It's All About the Broccoli

16th June 2017

As Jill Glenn discovers when she investigates what to eat in later life, in order to tempt a failing appetite…

My father used to pride himself on his attitude towards food. ‘I eat to live,’ he said, frequently. ‘I don’t live to eat.’ It’s fair to say he wasn’t a foodie – but, as he survived to the age of 101, it’s clearly a philosophy that worked for him.

Average life expectancy has been rising for many years, so, as the British Nutrition Foundation says, it’s vital that we adopt healthy lifestyle habits ‘to ensure that any extra years of life are enjoyable and disease-free’. Whatever our approach to eating, as we grow older we shouldn’t ignore our changing nutrition requirements: we need to attend to what we put in our bodies. With age, the number of calories we need begins to decline: every calorie we consume must earn its nutritional keep.

Sophie Murray, Head of Nutrition and Hydration at Sunrise Senior Living UK (www.sunrise-care.co.uk), suggests that we should be giving ourselves a diet review in our 60s, in order to set the foundations for the future. “At this stage, you will want to keep up your intake of B vitamins from wholegrains and seeds (these have a variety of healthy benefits) and keep a richly varied diet with plenty of fruit and vegetables,” she advises.

A healthy, balanced diet for older people is much the same as it is for the general population: five portions of fruit and veg a day, for example, and two portions of fish each week, one of which should be oily (the long chain omega-3 fatty acids can help protect against heart disease). One specific age-related recommendation is for vitamin D, synthesized in the skin by sunlight. Older people typically go outside less, and older skin isn’t as efficient at producing vitamin D from sun. The Department of Health recommends that the frail or housebound or those living in a care home take a daily supplement containing 10mcg of vitamin D. The BNF goes one step further and suggests that all adults over the age of 65 should do this.

For those in their 70s and beyond, Sophie Murray suggests eating little and often, and focusing on nutrient-rich food. “Eating times become more important than earlier in life,” she points out. “To support digestion, avoid eating too late at night – and eat plenty of vegetables such as turnips, kale and broccoli.”

Nutritionist Jenna Hope (www.jennahopenutrition.com) also identifies that it is not uncommon for an older person to have a decreased appetite and little interest in food. The reasons are manifold, and include disease, dementia, dietary changes, poor access to food and lower income.

In order to prevent nutrient deficiencies, she recommends nutrient dense foods, such as avocados, peanut butter, yoghurts and smoothies. “For foods rich in micronutrients, try vegetable soups and juices,” she says. “These are easy to eat and small amounts will provide ample energy.”

In addition to packing in the good stuff, there are, too, foods to avoid or restrict. According to NHS Live Well, the risk of food poisoning (which can, of course, be life-threatening) increases with age – the over 65s are more likely to succumb because their immune system isn’t as strong as that of someone younger, and they’re also more likely to take longer to recover.

Culinary culprits include mould-ripened soft cheese, such as Brie and Camembert, plus soft blue cheeses and unpasteurised soft cheeses, which can potentially harbour listeria. If you love them, though, don’t despair: you can eat them cooked, because heat kills the bacteria. Pâté – both fresh and chilled, including vegetable pâté – may also contain listeria, and should be regarded with suspicion. Eat canned (ie heat-treated) instead.

Avoid raw or runny eggs, and foods that contain them, such as homemade mayonnaise, eggnog, and hollandaise sauce: salmonella is the enemy here. Eggs should be cooked until whites and yolks are solid. In fact, it’s not just eggs: be cautious about anything raw or not-quite-cooked. Meat, especially poultry, which can nurture a range of food poisoning bugs, is obvious, but older people are also advised to refuse raw shellfish, sushi made with raw fish (unless it has been frozen first), cold cured/fermented meats and even raw or lightly cooked bean sprouts.

Despite this (and it is, of course, always worth discussing proposed exclusions or restrictions with a doctor or qualified nutritionist) a diet does not need to be bland – or repetitive. Jenna Hope points out that older individuals often fall into the trap of eating the same meals over and over, as they’re often no longer in control of what they eat. But, she says, there are plenty of tips which can help a caregiver provide more tasty meals and keep food-related excitement alive.

“Ensure that you’re mixing up the flavours by adding in a variety of spices such as turmeric, ginger, paprika, cumin, cardamom and celery seeds, and herbs such as rosemary, basil, mint, oregano and parsely,” she advises, adding, “You can buy these dry so they can be kept for longer and are therefore more cost efficient.” As a bonus, many herbs and spices have nutritionally beneficial properties – turmeric and ginger reduce inflammation, for example, “which is important for elderly individuals suffering with arthritis and other similar diseases”.

She also suggests creating ‘themed’ meals. “Try a Middle-Eastern style dinner… serve hummus or baba ganoush and pitta bread and chickpea and cauliflower tagine. The portions don’t have to be large but keeping that excitement and interest alive can help to reduce the individual’s loss of appetite.”

One of her top tips, and one that’s very easy to implement, is mixing up the cooking method. “Anyone given a plate of boiled broccoli on a daily basis is going to quickly find themselves with a lack of appetite,” she says. “I recommend switching between roasting, steaming and sautéing vegetables, fish and some meats. It’s often a good idea to mash root vegetables. Similarly, mix up the variety of vegetables and make sure you provide a sauce or a dip to accompany the dish – look for ones with reduced sugar.”

Sunrise’s Sophie Murray also advises that as digestive ability reduces, cooked foods instead of salads can be beneficial, because they have been partially broken down into more easily digested parts. “Good soups and stews, ideally home-made, with vegetables as well as protein, are convenient solutions and fantastic for retaining nutrients. If dentures pose an issue, easy-to-chew foods like soft vegetables, eggs, mashed potato, cottage cheese and yoghurt may help.”

The key mantra, perhaps, is ‘a little of what you fancy.’ It stands to reason that a few mouthfuls of a favourite food will tempt a failing appetite more than something that, notionally, is ‘good for you’. Of course, if the two coincide, so much the better. Don’t, though, do what I did with my hard-to-please father. Given that he rarely expressed a culinary preference, when he once mentioned that he liked broccoli, I was overjoyed. I served it every time I had to cook for him, and arranged for its regular inclusion in his shopping delivery. The day I visited and found four heads of broccoli in varying degrees of decay in the fridge I realised I’d gone too far. Variety is, after all, the spice of life. At any age.

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