February 2020 - Proportion Foods
Proportion Foods - Nutrition for Active and Healthy Aging

Nutrition for Active and Healthy Aging

My title page contents

Plants, protein and vegetarians

Posted by ProPortion Foods Blog on Feb 26, 2020 in Aging, Protein, Sustainability

“But where do you get your protein from?” This is a common question of vegetarians, perpetuated by a long-standing myth that if you don’t eat your meat you will become weak and emaciated.

 

This myth has been well and truly busted – but it doesn’t mean that people who eschew meat can rest on their laurels. Like all older adults, vegetarians need to be mindful of meeting their protein needs.

 

 

Protein matters

 

It is true that we need protein, even more so with aging. While Australian guidelines spout 0.75g/kg bodyweight per day, this falls short of international guidelines stipulating 1.2g/kg for older adults – and recent evidence putting it as high as 1.5g/kg.

 

These levels help counteract diminishing lean muscle mass and strength that occurs with aging, reducing risk of sarcopenia and associated falls, fractures, hospital admissions, declining independence and mortality.

 

And it’s not just muscles that need protein. These industrious amino acid assemblages support wound healing, bone density, immunity, lung function and cognition.

 

So how do vegetarians get theirs?

 

 

Unravelling plant protein

 

When combined with exercise, research shows it doesn’t matter which type of protein people eat – plant, animal or otherwise – to boost muscle health.

 

But while plant sources comprise 40% of the world’s protein intake, Australians get 60% of theirs from animal origins.

 

And although the Australian Guide to Health Eating recommends legumes as a primary protein source for vegetarians, a review found that legumes constitute a meagre 0.44% of diets in aged care facilities – served with meat.

 

Even for non-vegetarians, legumes are a no-brainer – they are cheap, versatile, packed with nutrients and fibre and one of the best solutions to soft-textured diets for older adults with swallowing or chewing difficulties.

 

The scrumptious, wholesome meals that can be cooked with legumes are only limited by the imagination, ranging from a vast range of soups and vegetable patties to dals, dips and casseroles.

 

Other non-meat sources of protein abound too, including eggs, milk, cheese, nuts, wholegrains, seeds and hemp.

 

For older adults with higher protein needs due to poor appetite, declining muscle mass and strength or illness, eggs and dairy (cream or milk powder) can be used to fortify meals and make a great base for snacks.

 

Beyond protein, evidence suggests that a good quality diet is most important for preventing frailty and fragility, providing all the nutrients, polyphenols and fibre essential for good health.

 

After addressing dietary needs, some nutrition supplements might be advisable. Vegetarians and vegans would benefit from an algal source of the long chain omega-3 fatty acid DHA that is consumed directly through deep-sea fish.

 

Vegans may need supplementation to meet requirements for Vitamins D and B12. Pea protein can be used as a concentrated protein source where needed. Contrary to popular opinion, there is plenty of iron in plant foods – including legumes.

 

 

What it means for residential aged care

 

With a growing population embracing various diets without animal-sourced food – for health, ethical or environmental reasons – aged care facilities need to step up and leave the antiquated “meat and three veg” behind.

 

Special diets aside, the variety and quality of food provided in residential care is in dire need of an overhaul to address nutritional, cultural and personal needs and preferences in a way that enhances appetite and the social bonding that can only come from sharing a tasty meal in a pleasant environment.

 

 

References

 

https://www.mja.com.au/journal/2013/199/4/protein-and-vegetarian-diets

https://www.nutritionsociety.org/papers/can-plant-based-proteins-support-healthy-musculoskeletal-ageing

https://www.reuters.com/article/us-health-diet-aging/cutting-back-on-vegetable-protein-tied-to-unhealthy-aging-idUSKCN1VB1ZB

https://www.theguardian.com/lifeandstyle/2020/jan/09/counting-beans-why-2020-should-be-the-year-of-the-legume?CMP=Share_iOSApp_Other

https://theconversation.com/why-iron-is-such-an-important-part-of-your-diet-69974

 

 

 


 

Cost of Malnutrition 

Our Cost of Malnutrition report outlines the problem of malnutrition and its various costs – both financial and physical – and offers a guide to its identification and management.

Download your free report HERE

 


 

Exercise in a pill?

Posted by ProPortion Foods Blog on Feb 20, 2020 in Exercise, Mobility, Muscle, Protein

Some people will do anything to get out of doing exercise, and researchers are scrambling to oblige, showing physical health benefits – in mice and flies, that is – of isolated proteins that could potentially be taken in a pill.

 

 

The research

 

Noting that a naturally occurring protein called Sestrin builds up in muscles after a heavy physical workout, scientists from the University of Michigan were curious to see if boosting Sestrin levels could produce the same health benefits without exercise.

 

They tested this in three groups of Drosophila flies, two of them bred either unable to produce Sestrin or saturated with it, and a normal group for comparison.

 

They were all put on a makeshift fly treadmill for three weeks.

 

“Flies can usually run around four to six hours at this point and the normal flies’ abilities improved over that period,” says researcher Jun Hee Lee.

 

But the flies without Sestrin showed no improvement with exercise, while those with maxed-out Sestrin levels showed superior abilities to the trained flies, even without working out – and exercising them didn’t increase their endurance.

 

They note studies with mice also found that Sestrin improved aerobic capacity, respiration and fat burning – all benefits associated with exercise.

 

Other researchers at Augusta University, US, targeted a different protein, myostatin, that inhibits muscle growth, testing lean and obese mice that couldn’t make the protein.

 

Both groups bulked up, but the obese mice had similar metabolic and heart health indicators to the lean mice, and better than obese mice that could produce myostatin.

 

“While much more research is needed, at this point myostatin appears to be a very promising pathway for protection against obesity-derived cardiometabolic dysfunction,” says researchers Joshua Butcher.

 

 

And beyond…

 

Assuming that you can extrapolate these findings to humans – which itself could be drawing a long bow – researcher and sports dietitian Karen Murphy, from the University of South Australia, expresses concern about replacing exercise with a pill.

 

“There are multitudes of benefits to physical activity beside burning muscle, like heart health, physical health, weight control, mental health and social interaction,” she says. Even cognitive decline can be buffered with exercise, as well as bone density.

 

And many other nutrients are essential for wellbeing and muscle mass.

 

“Most people consuming a balanced diet, with foods from all food groups in the right portions, will have little need for a supplement,” says Murphy.

 

High quality protein is particularly important for muscle wasting that occurs with age, as well as maintaining mobility and healthy bones.

 

“For some populations an added supplement that boosts muscle synthesis might help such as in elderly populations where muscle wasting is seen. However, to build muscle you also have to work the muscle.”

 

Essentially, for people who genuinely can’t exercise, there could be some benefits to pills – but they still can’t replace all the other benefits of moving your body.

 

Even incapacitated people with dementia can derive surprising benefits from personalised movement.

 

And in a world where people are moving less, getting active is more important than ever.

 

 

References

 

https://newatlas.com/health-wellbeing/exercise-sestrin-protein/

https://newatlas.com/exercise-pill-myostatin-protein-suppression-mice-augusta/49258/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4208946/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3381813/

 

Junk food in aged care

Posted by ProPortion Foods Blog on Feb 17, 2020 in Aged Care, Malnutrition, Nutrition, Supplements

While malnutrition is an insidious problem in aged care, simply giving residents more biscuits and cake is not the answer.

 

Yet that is what many residential facilities are doing, according to research in Melbourne presented at the Royal Commission into Aged Care Quality and Safety.

 

 

Skimping on protein

 

In fact, the study added to evidence that aged care facilities have been spending less on food, and in the process skimping on high protein sources – critical with aging to prevent disability and malnutrition.

 

Previous research by the group found that two thirds of residents were malnourished or at risk of malnutrition – and inadequate protein was a major factor.

 

Essentially, the facilities they researched only provided one serve of high-protein food, such as lean meat, seafood, eggs, poultry and legumes per day – only half of the recommended two serves every day.

 

Dairy protein only amounted to one serve each day, falling well short of the recommended four servings.

 

At the same time, the amount of “discretionary foods” high in sugar, refined carbohydrates and unhealthy fats and devoid of nutrients has increased.

 

So while centres might be trying to save costs, it’s a false economy, lead researcher Dr Sandra Iuliano argues.

 

Malnutrition results in a host of poor outcomes including bed sores, falls, poor wound healing and general immunity.

 

This is not only debilitating for sufferers; it also increases hospital stays, estimated to add nearly $1,800 to the cost of each admission.

 

 

Putting things right

 

Some argue that a ban on junk foods in health care facilities is a good start, and research shows it helps shape behaviour and improve diets.

 

For aged care, where a healthy diet is most critical, mandatory nutrition standards would help lift and standardise the quality of food and nutrition provided – with a particular focus on delivering quality protein.

 

As we age, protein becomes increasingly important to prevent loss of muscle mass and related problems including frailty and sarcopenia.

 

Beyond protein, poor and medium quality diets have been associated with 92% and 40% greater incidence of frailty, respectively, than a high quality diet.

 

Lifestyle factors such as diet and exercise can also reduce the risk of dementia.

 

Supporting older adults to eat healthy food – even just one extra meal a day – can save lives, and even replace a big chunk of unnecessary, expensive and harmful drugs.

 

Enhancing the dining experience would help overcome many obstacles to eating well, such as improving the sensory experience, and making food more appealing through greater choice, communal dining, cooking smells and attractive food presentation.

 

Some centres have even engaged residents with cooking to help stimulate appetite with foods they are familiar with – an enjoyable, social and stimulating activity with multiple rewards.

 

As Sandra Iuliano says, “It’s not about adding years to life; it’s about adding quality to the years they have.”

 

 

References

 

https://www.aihw.gov.au/reports/food-nutrition/nutrition-across-the-life-stages/contents/summary

https://www1.racgp.org.au/newsgp/professional/aged-care-residents-nutrition-a-false-sense-of-sec

https://pursuit.unimelb.edu.au/articles/nourishing-old-age

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350609/

 

Farmacy – food as medicine

Posted by ProPortion Foods Blog on Feb 10, 2020 in Nutrition, Research

Prescribing food could be as cost-effective – if not more so – than common drug treatments while delivering significant health benefits, according to research published in PLOS Medicine.

 

The study rides on a wave of interest in food as medicine – “farmacy” rather than pharmacy – by doctors, hospitals and insurers as drug treatments for food-related illnesses like diabetes, heart disease and cancer fail to fulfill their promise.

 

 

Cost and health benefits

 

The researchers modelled the economic and health benefits of subsidising 30 percent of fruit and vegetable and 30 percent of wholegrains, nuts/seeds, seafood and plant-based oils.

 

Results showed that fruit and vegetable subsidies could avert nearly two million cases of heart disease while the wider incentive could prevent more than three million people from developing heart disease and 120,000 from getting diabetes.

 

The cost savings were also staggering – the resulting reduced use of health care services saved nearly US$40 billion and more than US$100 billion, respectively, confirming the cost-effectiveness of such an intervention.

 

“These new findings support the concept of Food is Medicine,” says lead author Dariush Mozaffarian; “that innovative programs to encourage and reimburse healthy eating can and should be integrated into the healthcare system.”

 

 

What about reality?

 

In reality, how likely are people to eat healthier food if it were subsidised?

 

One of the biggest barriers is access, and that’s where prescribing and subsidising food can make a difference.

 

Nutrition and cooking education might help as well – and is effective, as shown by research such as Australian studies Helfimed and SMILE.

 

These two interventions gave people suffering major depression food hampers and nutrition education, and in Helfimed they received cooking workshops. Both studies showed significantly improved diets in the treatment arm.

 

Depression symptoms decreased as well, suggesting that even psychiatrists could start prescribing diet.

 

Other research has found health benefits from food prescription programs, including lower blood sugar levels in people with diabetes, weight loss and increased intake of fruit and vegetables.

 

Having a GP validate and promote diet as a treatment could also be powerful.

 

“People may be more likely to make a behaviour change if the recommendation comes from their healthcare provider,” says Associate Professor Heidi Wengreen, “as part of a treatment plan for conditions such as diabetes, heart disease, high blood pressure, or obesity.”

 

Already, some doctors have started prescribing diet in the US, such as the Food Farmacy program at Nunnalee Pediatric Specialty Clinics in North Carolina.

 

 

Food and aging

 

Older adults, who often can’t afford healthy food, could derive even greater benefits from diet prescriptions. Poor diet has been linked to frailty with aging, associated with spiralling loss of strength, mobility and quality of life.

 

Even one extra meal a day could save lives.

 

Added to that, a healthy diet could displace the multiple medicines that are being prescribed to older adults, with many negative consequences.

 

Changing the culture of drug prescriptions could require an overhaul of the insidious and far-reaching influence that pharmaceutical companies have on clinical practice.

 

And although nutritional supplements might be a welcome alternative in some cases, nothing can replace a wholesome diet.

 

 

References

 

https://time.com/longform/food-best-medicine/

https://www.sciencedaily.com/releases/2019/03/190319163532.htm  http://www.fimcoalition.org/

https://www.geisinger.org/freshfoodfarmacy

https://www.healthline.com/health-news/heres-how-healthy-food-prescriptions-could-save-lives-and-money#Food-prescriptions-target-food-insecurity

https://www.hsph.harvard.edu/news/hsph-in-the-news/food-as-medicine/

https://www.tandfonline.com/doi/full/10.1080/1028415X.2017.1411320

https://foodandmoodcentre.com.au/smiles-trial/

 

 


 

Cost of Malnutrition 

Our Cost of Malnutrition report outlines the problem of malnutrition and its various costs – both financial and physical – and offers a guide to its identification and management.

Download your free report HERE

 


 

Page 1 of 2
1 2