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 Good Dietary Habits
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- We are what we eat. This catchphrase has been uttered a million times over, but that doesn’t negate the truth in the lesson. A healthy diet helps us feel better, look better, think well and feel full of energy!
- Maintaining a healthy diet is a contributor to reducing the risk of cardiovascular disease, cancer, can lower high blood pressure, and there is preliminary evidence that a healthy diet might be effective in preventing cognitive decline and dementia (Lichtenstein et al 2008, Vogt et al 1999).
- Nutrient needs should be met through consuming foods, while supplements and fortified foods can be helpful, they cannot replace a healthful diet (and they have limited evidence of benefits)
- Check it out:
In 2005, the USDA debuted MyPyramid, an Internet-based program capable of dispensing individualized dietary guidance based on sex, age, height, weight, and exercise habits -also available MyPyramid to print form- The Modified MyPyramid for Older Adults is available as a graphic print-out with icons representing foods in the following categories, and fluid and physical activity (Lichtenstein, Rasmussen 2008):
Foods to Focus On
- Whole, enriched, and fortified grains and cereals such as brown rice and 100% whole wheat bread.
- Bright-colored vegetables such as carrots and broccoli.
- Deep-colored fruit such as berries and melon.
- Low- and non-fat dairy products such as yogurt and low-lactose milk.
- Dry beans and nuts, fish, poultry, lean meat and eggs.
- Liquid vegetable oils and soft spreads low in saturated and trans fat.
- Fluid intake.
- Physical activity such as walking, house work and yard work.
- Consume a variety of nutrient-dense foods and beverages within and among the basic food groups while choosing foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol.
- Meet recommended intakes within energy needs by adopting a balanced eating pattern, such as the USDA Food Guide or the DASH Eating Plan (Karanja et al 1999) (Vogt, Appel 1999).
- Recommendations for balancing nutrition for an older population:
- People over age 50. Consume vitamin B12 in its crystalline form (i.e., fortified foods or supplements).
- Individuals with hypertension, blacks, and middle-aged and older adults should aim to consume no more than 1,500 mg of sodium per day, and meet the potassium recommendation (4,700 mg/day) with food.
- Scientists found that adhering to the DASH (Dietary Approaches to Stop Hypertension) substantially reduces blood pressure. When combined with decreases sodium intake (1100 mg/day) the effect was even greater (Sacks et al 2001).
- A catch-22 for many Americans is that while they consume more calories than they use, they still may not be getting enough nutrients. This means that most people need to consume foods that are highly nutritious but relatively low in energy content. This is crucial for a healthy lifestyle— contributing to reducing the risk of developing chronic diseases.
- Based on dietary intake data or evidence of public health problems, intake levels of the following nutrients may be of concern for:
- Adults: calcium, potassium, fiber, magnesium, and vitamins A (as carotenoids), C, and E,
- Older adult populations: vitamin B12, iron, folic acid, and vitamins E and D.
- While traditionally nutritional research has primarily focused on single nutrients or foods, studying dietary patterns or combinations of dietary factors is fundamental to consider the complexity of overall diet (Heidemann et al 2008).
- Investigators from Harvard University evaluated the potential impact of major dietary patterns on subsequent risk of all-cause mortality and mortality from cancer and cardiovascular disease in the Nurses’ Health Study cohort (Heidemann, Schulze 2008).
- In these analysis two major dietary patterns were identified:
- The prudent pattern, characterized by a high intake of vegetables, fruit, legumes, fish, poultry, and whole grains, was related to a 17% lower risk of total mortality and a 28% decreased risk of cardiovascular mortality. On the other hand.
- The western pattern, reflecting a high intake of red and processed meat, refined grains, french fries, and sweets and desserts; was linked to a 20% higher risk of total, cancer and cardiovascular mortality (Heidemann, Schulze 2008).
- Beyond the impact that dietary factors or patterns might have on mortality, a healthy diet might also be linked with an increased life expectancy and more years lived without disease.
- Investigators from Erasmus Medical Center, Rotterdam, The Netherlands, calculated in the Framingham Heart Study that the potential effect that a “healthy” diet may have on the amount of years expected to remain alive could be an increase of above 9 years extra of healthy life expectancy in middle age populations (Franco et al 2004).
Additional Information
http://www.mypyramid.gov
http://www.health.gov/dietaryguidelines/
http://nutrition.tufts.edu/1197972031385/Nutrition-Page-nl2w_1198058402614.html
http://www.fruitsandveggiesmorematters.org/
http://www.nhlbi.nih.gov/hbp/prevent/h_eating/h_eating.htm
Mayo Clinic Cookbook 2004
Mayo Clinic Physical Activity Guide
http://www.cdc.gov/nutrition/index.aspx
http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid/
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Plenty of Physical Activity
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- Keeping active and physically fit is indisputably connected with lower levels of morbidity, mortality and disability. The more physical activity you do, the lower your risk becomes for mortality. The best part is it’s never too late. Even if you begin physical activity in old age, your risk of mortality lowers at the same time your risk of morbidity decreases (Church et al 2005) (Franco, de Laet et al 2005, Taylor et al 2004).
- Physical activity has its effect through a variety of mechanisms (e.g. lowering the inflammatory response and positively attenuating several risk factors for cardiovascular disease), and is associated with decreases in the risk of developing diabetes, cardiovascular disease, cognitive decline and mortality, as well as improvements in wellbeing (Church, LaMonte 2005) (Franco, Peeters et al 2005) (Haskell et al 2007).
- Exercise positively impacts all of the big bad five, improving functioning and health, and reducing disease and disability that already exists.
- In 2005, almost one-third of adults 18 years of age and over engaged in regular leisure-time physical activity. Adults in families with income above twice the poverty level were more likely to engage in regular leisure-time physical activity (34% ) than adults in lower income families (20%–22% )
- Osteoarthritis affects 50% of people over 65 years old. Though it was once thought that exercise would exacerbate arthritis, current research finds that exercise is an effective treatment for primary, secondary and tertiary prevention of OA and it’s consequences.
- Some of the effective exercises include walking, and aquatic exercises and stationary bike use. Strength training shows benefits at both low and high intensity progressive resistance levels (see table containing recommended exercises for each illness (Bean,Vora 2004)). Exercise increases bone density and when combined with building muscle in low and high intensity exercises, helps to prevent frailty, fractures and maintain bone mass in later life (Bean, Vora 2004).
- Adults who are physically active throughout life have higher bone density than those who are physically inactive.
- The recommendations from the American College of Sports Medicine and the American Heart Association state that people age 18-65 need moderate intensity aerobic physical activity for at least 30 minutes a day, five days a week, or vigorous intensity aerobic activity for 20 min at least 3 times per week to promote and maintain health.
- An example of moderate activity would be a brisk walk that accelerates the heart rate, while an example of vigorous activity would be jogging such that your heart rate rises substantially and rapid breathing.
- The recommendations conclude that people wishing to reduce their risk of chronic disease and disability and prevent unhealthy weight gain may benefit from exceeding the minimum recommendations for physical activity.
- Physical activity has long remained as one of humankind’s oldest secrets to living healthy for a long period of time. In the last decades this old secret has been confirmed by different studies that have demonstrated the health benefits of physical activity and adequate cardio-respiratory fitness.
- Church et al, quantified the effect of cardio-respiratory fitness on mortality among men with diabetes mellitus that participated in the Aerobics Center Longitudinal Study. The authors found that men with low fitness levels had a 2.7 fold increased risk of mortality compared to those with a high level of cardio-respiratory fitness (Church, LaMonte 2005).
- analysis in the general population corroborate these findings: investigators from Erasmus Medical Center in Rotterdam, evaluated the potential impact of different levels of physical activity in the Framingham Heart Study. They found that high levels of physical activity were associated with a 23% decreased risk of cardiovascular disease and 32% decreased risk of mortality in approximately 12 years of follow-up (Franco, de Laet 2005).
- Furthermore, life expectancy for sedentary people at age 50 is one and a half years less than for people conducting moderate daily physical activity and over three and a half years less than for people with high physical activity levels. The benefits also become apparent at moderate levels (Franco, de Laet 2005).
- These results underline current recommendations for physical activity and suggest that following an active lifestyle is an effective way to achieve healthy aging.
Additional Information
http://www.health.gov/paguidelines/
http://www.cdc.gov/nccdphp/dnpa/physical/stats/index.htm
http://www.cdc.gov/healthyweight/index.aspx
Exercise For Community-Dwelling Older Adults
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Sun Exposure: Friend or Foe?
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- While prolonged sun exposure can put you at risk of skin cancer, lack of sunlight might result in vitamin D deficiency, which is associated with poor bone health, multiple sclerosis and prostate cancer (Cranney et al 2007).
- While no definitive cause and effect relationship can be proved at this point in time, having the sunshine on your face feels good because it is good – just don’t overdo it.
- National Dietary guidelines for Vitamin D:
- 200 International Units (IUs) a day up to age 50
- 400 IUs to age 70
- 600 IUs over 70.
- For people with fair skin, this translates into around 10 minutes per day of sun exposure in a t-shirt and shorts
- Getting adequate levels of vitamin D through exposure to the sun is associated with a lower risk of developing some diseases including osteoporosis, heart disease, and breast, prostate, and colon cancers.
- Additionally, sun exposure might also help boost your immune system and improve your sleep.
- If you live north of Boston, (42 degrees latitude) there might be not enough sunlight to get sufficient levels of cutaneous vitamin D synthesis from November through February and a good period of holidays heading south is advisable
- Approximately 5-30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to the face, arms, legs, or back without sunscreen usually lead to sufficient vitamin D synthesis
- Moderate use of commercial tanning beds that emit 2-6% UVB radiation is also effective (NIH Office of Dietary Supplements)
Additional information
https://www.health.harvard.edu/fhg/updates/update0604d.shtml
http://ods.od.nih.gov/factsheets/vitamind.asp
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None to Low Alcohol Consumption
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- Those who choose to drink alcoholic beverages should do so sensibly and at low quantitites—defined as the consumption of up to one drink per day for women and up to two drinks per day for men (Schonfeld et al 1991, 1995, 2009).
- Tips for moderating alcohol use (2008)
- While drinking alcohol can be beneficial, it’s not for everyone. If you’ve never drank before, there is no need to start drinking ‘for your health’.
- You shouldn’t drink if you take medications that may potentially interact with alcohol, if you have liver disease, if you are pregnant, or if you are a recovering alcoholic.
- Even though studies show that alcohol can have some benefit for your heart health, there are plenty of other ways you can enhance the health of your heart (as described here!).
- If you find you prefer a little libation it doesn’t matter what you drink- beer, wine, or spirits, all seem to deliver similar small positive effects.
- Talk to your doctor about your drinking habits – if you think you may have a problem, getting help sooner rather than later is important.
- Pick a designated driver. Don’t drive after drinking.
- Recommended amounts of alcohol is one drink per day for a woman and up to two drinks per day if you are a man.
- A general guideline is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of hard liquor, such as vodka or whiskey.
Additional information
http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/alcohol/index.aspx
http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/alcohol-full-story/index.aspx
Reviews in Clinical Gerontology (1999), 9:151-162 Cambridge University Press Copyright Cambridge University Press 1999
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Smoking: Kryptonite to the HAPY Phenotype
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- In 2005, 23% of men and 18% of women were smokers. Cigarette smoking by adults continues to be strongly associated with educational attainment. Adults with less than a high school education were three times as likely to smoke as those with a bachelor ‘s degree or more education.
- In 2007, an estimated 19.8% (43.4 million) of U.S. adults were current cigarette smokers. Smoking prevalence was higher among men (22.3% ) than women (17.4% ) (CDC 2008).
- 443,000 deaths each year are attributable to smoking cigarettes.
- Those who quit smoking at age 35 live 7-8.5 years longer than those who continued to smoke. The earlier you quit smoking the better, but quitting smoking at any age has meaningful life extensions (Mamun et al 2004, Taylor, Brown 2004).
- Exercise, even moderate such as walking briskly, improves lung capacity, and can have positive benefits such as controlling cravings and withdrawal symptoms. It can also help to control potential weight gain.
- Quitting smoking can improve outcomes during surgery, because smoking decreases the levels of oxygen in your body, it can increase the risk of heart attack, slows the healing process and can increase the risk of infection.
- Quit Tips:
- In the ‘resources’ portion of this section, you can find many links to tips and more information on how to quit, how to get started and where to find support.
Additional information
American Lung Association: http://www.lungusa.org/
http://www.smokefree.gov/
http://www.quitsmokingusa.com/
http://www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm
http://whyquit.com/
http://www.lung.ca/protect-protegez/tobacco-tabagisme/quitting-cesser/benefits-bienfaits_e.php
http://www.mayoclinic.org/stop-smoking/
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