s also important for your immune system. Sitting in a sunroom behind glass won’t do it. If at all possible, get up and take a walk around the garden for 30 minutes. Older people who can’t get outside each day may need a low dose (10ug a day) vitamin D supplement. But too much can be toxic so check with your doctor before taking a supplement.

Well watered

As we age we lose our sensitivity to thirst. On top of not feeling thirsty some older people deliberately drink less to avoid embarrassing moments of incontinence. This drying out of the body can lead to headaches, constipation and more concentrated (even toxic) medication levels. It’s important to drink fluids even when you don’t feel thirsty, especially in hot weather. With some medication, the doctor may tell you to restrict fluids but for everyone else it’s good to drink enough to keep your urine clear – about eight glasses of water a day. If that much water sounds too daunting fill a two litre jug with water, add sliced lemon and ice, and drink slowly over the day. Or have a few cups of herbal or green tea. Green tea has more antioxidants and less caffeine than black tea.

Fruit juice also counts as fluid and is good for people who need to gain weight or have no appetite. A glass of unsweetened juice has about three teaspoons of sugar (mostly from the fruit) along with vitamins and antioxidants, depending on the variety. Too much coffee and alcohol causes dehydration. However a study of almost 6000 people aged over 65 found that those who had 7-10 alcoholic drinks a week (not all in one session!) had a third less risk of heart failure compared with abstainers. Maybe it’s due to the relaxing effect of a glass of wine with a meal each night!

Part 3 tommorrow…

While most of us are still dragging ourselves from warm cosy beds hundreds of energetic seventy and eighty-somethings are greeting the dawn, and each other, as they cycle or walk along beaches and through parks. Don’t bother looking for them after 7am. They are already at the cafes sipping lattes or juice while catching up on the latest news, gossip and jokes. All across the world a growing number of the 65-plus age group, often from ‘power’ careers, are into ‘power-aging’. They exercise regularly, get involved in their local community, travel frequently and search out the latest anti-aging foods and supplements.

I was recently at the home of my ‘power-aging’ aunt and uncle for lunch and asked their 91 year old friend – who looks about 70 – what she thought was the secret of healthy aging. She replied, “Looking out more than you look in.” This dynamic woman has suffered tragic personal loss and debilitating disease yet you would never know it to meet her. I asked her whether she ate any particular diet. She replied, “I’ve never been on a diet. I just eat a bit of everything.”

The former head of the British Nutrition Foundation – an amazing woman whose career extended from re-feeding the people coming out of Nazi concentration camps to testing the effects of potentially toxic metals on herself because it wouldn’t be ethical to test on others – had a similar answer. When this 90-something nutrition expert was asked what she thought was the key to healthy eating, she said, “Eat a little bit of a lot of things – and have a glass of milk each day.”

We can’t stop aging but we can slow it down depending on what we eat, how active we are and whether we have any disease. The American Institute for Cancer Research says that one-third of the most common cancers can be prevented through diet, activity and weight control. And another third can be prevented by not smoking.

As we age we lose muscle and fat from the places we like it and gain fat where don’t want it. Scratches take longer to heal, we get more aches and pains, everyone speaks far too quietly and food just doesn’t taste the same. Then there are the social changes: grief from losing loved ones to death or disease, loneliness, being stuck at home because we can’t drive anymore and financial struggles. Such things change how we cook and eat. Sometimes it’s just too hard to cook a meal of meat and vegetables. A quick pop of the toaster and a nice cup of tea is much easier. But it’s never too late to make changes – to your eating, activity or attitude. And these changes can delay and sometimes reverse many of these problems associated with ageing.

Follow me over the next few days as we look at ways to put more life into your years…   Part 2 here