Healthy Eating At Various Lifestages
Women 70+ years old
This information is based on the Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes, the Dietary Guidelines for Australian Adults, the Dietary Guidelines for Older Australians and The Australian Guide to Healthy Eating. These recommendations are for healthy people over 70 years who are able to live independently. The weight, height and estimated energy requirements used have been standardised and may not meet the specific nutritional requirements of individuals. Specific advice for individual needs should be sought from a qualified dietitian.
Healthy Eating Guidelines for Women aged 70+
The Australian Guide to Healthy Eating recommends the following servings per day:- 4-7 servings from the bread, cereals, rice, pasta, noodles group
There is an allowance of about 20g a day for poly or monounsaturated fats and oils that can be used to spread on breads or rolls or used elsewhere in the diet.
- 5 servings from the vegetables, legumes group
- 2 servings of fruit
- 2 servings from the milk, yoghurt, cheese group
- 1 serving from the lean meat, fish, poultry, eggs, nuts and legumes group
Note: You get plenty of fats and oils from the amount used with cereal foods and from meat, eggs, cheese, peanut butter, margarine, etc so fats and oils are not included separately.
For more information check out the Australian Guide to Healthy Eating at:
www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-food-resources.htm#consumers
Energy requirements (kilojoules/day)
Energy requirements for people vary depending on age, gender, body size and activity levels. Energy requirements decline with age because older people have less lean body mass (leading to a slower metabolic rate) and are also often less active. As energy use decreases less food needs to be eaten.For older women, being underweight is as much of a risk as being overweight. It is important for older women to eat regular meals and eat enough to sustain their body weight.
For more information on energy requirements for adults see your local dietitian or follow this link to the Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakesand go to page 20-22.
http://www.nhmrc.gov.au/publications/synopses/_files/n35.pdf
Physical Activity
For the general adult population, regular physical activity is good for your body, good for your mind and makes you look and feel better. For example, physical activity can help to control:- Weight (reduce body fat)
- Blood pressure
- Cholesterol
- Diabetes
- Bone and joint problems (eg arthritis)
Physical activity can reduce stress and anxiety, improve concentration, improve self-confidence and reduce feelings of sadness.
Physical activity gives you more energy, helps you sleep better, helps you to relax, helps you to meet people and make friends, is fun and tones your body.
All adults should try to
- Think of movement as an opportunity, not as an inconvenience.
- Be active every day in as many ways as you can.
- Put together at least 30 minutes of moderate-intensity physical activity on most, preferably all, days.
- If you can, also enjoy some regular, vigorous activity for extra health and fitness.
Why 30 minutes?
30 Minutes is needed to keep your heart, lungs, muscles and bones in good working order. But if you can’t do 30 minutes now, start with 10 minutes once or twice a day. After two weeks, make it 15 minutes twice a day and you will have reached your goal of 30 minutes a day. If you can do more than this, there will be additional benefits. If you can’t get to 30 minutes a day, don’t worry. Any amount of additional physical activity will improve your health.What is moderate activity?
Moderate intensity means you don’t have to puff and pant. You don’t have to work up a sweat – but if you do – it’s OK. Brisk walking is great moderate activity. If you don’t like walking, try working in the garden or going for a swim.Don’t forget to consult your doctor before commencing physical activity or if you have a medical condition.
Healthy Eating for Women aged 70+
As people tend to eat less as they age it is often harder to get all the necessary nutrients for good health. Greater intake is required of some nutrients in older people so it is important to eat lots of nutritious foods. The body’s ability to some absorb some nutrients becomes less efficient with age. Medications, smoking and alcohol consumption can also affect nutrient intake and absorption and increase the need for certain nutrients.Ageing can be associated with diminished sense of taste and smell. In order to maintain interest in food and obtain all necessary nutrients it is very important to eat a varied diet. This can be done by making meals look appealing and by varying the food on the plate. Ensure that the same meals are not repeated all the time.
In older people, the amount of food eaten is often reduced so it is important to consume a variety of nutritious foods to ensure that a wide variety of vitamins, minerals and dietary fibre occurs.
Consuming a wide range of nutritious foods every day like vegetables; legumes; fruits; breads and cereals; lean meat, fish, poultry or meat alternatives; milk products; and water is essential to good health.
For healthy, independent Australians aged over 65, the dietary guidelines are:
- Enjoy a wide variety of nutritious foods
- Keep active to maintain muscle strength and a healthy body weight
- Eat at least 3 meals every day
- Care for your food: prepare and store it correctly
- Eat plenty of vegetables (including legumes) and fruit
- Eat plenty of cereals, breads and pastas
- Eat a diet low in saturated fat
- Drink adequate amounts of water/and or other fluids
- If you drink alcohol, limit your intake
- Choose foods low in salt and use salt sparingly
- Include foods high in calcium
- Use added sugars in moderation.
Nutritional Considerations
Recommending that Australians ‘enjoy a wide variety of nutritious foods’ will not only help ensure appropriate intakes of major dietary components such as carbohydrates, protein and fats but also ensure adequate and appropriate intakes of vitamins and minerals.For individual nutrient requirements such as those described below, the Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes provides an average nutrient intake requirement for individuals and a value that would meet the needs of most individuals in the population. Because it is difficult to assess an individual’s exact requirement for a particular nutrient, you might like to aim for the upper figure to maximise the certainty that a sufficient amount of the nutrient is obtained from food. For more information go to: http://www.nhmrc.gov.au/publications/synopses/_files/n35.pdf
There are some nutritional considerations which are most important for women over the age of 70 years. These are explained below:
Protein
Older people require more protein than younger people. Older people often experience more surgery and injuries from falls and everyday activities than younger people. Immobile older people can also suffer from pressure sores resulting in severe wounds. Adequate protein in the diet will assist in wound healing. Protein can be found in foods like meat, fish, poultry, dairy foods, eggs, legumes (beans) and nuts. The average requirement for protein for women over 70 years is 46g per day but because of individual variation, some women in this age group may need 57g or more per day.Calcium
Older people have the highest dietary requirements for calcium and require the lowest energy intakes. Calcium is important for the development and maintenance of the skeleton. People lose bone mass as they age and so it is important to increase the amount of calcium in the diet to slow down the process of age-related bone loss. After menopause, women are particularly susceptible to osteoporosis and reduced bone density. This is because the hormone oestrogen has a protective effect over bone breakdown and after menopause, less oestrogen is produced. As a result, it is particularly important that older women obtain plenty of calcium from their diet so as to minimise bone loss. Calcium can be found in foods like milk, cheese, yoghurt, fish with edible bones (salmon, sardines), legumes, calcium fortified soy products (milk, tofu) and fortified breakfast cereals.Some ways to increase calcium intake in your diet include:
- Consuming calcium rich foods in the diet eg milk, cheese and yoghurt.
- Consuming broccoli, beans, almonds, tinned salmon and sardines regularly.
- Adding skim milk powder to soups, puddings, smoothies, milkshakes and sauces.
- Consuming calcium fortified foods (i.e. foods with added calcium) such as breakfast juices and breads.
- If consuming soy milk, always select a calcium fortified brand.
In later life, recommendations for reducing the prevalence of osteoporosis are aimed at maintaining bone mass can include such things as increasing calcium through the diet, hormone replacement therapy, weight-bearing exercise and supplements of both calcium and vitamin D.
Vitamin D
Vitamin D deficiency increases the risk of major illness and adverse health outcomes, including osteoporosis. Calcium and vitamin D interact in their role in bone health. Vitamin D is necessary for calcium absorption. Consuming enough Vitamin D and calcium can help to minimise bone demineralisation and reduce the incidence of falls and fractures in older people.The main source of Vitamin D is through exposure to sunlight. Some Vitamin D can also be obtained from dietary sources such as margarine, dairy products, oily fish, cheese and eggs. The recommended intake for Vitamin D for women over 70 years is 15 µg (micrograms) per day (1 g = 1000 µg).
Older people who are confined indoors may not receive the necessary sun exposure for adequate amounts of Vitamin D to be produced and so are at higher risk of deficiency.
Housebound older Australians, those in residential care or those who have very restricted exposure to sunlight and a decreased intake of food may require supplementation with vitamin D. Advice should be sought from a doctor or dietitian.
Iron
Iron is important for transporting oxygen around the body, and helps to prevent infection. Older people who have low energy intakes are at risk of being deficient in iron. Medication and blood loss from disease can also cause iron deficiency. Symptoms of an iron deficiency are tiredness and breathlessness.The average requirement for iron for women over 70 years is 5mg/day but because of individual variation, some women in this age group need 8g or more per day. Sources of iron include lean red meat, chicken, fish, dark green leafy vegetables, iron-fortified breakfast cereals, legumes, eggs and dried fruit.
There are two different types of iron found in food: haem iron and non-haem iron. Haem iron is found in red meat, chicken and fish and is easily absorbed by the body. Non-haem iron is found in plant foods such as leafy green vegetables, legumes and iron-enriched breakfast cereals. The iron from plant sources is not as readily absorbed by the body.
Consuming a source of Vitamin C with foods containing non-haem iron, for example, drinking a glass of orange juice with an iron fortified breakfast cereal, will promote iron absorption. In contrast, tea, coffee and unprocessed bran can inhibit iron absorption.
Zinc
Zinc has a role in wound healing and immune function. Zinc intake can also be low in older people due to reduced food intake. As people age they absorb zinc less efficiently and factors like medication can also impair the body’s ability to absorb zinc. Having a low zinc intake can have an impact on food intake by reducing taste sensation. As taste is often already reduced in older people this can seriously affect food choice. Older people should make a special effort to eat foods high in zinc such as red meat, liver, oysters, fish and eggs. The average requirement for zinc for women over 70 years is 6.5mg/day but because of individual variation, some women in this age group need 8mg or more per day.Fibre
A diet high in fibre has been linked with decreased risk of obesity, coronary heart disease, diabetes and some cancers. Fibre is also important for a healthy digestive system. Wholegrain cereals, bread and pasta are higher in fibre than the refined or white alternatives. Fibre is also found in fruits and vegetables. Using a large variety of these foods is recommended for older people. The recommended intake for fibre for women over 70 years is 25g per day.Be wary of using fibre supplements as these can affect the body’s ability to absorb nutrients like iron, zinc and calcium. It is much better to get fibre naturally from food sources.
Older people sometimes suffer from constipation because they may be largely inactive or on certain medications. In order to prevent constipation, older people should eat plenty of fibre-rich foods. It is also very important to drink lots of water when eating a diet high in fibre.
The importance of eating regular meals
It is important for older women to eat at least 3 nutritious meals a day to ensure energy and nutrient requirements are met. As we get older, there are lots of things that might cause us to miss a meal. Some of these are:- Not having the energy to prepare food
- Lack of motivation to eat
- Not feeling hungry
- Having difficulty swallowing or chewing
- Reduced taste perception
- Eating meals at a similar time each day to build a routine.
- Using pre-made foods such as frozen vegetables, tinned fruit or ready-made meals (use the low salt and low sugar varieties). These will take less time and energy to prepare
- Eating small, frequent meals rather than just a few bigger meals. This will help to get in all the necessary nutrients without having to eat large amounts at one time
- Avoiding drinking with meals as this can be filling
- Choosing softer foods when feeling tired. Eating soft foods requires less effort in chewing and swallowing
- Adding herbs, spices and condiments such as lemon juice to meals to add flavour
The importance of fruit and vegetables (including legumes)
Fruit and vegetables contain many vitamins and minerals essential for good health as well as antioxidants and phytochemicals. They are also generally low in fat and high in fibre. Many studies have shown that people who consume diets high in fruit and vegetables have lower risk of coronary heart disease, stroke, diabetes, some forms of cancer and hypertension.Dark green, yellow and orange fruit and vegetables, such as carrot pumpkin, spinach and rockmelon, are good sources of vitamin A. Fruits and vegetables such as tomatoes, capsicum, broccoli, cabbage, citrus fruit (eg oranges), rockmelon and kiwi fruit are all rich in vitamin C. Both fruit and vegetables also contain dietary fibre. Fruit and some vegetables contain soluble fibre which may help lower blood cholesterol levels. Insoluble fibre is found in vegetables and helps to prevent constipation. Fruit and vegetables also have low energy (kilojoule) content.
It is recommended that all Australian adults aim to eat at least 5 serves of vegetables and 2 serves of fruit every day. A serve of vegetables equals either 1 cup of salad vegies, 1/2 cup of cooked vegies or cooked legumes or 1 medium potato. A serve of fruit equals 1 medium piece of fruit (eg apple), 2 small pieces of fruit (eg apricot) or 1 cup of canned or chopped fruit.
Try these useful suggestions to ensure an adequate intake of fruit and vegetables:
- Always serve main meals with cooked vegetables or a salad
- Make meat go further by adding extra vegetables in a stir-fry or casserole
- Add vegetables in season or legumes (eg dried beans, peas or lentils) to soups for added flavour and taste
- Include fruit juice or fresh fruit at breakfast, either by itself or on top of cereal or porridge
- Have fruit salad or baked fruit for dessert
- Puree stewed fruit as a topping for desserts or swirl into yoghurt
- If there is a lack of time to cook, use tinned or frozen fruit and vegetables in meals. Tinned or frozen fruit and vegetables are just as nutritious but be wary of brands with a lot of added salt and sugar.
Water
Water is essential to life and so is an important part of the diets of people of all ages. Older people may be at greater risk of dehydration compared to younger people because of insufficient fluid intake or increased fluid loss, particularly those who are frail or have a chronic illness. Ageing produces a decrease in thirst sensation; dehydration may go undetected and lead to electrolyte imbalance and confusion.Chronic mild dehydration increases the risk of kidney stones, urinary tract cancers, colon cancer, mitral valve (in the heart) collapse, constipation, as well as diminished physical and mental performance.
Water should be everyone’s primary drink. Caffeine and alcohol act as a diuretic, this means that your body is actually losing some of the water to get rid of caffeine and alcohol in these drinks through urination.
Requirements differ depending on climate, physical activity and metabolism, but the recommended intake for women over 70 years is 2.1 litres per day. This equates to about 8 cups a day (this does not include water obtained from food but includes plain water, milk and other drinks).
Salt
A diet high in salt can have adverse health effects. It is recommended that older Australians ‘Choose foods low in salt and use salt sparingly’. While some salt, or sodium, in the diet is necessary for health, too much can cause fluid retention, increase calcium excretion and raise blood pressure.Foods high in salt are largely commercial or processed foods. Only very low amounts are found in natural unprocessed foods. Foods high in sodium, or salt, include: table, sea and vegetable salts; anchovies; monosodium glutamate (MSG); soy sauce; bottled sauces; gravy; stock cubes; deli meats; canned vegetables and packet soups.
Older people often experience a decrease in taste sensation which causes them to add salt to meals for flavour. It may therefore be necessary to use other sources of flavour in cooking. Try using herbs, spices and a variety of different foods to flavour meals instead of adding salt and choose low salt foods where possible.
Women of any age should aim to keep their daily intake of sodium between 460-920 mg per day. To put this into perspective, a meat pie might contain around 470mg of sodium, whereas a tub of yoghurt contains 140mg/day.
Reducing salt in the diet can be easy, it just involves making a few small changes to the foods you choose and the methods you use to cook them. Try these ideas:
- Leave the salt shaker off the table. This will remove the temptation to add it to your plate
- Use herbs, spices and a variety of foods to flavour meals rather than adding salt
- Choose salt-reduced products where possible
- Look at the salt (sodium) levels on product labels to compare which products contain less salt than others of the same type
- As breads and cereals are major contributors to salt intake in Australia, choose salt-reduced varieties
- Choose fresh foods rather than packaged varieties where possible
- Cut down on the salt you are eating gradually. Your taste will slowly adapt to eating less salty foods
Fat
Dietary fat is around twice as energy (kilojoule) dense as carbohydrate or protein so excess consumption can contribute to weight gain. For a healthy heart and to prevent obesity and type 2 diabetes, it is important to limit the amount of fat in the diet, especially saturated fat and trans fats. Saturated fat is found in animal products including meat and dairy. Small amounts of trans fats occur naturally and are also formed by the hydrogenation of vegetable oils during the manufacture of some processed products. Saturated fat and trans fats are associated with many adverse health effects, including heart disease.To reduce the saturated fat in your diet, try the following strategies:
- Instead of butter, use only small amounts of margarine and vegetable oils (such as canola, olive and sunflower oil)
- Choose lean meats
- Cut the visible fat off meat and remove the skin from chicken
- Grill, steam, bake or boil food instead of frying
- Choose low-fat dairy products where possible
- Avoid deep-fried foods
- Minimise intake of cakes, biscuits, chocolate and pastries
- Avoid high fat and/or high sugar foods including fast foods, packaged desserts and confectionary
Alcohol
Alcoholic drinks can be a regular and enjoyable part of meals for many Australians. Alcohol is a nutrient which contains kilojoules but it is also a drug affecting the brain and most of the body’s tissues. Older people are more susceptible to the toxic effects of alcohol. This is because the amount of lean body mass decreases with age causing an older person to become more intoxicated after a certain number of standard drinks than a younger person will. This is especially true for older women because they are generally much smaller than men are. Excessive consumption of alcohol can also deplete the body’s stores of important nutrients.Older people, especially women, must be careful not to drink too much. Older people are more susceptible to falls or other injuries when intoxicated. This can cause fractures which can be serious and even life-threatening. Alcohol can also interact with a number of commonly prescribed, powerful drugs.
A moderate intake of alcohol (no more than one to two glasses) with meals may be useful for older people because it stimulates the appetite. It may also be socially pleasurable. A moderate amount of alcohol taken regularly may also be protective against coronary heart disease. However, if older Australians choose to drink alcohol, they should limit their intake.
Fore more information on alcohol and the alcohol guidelines for Australians, visit the link:
http://www.alcohol.gov.au/
Drug interactions
Older people often take more medications than younger people do. Certain nutrients can either speed up or slow down medication absorption. Some nutrients may also change the activity of the medication in the body or affect the rate at which the medication is broken down eg dietary calcium can bind to antibiotic tetracycline resulting in the body not absorbing the amount of antibiotic medicine.Long term medication use can lead to nutritional problems such as diarrhoea and suppression or stimulation of the appetite. Some medications can also reduce salivary flow rates causing dry mouth and make some foods taste unpleasant. If unusual symptoms are being experienced while taking prescription or non-prescription drugs you should seek advice from a doctor and/or pharmacist.
Oral Health
Dental, mouth or throat problems can result in inadequate nutrition. When it is painful or difficult to chew or swallow, older people tend to eat less or choose only soft foods which may not be as rich in nutrients. This can lead to deficiencies of nutrients and insufficient energy in the diet. It is important for older people to maintain good oral health. If some foods are not eaten because of pain on chewing or swallowing, a dietitian should be consulted to ensure an adequate diet that will maintain good health.People in lower income groups may find it difficult to access dental care due to the cost or immobility. Oral health is increasingly important as people get older. Poor oral health is a known risk factor for undernutrition, chest infections, upper respiratory tract infections, and poor management of diabetes. Undernutrition complications include recurrent infections, falls, pressure sores, adverse drug reactions, dehydration, hospitalisation and early nursing home entry. Older people who have difficulty accessing suitable dental care should talk to their doctor about whether they qualify for an Enhanced Primary Care plan. The plan is available to older Australians with a chronic condition and complex care needs. On this plan, older people can be referred to a dentist if dental problems are exacerbating a chronic condition and Medicare will rebate up to three dental services per year.
Example of a Healthy Meal Plan for a 75 year old woman
For this example we have based the daily energy requirement on a 75 year old woman, about 1.5m in height, weighing about 50kg. It is based on an individual with an exclusively sedentary lifestyle with little or no strenuous exercise (for example, someone who is retired and spends most of the day sitting). The meal plan is designed as a guide and meets recommended dietary intakes. The meal plan is for a single day. The Australian Dietary Guidelines for Older Australians recommend eating a variety of foods every day to meet nutritional needs.
Energy requirements (kilojoules/day)
- About 6,500 kJ/day (1,550 kcal/day)
Food | Quantity | Energy (kJ) | Protein (g) | Carbohydrate (g) | Fat (g) | Salt (Sodium, mg) |
Breakfast | ||||||
| Breakfast cereal, rice and oat flakes (fortified*) | 1 cup | 473 | 2.6 | 23.3 | 0.6 | 190 |
| Milk, reduced fat (added calcium) | 1/2 cup | 264 | 5.1 | 6.9 | 1.8 | 62 |
| Bread, mixed grain with fruit, toasted | 1 slice | 525 | 3.6 | 22.5 | 1.7 | 101 |
| Margarine, polyunsaturated | 2 tsp | 287 | 0 | 0.1 | 7.7 | 76 |
| Orange, raw | 1 large | 340 | 2.1 | 15.6 | 0.2 | 6 |
| Water | 1 glass | 0 | 0 | 0 | 0 |  |
Nutritious Snack | ||||||
| Crispbread biscuits | 2 biscuits | 174 | 1.5 | 7.5 | 0.4 | 39 |
| Asparagus, drained | 5 spears | 66 | 1.2 | 1.0 | 0.1 | 156 |
| Cheese, cheddar (50% reduced fat) | 1 slice (21g) | 233 | 6.6 | 0 | 3.3 | 145 |
Lunch - Sardine and salad roll | ||||||
| Bread, wholemeal, toasted | 2 slices | 619 | 6.2 | 24.4 | 1.9 | 313 |
| Margarine spread, polyunsaturated | 2 tsp | 248 | 0 | 0 | 6.7 | 50 |
| Sardines, canned in oil | 4 small fish | 768 | 10.6 | 0 | 16.0 | 300 |
| Lettuce, raw | 2 medium leaves | 7 | 0.1 | 0.1 | 0 | 4 |
| Parsley, raw | 2 tsp | 2 | 0.1 | 0 | 0 | 1 |
| Tomato, raw, sliced | 3 thin slices | 30 | 0.5 | 0.9 | 0.1 | 3 |
Nutritious Snack | ||||||
| Fruit salad, canned in natural juice, drained | 1/2 cup | 206 | 0.9 | 10.3 | 0.1 | 7 |
| Yoghurt, reduced fat, vanilla | 1 tub (200g) | 834 | 10.6 | 32.7 | 3.5 | 141 |
| Water | 1 glass | 0 | 0 | 0 | 0 | 0 |
Dinner - Chicken and vegetables with rice | ||||||
| Broccoli, cooked (from frozen) | 1/2 cup | 134 | 4.6 | 0.6 | 0.3 | 19 |
| Cauliflower, cooked | 1/2 cup | 63 | 1.5 | 1.4 | 0.1 | 9 |
| Chicken, breast, grilled, no skin | 1/4 cup | 277 | 10.1 | 0 | 2.9 | 31 |
| Rice, brown, boiled, added salt | 1/2 cup | 578 | 2.9 | 28.6 | 0.9 | 99 |
| Canola oil | 1 tsp | 170 | 0 | 0 | 4.6 | 0 |
| Water | 1 glass | 0 | 0 | 0 | 0 | 0 |
Nutritious Snack | ||||||
| Milk, reduced fat (added calcium) | 1/2 cup | 264 | 5.1 | 6.9 | 1.8 | 62 |
Variation to Energy Expenditure depending on Physical Activity Level for a woman aged 75 years, about 1.5m in height, weighing about 50kg
Description of lifestyle | Energy requirements (kJ/day) |
| At rest, exclusively sedentary or lying (chair-bound or bed-bound) | 5,600 kJ/day |
| Exclusively sedentary activity/seated work with little or no strenuous leisure activity eg office employees | 6,500 – 6,950 kJ/day |
| Sedentary activity/seated work with some requirement for occasional walking and standing but little or no strenuous leisure activity eg drivers, students | 7,400 – 7,850 kJ/day |
| Predominantly standing or walking work eg housewives, salespersons | 8,300 – 8,800 kJ/day |
| Heavy occupational work or highly active leisure | 9,300 -10,200+ kJ/day |
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