Food is the most important thing for people, and "eating" has played a decisive role in our life since ancient times. Food is the source of life and provides us with the most basic nutrients for life activities. But for the elderly, eating the right food is the "magic weapon" to delay the aging process and control the development of diseases. In this issue, we invited researcher Zhang Jian, chairman of the Nutrition Branch of China Nutrition Society, to share the simplest regimen of "eating" for elderly friends.
The intake of protein by most elderly people is not up to standard.
Life Times: What is the current nutritional status of the elderly in China? What are the main problems?
Zhang Jian: Generally speaking, the nutritional status of the elderly in China is constantly improving. Indicators to measure nutritional status, such as low weight (emaciation) rate and anemia rate, are declining. However, due to the accelerated aging process and the increase in the number of elderly people, the number of elderly patients with chronic diseases is huge. There are still many problems in nutrition. For example, the food intake of the elderly in China is monotonous, especially in rural areas and the elderly. Our data show that the anemia rate of the elderly over 75 years old is 1 times higher than that of the younger elderly aged 65-74 years old.
Life Times: Can you elaborate on which nutrients are lacking frequently among the elderly in China, and what health problems will it lead to?
Zhang Jian: First of all, protein's intake is low. High-quality protein is easy to digest, absorb and utilize, but the intake of some high-quality protein-rich foods such as fish, lean meat, eggs and dairy products by the elderly in China is not enough, which leads to the low intake of protein. According to the statistical data of 20 19, 50%~60% of the elderly in China do not meet the recommended amount in the dietary guidelines. In addition, some micronutrients, such as vitamin A, zinc and so on. The intake did not reach the recommended amount.
Nutritional deficiency is not as obvious as disease, but it devours our bodies like ants. "A levee of a thousand miles is destroyed by an ant's nest", lack of nutrition will affect people's physical strength and mood and reduce their resistance; Nutritional deficiency, such as protein deficiency, will lead to muscle loss, and insufficient calcium intake will increase the risk of osteoporosis. When the ability of bones and muscles deteriorates, people will easily enter a weak state and lose their self-care ability. It not only makes it difficult for the elderly to live independently, but also requires extra manpower to take charge of the daily life of the elderly, which is a huge burden to the elderly, families and society.
To sum up, the nutrition improvement of the elderly is a very urgent problem, but compared with various major diseases, nutritional deficiency is more like "warm water" for boiling frogs, which has not attracted people's attention.
Compared with diseases, nutrition is neglected.
Life Times: Why are the elderly prone to malnutrition? What are the subjective and objective reasons?
Zhang Jian: First of all, in physiology, the physical functions of the elderly will decline to varying degrees, such as decreased chewing and digestive abilities, decreased heart and brain functions, and slow sensory responses such as vision, smell and taste, which will affect the food intake, digestion and absorption ability of the elderly and increase the risk of nutritional deficiency of the elderly. In addition, the proportion of elderly people suffering from one or more chronic diseases is high, and their physical condition is more complicated. In addition, drug treatment will also lead to poor appetite of the elderly, and their dietary needs will be more diverse. Once the old people don't realize this and continue to use their previous dining habits, they will be prone to malnutrition and affect their physical functions.
Second, the market provides very limited kinds of food for the elderly. We have entered an aging society, but the facilities and food supply have not fully adapted to this change. For example, we recommend the elderly to eat whole grains, but their chewing function and digestive ability are poor and they need softer food. There are few foods on the market that can not only retain the nutrition of coarse grains, but also be finely processed and suitable for the chewing ability of the elderly; Moreover, most of the coarse grain steamed buns in the supermarket are packed in packs of five, which is a burden for the elderly who don't eat much and empty nesters. Similarly, vegetables, meat, nuts and other categories of food are rarely suitable for the elderly.
Third, economic factors. The elderly, especially some elderly people in rural areas, have relatively poor economic conditions and cannot afford it if the expenses are too high. At present, we have some subsidies for these old people, but because it is cash, many old people spend it on other aspects that they think are "more important".
Life Times: Will the misunderstanding of the elderly also lead to nutritional deficiency? What are the most common dietary misunderstandings of the elderly?
Many old people pin their hopes on a certain food or nutrient, expecting a "special substance" to play a magical role, but ignore the real food they eat every day. Many elderly people would rather spend dozens or hundreds of dollars a day on various supplements than spend thirty or forty dollars a day on some high-quality ingredients.
Life Times: Does the nutrition department of the hospital really play a positive role in improving the nutritional status of the elderly? How to popularize professional nutrition knowledge into people's lives?
Zhang Jian: The state stipulates that hospitals above Grade III should set up nutrition departments, which will greatly promote the nutrition work. The nutrition department of tertiary hospitals mainly serves patients, especially inpatients, most of whom are elderly people, especially seriously ill patients. Nutrition department provides them with special medical food to cope with the special physical condition in the process of treatment and recovery, which greatly promotes the overall rehabilitation of patients.
However, after all, these people account for a relatively low proportion of the elderly. According to some surveys, from a nationwide perspective, 70%~80% of the elderly are first diagnosed in community hospitals. If you provide them with basic nutritional support at this time, you may not need to spend a lot of time and energy to achieve better results; As long as the elderly make some small changes, they can avoid functional decline or even illness caused by nutritional deficiency and reduce nursing costs. This will bring great benefits to the elderly, families and society. To this end, we have been promoting the implementation of this idea, and some long-lived countries such as Japan are also trying this plan, but at present, this idea is still in the exploratory stage.
Eating a good meal is much more important than taking supplements.
Life Times: In daily life, what simple indicators or methods can the elderly find malnutrition in time?
Zhang Jian: Weight changes. Old people should maintain a relatively stable weight level. In old age, no matter whether you are obese or not, you don't advocate fast weight loss, let alone strict dieting. The relatively thin elderly should ensure adequate food intake. Generally speaking, unexplained wasting may mean malnutrition or major diseases. Once found, you should see a doctor in time.
Life Times: How do the elderly eat three meals a day?
These basic points are done, so there should be no big problem. If you want to further improve the nutritional status, you can teach yourself nutritional knowledge, such as dietary guidelines, or take regular courses, or consult a nutritionist.
Life Times: What principles should the elderly with dysphagia pay attention to in their diet?
Zhang Jian: Elderly people with dysphagia have special requirements on the viscosity and consistency of food, which is more delicate than daily food. Professional evaluation is usually needed to determine what kind of food is more suitable. Elderly people with dysphagia often have insufficient nutritional intake and need some nutritional supplements, including protein and micronutrients. It is recommended to go to the hospital to see a nutrition clinic and ask a professional doctor for guidance.
Life Times: How do the elderly rationally treat various health care products?
Zhang Jian: Health food is different from the food we eat every day. It mainly emphasizes some functions, and the content of one or more ingredients will be much higher than that of ordinary food. However, according to the recommended consumption of products, the corresponding nutrients contained in health food are still much less than those in our three meals a day. Moreover, the absorption rate of a certain nutrient in a single large dose is not high. In contrast, a diet of three meals a day can help us absorb nutrients better. So health care products are just supplements. To ensure nutrition, the most important thing is to adjust the diet and eat well. On this basis, we should make targeted choices according to our own health problems.
It should be noted that some elderly people rely too much on nutritional supplements and eat a lot at a time, which is very dangerous. There is also an upper limit on the intake of nutrients, which we call a "safe level". If it exceeds this level, it may have certain toxicity, and at the same time it will interfere with the absorption of other nutrients, leading to the lack of other nutrients. Therefore, if the elderly really need to supplement, they should learn some knowledge in this field instead of hearsay. A balanced diet, not a certain ingredient has the effect, the more the better.