Every five years since 1980, the U.S. government has released a new version of the “Dietary Guidelines for Americans”. These reports are thorough reviews of up-to-date diet and health research, focused on population-wide health promotion and chronic disease prevention. If one looks at the earliest guidelines through to the present, in some ways they don’t appear terribly different. But, the small and subtle changes in each version are the result of exhaustive consideration of the evidence and expert scientific thought.
The earliest versions of Dietary Guidelines were produced for the public as booklets and brochures. More current guidelines are less consumer-friendly and are primarily designed for health professionals and policy makers, who translate the information into messages, programs and policy for the public. Nonetheless, the guidelines provide perspective and lots of basic information seniors can consider when setting nutrition goals.
We’ve just gotten a look at the 2020-2025 guidelines and there is something in there for seniors. The guidelines have been presented from the perspective of “life stages” from birth to old age, emphasizing that healthy eating at each life stage can improve health and lower disease risk. Improved eating habits can even be a “treatment” for some of the common chronic conditions experienced in older adults. The Dietary Guidelines stress that nutrition-savvy seniors can experience the following benefits from following healthy eating patterns throughout their lifetimes:
Lower risk of all-cause mortality
Lower risk of cardiovascular disease
Lower risk of cardiovascular disease mortality
Lower total and LDL cholesterol
Lower blood pressure
Lower risk of obesity
Lower body mass index, waist circumference and body fat
Lower risk of type 2 diabetes
Lower risk of cancers of the breast, colon and rectum
Favorable bone health, including lower risk of hip fracture
Looking at weight
A key idea in the 2020-2025 Dietary Guidelines, is an emphasis on healthy body weight. Just as the rest of the population, seniors are experiencing overweight at an ever increasing rate. The current Dietary Guidelines tagline - “Make Every Bite Count” - is especially important for older individuals who may have lower energy needs than younger adults but not lower nutrient needs. Maintaining and attaining a healthy body weight and good health, requires making sure that every bite is packed with nutrients but not packed with excess calories.
In 1960, the average American man weighed 168 pounds; today, the average man is taller by about 1 inch but weighs 199 pounds. The average woman has gone from 140 pounds in 1960 to 170 pounds in 2019. Over the same period, type 2 diabetes, which is strongly associated with overweight, has risen and now affects 26.8% of seniors over 65 years; and, 48% of seniors have prediabetes. One bit of good news is that individuals over 60 years of age can be very successful in losing weight and preventing the onset of diabetes with lifestyle changes.
Areas for improvement
On another bright note, the dietary guidelines show that by most measures, seniors eat better than any other age group. But, only 50% of seniors eat as healthfully as recommended. So, good job, seniors, but there is still room for improvement. Many seniors aren’t eating sufficient vegetables, fruits, whole grains or dairy; and, some but not all, need more protein.
If you don’t drink milk, make sure that you are getting enough calcium either though fortified foods, high-calcium foods like turnip greens, almonds or broccoli, and you may use a supplement (food is preferable).
Older women are more likely than older men to fall short on protein. 50% of women and 30% of men over 71 years do not consume adequate protein. But, any senior may consume insufficient protein due to poor appetite, chewing problems, preferences or finances, so check with a registered dietitian or medical provider for ideas for increasing protein. Also consider the many options within the protein food group – eggs, tofu, legumes, nuts, fish and shellfish, poultry, beef and pork. These can be fresh, frozen or canned and may be more affordable and palatable than imagined.
The consistent recommendations in recent years have been to increase vegetables, fruits, whole grains and lean protein like legumes and fish, or to follow a “Mediterranean” dietary intake pattern at a calorie level that does not lead to weight gain. The Dietary Guideline’s indexes lay these out in great specificity and the body of the report gives some nice examples that illustrate the recommendations. Paying attention to your portion sizes will be one of your strategies for maintaining or attaining a healthy weight and also for assuring dietary adequacy.
Going from the general to some more specific guidelines, everyone should “limit foods and beverages that are higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages”. These may seem obvious, but one needs to understand the meaning of “limit”.
Added sugars. Should account for no more than 10 percent of your total calories per day. If you are eating 1,600 to 1,800 calories per day, this would translate to about 8 to 10 teaspoons. Seniors seem to have gotten the message about cutting back on sugar with only slightly more than one half of senior men and 58% of women eating more than the recommended ten percent of calories in added sugar.
Saturated fat. Should be limited to less than 10 percent of calories per day. This can be visualized as teaspoons of butter. If you eat 1,600 to 1,800 calories per day, this would be about 5 teaspoons of butter. Other sources of saturated fat are visible and invisible fat on meat or bacon, half and half, ice cream, coconut or palm oil. Seniors didn’t do as well with this guideline. More than 77% of women and 80% of men exceed the 10 percent limit. Following this guideline may help lower blood cholesterol levels and reduce risk of heart disease.
Sodium. Should be limited to no more than 2,300 milligrams per day. For many people, especially those with high blood pressure or diabetes, lowering sodium intakes may be helpful. Senior men really have to work on this one, with 94% exceeding the recommendation. Senior women did a little better with 72% consuming more sodium than recommended. Processed foods contribute the most sodium to our diets, so read food labels for this information. 2,300 milligrams is the amount of sodium in one teaspoon of table salt.
Alcoholic beverages. We have suggested for years that moderate drinking could be good for you but we say this more cautiously for older adults. Alcohol is associated with poor balance and falls and other sorts of accidents. There is also concern about alcohol contributing to cancer and any number of other health problems. If you don’t drink now, do not start. Seniors can choose to drink in “moderation” by limiting intake to two drinks or less per day for men and one drink or less per day for women. Drinking less is better for health than drinking more.
Make it personal to make it count
What we decide put on our plates is important and some final guidance from the 2020-2025 Dietary Guidelines is “eat the foods that best fit your personal preference, culture, traditions and individual medical conditions. Quality of life is important, so eat foods you enjoy while not forgetting to make every bite count.
View and download the new Dietary Guidelines at http://www.dietaryguidelines.gov.
Leslie Shallcross is a registered dietitian and professor at the University of Alaska Fairbanks Institute of Agriculture, Natural Resources and Extension.
