As a doctor, it’s hard for me to believe that in a country of abundant food sources that anyone in the U.S. could suffer from malnutrition. But, it’s true. In fact, there is an epidemic of “hidden” malnutrition amongst older people in the U.S. today. Each week, I see at least a handful of them. An older adult you know could be suffering from malnutrition right now and you may not realize it. Let me tell you more about why this condition may be hiding in plain sight…
Older People May Be Part of Hidden Malnutrition Epidemic
When you think of someone who’s malnourished, your first thought might be of someone who’s very thin, gaunt and unwell looking. While that could describe a person with malnutrition, a malnourished person can also be someone who’s weight is normal, or even very overweight. It’s not the amount of food/calories you eat, but what kind of nutrition that food contains. Even you could be malnourished and not know it.
In a recent study, the Gerontological Society of America recently reported that just getting older is a significant risk factor for malnutrition. The study surprisingly found that 1/3 to 1/2 of older American adults is malnourished. In rehab settings, the study revealed that at least 1/2 of older population was malnourished. Both groups pose a risk to the healthcare system because of it.
Think about it. When you see your doctor for your regular check up each year, how often does he/she ask what kind of diet you’re following or if you take nutritional supplements? I would bet, never. The truth is, most medical students in America don’t spend much time in nutrition classes.
The Gerontology Society’s study survey revealed that only 1/4 of U.S. medical schools offered at least 25 hours in nutrition. That means, a large amount of medical students in American medical schools are learning very little about nutrition. Why? Nutrition is considered preventative medicine measures and most medical doctors learn symptomatic treatment medicine. As a result, most medical doctors have very little knowledge about nutrition and can’t adequately counsel their patients.
Why are older people so malnourished? The first, most important reason is that many people over age 62 may be retired with a fixed income. Some may live on very strict food budgets. Therefore they tend to buy very cheap, nutrition-poor processed foods that are low in health-sustaining vitamins, minerals and protein. They likely can’t afford much fresh fruit and vegetables.
Another reason is just plain lack of nutrition knowledge in food choices. Many older people just eat what they’ve always eaten without regard to its nutritional content. Many people are very unaware of what type of food they’re eating –at least the proteins and carbohydrates. They’re also often surprised to learn that they’re favorite breakfast cereal may be almost 50% sugar. They don’t bother to read labels or don’t quite understand them if they do.
A third reason for malnourishment is fear of weight gain, especially in older women. When I ask some of my older, female patients what they typically eat for a day, I’m actually shocked. I think birds probably eat better than a lot of them. They may be thin, but their bone scans show deterioration from lack of calcium, their poor skin tone shows a lack of protein and vitamin C, and their hair and nails tell me about their vitamin B deficiencies.
What You Need to Know To Prevent Malnutrition
Even if you need to live on a budget, there are ways to get the most nutritional bang for your buck. And if you’re trying to maintain your weight, eating smarter will also maintain your health as well. Here’s what to concentrate on:
1. Fruit. Choose high Vitamin C and A content fruits. Canned in water fruits like orange, grapefruit, apricots, peaches, pears all contain good amounts of C and A and are not as expensive as fresh produce. Yet, canned fruits often have higher vitamin content as they’re canned quickly after picking. If lite syrup canned fruits are on sale, you can take advantage of it by rinsing off their syrup in cold water and storing in your refrigerator. Forego dried fruits as they are full of sugar and devoid of nutrition.
2. Vegetables. Look for fresh, powerhouse veggies like kale, bok choy, radishes, onions, celery as fresh produce. These are much lower in cost and are packed with nutrition. Canned vegetables are also higher in nutrition than most produce that has sat on the shelf for a while. It’s best to rinse all the salt off them in cold water, though, and refrigerate.
3. Omega-3’s. Most large grocery chains sell their own brand “wild caught tuna” packed in water for about 69 cents per 6 ounce can. They contain Omega-3 fatty acids and are high in protein. In addition, a 1/4 cup serving of mixed nuts per day also contains Omega-3’s, as do cereals fortified with flax seed.
4. Protein. Keep track of your protein intake daily. This can come from meat, eggs, fish, poultry, or protein drink supplements. You need at least 0.5 to 0.75 gram protein per pound of body weight. So, if you weigh 160, shoot for 80 to 120 grams per day. Read labels.
5. Calcium: A must have for all older adults. Fortified cereals can help meet your calcium goals, as well as 2 additional servings of calcium rich food. 1,200-1,400 mg per day.
6. Sugar. I ask my patients to omit all refined sugar, or save it for a very occasional treat, like birthday cake, or a holiday treat. Refined sugar is an empty nutrient that breaks down collagen in your body, the very thing you need to maintain skin, joint ligaments and tendons. It also keeps blood sugar levels elevated which can lead to diabetes.
7. Vitamin/Mineral Supplement. Absolutely crucial! Look for “senior” formulas that have all the important nutrients you need to maintain good health. These include lutein, bilberry, beta carotene for your eyes, vitamin C, E, A, D3 for immune health, as well as minerals zinc, copper, magnesium, potassium, etc for nerve, brain and bone health.
If you have concerns about your nutrition levels, ask your doctor to run some blood tests to determine any deficiencies. Generally, anemia and low Vitamin D and B12 levels are common in older adults. If your income poses a nutritional challenge, you don’t have to run the risk of malnutrition and illness. There are many community food banks that can offer you assistance if you need it. Call or visit your nearest community senior center to see what type of help is available in your area.
Mark Rosenberg, M.D.
Malnutrition a Hidden Epidemic Amongst Older People, http://www.sciencedaily.com/releases/2014/12/141218120846.htm
Smart Shopping Guide to Fruits and Vegetables, http://www.choosemyplate.gov/food-groups/downloads/TenTips/DGTipsheet9SmartShopping.pdf