Healthy aging is a result of
preventing or delaying chronic disease and illness. Healthy aging is accomplished with proper
nutrition, exercise, and positive lifestyle behaviors. However, proper nutrition is the cornerstone
of successful aging. Why? Proper nutrition can prevent or delay chronic
illness. Some of these include
osteoporosis, diabetes, cardiovascular disease, and hypertension. Illnesses such as cancer and stroke may also
preventable or can be delayed with proper diet intervention and lifestyle
behaviors. Exercise is also a key
component of healthy aging. The single
most significant predictor of developing cardiovascular disease and
cardiovascular death is elevated HDL cholesterol. HDL is controlled by both diet and
exercise.
What exactly is “healthy
aging?” How is that different than
“normal aging?” The term normal aging is a medical term that uses
the biomedical model for aging. It
focuses on treating illness, not prevention.
Normal aging is how the body changes as people get older regardless of
chronological age and can best be described as “how most people age.” Therefore, normal aging does not have a
prevention focus (National Institute on Aging, Baltimore Longitudinal Study of
Aging, 2020). For example, we know that
memory loss is NOT normal aging. However,
slower retrieval IS normal aging. Often, people assume that losing keys is a
sign of memory loss. Not so! Losing keys is normal at ANY age.
Healthy aging is a three-legged
stool, a combination of positive lifestyle factors, exercise, and proper
nutrition. This triad formula for
successful aging can prevent or delay the onset of chronic illness and
hopefully prolong life and enhance lifestyle satisfaction. Adopting healthy habits and behaviors,
staying involved in your community, having a strong social network, using
preventive services, managing health conditions, and understanding all your
medications can contribute to a productive and meaningful life (Health and
Human Services, 2020). The healthy
aging model combines the biomedical model and the social model. The focus
is on intervention strategies to prolong the onset or prevent illness and
chronic disease.
Successful aging includes a healthy
lifestyle, exercise, strong social networks, and a nutrient-dense diet. Studies show that dietary and lifestyle
intervention can prevent or reverse the onset of disease even in people age
sixty and over.
A well-balanced,
nutrient-dense diet is the key to proper nutrition. It provides the necessary vitamins and
nutrients necessary for maximum health.
As shown above, a food pyramid has been developed by Tufts University, the “70+
Pyramid.” [Although Tufts developed a revised
version of their pyramid, I prefer the older version because it is user-friendly
and less confusing.] The FDA food pyramid, developed in 1992, is for all people
age two and over. It does not meet the
requirements of the aging population because their dietary requirements are
different. At the foundation of the
Tufts food pyramid is water. They
recommend 8 glasses of water to prevent dehydration. Older adults have a reduced thirst receptor
and therefore may become dehydrated without knowing it. Proper hydration is essential for cognitive
function and body temperature regulation.
Next up on the 70+ Pyramid is 6 servings of grains, pasta, and cereal
that are high in fiber. Next, 3
vegetables and 2-3 fruits. At the next
rung are 2 servings of milk, yogurt, or cheese and 2 servings of lean
meat. Next, are fats with the guidance,
“use sparingly.” Unlike the USDA
pyramid, the 70+ Pyramid includes vitamin supplements. They have added Vitamin B-12, Calcium, and
Vitamin D. These are often lacking in
the diets of older adults and will ensure cognitive function, prevent anemia,
and ensure strong bone health.
Exercise is another
component of successful aging. Exercise can reduce the HDL cholesterol, also
known as the “bad cholesterol.”
Exercise, especially resistance exercises, results in more lean body
mass and toned muscles. This is
especially important for prevention of osteoporosis and weight control. Exercise also aids in balance and
coordination, important for preventing falls.
How do we know what older
adults need for successful, healthy aging?
The centenarian studies look at the lifestyles and nutrition of people
age 100 and over. The centenarians are
healthy, active, living in their communities, and seem to be thriving despite
their chronological age. By studying
them, we are able to see commonalities that lead to successful aging. Three important centenarian studies are the
New England Centenarian Study, the Georgia Centenarian Study, and the Okinawa
Study.
The New England and Georgia
studies show that centenarians have these common habits:
1.
Social support networks
2.
Nutrient-dense diet
3.
Eat breakfast
4.
Exercise
5.
Lower caloric intake
6.
Little or no alcohol
7.
“5 A Day” diet. This means 3 vegetables and 2 fruits daily
8.
Stable weight over their lifespan
The Okinawa Study yielded
similar results. Japan has the highest
life expectancy of any other country.
Okinawa, an island off Japan, has more centenarians than any other
region. This 25-year study shows a
similarity to the other two centenarian studies:
1.
Strong social support network
2.
Mostly fruits and vegetables consumed
3.
Fish in small quantities
4.
Little or no alcohol
5.
Exercise
6.
Stable weight over their lifespan
What is amazing about the
Okinawa study is that older adults in Okinawa work at jobs and often remain employed well
into their 80’s and 90’s.
What we also glean from the
centenarian studies is the importance of lifestyle behaviors that have prevented
or prolonged the onset of illness and chronic disease among this population
group. For instance, all three studies
show a low intake of alcohol. Two drinks
per day reduce HDL cholesterol, thins the blood, and assists platelet
formation. However, more than two has a
negative effect by elevating HDL cholesterol.
Also, the centenarians’
low-fat, high fiber diet reinforces the connection between certain cancers and
nutrition. Four types of cancer are
linked to hereditary and dietary factors.
Breast cancer is associated with a high fat diet; colon cancer is
associated with a diet high in red meat and high in fat; rectal cancer is
associated with a diet low in fiber; and lung cancer is associated with a diet
low in both vegetables and fruit.
Food insufficiency is
another factor related to nutrition.
Food insufficiency means that a person doesn’t have enough food for a
variety of reasons. Often it is due to
poverty or the inability to shop and/or carry groceries. People cannot age successfully if they don’t
have enough food to eat. There are
several social programs to alleviate food sufficiency. Some means-tested programs are food stamps
and soup kitchens. These programs are
not successful among older adults. Only
25% of eligible older adults receive food stamps and 24% utilize soup
kitchens.
Two other programs are
nutrition education and nutrition screening.
Local Extension Services conduct nutrition education seminars in a
non-threatening, informative, non-competitive environment. The Nutrition Screening Initiative, begun in
1989, is a program for home health
workers to evaluate the food status of older adults and make recommendations.
The Early Nutrition Program (ENP)
is part of Title III of the Older American Act (OAA). There are two types of ENP’s available to
persons age 60 and over, and their spouse of any age. Begun in 1954 in Philadelphia, the first ENP
meals were congregate meals. These group
meals are still popular in communities.
It is a nutrient-dense hot meal served in a community center or senior
center. To meet the needs of the frail
elderly, Meals on Wheels (MOW) is another ENP program of delivered hot
meals. Because the ENP meals are not means-tested
and are available to any person age 60 and over, both programs are enormously
successful. The expected outcome is a
healthier older population.
The most recent news about healthy aging
and lifestyle changes comes from the Surgeon General Dr. Jerome Adams. In his “Health is Wealth” podcast, Adams
stated, “Money spent on health care is money that’s not
being saved and not being used for a host of other things that help us be
productive.” He also addressed the Big Five contributors to
health declines and chronic conditions including childhood obesity, adult
obesity, diabetes, hypertension, and physical inactivity. He added implied that Food Deserts, defined
as neighborhoods without grocery stores, contribute to malnutrition and food choices. “We can
make a choice to eat fresh fruits and vegetables because the grocery store is
closer than the fast food restaurant, and not everyone can say that. So we need
to both help individuals become better educated so they can make better
choices, but we need to put better choices in front of them” (Bostic, 2019).
Researcher Ryan T. Williams
stated that our greatest threat in America isn’t the terrorists, but is obesity,
which also undermines national security (Williams, 2017). Almost three-fourths
of Americans are overweight or obese and is the primary hindrance for enlisting
in the Armed Forces (Williams, 2017). The implications of the “obesity
epidemic” are staggering. The result of
overeating and not enough exercise are the primary causes. We can expect that this trend toward obesity
means more diabetes, cardiovascular disease, arthritis, hypertension, stroke, and premature death.
References:
Bostic, R.,
& Adams, J. (2019, January 29). Build healthy places network. “Health is Wealth:”
A conversation with the U.S. Surgeon General. [Audio podcast]. Retrieved from
Health and Human Services,
Health Aging (2020). Retrieved from https://www.hhs.gov/aging/healthy-aging/index.html
National Institute on Aging,
Baltimore Longitudinal Study of Aging (2020). Retrieved from https://www.nia.nih.gov/research/labs/blsa
Tufts University 70+ Food
Pyramid available at https://www.researchgate.net/figure/The-food-guide-pyramid-for-older-adults-From-Tufts-University-2002-TUFTS-food-guide_fig1_223797950
Williams, R.T. (2016-2017). Size really does matter: How obesity is undermining
America's national security. University
of Toledo Law Review, 48(1). Retrieved from https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2765529
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