By JUDD MATSUNAGA, Esq.
I have two goals in life. The first goal is to live to be 100 years old. My second goal is to bowl a perfect 300 game. My bowling friends tell me I have a better chance of living to 100. Of course, if I do make it to 100, I want to be of sound mind and hopefully — still walking. So science and research says there are things I can do (or not do) to increase my odds.
This article is the second of a two-part series on successful aging. This one will cover: (1) the importance of nutrition; and (2) foods that are good for the brain. Loss of appetite can result from several different factors, such as difficulty swallowing, lack of exercise, seemingly tasteless food, side effects of medications. This ultimately leads to a major problem in the older adult population — malnutrition.
Almost 50% of older Americans are malnourished. In our country, senior malnutrition is an epidemic hiding in plain sight. Because malnutrition generally occurs over time, you cannot suspect malnutrition from just looking at someone. That is why malnutrition hides in plain sight (Source: https://acl.gov/news). Also, because the outward signs are the same as problems associated with age — falling, anemia, slow healing, and fragile bones — it can escape notice.
Malnutrition greatly affects one’s abilities to remain healthy, especially when faced with a serious health situation. In fact, approximately 30% of older people admitted to the hospital arrive malnourished and being malnourished while in the hospital will generally increase the length of stay.
Fortunately, there are changes that you can watch for that serve as clues:
● Clothes looking loose or baggy.
● Eating less at meal time.
● Failing strength, wobbly walking or weakened hand grip.
● Changes in denture fit, or dentures that appear to be floating in the mouth.
● Unintentional weight loss of 5% of body weight or more per month.
If you notice any of these changes in your aging loved one, be concerned. The Internet has lots of helpful information on senior eating tips and malnutrition. If your aging loved one has Alzheimer’s or other dementia, here are 12 tips on eating that come from the Alzheimer’s Association (https://www.alz.org/help-support/caregiving/daily-care/food-eating):
(1) Bite-size pieces.
Prepare foods so they aren’t hard to chew or swallow. Grind foods, cut them into bite-size pieces or serve soft foods (applesauce, cottage cheese and scrambled eggs).
(2) Be alert for signs of choking.
Avoid foods that are difficult to chew thoroughly, like raw carrots. Encourage the person to sit up straight with his or her head slightly forward. If the person’s head tilts backward, move it to a forward position. At the end of the meal, check the person’s mouth to make sure food has been swallowed. Learn the Heimlich maneuver in case of an emergency.
(3) Address a decreased appetite.
If the person has a decreased appetite, try preparing some of his or her favorite foods. You may also consider increasing the person’s physical activity or plan for several small meals rather than three large meals.
(4) Limit distractions.
Serve meals in quiet surroundings, away from the television and other distractions.
(5) Keep the table setting simple.
Avoid patterned plates, tablecloths and placemats that might confuse the person. Using color to contrast plates against a tablecloth or placemat can make it easier for the person to distinguish the food from the plate or table. Consider using a plastic tablecloth, napkins, or aprons to make cleanup easier. Provide only the utensils needed for the meal to avoid confusion.
(6) Distinguish food from the plate.
Changes in visual and spatial abilities may make it tough for someone with dementia to distinguish food from the plate or the plate from the table. It can help to use white plates or bowls with a contrasting color place mat. Avoid patterned dishes, tablecloths, and place mats.
(7) Check the food temperature.
A person living with dementia might not be able to tell if something is too hot to eat or drink. Always test the temperature of foods and beverages before serving.
(8) Offer one food item at a time.
The person may be unable to decide among the foods on his or her plate. Serve only one or two items at a time. For example, serve mashed potatoes followed by the main entree.
(9) Be flexible with food preferences.
It is possible the person may suddenly develop certain food preferences or reject foods he or she may have liked in the past.
(10) Allow plenty of time to eat.
Keep in mind that it can take an hour or more for the person to finish.
(11) Eat together.
Give the person the opportunity to eat with others. Keeping mealtimes social can encourage the person to eat.
(12) Keep in mind the person may not remember when or if he or she ate.
If the person continues to ask about eating breakfast, consider serving several breakfasts — juice, followed by toast, followed by cereal.
Secondly, if loss of appetite is a contributing problem, it might be a good idea to make sure that what is consumed is nutritious and good for the brain. Nutritionists emphasize that the most important strategy is to follow a healthy dietary pattern that includes a lot of fruits, vegetables, legumes, and whole grains. Try to get protein from plant sources and fish and choose healthy fats, such as olive oil or canola, rather than saturated fats.
Harvard Medical School published an article titled “Foods” linked to better brainpower
(March 6, 2021). Of all your organs, your brain takes the most energy. Your body requires healthy food with certain nutrients and vitamins to fuel your brain. These nutrients help build brain structure, keep cells working, and help you learn, think, and do tasks. Research shows that the best brain foods are the same ones that protect your heart and blood vessels, including the following:
● Green, leafy vegetables.
Leafy greens such as kale, spinach, collards, and broccoli are rich in brain-healthy nutrients like vitamin K, lutein, folate, and beta carotene. Research suggests these plant-based foods may help slow cognitive decline.
● Fatty fish.
Fatty fish are abundant sources of omega-3 fatty acids, healthy unsaturated fats that have been linked to lower blood levels of beta-amyloid—the protein that forms damaging clumps in the brains of people with Alzheimer’s disease. Try to eat fish at least twice a week, but choose varieties that are low in mercury, such as salmon, cod, canned light tuna, and pollack. If you’re not a fan of fish, ask your doctor about taking an omega-3 supplement, or choose terrestrial omega-3 sources such as flaxseeds, avocados, and walnuts.
Flavonoids, the natural plant pigments that give berries their brilliant hues, also help improve memory, research shows. A study done by researchers at Harvard’s Brigham and Women’s Hospital found that women who consumed two or more servings of strawberries and blueberries each week delayed memory decline by up to two-and-a-half years.
● Tea and coffee.
The caffeine in your morning cup of coffee or tea might offer more than just a short-term concentration boost. In a 2014 study published in **The Journal of Nutrition,** participants with higher caffeine consumption scored better on tests of mental function. Caffeine might also help solidify new memories, according to another research. Investigators at Johns Hopkins University asked participants to study a series of images and then take either a placebo or a 200-milligram caffeine tablet. More members of the caffeine group were able to correctly identify the images on the following day.
Nuts are excellent sources of protein and healthy fats, and one type of nut in particular might also improve memory. A 2015 study from UCLA linked higher walnut consumption to improved cognitive test scores. Walnuts are high in a type of omega-3 fatty acid called alpha-linolenic acid (ALA). Diets rich in ALA and other omega-3 fatty acids have been linked to lower blood pressure and cleaner arteries. That’s good for both the heart and brain.
In conclusion, if you’ve noticed a change in your loved one’s appetite or weight, make an appointment with the doctor. Ask the doctor or other health professional how to improve appetite. Ask if any current prescriptions might be suppressing appetite, if a prescription change could increase appetite, and/or whether nutritional supplements are needed.
If you are present during the appointment, your participation should depend on how well your loved one can carry and comprehend the conversation. Let your loved one take the lead. Your job is to: (1) Arrive with written questions; (2) Take notes; (3) Clarify questions and answers; and (4) Let unwelcome orders come from the medical provider (doctors are more easily forgiven than relatives and friends).
You may request the name of a nutritionist or dietician specializing in geriatrics for a nutritional evaluation. A Nutritional Risk Screening (NRS) and a Mini Nutritional Assessment (MNA) can help to determine if your loved one (i.e., the patient) has or is at risk of malnutrition.
Finally, remember the other things you can do that can help you stay fit and have a healthier brain: (1) Don’t drink alcohol; (2) Quit smoking; and (3) Stay active.
Judd Matsunaga, Esq., is the founding partner of the Law Offices of Matsunaga & Associates, specializing in estate/Medi-Cal planning, probate, personal injury and real estate law. With offices in Torrance, Hollywood, Sherman Oaks, Pasadena and Fountain Valley, he can be reached at (800) 411-0546. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.