Taking a Bite Out of Senior Diet Myths

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The varied health concerns of seniors can make it difficult for caregivers to know how to manage their elderly loved one's diet.

Is it normal for a senior to lose their appetite or weight for no obvious reason? What combination of vitamins and minerals does a senior really need? Are supplements safe?

Ruth Frechman, M.A., a registered dietician and spokeswoman for the Academy of Nutrition and Dietetics, debunks some common myths about senior nutrition and offers advice for caregivers:

  1. "A senior can eat whatever they want." Frechman feels that this misconception tops the list as one of the most common senior nutrition myths. "Proper nutrition is important at any age—how you eat affects how you age," she says. The key for seniors, according to the National Institutes of Health (NIH), is to look for foods that are low in calories, but high in nutrients. This includes: fruits, veggies, whole grains, lean sources of protein (fish, poultry beans, nuts)
  2. "A senior's nutritional needs don't change when they get older." Following this line of thought is a big mistake, according to Frechman. There are a few important tweaks older adults should make to their daily diets. The U.S. Department of Health and Human Services advises seniors to cut back on their daily sodium intake, consume a higher volume of whole grains, increase their daily potassium intake, and eat foods fortified with vitamins D and B12.
  3. "Dietary supplement pills are a safe way to make sure that a senior is getting all of their vitamins and minerals." Grocery stores often devote several shelves to vitamin and mineral supplements, but caregivers should be careful when considering giving these pills to their elderly loved ones. Seniors who eat a balanced diet should be able to get all of their nutritional needs met from the food they eat. Using supplement pills to make up for a deficit in an elderly person's diet may cause adverse reactions with prescription medications or cause them to overdose on a particular vitamin or mineral.
  4. "Eating out all the time is fine, as long as we don't get the same thing every day." Caregivers (and seniors who live alone) may find it difficult to find the time and energy to cook meals. This may cause them to turn to dinner options that require less effort and time to prepare, such as restaurant take-out or pre-packaged frozen meals. But, according to Frechman, these seemingly handy short-cuts come with a price: high amounts of fat and sodium. This can be particularly dangerous for seniors with heart problems or high blood pressure.
  5. "If a senior doesn't feel like eating a whole meal, a supplement shake is a fine substitute." Meal replacement and supplement shakes are not suitable alternatives to a balanced meal. When used too frequently, these shakes may cause a host of health problems, including: malnourishment, and diarrhea. A good rule of thumb to follow when it comes to these kinds of drinks is that they should be used periodically as a snack, not a substitute.
  6. "It's normal to lose your appetite as you get older—I shouldn't try to get my loved one to eat if they're not hungry." An older person may lose their appetite for a variety of reasons, none of which should be ignored or brushed off as a symptom of aging. Medication side effects, problems with chewing and digestion, loneliness, depression, and a reduction in the ability to taste and smell are all things that can contribute to a senior's reluctance to eat. Frechman says a lagging appetite can cause a senior to become malnourished. She advises caregivers to entice seniors to eat by making the meal look as appealing as possible; using fancy silverware, lighting candles, and arranging the food in a pleasant manner. It may also be helpful if the senior has an eating companion. Try to schedule in some time to sit down and eat with your elderly loved one when you can.
  7. "My loved one doesn't have diabetes, high blood pressure, or high cholesterol, so they don't need to see a nutritionist about their diet." Frechman feels that all seniors could benefit from consulting with a professional about their diet. She says that there is a great deal of conflicting and incorrect nutrition information out there, so it can be helpful to get advice from a knowledgeable source. Medicare Part B only covers dietary consultations if a senior has diabetes or renal disease. Some Medicare Part C Advantage programs will pay for a person to see a nutritionist, if their doctor deems it, "medically necessary." A senior's primary care doctor may also be a good source of information on proper diets for the elderly.
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12 Comments

Kedwards460, my hubby doesn't like Ensure or Boost or the others. He really needs to gain some weight and I'm eager for ways to add calories rather than use these as substitute meals. If I heat the chocolate supplement drink in a mug he drinks it as hot chocolate with his breakfast. He can usually be enticed to have a milkshake as a snack, and I make those with either whole milk and Carnation Instant Breakfast or Boost or a hi-protein yogurt smoothie. Then I add ice cream and something flavorful. With chocolate I might add a banana and peanut butter. With vanilla I'll use strawberry ice cream and a few fresh strawberries. The smoothies are good with strawberries and blueberries added. You get the idea. I supplement the supplements to make them taste better and to add even more calories. :-D.

The seven points in this article are useful and worth reading and considering. However, they may not apply in all situations. After more than 40 years of following a heart-healthy diet (and all the changes in midstream that entailed, as scientists learned more), my husband is now encouraged by his geriatrician to eat anything he wants. He has swallowing problems so he avoids foods that are most difficult. But he is eating lots of cream sauces and pasta dishes and ice cream. As for selecting low-calories options, no way! I think his dementia has interfered with his metabolism and he seems to need a lot of fuel to even maintain his new low weight.

We eat a lot of restaurant take-out and frozen meals. With care in their selection they can be reasonably healthy and nutritous. When I think of my 92-year-old mother who lives independently and can microwave but not cook, the choice is sometimes between a microwaved frozen meal or not bothering to eat. The choice really isn't between a microwaved frozen meal or a home cooked meal from fresh ingredients.

I'm sure it's a good idea to make sure seniors eat properly. However when one is already in dementia, and 95 years old. How are we supposed to get them to eat a balanced diet? I'm sorry, but it's not possible! Mom eats an american cheese sandwich on whole wheat bread for lunch EVERY DAY! Then she wants an omelet ( one egg, no cheese ) for dinner. She eats no vegetables. Maybe an occasional bite but that's it. She never ate fruit! Likewise when I worked in a nursing home, nutritional shakes, often were given when residents refused to eat. It's simply not always feasible to make someone eat when they do not want to!
Yes, reading the other posts always helps me put issues in perspective, for it is a huge difficulty for family caregivers particularly, to pay attention to food, worry over it, adjust this or that, persuade an elder - who is often their parent - to eat differently... it's not parallel, but related: I was trying to analyze food allergy issues of my cat, and spent 4 months making adjustments, tracking, I was exhausted. Finally the vet decided it was not a food allergy - maybe Irritable Bowel Syndrome, and finally when his health deteriorated again, I followed the vet's instructions to add a pancreatic supplement to his diet - voila - major change, as his pancreas had gotten inflamed and irritated - maybe with meds and treatments, maybe ongoing issue, he may still have cancer, but I'm thrilled to find an ongoing diet that is helping him gain weight again - as I found it exhausting to struggle with all the questions every day, several times a day - about diet.

I empathize greatly. And maybe we caregivers need more support and help if we are managing these issues - I do like the idea of neighborhood nutritionist offices - where we can bring our questions and specific variations, and maybe have them confer with our elder, or propose simple charts to help influence.

And yes, if the elder is over 90, maybe even over 80 - changing a diet is not necessary or kind. Issues only arise if they are gaining weight which adds difficulty to their lives and care, or losing it dramatically. Then special attention and some remedy is worth trying to find, understanding all along, that we are allowed to fail. We are not responsible for keeping elders healthy and happy - for our many reasons, we try, and to me, that is it. If we fail, there were too many circumstances, current or historic issues lined up against us. We are not god, we are relatives, trying to help, while also managing our own health and relationship to the world. We set aside extra time, and do what we can, no more.