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Healthy eating can be difficult for anyone, but it’s particularly challenging as we get older.
The diet of the average American over 65 is too low in whole fruits, vegetables, beans, whole grains, heart-healthy oils and dairy, and too high in refined grains, sodium, and other empty nutrients, according to the 2016 report of the Federal Interagency Forum on Aging-Related Statistics.
“A wide variety of factors can impact an older adult’s ability to eat healthfully, ranging from lack of appetite to chewing and swallowing troubles to having conditions such as depression and dementia,” says Elizabeth Eckstrom, chief of geriatrics at Oregon Health & Science University. And poor nutrition can lead to frailty, make you more susceptible to infections and weakened muscles.
Here are some ways to overcome these obstacles.
Losing your appetite
A slight drop in appetite is typical with age. And because your sense of smell and sense of taste decline over the years, food can seem less appetizing, says Ronan Factora, a geriatrician at the Cleveland Clinic. Chronic conditions such as dementia and kidney failure can reduce appetite, too.
Smart solutions: You don’t need to be overly concerned unless you’re unintentionally losing weight. But to ward off problems, stay as physically active as possible. Exercise, including resistance training, helps you retain muscle mass, which keeps your metabolism humming and potentially ramps up appetite.
And consider tai chi: A study in the journal BMC Complementary and Alternative Medicine found that older adults who practiced this regularly reported increased appetite.
If you get full quickly, consider eating five smaller daily meals instead of three larger ones (with protein in at least three meals). Add healthy nutrients and extra calories, if needed, by including milk powder, egg whites, olive oil and drinks, such as fruit smoothies in your diet.
To stimulate your appetite, suck on hard candy before meals, says Lauri Wright, a nutrition professor at the University of North Florida. Prescription appetite stimulants such as megestrol acetate (Megace and generic) improve appetite only slightly but boost the risk of blood clots and fluid retention.
Chewing or swallowing trouble
About 11 percent of people older than 60 have difficulty chewing, according to a 2013 study in the Australian Dental Journal. This is often because of dental problems, such as poorly fitting dentures or broken or missing teeth. And up to 10 percent might experience trouble swallowing, which can be caused by a neurological disorder such as Parkinson’s disease, damage from a stroke, wear and tear on your esophagus, or tooth loss.
Smart solutions: Find ways to replace hard-to-chew foods with softer options that have similar nutrients. So focus on softer proteins such as fish, ground beef, chicken and turkey. You can also steam hard-to-chew items such as red meat and crunchy vegetables. Get dentures checked, and if you have jaw fatigue when chewing, make sure it’s evaluated by your doctor, Factora says.
For difficulty swallowing because of a neurological disease or an event such as a stroke, speech therapy can strengthen your tongue, lips, throat and mouth muscles. Your doctor may also recommend a therapy called neuromuscular electrical stimulation to strengthen the swallowing muscles. If the trouble is related to esophageal irritation, you may have a condition such as reflux that needs to be treated. And if you’ve lost teeth, replace them with the most stable prostheses you can afford.
Food moves more slowly through your digestive tract as you age, and more than a quarter of women and about 16 percent of men older than 65 report chronic constipation. Constipation is uncomfortable and delays hunger signals to your brain.
Smart solutions: Drink plenty of water, exercise and get your fill of fiber, which eases constipation and increases “good” bacteria in your gastrointestinal tract. (This can help you absorb nutrients.)
Women older than 50 should aim for 21 grams daily; men, 30 grams. Because many fiber-rich foods, such as apples, are also hard to chew, consider whipping them up into a smoothie or steaming them, Eckstrom suggests. You can also take a couple of tablespoons of Eckstrom’s recommended home laxative every day: a mix of equal parts prune juice, bran or wheat germ, and applesauce.
If these steps don’t work, it’s fine to try a laxative that contains polyethylene glycol (MiraLax and generic). Avoid stimulant laxatives, such as bisacodyl (Correctol, Dulcolax and generic) and senna (Ex-Lax, Senokot and generic), which can cause dependency, and stool softeners, such as docusate (Colace and generic), which research shows aren’t effective. It’s also wise to eat more foods such as yogurt and fermented vegetables. These are rich in probiotics, which relieved constipation in up to 40 percent of the seniors in a study in Archives of Gerontology and Geriatrics journal.
Loss of mobility
If you have a condition that affects your ability to move, tasks such as grocery shopping, opening cans of food and preparing a sandwich can seem daunting. Almost half of 54.4 million adults who have received a diagnosis of arthritis, for example, have difficulty grasping a small object, reaching above their head, kneeling or just walking a quarter mile, according to the Centers for Disease Control and Prevention.
Smart solutions: Consider an online shopping service, or see whether local food stores deliver. Minor at-home modifications can help make food preparation and healthy eating easier, says Karen Smith, approved provider program manager at the American Occupational Therapy Association.
For example, lightweight ceramic cookware is easier to lift and move, and large C- or D-shaped cabinet handles are easier to grasp than knobs. Choose cooking and serving utensils and cutlery with large grips, and products such as automatic can openers and spring scissors, which require less wrist or finger strength. Your doctor may also be able to refer you to an occupational therapist who can come to your home and provide advice. (Insurance may or may not cover this.)
Up to 20 percent of older adults lose weight without intending to. Though some loss — about ¼ to 1/ 2 pound a year — is normal after about age 70, alert your doctor if you’re losing a significant amount. In some cases, this could be linked to a serious health condition, such as cancer.
“Anything more than a 5 percent reduction in body weight within six months should be evaluated by a doctor,” Eckstrom says. The doctor should take a thorough history, do a physical exam, assess you for depression and dementia, review your medications, order further testing based on symptoms and then determine how best to treat you.