- Written by Karen Lentner, MA, RD, LDN, Nutritionist
LifePath’s Nutrition Program – a path to better health
Malnutrition is an epidemic that affects nearly 50 percent of elders. It can affect both the overweight and underweight, and can impact our ability to remain healthy and independent. The amount and quality of food you eat are critical for good health.
If you are age 60, homebound, and unable to prepare your meals or attend a congregate meal site, you may want to consider Meals on Wheels.
The Elderly Nutrition Program at LifePath, in cooperation with other programs throughout Massachusetts, serves more than nine million nutritionally-balanced meals to approximately 75,000 elders each year across our state. Meals are provided at approximately 400 congregate sites in Massachusetts, and more than half of the meals are delivered to elders in their homes through the Meals on Wheels program. Meals on Wheels provides nutritionally balanced noontime meals to homebound elders, delivered by dedicated volunteer drivers. LifePath’s volunteers deliver the meals and ensure daily contact and a wellness check for elders who are alone.
Registered dietitians create the menus for all of our home-delivered meals and congregate meal sites based on current federal and state guidelines. The meals contain approximately one third of the current daily Recommended Dietary Allowance of nutrients and take into consideration the special dietary needs of our elderly participants. Many things are considered when a menu is created, including variety of foods, color, appeal, texture, consistency, cost, and nutritional value. The average meal provides approximately 700 calories, a good source of vitamin C, a meat or meat alternative providing 15-21 grams of protein per serving, and eight ounces of fortified low-fat milk. In addition, we incorporate high-fiber food sources, including fruit and/or fresh fruit three times weekly, vegetables and/or soup daily, and high-fiber bread three times weekly. We aim to limit the fat content to approximately 30 percent of total calories and the sodium content to an average of 800 mg per day. We post the sodium and calorie content of every food item on the menu for individuals who are monitoring their sodium intake. There are no more than two high sodium meals (greater than 1200 mg sodium) served per month. Therapeutic meals for special diets are available if prescribed by your healthcare provider.
Collaboratively, our dietitians and caterer are always looking at new recipes, meal combinations, alternative herbs and seasonings to enhance the flavor of meals, and healthy alternatives that meet the health needs of our elders. It is our goal to provide meals that are nutritious, flavorful, and appealing to ensure elders are consuming their meals. A registered dietitian also provides nutrition education at our senior centers and individual counseling for homebound clients receiving Meals on Wheels.
- Written by Karen Lentner, MA, RD, LDN, Nutritionist, LifePath
What you need to know about vitamin D, the “sunshine vitamin”
Have you seen more information in the news about vitamin D in the past few years? Does your doctor check your vitamin D levels with your annual blood test? The reason vitamin D has been in the spotlight is because, in addition to its role in maintaining strong bones and preventing osteoporosis, many studies have found it is also beneficial for our immune system and helping our bodies resist diseases, including cancer, bacteria and viruses.
How much vitamin D do I need?
The most recent recommendations are 600 IU (International Units) for individuals age one to 70, and 800 IU if 71 years and older. In order to have adequate levels in our blood, we need to get vitamin D from all sources, including food, sunshine, and supplements. Vitamin D is often called the “sunshine vitamin” because humans can make vitamin D in their skin from exposure to the sun. The amount of exposure however, varies from person to person based on skin type or color, length of exposure, season of the year, sunscreen use, and time of day. In addition, your skin changes as you age, and it may be more difficult for your body to make vitamin D. Since it is difficult to meet your needs entirely with sunshine, especially in winter, it is best to focus on food and consider a supplement as well.
Who is at risk for vitamin D deficiency?
Individuals with limited sun exposure or those who are overweight or obese, with dark skin, or age 50 or above are at risk for vitamin D deficiency.
What foods contain vitamin D?
- hard boiled eggs contain 44 IU
- fortified milk/yogurt: 100 to 125 IU
- three ounces salmon, tuna, mackerel: 300 to 450 IU
- fortified cereal: 40+ IU
This information appears on food labels. If your diet does not contain these foods and you have limited exposure to sunlight, consider a multivitamin that contains vitamin D. Ask your physician what your vitamin D levels are and if a supplement is right for you.
What kind of vitamin D supplement?
In order to meet your requirement in a multivitamin, select one that contains 600 to 1000 IU. In addition, there are other acceptable vitamin D supplements in the form of D2 and D3.
How much vitamin D is too much?
The most recent recommendation is to stay below 4000 IU per day, both from food and supplements to avoid toxicity. Exposure to the sun will not cause vitamin D toxicity.
Should I pay attention to my other medications?
YES. Some medications may affect the absorption of vitamin D. These include steroids and cholesterol-lowering medications. It is best to ask your physician or pharmacist about your medications and if there needs to be an adjustment to your supplementation.
- Written by Karen Lentner, MA, RD, LDN, Nutritionist
All about fiber, and more
Did you know that fiber is good for your digestion, can help lower your cholesterol, and can assist with weight loss? High fiber foods tend to have fewer calories by volume of food, and help you feel full for longer periods. Fiber is also helpful in preventing and treating health conditions including diverticulitis, constipation, colon cancer, type 2 diabetes, and irritable bowel syndrome.
Diverticulosis is a condition where balloon-like sacs (diverticula) develop in the large intestine. According to Harvard Health, diverticulosis is uncommon in people under 40 years old, but one third of people develop it by age 60 and two thirds by age 85. Diverticula generally form where there is pressure inside the colon, often due to constipation. Diverticulitis occurs when inflammation and infection develop in the diverticula sacs and requires immediate medical attention. Eating a diet high in fiber and fluids is helpful in preventing diverticulitis.
There are two types of fiber, soluble and insoluble, and both are beneficial for your health.
- Soluble fiber forms a gel and dissolves when water is added. Soluble fibers help control blood cholesterol and blood sugar by binding with fatty substances and sugar, helping remove them from the body.
- Insoluble fiber doesn’t dissolve, absorbs water, and swells up in your intestine, helping to prevent constipation by pushing waste through your intestines. Try to eat fiber from a variety of foods to get both sources.
How do I increase my fiber intake?
Fiber, found in plants, includes fruits, vegetables, legumes, seeds, nuts and whole grain breads, flour, pasta, and cereal. Fiber is not found naturally in meat or dairy and contains no calories. Try to incorporate these foods into your diet at every meal or snack in order to meet the recommended dietary guidelines of approximately 21 to 30 grams of fiber daily.
Good sources of fiber
A good source of fiber is a food containing 2.5 to 5+ grams per serving. High fiber sources may include ½ cup of bran cereal containing 5 - 8 grams of fiber, ½ cup of cooked black or kidney beans with 7.5 grams of fiber, and baked unpeeled sweet potato with 5 grams. When looking at bread labels, anything with 2 grams of fiber or less is considered low fiber.
Additional recommendations for getting fiber ito your diet:
- Fill 75% of your plate with fruits, vegetables, whole grains
- Eat legumes two to three times per week
- Try main dishes with beans rather than meat
- Eat the skins of fruits and vegetables
- Choose healthy snacks including fresh fruits, vegetables, low-fat popcorn, dried fruits, and nuts
- Add fiber gradually to your diet, allowing time for your digestive tract to adjust and preventing gas, cramps, or bloating.
- Written by Karen Lentner, MA, RD, LDN
Sodium and salt: how much is right for me?
When you think of sodium, does salt come to mind? Sodium is a mineral our bodies need in small amounts for many functions; generally it comes from our food. The sodium in foods is mostly sodium chloride, or table salt, but foods can also contain sodium naturally. Salt may preserve our foods and improve texture, but most often it is used to make foods more flavorful.
Research suggests there’s a link between high sodium intake and medical conditions including high blood pressure, heart disease, and stroke.
Has your doctor told you to “stay away from salt” or follow a low-sodium diet? If the answer is yes, it is important that he clarifies how much sodium is acceptable for you. There is a difference between a no-salt, low-salt, or no-added-salt diet. The new Dietary Guidelines for Americans recommends consuming no more than 2,300 mg of sodium per day as part of a healthy eating pattern. The average consumption is often much higher. If your doctor has recommended limiting your sodium to 2,000 mg per day, what does this mean for you?
The salt you use at the dinner table is often not your biggest source of sodium; however, one teaspoon of salt contains 2,300 mg of sodium. Often the major source of the sodium consumed comes from processed foods, grains, and meat. Think about what you eat and be aware of your total sodium consumption for the entire day.
Did you know one slice of bread contains 80 to 250 mg of sodium; a slice of frozen pizza, 500+ mg sodium; half cup canned soup, up to 900 mg of sodium?
Tips for managing your sodium consumption:
- Learn to read labels on foods; select items with less sodium.
- Start your day with lower-sodium cereals and breads.
- Choose fresh, frozen, or canned items without added salt.
- Limit salted snacks, bacon, luncheon meats, hot dogs, diet soda, and packaged seasonings.
- Avoid or reduce salting food during cooking.
- Cook rice, pasta, and oatmeal without salt; avoid instant or flavored mixes.
- Limit ketchup, pickles, soy sauce, and sauces containing salt.
- Use herbs, no-salt seasoning blends, spices, flavored vinegars, or lemon or lime juice for seasoning. Try growing fresh herbs!
- Choose fruit for snacks as they often don’t contain sodium.
LifePath offers meals at congregate sites and home-delivered meals planned by a licensed dietitian with sodium content of each item posted on monthly menus. Any menu item 500 mg of sodium or higher is marked on the menu, with no more than two high-sodium days per month. If this is your main meal of the day, you are likely not eating too much sodium, and reading food labels will help you determine what to eat for the rest of the day.
Think about what you eat, try new herbs and spices, and enjoy. Bon Appétit!
- Written by Karen Lentner, MA, RD, LDN
Healthy eating for older women
March is National Nutrition Month, a campaign created by the Academy of Nutrition and Dietetics to focus attention on healthful eating and developing long-term sound eating and physical activity habits. The theme for 2016, “Savor the Flavor of Eating Right,” encourages everyone to appreciate the pleasures, flavors, and social experiences food can add to our lives. On March 8, we also recognize International Women’s Day, celebrating the achievements of women. In honor of Nutrition Month and women, let’s take a look at nutrition recommendations for aging women.
It’s never too late to improve your diet! As we age, the benefits of adopting a healthy diet include increased energy, increased resistance to illness, decreased stress, and helping you look and feel your best physically and mentally so you can enjoy your life.
Healthy Eating Suggestions:
- Eat a variety of foods.
- Balance the food you eat with physical activity; maintain healthy weight.
- Eat plenty of whole grains, vegetables, fruits, water.
- Select foods low in sugar and salt.
Many older women need fewer calories than they did in their younger years. A sedentary woman over 50 needs approximately 1600 calories daily, while an active woman needs 2000+ calories.
How much protein do women need? A woman over 50 weighing 140 pounds needs at least 64 grams of protein daily. Select poultry, dairy, beans, fish, limiting red and processed meats. Add beans to soups and stews and snack on nuts, seeds, and yogurt instead of cookies or chips.
Whole grains, fiber, “good” carbohydrates: Many people think they should eliminate carbohydrates to lose weight or control diabetes. Carbohydrates are an important part of a healthy diet and shouldn’t be eliminated. “Good” carbohydrates are high in fiber, help make you feel full longer, and include high fiber cereals, whole grains, and brown rice. Fiber benefits digestive health and can lower your risk of diabetes and other diseases. Other fiber sources include nuts, seeds, fruits, and vegetables.
Bone health: As women are at risk of developing osteoporosis, calcium and vitamin D are crucial for bone health. Calcium sources include dairy, green leafy vegetables, and calcium-fortified cereals and orange juice. Vitamin D sources include sunlight, salmon, and dairy, however supplements are often necessary.
Choose healthy fats, including olive oil, avocado, and salmon, to protect against heart disease.
Don’t eat alone or skip meals. Sometimes it’s easier to eat unhealthy food. Eating with others helps you enjoy meals and eat healthier. As the Academy of Nutrition and Dietetics suggests, “How, when, why and where we eat are just as important as what we eat. Develop a mindful eating pattern that includes nutritious and flavorful foods.”
Consider joining us for a meal at one of our dining centers (find a complete list on LifePathMA.org) or call LifePath to set up Meals on Wheels: 413-773-5555 or 978-544-2259.