We don't grow older, We grow Riper - Healthy Eating and Aging

- Quote by Pablo Picasso -

Nutrition for the Aging Body – Interview with Dr Nikki Cummings from Optimal Intake

Dr Nikki Cummings, principal dietician from Optimal Intake, spoke with Dr Mark Hurworth about her approach to good nutrition - improving our relationship with food and shifting the focus to what we put into our bodies rather than cutting foods out. Nikki advocates that ditching the scales completely might be the way to go. “It is very hard to improve someone’s relationship with food when their only measure is weight loss; all they will end up doing is restricting their intake”.

We have seen many dieting fads come and go over the past few decades. From low fat, to low carbohydrate, to high protein, to high fat.  The general principle with most of these fad diets is to cut out a major macro-nutrient group in order to achieve weight loss. The three main macro-nutrients being: carbohydrates, fats and proteins.

Cutting out major food groups, as recommended by restrictive diets could be detrimental. We are now coming to understand that the gut micro-biome, which has a strong influence on our general health, can be affected by what we do and don’t eat. When cutting out main food groups, people inadvertently also end up cutting out important vitamins, nutrients and fibre.

Nikki advises that we should avoid thinking about foods as good or bad. Rather, for carbohydrates consider fibre rich carbohydrates, and for fats focus on foods low in saturated fats. There seems to be reasonable evidence that a Mediterranean type diet can lead to lower rates of heart disease and increase life expectancy.

Why is good nutrition so important as we age?

Every system in our body changes as we age: bones, gut, muscles, brain and many more. A well balanced nutrient rich diet can help to keep these systems strong and healthy.

  • Bone Density - Calcium and Vitamin D - read more about osteoporosis here

  • Cognitive Function - Foods high in Omega 3 fatty acids

  • Slower/More Irritable Gut - Higher nutrient rich foods that need less volume. Consider decreasing coffee and alcohol intake

  • Muscle Loss - Protein and Iron rich foods

This sounds like a lot to think about, but if you aim to have a good variety of healthy foods on your plate at each meal, you will manage this without too much extra effort.

Nikki uses the basic plate division rule to help people achieve a balanced diet:

  • ¼ fibre rich carbohydrates (rice, pasta)

  • ¼ lean protein

  • ½ colourful vegetables or salad

  • small amount of fat (cooked in olive oil, avocado added)

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A good “diet” or healthy eating approach should be one that is sustainable, puts a positive focus on healthy food and ideally has a social support network of some kind.

What about supplements?

Most people get enough vitamins and nutrients from a balanced diet alone, however those with diagnosed health conditions may find some benefit from supplementing their usual diet with condition specific supplements. The other exception would be those who have a medical condition that prevents them from eating an adequate amount or variety of food.   

As discussed above; Vitamin D, Calcium and Magnesium for those with bone density issues, Omega 3 fatty acids for those with cognitive disorders.

The evidence for joint supplements like glucosamine sulphate is still non-conclusive. For a full review of the research see our blog on joint supplements (link).

What are the potential problems with restrictive dieting?

  • When people follow highly restrictive diets, they often achieve some initial weight loss. However, such strict dieting is difficult to maintain, and commonly results in an eventual relapse into previous poor eating habits. This generally results in guilt, anxiety, binge eating and weight gain.

  • Nikki often sees patients who have tried every diet under the sun and have inadvertently “dieted themselves heavier”.

  • The mental stress or feeling of being unable to stick to a strict diet can cause an increase in your cortisol levels, a hormone made by the body which causes fat to be held onto and stored.  Thus, resulting in further weight gain.

  • Very restrictive dieting can lead to deficiencies such as low iron, low fibre or low calcium. This can contribute to health conditions like osteoporosis or constipation.

  • Although many surgeons and surgical procedures require patients to be below a certain weight, Nikki poses the question whether patients who are strictly dieting before surgery may be malnourished and therefore at higher risk for infection, delayed healing and poor outcome? This can be a vicious cycle: Joints that are too painful to exercise, can’t get the surgery due to obesity, can’t lose weight because they can’t exercise.

How to manage weight and diet during menopause:  

As weight gain and weight distribution are strongly driven by hormonal changes, post-menopausal women are likely to gain weight around their torso during this time in their lives.  It may also be difficult or impossible to lose weight during these years, despite your best efforts. Nikki would suggest that women try not to focus on weight loss, rather use this as a time to add weight bearing and resistance exercise to help prevent osteoporosis and address any unhealthy eating habits to manage cholesterol and other health indicators.

This is a great time to begin looking at eating awareness, considering the what, when and why of eating habits.

What about chocolate, coffee and alcohol?

Everything in moderation!