By Faraz Ahmad, MD, Preventive Medicine Resident and Holly H. McPeak, MS, Nutrition Advisor at ODPHP
Older Americans Month provides an opportunity to raise awareness about important issues facing older individuals. Health care providers can be a critical resource to help older individuals understand the importance of following a healthy diet for preventing, managing and treating chronic diseases such as diabetes and heart disease. A healthy diet is of particular importance in older individuals whose age alone increases their risk for chronic medical problems. The U.S. Centers for Disease Control and Prevention issued a report stating that by the year 2030 nearly 20 percent of the American population will be 65 years and older. As health care providers, it is critical that we talk with patients to learn about their eating habits and help empower them to make healthy choices. Although most health care providers have a good understanding of the types of foods that patients should limit, it can be a struggle to recommend healthy alternatives. The 2015-2020 Dietary Guidelines for Americans can help aid providers in this discussion. Although the guidelines do not contain a section specifically focused on older individuals, there are recommendations that are relevant to this age group.
Food and beverage components to limit and healthier alternatives:
- Sodium: We all know that sodium should be limited due to its effect on blood pressure. But how much sodium is too much sodium? The guidelines recommend that adults consume no more then 2,300mg of sodium daily, which is equivalent to one teaspoon of table salt. However, for individuals with hypertension or prehypertension, it is recommended that they limit their sodium intake to 1,500mg/d, which is roughly equivalent to 2/3 teaspoon. This is significantly less than the daily average sodium intake of men (3,183 mg) and women (2,550 mg) over the age of 71. It is important to know that most of the sodium consumed has been added during commercial food processing and preparation. Adding salt during home cooking or at the table and salt already naturally found in the food accounts for only a small part of the total sodium consumed daily. More than half of the sodium taken in by Americans comes from mixed dishes, which includes burgers, sandwiches, tacos, pizza, seafood dishes, and soup.
Given this information, providers should focus on counseling their patients to limit eating commercially processed food high in sodium and to teach them how to use the Nutrition Facts label to choose foods low in sodium. The Dietary Guidelines recommend choosing “fresh, frozen (no sauce or seasoning), or no-salt-added canned vegetables, and fresh poultry, seafood, pork, and lean meat, rather than processed meat and poultry.” Additional ways to lower sodium intake include cooking at home rather than eating out so patients can control the amount of sodium used, limiting sauces, mixes, and “instant” products, and using more herbs and spices to season food.
- Added sugars: With the current obesity epidemic, there has been an increased effort during the last few years to raise public awareness regarding the importance of limiting the consumption of added sugars. Added sugars contribute to the total daily calorie intake for individuals but have no essential nutrient benefit. It is important to educate patients that added sugars are sugars that are not naturally found in food such as sodas, candies, cereals, and cookies. Currently, Americans on average consume 270 calories, greater than 13 percent of total calories, from added sugars each day; almost half of added sugars comes from drinks such as sodas, fruit drinks and other sweetened beverages. The Dietary Guidelines recommends limiting calories from added sugars to less than 10 percent of the total daily calorie intake. When added sugars in foods and beverages exceed 10 percent of calories, a healthy eating pattern may be difficult to achieve.
These tips can help patients reduce their consumption of added sugars:
- Check the ingredient list to see if added sugars are listed. It is important to know the different names of added sugars, which include brown sugar, corn sweetener, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, honey, invert sugar, lactose, malt syrup, maltose, molasses, raw sugar, sucrose, trehalose, and turbinado sugar.
- Replace foods higher in added sugars with foods that have sugar naturally found in them and those with little or no added sugars. For example, instead of eating cookies, eat fruits; instead of eating sugary cereals, eat unsweetened whole-grain cereal with fruits; or instead of drinking sugar sweetened sodas, drink water.
- Saturated fats: Many patients might be aware that they should limit their intake of saturated fats because they increase their risk of cardiovascular disease. The current Dietary Guidelines recommends limiting saturated fats to less than 10 percent of total daily calories. In fact, individuals who are 2 years and older have no dietary requirement for saturated fats because the human body makes enough of them by itself to meet its needs. Mixed dishes are the major source of saturated fats in the U.S. diet. These include dishes containing cheese and/or meat such as burgers, tacos and pizza.
The Dietary Guidelines recommend replacing saturated fats with polyunsaturated and monounsaturated fats. A helpful tip to tell patients is that polyunsaturated and monounsaturated fats are liquid at room temperature as opposed to saturated fats, which are solid at room temperature. Again, it is important to check the Nutrition Facts label and ingredient list and choose food products lower in saturated fats. Additionally, providers can recommend to their patients to choose or make mixed dishes with more vegetables, whole grains, lean meat, and low-fat or fat-free cheeses in place of fatty meat and regular cheese.
- Trans fats: Similar to saturated fats, trans fats have harmful health effects. The Dietary Guidelines recommend that the intake of trans fats be as low as possible. It is important for patients to understand how to limit the consumption of foods that contain synthetic sources of trans fats, such as partially hydrogenated oils in some margarines, and other solid fats. Trans fats can also be found in some processed foods such as some desserts, microwave popcorn, frozen pizza, and coffee creamers. Look for food products that are labeled no trans fats.
Trans fats can also be found naturally in dairy products and meats. However, since these products contain only small quantities of trans fats and contain many important nutrients, they can be included in a healthy diet.
The Dietary Guidelines serve as an effective resource to help health care providers talk with older individuals about how to limit sodium, added sugars, saturated fats and trans fats in their diet and replace them with healthier alternatives. Learn more about Dietary Guidelines resources for health professionals.