Food & Fitness After 50: How to Age Well While Living with a Chronic Disease

Meet Mike, a 64-year old artist who weighs the same as he did when he was in high school. How many of us can say that? Many of us over 50 live with chronic diseases, but Mike has been dealing with a serious disease since he was diagnosed with Type 1 diabetes 34 years ago, at the age of 30. Most of you have heard of diabetes, but did you know that only 5% of the people with diabetes have Type 1? In this form of diabetes, no insulin is produced so Mike must give himself multiple daily insulin shots to survive. Insulin acts like a key to allow glucose (sugar) to enter cells to produce energy. Without insulin, his blood sugar can reach dangerously

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Illustration by Mike

high levels, while his cells starve because they can’t use glucose. (Fun fact: Prior to 1982, insulin was produced from the pancreas of cows or pigs; it wasn’t a very efficient process. To get 8-ounces of insulin, 2 tons of pig pancreas had to be processed. In 1982, genetic engineering (or GMO, if you’ve heard of that term) produced the first purified insulin from bacteria for human use. The technique is called recombinant DNA and the genetically engineered insulin has greatly reduced allergic reactions from cow or pig insulin. It is a modern medical miracle for those with diabetes.) For those who want to know more about all types of diabetes, the American Diabetes Association is a great resource (American Diabetes Association).

The pillars of management for Type 1 diabetes are insulin, diet, and activity. So, how does Mike eat and stay active to manage diabetes?

“I eat as good as I can,” he says, but doesn’t follow the old school notion of a diabetes diet. He counts carbs to help him adjust his insulin dose to match food intake. He eats peanut butter toast most mornings, but is trying to add more protein to his breakfast. He keeps his snacks simple and healthy; a small apple, pear, or handful of raisins and nuts. He has learned that portion size is key to managing his blood sugar levels.  As for meals, he “can make a whole meal out of a steamed bunch of broccoli.” He enjoys a couple of beers most days, with his favorite food, peanuts. He doesn’t eat a lot of meat, but gets protein from nuts, beans, rice, and fish, especially sardines (a good source of omega-3-fats). “I want to eat as healthy as I can to manage my blood sugar and avoid the complications of diabetes. I want to be around for a long time so I can hang out with my 4-year old grandson and watch him grow.”

Mike doesn’t belong to a gym or “exercise” in the way many of us do; he gets his exercise by walking and biking because he doesn’t own a car. “Biking to the grocery store is great exercise because I carry the groceries home in my backpack; I’m not tempted to buy things I don’t really need.” He also sees house and yard work as exercise. “Scrubbing floors and using an old-fashioned push mower to cut the grass” is seen, not as a chore, but as exercise.

Mike’s goal is simple: “feel good, not gross.” I’d say he is meeting his goal!

Chris Rosenbloom and Bob Murray’s new book, Food & Fitness After 50, is available for pre-order through Amazon (preorder link).

Why this dietitian promotes healthful eating and exercise for those over 50

When talking about food and fitness for those over 50, it is the best of times, and sometimes the worst of times. Everyone want to know the ”best” exercise or food to eat to prevent aging. A quick Google search will provide you with many answers, unfortunately most of them are less than science-based and are usually trying to separate you from your money. Let’s be clear: there is no one superfood or exercise that will prevent aging.

That is why, I am excited to launch Food & Fitness After 50, with co-author, exercise book-front-pagephysiologist, Bob Murray. The book will be published later this year. While there might not be a “best” exercise or food, that doesn’t mean that food and fitness are unimportant as we age. You can be healthier at 65 than you were at 45 by eating well and starting (or increasing) your physical activity. This is important because so many of us are living longer. Baby boomers, those born between 1946 and 1964, began turning 65 in 2011 and by 2029 when all boomers will be 65, more than 20% of the population will be over 65. Why is 65 an important number? Because people reaching age 65 have an average life expectancy of 19.3 years (20.5 years for women and 18 years for men). How do you want to spend those 20 years? Do you want to travel, enjoy your favorite physical activities, and be a vibrant person in the lives of your grandchildren and great grandchildren? I am sure that we all want that, so being active and eating healthfully are steps you can take right now to increase your odds of being healthy into your later years.

Just this week, The Journal of the American College of Cardiology published an article on nutrition controversies in preventing heart and blood vessel disease. The article can be found here  http://www.onlinejacc.org/content/69/9/1172?_ga=1.183783078.1620905078.1488293025 and here is an easy to guide to see their recommendations.

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While their article focused on heart disease, our book covers many healthful eating patterns to keep your heart, bones, joints, blood sugar, blood pressure, and brain healthy. Remember there isn’t one “best” eating plan. So, we feature four plans that we think most older adults will find fit their lifestyle and their enjoyment of foods:

  • The DASH eating plan (DASH stands for Dietary Approaches to Stop Hypertension)
  • The Flexitarian plan
  • The Mediterranean Diet
  • The MIND diet (MIND stands for Mediterranean- ASH Intervention for Neurodegenerative Delay)

We also dive into exercise for endurance, strength, agility, balance, and functional fitness. Keeping our heart and lungs strong, halting muscle loss, and keeping agile all contributes to functional fitness….the ability to do the things you did when you were younger without a second thought. I want to be able to lift my suitcase in the overhead bin when I travel and pick up a 50-pound bag of dog food, all examples of functional fitness. Age-related muscle loss usually starts at about age 40. We can lose 10-15% of muscle mass and muscle strength every decade if we don’t engage in progressive, resistance exercise.

We hope that our book can help those over 50 learn to separate usual aging from the disuse of a sedentary lifestyle and sort out the fact from fiction about foods. Please visit our webpage to learn more about the book and leave us a question that you might see featured in an upcoming blog post. Web page for Food & Fitness After 50

 

 

 

 

There is Good News on Beef

Americans love beef but some media headlines have frightened consumers into thinking that only “white” meat is healthful. A new study from Penn State University researchers shows that lean beef when part of a heart healthy diet can lower total and low density lipoproteins (LDL or “bad” cholesterol) and even lower markers of inflammation. The key is choosing the leanest cuts of beef, paying attention to preparation in the kitchen and watching portion size. And that is good news for all of us who love beef.

The BOLD study (Beef in an Optimal Lean Diet) was conducted with adult men and women with elevated total cholesterol and LDL-cholesterol (LDL levels ranged from 110 to 177 milligrams) with different diets prepared in a test kitchen (that means it was a well-controlled diet study). None of the study participants were on cholesterol-lowering medications. The diets studied included the DASH (Dietary Approaches to Stopping Hypertension) which contained only 1 ounce of beef a day and the BOLD and BOLD plus diets contained 4 and 5 ounces of lean beef, respectively.

Weight remained constant during the study (losing weight in itself can lower blood lipid levels so monitoring weight was a positive aspect of this study) and researchers found about a 5% reduction in LDL-cholesterol when the BOLD and BOLD plus diets were consumed, similar to the DASH diet. Researchers also noted that a marker of inflammation (CRP) was lower in those who had the highest levels of blood cholesterol and LDL-cholesterol.

The take away from this study is that lean beef can be part of a heart-healthy diet. While there are 29 cuts of lean beef that meet the criteria for lean meat, the study authors note that most grocery stores carry top loin and top round steak, top sirloin bottom round roast and 95% lean ground beef.

There is another good reason to include lean beef in your diet…a 4-ounce serving is an excellent source of the nutrients that are often low in the diets of the 50+ population: protein, B-vitamins niacin, B6 and B12 and minerals zinc and selenium. It is also a good source of choline, phosphorus, and iron. Beef is nutrient rich and many cuts of beef are 20% leaner than 15 years ago, according to the USDA.

It is important to keep portions moderate (4-5 ounces). Good ways to incorporate lean beef in your diet is by making kabobs with plenty of veggies, slicing lean grilled meat over a salad, and whipping up a stir-fry dish. Lean ground beef can be used as patties, meatloaf, and meatballs or as pizza topping or in pasta sauces. To further reduce the fat in ground beef, check out these tips at http://www.beefnutrition.org/cmdocs/beefnutrition/reducingfatincookedgroundbeef.pdf

Forty ng/mL? That is the level of vitamin D (also called serum 25(OH)D3) in my blood but what does it mean? Vitamin D is one of the most talked about nutrients and for good reason–along with calcium it is critical for building and maintaining healthy bones, but vitamin D is also one of the most confusing vitamins. We can get vitamin D three different ways:

  • through foods (although very few foods are good, natural sources)
  • through supplements (although it comes in different forms and researchers aren’t always consistent in their advice about which form is best)
  • through sunshine or the ultraviolet rays from the sun to be more precise (but SPF 8 or greater, heavy cloud cover, skin color, aging, and even the angle of the sun in winter blocks vitamin D from being made in sufficient amounts)

So what is an over-50 year old adult to do?

First, choose foods that contain vitamin D or foods that are fortified with vitamin D: salmon, mackerel, tuna and sardines are good sources because fatty fish contain this fat-soluble vitamin. Mushrooms (they are being exposed to ultraviolet light to make them good sources), milk, some but not all yogurts (read the label), many breakfast cereals and orange juice contain vitamin D. A recent study found that half of vitamin D intake comes from milk so that is a good place to start.

Second, consider supplementation; you might be getting some in your multi-vitamin and most contain 400 IU (IU stands for international units, the measure used in supplements). Vitamin D comes in two forms–D2 and D3 and most, but not all, experts recommend the D3 form because early research showed that D3 is more effective at raising vitamin D blood levels than D2. However, some research shows that both forms are effective at improving blood levels.

Third, consider getting some sensible sun–10 to 15 minutes of sun exposure twice a week can improve vitamin D levels. This recommendations is controversial because UV rays from the sun or tanning beds are tied to the million of skin cancer diagnoses each year.

Which leads us back to that 40 ng/mL blood level–is that good or bad? According to the lab report 40 is a healthy level, but trending more toward the insufficient end of the range. A controversial article in an international osteoporosis journal suggests that older adults need 800 to 1000 IU of vitamin D each day to reach the maximal blood levels of vitamin D.

Next time you go to the doctor and have blood drawn, ask for a vitamin D level–in the meantime, increase your intake of vitamin D from foods and if you supplement, look at the supplement label to determine how much vitamin D your supplement provides.

For more information check out Dr. Michael Holick’s website http://www.vitamindhealth.org/ or his new book, The Vitamin D Solution.