By Kelsie Mhoon (December 10, 2011)
“I’ll take the grilled chicken,” the woman tells her server, looking the menu over though the glasses perched on her nose. Her fingers tap the rim of her tall mug, its dark green color a stark contrast to the monochromatic table settings. She considers her options. “And a large order of broccoli and a green salad.”
Her tablemates shake their heads with knowing smiles. “There goes Virginia with her greens,” one of them laughs.
Virginia Nielsen and her fellow diners are residents of the Cristwood Park retirement community in Shoreline. By her own standards, Nielsen is extremely health conscious, paying close attention to what she eats and how much she eats, ensuring that she gets enough essential nutrients each day. She would hesitate to say the same of her neighbors, observing quietly when the man to her left begins vigorously pouring salt into his clam chowder.
Though all of the food served in Cristwood’s dining room is healthier than what you would find at a typical restaurant, many of the residents aren’t making the best choices for their health. It’s not just exclusive to seniors living in pampered retirement centers: this problem is prevalent nationwide.
Nearly 70 percent of seniors have poor nutrition habits, according to the National Center for Health Statistics. Going by the United States Department of Agriculture’s (USDA) standards, less than one-third of people over the age of 65 are consuming enough fruits, vegetables, or foods rich in calcium and iron. What’s more, seniors are frequently overindulging in foods with an abundance of salt and sugar, which the USDA insists should be heavily regulated.
While there are more-pressing health concerns that seniors have to take into account, whether it be diabetes, high blood pressure, high cholesterol, or obesity, it’s still important for them to follow basic nutrition tips that are applicable to everyone in their age group.
In an effort to help keeping a healthy diet manageable for seniors, the food service staff of retirement homes and assisted living facilities have stepped up their game in recent years, committed to making healthier, more flavorful, and cost-effective meals. Cristwood Park is determined to take the lead in this regard, if their recent remodel of the dining room, now complete with fireplaces and ambient lighting, is anything to go by. The quality of the food, however, is still the priority.
“We try our best to keep everyone happy,” Brent McDaniel, the manager at Cristwood Park Dining said. The kitchen staff, he explained, is expected to strike a balance between the kinds of food residents want and the kinds of food that are healthy for them.
Apart from the two special entrees that are offered each night with various starch and vegetable side dishes, McDaniel has made sure to have items like grilled chicken, baked potatoes, gluten-free pasta, and omelets available at all times to accommodate any resident with a more restrictive diet.
With the numerous resources available and the painstaking efforts of the kitchen staff to make healthy eating easier, why aren’t more seniors themselves focused on nutrition?
For most, it’s a struggle having to choose between what’s good for their health and the food preferences they’ve had their entire lives. According to the National Institute on Aging, seniors may also be put off by the time it takes to plan meals. Others have lost interest in eating full meals altogether.
“A lot of these people don’t want to deal with nutrition,” local nutritionist Sally Pechstein said. “They see it as an unnecessary stress.”
For seven years, Pechstein worked at Harborview Medical Center as a nutrition specialist for seniors. Based on her experiences, she said that it usually “took something big” like an illness or hospitalization to get elderly patients to realize just how seriously they need to make changes to their diets.
“There’s definitely this sense of ‘If they can eat that, why can’t I?’ But everyone has different reactions to food,” she said. Though currently managing her own practice, which focuses on naturopathic counseling, she still tries to get older people to understand that common things like heartburn and indigestion aren’t unavoidable signs of age.
“It simply means that something you ate isn’t right for your body,” she said, “and a lot of times, it’s an easy fix.”
Nielsen too has said that she attempts to convince some of her fellow residents to be more mindful of their diets and to cut out the foods that have a negative effect on them. Most of them, she said, are too set in their ways.
“I don’t understand why people willingly endure heartburn or indigestion,” Nielsen said.
Before she started her current diet, a fairly strict regimen found in the book “Eat Right For Your Type” by Dr. Peter J. D’Adamo, those were problems she frequently experienced. And now?
“I’ve been following this diet for 10 years and I feel great,” Nielsen said. “I’m not sure of the science behind it, but it’s working for me.”
In the book, D’Adamo provides lists for the kinds of foods people should be eating plenty of and those they should avoid completely, all based on a person’s blood type. Nielsen, an A-positive blood type, has stopped eating beef, wheat, potatoes, tomatoes, and many other foods in keeping with the diet’s recommendations.
Despite facing items on the daily menu that she’s not allowed, Nielsen said that getting a healthy meal in the dining room isn’t something she or the residents need to fret over because of the careful planning that goes on in the kitchen.
“Here, we’re doing the work for them,” Margie Beavers said. As the assistant manager of the dining room at Cristwood Park, she’s always looking for ways to revamp the menu. Offering more fresh foods and cutting back on the processed foods is something she feels strongly about.
Referring to MyPlate, the USDA’s new Food Guideline System, she explained that fruits and vegetables should make up half of a senior’s diet.
“My mother always told me to eat a yellow and a green. If you have squash, balance it out with kale or spinach,” Beavers said. “The darker the green, the better.”
To this day, at 67, she still abides by these words and applies them to her work, where she ensures that steamed greens of some kind will be on the menu each day. Turns out, this motherly advice is similar to what any physician or nutrition book will tell you.
One such book is the Purity Research Department’s “The Best Kept Secrets to Healthy Aging,” which stresses the importance of consuming plenty of fruits and vegetables. In plain terms, the nutrients found in these foods “support the healthy aging of every organ in the body and help them maintain their functionality.”
“If you’re going to look, feel and act healthy and full of life,” the guide reads, “you’re going to need your cells to radiate youthfulness.”
But feeling healthy isn’t just about what you eat. It’s also about what you don’t eat. For seniors, sodium is one thing that experts agree should be avoided because it aggravates high blood pressure conditions, affecting over 60 percent of the senior population.
“We try our best to use less salt,” Beavers said. Apart from monitoring how much salt the cooks use to prepare the food, she and McDaniel try to use primarily fresh or frozen foods.
“Do you have any idea how many additives are in canned food?” Beavers asked, wide-eyed and shuffling through a stack of menus on her desk. The amount of sodium in a can of green beans, she said, is staggering; “I had no idea and now I don’t even eat them at home!”
Apart from cutting down on the use of canned or prepared foods, monitoring the amount of salt the cooks use is the easiest thing the managers can do to make any meal more healthful. Anything that caters to residents who have high blood pressure or heart disease is a priority and it’s something Beavers has personal experience with.
“After my husband had a heart attack, we cut out all the oil, salt and fats at home and started eating more greens,” Beavers said. “Now he’s feeling better than he has in a long time.”
That experience has compelled her to make more detail-oriented choices as a manager, including her decision to ask the cooks to leave salt out of their daily soups. Beavers encourages the residents to leave feedback for the managers and she said that without fail, there will be at least one comment each week that the soup “needs more salt.”
“You can’t win,” Beavers said with a shrug.
“There’s salt and pepper on every table, so who cares?” Nielsen said, surprised by news of the complaints. “We shouldn’t be eating salt at our age anyway.”
Nielsen, 84, has gone without adding salt, sugar, and a variety of other additives to her food for years. She doesn’t miss them.
“Your body becomes used to the change after a while, but I think most people are too stubborn to give it a try,” she said.
This is especially true with sugar. Contrary to popular belief, the consumption of sugar is not just an issue pertaining to those with diabetes, which the U.S. Department of Health and Human Services estimates to affect nearly 27 percent of seniors. According to Dr. Nina Marinello, Chairwoman of Nutrition Science at The Sage Colleges in New York, every elderly individual should take care to only eat foods with added sugar in “moderation.”
“With age, muscle mass decreases. This results in a lower metabolic rate making weight gain easier,” she said, explaining that something as simple as regulating sugar intake is a good way to curb this effect of aging.
Nielsen, who has been struggling with her weight for years, is aware of these facts and tries to avoid sugar and dairy products wherever she can- except when frozen desserts are involved.
“I eat healthy all the time! I figure if I fudge now and then, it might as well be with ice cream,” she laughed. “I’m sure it’s not hurting any.”
Many other seniors share this same attitude and often, they overindulge in the sweet stuff. Although seniors typically have less than half the amount of functional taste buds they had at the age of 30, those that register sweetness may still work properly for years. According to HelpGuide.org, this explains why many elderly people get far more enjoyment from sweet foods than any others. Though they still want to cater to a resident’s sweet tooth, more and more senior living facilities are starting to enact portion control when serving desserts. Residents, however, will often compensate by ordering a large portion of ice cream.
In turn, the kitchen staff at Cristwood Park currently offer sugar-free dessert options for those with diabetes and anyone taking the step to cut back on sugar. Unfortunately, the cakes and pies haven’t been hot sellers among the residents. Beavers says that very likely, they’ll do away with the specialty items and have prepackaged sugar-free cookies and ice creams on hand instead. Otherwise, the adage “eat less and more slowly” would be the only thing the residents have to work with.
Of course, good nutrition isn’t limited to consuming more whole foods or decreasing the use of additives. Staying hydrated is also a major concern for seniors. Drinking enough water helps maintain good kidney function and aids the digestion process, both of which decline with age. At Cristwood Park, servers are instructed to keep the water pitchers on each table full, an encouraging reminder for residents to stay hydrated.
Some residents, however, aren’t interested in such reminders.
Evelyne Coonrod has no major health concerns, even at 84 years of age, and makes a point of exercising regularly. She eats a good deal of fruits, vegetables and lean proteins. This is how she’s lived for the past few decades and she’s never felt compelled to modify her diet in any way. So what’s her doctor’s only recommendation for her? Drink water.
“But I don’t like water,” she said, waving off one of the servers who attempted to fill her tall drinking glass. The remnants of her French accent roll off every word as she asks for a carafe of decaf coffee instead, before overturning her empty water glass to make a point. “No need to waste it on me.”
It’s been well documented that many senior citizens have a lowered sense of thirst and general disinterest in drinking clear fluids. But why? In 2009, researchers at Australia’s Howard Florey Institute discovered that the brains of elderly people underestimate the amount of water needed to quench their thirst. This, as well as a general disinterest in drinking clear fluids, is what puts many seniors at risk for dehydration, which in turn can complicate existing health conditions and result in severe illness. For those who need help tracking their water intake, most experts recommend carrying around a water bottle or taking two sips for each bite of food.
“We can’t make them drink water,” Beavers said, sighing as she picked up a few untouched pitchers at the end of the dinner service. “All we can do is help them understand why it’s important.”
Although coffee is considered a “safe food” by the folks over at MyPlate, low-sugar juices and teas are better alternatives for those who don’t want to drink straight water. Green tea, championed by both the USDA and every health magazine on grocery store shelves for its antioxidant properties, is becoming the most popular substitute for coffee at Cristwood Park. Recently, the kitchen has had to order more boxes of Stash brand tea to keep up with demand.
“Advice gets spread like gossip around here. One person will try something then everyone else is scrambling to jump on board,” Beavers explained. “But this is a good trend! Everyone should be drinking green tea.”
Nielsen, though more of a coffee drinker, said that she’s pleased to hear of these changes, not just in her fellow diners’ increasingly good habits, but in the way the kitchen is helping promote them.
“I think people have this attitude of ‘oh, I’m getting old, this is probably the best I’m going to feel,’” Nielsen said, arranging her sliced grilled chicken neatly on her salad plate. “But the point is, you don’t have to feel that way.”