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Clinician’s Practical Guide for Nutritional Health

Constipation

Our gastrointestinal tract slows with age, and loses strength and elasticity. Fiber “exercises” it, so at least 25- 35g/day fiber is needed for the ideal two daily bowel movements (think a ripe banana). 4.5g fiber is in 1 whole apple with 1 T almond butter or 1 whole pear. A breakfast of ½ cup of cooked oatmeal with ¼ cup walnuts, 1 T ground flax, and ½ cup blueberries is almost 11g fiber. Fiber is only found in plants and only if they are unrefined, so a slice of white toast with bacon and egg will is fiberless and constipating. Increase water intake along with fiber, or you will be constipated!

Hydration

Dehydration can cause constipation and is common among seniors due to decrease in thirst mechanism, swallowing problems and forgetfulness. Unlike young people, you do not know when you are dehydrated, so drink 8 glasses of water a day even if not thirsty. Caffeinated beverages (coffee or strong black tea) can worsen dehydration. Keep track of your intake by filling a pitcher with filtered water. Dehydration in seniors can be mistaken for cognitive deterioration such as Alzheimer’s (including speech difficulties or blurred speech). It can cause altered drug effect, headaches, dizziness, weight loss, dry mouth and nose mucous membrane, a swollen dry tongue, and changes in blood pressure.

Minerals and B Vitamins

About 80% of population over 70 has stomach that is less able to break down protein (fish, meat, legumes, dairy), some minerals, and some vitamins, e.g. calcium, magnesium, iron, zinc, B6, B12 and folate. These very important nutrients may become gradually depleted. Vitamin B12 deficiency is most dangerous, can mimic cognitive deterioration just like dehydration and 10-15% of population over 60 is deficient. A sublingual B12 supplement is effective and available on the market. A good quality multivitamin/multimineral supplement is prudent too.

Bone Health

Calcium, magnesium, manganese, boron and vitamin D3 are all important to help you maintain strong bones, so do not take calcium in isolation. Calcium intake decreases with age, but we may also lose existing calcium from bones with diet high in animal protein (meat, eggs, poultry, seafood), phosphorus in soda and meat, and coffee or some medications. Epidemiological studies suggest a link between high dairy intake and high incidence of osteoporosis. But no matter how much calcium we get, we cannot build bones without Vitamin D, so spend some time in the sun. Highly bioavailable calcium can be found in all green vegetables such as bok choy, broccoli, watercress, mustard greens, kale, collard greens, Swiss chard, beet tops, parsnip greens, even basil, cilantro, or dill weed. Other good sources of calcium are quinoa, sardines with bones, tofu processed with calcium, almonds, unhulled sesame seeds, tahini (ground sesame), or corn tortillas. Over-supplementation can lead to calcification of soft tissue and kidney stones.

The Sunshine Vitamin

Since we stay indoors, Vitamin D deficiency is rampant, especially in among seniors, and may lead to soft bones, rickets or osteoporosis/osteopenia. Most doctors check for it and prescribe supplementation of Vitamin D3. However, it should be supplemented along with Vitamin K2 to prevent arterial calcification, and independent risk factor of heart disease. Vitamin D is actually a hormone that not only builds strong bones but may also protect our heart, boost the immune system, and have protective qualities against cancer, according to research, and simply put, it makes us happier. If being outside daily is not an option, have your Vitamin D level checked and discuss the course of action with your doctor. Foods are unreliable sources of Vitamin D and fortified foods use mostly Vitamin D2, which is not the right form.

Body Composition

With age, muscle decreases while fat increases. A high vegetable diet may be too low in protein and energy, but a high protein diet from meat may overload the kidneys and increase the cardiovascular risk, so finding a balance is important. One egg or 1 oz of meat is about 7g of protein, and you may need 50-70g protein a day, which isa two egg breakfast, a 3 oz salmon for lunch, and a sardine sandwich with 2 oz sardine. Since these contain no fiber, though, pile vegetables on your plate! Good sources of protein that contain fiber are quinoa, millet, buckwheat, nut butters, nuts, whole grain bread/crackers, and hearty homemade lentil, bean chili or split pea soups.

Gas/Heartburn

These are common complaints that can be avoided. Either can be caused by overeating, too many fatty foods, alcohol, carbonated beverages, swallowing air, reclining after a meal, taking drugs such as aspirin, hurrying while eating, or gulping foods. Increase fiber and water intake, eat smaller more frequent meals, and allow three hours after last meal before retiring to bed. Make your lunch bigger and your dinner smaller.

Work with Fat

Omega 3 is essential to life. Eat wild salmon, mackerel, herring, sardines, walnuts, kale, raw finely ground flax seed, or fish oil regularly. Monounsaturated fat from extra virgin olive oil, olives, or avocados is heart healthy. Extra virgin coconut oil takes high heat well, is safe for arteries, gives energy, and does not store as fat. Healthy fats are important for our hormonal and brain functions, and eliminating fats completely is not recommended. Here are fats to limit. Excess of Omega 6 adds to inflammation. These are “vegetable”, corn, safflower, sunflower, and soy oils. Saturated fat from chicken skin, meat, and dairy can increase the risk of heart disease. Trans-fatty acids or “(partially) hydrogenated” oils are found in butter substitutes, oil reused for deep frying in restaurants, many cookies, and baked goods. They may decrease your healthy and increase your unhealthy cholesterol and may be linked to increased risk of cancer. They are best to be avoided altogether. Cholesterol is in even leanest meat cuts. Eat more fiber, and take fish oil for optimal cholesterol.

Always discuss your diet or supplement needs with a health professional.


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Boomers Resource Guide is a special supplement to the Senior Citizen's Guide