Yashna Harjani

Everyone's living longer these days. Advances in medical science have made this possible. Great news isn't it? But with long life comes one important responsibility - the responsibility of living a "good quality" life - a life of mobility and health so as to enjoy the so called "golden years" without being bed-ridden or dependent on another human being.

Fortunately, a good health status is possible and can be easily achieved. Firstly, you need a change in mindset. Stop telling yourself that you are old, and you are not going to bother with what to eat or even bother to exercise. Instead, tell yourself that you are going to live long and live healthy. Secondly, eat the right diet and lastly, exercise regularly. Here are food tips that will give you the right nutritional support.

Drink plenty of fluids
Singapore's hot climate may predispose you to dehydration if you don't drink enough water. Besides, constipation - a common problem in older people - is also sometimes due to inadequate water intake. So, aim to drink 30ml of fluids per kg body weight per day. This works out to about 1500ml or 6 cups (250ml) of fluid daily for a 50 kg woman and 1800ml or 7 cups of fluid daily for a 60 kg man. Fluid goals are relatively easy to meet and water, soup, juice, milk and other beverages can all be included as part of your fluid allowance.

Take water breaks through the day. Don't wait till you are thirsty; sometimes, the sensation of thirst may be dulled due to the natural process of aging or medication you may be taking.

Get enough energy
Adequate energy or calorie intake is essential not only for normal functioning of the body, but also to prevent a decrease in muscle or lean body mass, a common occurrence with age. Aim for 30 calories per kg body weight per day. This works out to a daily allowance of 1500 calories for a 50kg woman and 1800 calories for a 60kg man.

This minimal calorie requirement is usually accompanied with an increase in nutrient needs as one ages. This means that you have to ensure that every food you eat provides something for you nutritionally. It is a good idea to ask yourself, "What's in it for me?" - before you actually pop something into your mouth.

Veggies and fruits
Aim to consume at least two vegetable servings (half a bowl of cooked vegetable or 1 bowl of uncooked greens) and two fruit servings (a small fruit or a hawker-sized portion of a large fruit) daily. This is because:

• nutrient needs are high due to poor absorption of nutrients as you age;
  


• vitamins and minerals enhance immunity and therefore ensure a better health status;
  


• vegetables and fruits are both an excellent source of many vitamins and minerals;
  


• vegetables and fruits come packed with fibre and adequate fibre intake is essential to keep constipation at bay;
  


• vegetables and fruits contain many antioxidants. Antioxidants neutralize harmful substances called free radicals, which are the cause of aging, cancer, heart disease and other degenerative diseases.

Sometimes however, the sense of taste may be affected either due to the aging process or due to medication. This may affect vegetable consumption especially and extra attention must be given to make the food more appetizing. Paying attention to the visual presentation and addition of the right seasonings, herbs and spices so that the food smells good can really whet the appetite. If you find chewing difficult, cut vegetables into bite-sized pieces, cook it soft or mince it after cooking.

With fruits, the problem lies with age-old myths about certain fruits viz., banana, orange, melon and watermelon being considered too cold for the body and causing cough, cold and joint pain. There is no scientific basis for these beliefs. Eat these fruits for a few weeks, if it really causes the above symptoms then maybe it really does not agree with you. If chewing is a problem, try soft fruits like papaya, banana, orange or watermelon. For constipation try eating papaya or banana regularly.

If you don't get the minimum two servings of vegetables and fruits daily, consider a multi-vitamin mineral supplement that provides about 100% of the RDA (Recommended Dietary Allowance) for most nutrients.

Carbohydrates matter too
Rice, porridge, bread, noodles, oats and cereals are all good sources of carbohydrates. Carbohydrates provide energy to keep you moving through the day. Eating enough carbohydrate is also essential for another important reason viz., sparing dietary protein for repair and maintenance of the body so that muscles need not break down to provide protein for this function. Extra caution is necessary in bed-ridden individuals, as they are more likely to lose muscle due to inactivity.

For poor eaters, provide carbohydrate-rich snacks viz., wholemeal bread dipped in milk, oats cooked in milk, biscuits or pao between meals to help meet carbohydrate goals.

Aim to consume 5 servings of carbohydrate rich foods daily. A serving of carbohydrates is equal to 1/2 bowl* cooked rice, 1 bowl* porridge, 1/2 bowl* of noodles / pasta,
2 slices of bread, 1/2 bowl cereal, 3 Tbsp. oats, 4 biscuits or 2 chapatis (wholemeal Indian pancakes).

Include wholegrains viz., brown rice, wholemeal or high-fibre white bread, wholemeal biscuits and crackers, oats, Cornflakes and other high-fibre cereals daily. These foods come packed with fibre (so it can help relieve constipation) and are also rich in many B vitamins which are essential for release of energy from food.

Don't forget protein
Adequate protein intake is essential to provide for repair and maintenance and also to preserve muscle, a necessity for mobility. Besides, meat, fish and poultry, protein can also be obtained from milk and other vegetarian sources viz., tofu, taukwa, tempeh, soymilk, dried beans, peas and lentils.

Aim for 2 servings of protein foods daily. A serving of protein foods is equal to a lady's palm-sized portion of meat, fish or chicken; 2 small squares of beancurd; 1 cup of cooked beans; 3 eggs; 6 fishballs; 5 prawns or 2 glasses of milk.

Besides protein, meat, fish, chicken, egg and milk are also good sources of many B vitamins, especially vitamin B12. As one ages the ability to absorb nutrients diminishes, vitamin B12 is one such vitamin that is affected and a deficiency may result. So, do include adequate quantities of vitamin B12 sources in your diet regularly. Include two to three servings of red meat every week, it is an excellent source of easily absorbable iron, another nutrient one tends to fall short of as you age.

If you have a problem with chewing food, mince or finely chop meat or chicken into small pieces and finely flake fish. This can be mixed in or blended with soft rice porridge.

Bone up on calcium
Your bones get as strong as they can get up to the age of 35. After that, you still need adequate calcium to maintain the calcium levels in bones and teeth. Without enough calcium, bones tend to lose calcium and become brittle, this can lead to osteoporosis or brittle bone disease. Besides, adequate calcium also helps regulate blood pressure.

So, aim to consume adequate calcium daily. Daily calcium requirement is about 1200mg (US Dietary Reference Intake 1997) for both males and females. Good sources of calcium include milk, taukwa, green leafy vegetables and calcium-fortified foods like orange juice, biscuits, bread and soymilk. Of these, calcium in milk is best absorbed by the body, followed by calcium-fortified orange juice.

For the best source and right amount of calcium, aim for two cups (250ml) of a high-calcium milk along with a cup (250ml) of calcium-fortified orange juice or 1/2 a bowl (rice bowl) of cooked green leafy vegetables daily. Opt for a high calcium milk: a cup (250ml) provides about 400mg of calcium, versus 280mg of calcium in a cup (250ml) of regular milk. Also, switch to skim milk, it has less calories, fat and cholesterol than full cream milk, but provides the same amount of calcium as full cream milk.

If you cannot drink milk, try drinking small quantities of milk with some foods during the day, for example, a quarter cup (about 60ml) eight times per day with oats, bread, and biscuits or even after a meal - milk is quite well accepted by many when consumed like this. For lactose intolerance, low lactose milk or calcium-fortified soymilk or orange juice is options that can be considered. Three cups (250ml) of calcium-fortified soymilk along with 1/2 bowl (rice bowl) of green leafy vegetables provides enough calcium for the day, the rest can come from other foods.

On days when calcium intake is short, a supplement should be considered. For better absorption avoid taking large doses at one time, take a small dose for example 100mg three times per day or two 300mg tablets twice a day.

Go easy on fat
Aim to consume less fat in your diet. There are two reasons for this:

1. Fat is the most calorie dense nutrient providing about 9 calories per gram and calorie needs are low.
   


2. High fat diets have been linked with high risk of cancer, heart disease and stroke.

To cut down fat intake:

• use less oil in cooking and less spreads on bread;
  


• choose low-fat foods viz., skim milk, lean meat, poultry without skin and other low fat packaged foods;
  


• make healthier choices when eating out: soupy noodles instead of fried noodles, plain white rice instead of briyani or fried rice, boiled/broiled or grilled food instead of deep-fried foods and steamed snacks like pao or chee cheong fun instead of fried snacks like curry puff.

The bottom line
Healthy eating is still important when you enjoy the "golden years" and it can be easily achieved. All you need is a desire and determination to change and a daily inclusion of a wide variety of foods. Make the changes one step at a time and you will be able to achieve success. Good Luck.

*bowl = rice bowl

Yashna Harjani is a consultant dietitian with Food + Nutrition Specialists.

Date reviewed: 06 March 2000