Poor nutrition puts elderly at risk

By Judy Siegel-Itzkovich

The Jerusalem Post, October 13, 2002

Many elderly people are eating too little - and what they do eat often doesn't contain the minimum nutrients necessary for health.

This is the conclusion of a Maccabi Health Services' study of a representative sample of 158 Tel Aviv residents over the age of 70.

The researchers - dietitians Ronit Endevelt, Yehudit Zamir, Danit Shahar, Drorit Sirkis and Prof. Jacob Menczel - write about their findings for the Israel Medical Association's Hebrew-language journal Harefuah.

Of those surveyed, eight percent ate fewer than 800 calories a day, while 33% ingested fewer than 1,200. Men over 65 should be getting an average of 1,836 calories daily, while women of this age group should be eating 1,610 calories. Their caloric deficiency exists despite the fact that nine out of 10 said they eat three meals a day. This minimal amount of food, the authors stressed, is inadequate to provide all the minerals, vitamins and trace elements needed to maintainhealth.

People over 70 constitute 10% of the Israeli population, and their share is constantly increasing. Pensioners are responsible for 40% of all medical expenditures. Thus, say the authors, improving the diet of the elderly and preventing diseases can result in less use of medical services. and a major saving of money. Among younger people, overweight causes diseases, but in older people, the opposite is true. A diet with inadequate amounts of B vitamins, for example, can cause symptoms of dementia that are reversible if the person gets the right food.

The researchers found that the older people had the largest deficiency in dietary calcium, vital for reducing the bone-thinning and sometimes fatal condition of osteoporosis. Recommended calcium consumption in this age group was 70% higher than the amount they actually consumed.

The reasons why the elderly do not get the nutrients they need are not clear, the Maccabi researchers write. Some explanations offered are that older people feel satiated sooner than younger people and don't eat after they no longer feel hungry. Because the taste buds are weakened in old age, they may not enjoy food as much as younger people. Dental problems may cause trouble chewing; people living alone are generally not able to cook or don't have the strength to do much shopping; and their appetite may be reduced by depression, which is common among the elderly.

"At a time when health system costs are mushrooming, there is great importance in locating and eliminating risk factors for disease. So identifying risk factors in the elderly, who use much of the nation's medical services, is very important," they conclude. "We must continue to investigate the influence of improved nutrition on health and disease and determine if a deterioration in one's nutrition causes disease or the opposite."

ERAN ON-LINE - The voluntary organization ERAN, which has run an emotional first aid phone service for decades, now offers help to those who seek it anonymously over the Internet. Located at www.1201.org.il, it is available in Hebrew and English. People who want to write about their personal problems can do so without identifying themselves by entering the ERAN forum section; responses from trained volunteers will follow. Troubled people who have no Web access or who prefer to hear a human voice can continue to call the organization's toll-free number at 1201.

WHAT'S TO EAT - What refreshments do you serve at an all-day US medical conference on American obesity? A typical academic event's menu might include bagels and cream cheese in the morning, a lunch of tuna sandwiches with potato salad and soda pop and an afternoon snack of cookies, brownies and fruit. But organizers of the September 30 event at the University of Michigan's School of Public Health thought such a menu was inappropriate for the topic.

Gone were donuts and cream-cheese danish, with muffins in their place - not butter-laden, cake-like affairs, but low-fat, higher-fiber treats. No carbonated beverages found their way to the event, with water, juices and low-fat milk offered instead. In a concession to one American addiction, Anita Sandretto, director of the school's human nutrition program and organizer of the symposium, allowed coffee and tea.

When attendees registered for the event on-line, they were allowed to select not only which breakout sessions they planned to attend but also which lunch they preferred - and they found detailed nutritional information about each option before they chose. The menu represented a more healthful selection than usual conference fare, with an emphasis on lower calorie items and fresh, rather than processed, ingredients. Grilled, herbed vegetables rolled in flat bread was one choice, along with foccacia topped with grilled chicken."We always need to realize that people eat with all their senses and their psyche as well. We have to balance our waistline concerns with taste. If it tastes like cardboard, it won't be consumed, even if it has a great nutrient profile," Sandretto said.

PIE IN THE SKY - Do you know anyone with the surname Cialis? If so, you might invite him or her to join a lawsuit against the Eli Lilly pharmaceutical company, which is about to launch a so-named pill for impotence. The drug, generically known as tadalafil, is slated to be the "new Viagra" and much more effective. The company claims that men with persistent erectile dysfunction reported an improved ability to achieve erections up to 24 hours after taking the drug, allowing couples to regain a more spontaneous sex life. It's due to be launched with a worldwide publicity campaign next year, once it has approval from the US Food and Drug Administration. A Formula One racing car driven by Christian Fittipaldi, currently bearing the Eli Lilly logo, will race under the Cialis brand.

But the Cialis family, which has branches in the United Kingdom, France, Australia, and Canada, says that it will become the butt of jokes and abuse. If the Cialis family succeeds in getting the product renamed, it will cost Eli Lilly around $1.5 million to rebrand the product for launch and promotion in the UK alone.