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o one is exempt from aging, not even in our youth-obsessed culture. According to the latest data from 2005 from the Department of Health and Human Services’ (HHS) Administration on Aging (AoA), about one in eight Americans (36.8 million persons) is 65 years of age or above. That is about 12.4% of the population; by 2030, that number is predicted to grow to 20%.¹
       There is no doubt that nutritional needs fluctuate throughout the life cycle, and the mid-60s years and beyond are no different. Since aging is a process of physiological metamorphosis, nutritional needs constantly change. As our population ages, healthy aging is at the top of the public health priority list. There are a myriad of media (eg, blogs, books, CDs, and DVDs) devoted to the topic of healthy aging. But are we aging better as a result? Our aging population is far from proclaiming a clean bill of health. According to AoA data from 2002-2003, most older Americans have the following chronic conditions: hypertension (51%), diagnosed arthritis (48%), all types of heart disease (31%), cancers (21%), diabetes (16%), and sinusitis (14%).¹
       There are several key factors to living healthy well into your 80s. Findings from one of the largest and longest studies on aging, the Kuakini Honolulu Heart Program/Honolulu Asia Aging Study, were recently published in the Journal of the American Medical Association (JAMA). Researchers followed 5,820 Japanese-American men of the Hawaiian island of Oahu over the course of 40 years, beginning at the average of 54 years of age. Although the subjects were Japanese men, the researchers believed the findings applied to both men and women of all nationalities.
       Did the researchers find proper diet and nutrition to play a key role in healthy aging? Not surprisingly, five of their nine keys to healthy aging were nutrition-related: avoidance of excess weight, avoidance of hyperglycemia (high blood sugar), avoidance of hypertension (high blood pressure), avoidance of excess alcohol consumption, and avoidance of hypertriglyceridemia (elevated triglycerides, a type of blood fat). The other four: having high grip strength, avoiding smoking, having a high education level, and having a marital partner.² Since the five nutrition-related keys to healthy aging are so important, let us look at them more closely.

1. Balancing Calories In with Calories Out

       What is “overweight?” For older Americans, a healthy body weight is defined as a body mass index (BMI) between 18.9 kg/m2 and 24.9 kg/m2; a BMI of 25 kg/m2 or above is considered overweight. Statistics for the prevalence of overweight persons among older Americans reveal that more than half (75% of non-Hispanic white men, 67% of non-Hispanic white women, 73% of non-Hispanic black men, 83% of non-Hispanic black women, 75% of Mexican-American men, and 74% of Mexican-American women) are overweight.³
       What is the solution? In simple terms, eat less and move more. Restricting calories is one part of the equation. Calorie restriction done in a healthy way, without malnutrition, has been found to extend life span and reduce oxidative stress during aging.⁴ From a chronic disease standpoint, calorie-restrictive diets have been found to reduce the health risks of obesity and delay the onset of a number of age-related diseases, such as cancer, nephropathy, cataracts, diabetes, hypertension, and hyperlipidemia.⁴ To reverse the trend toward obesity, HHS’s Dietary Guidelines for Americans recommends for most Americans to eat fewer calories, be more active, and make wise and healthful food choices.⁵

2. Balancing Blood Sugar Levels

       A lack of nutrition education and a poorly balanced diet from refined, white flour products, excessive sweets, and high-sugar beverages can send blood sugar levels out of control. With the increasing incidence of diabetes among older Americans, it is important to keep tabs on blood sugar levels. If there are constant highs in blood sugar, the body becomes less efficient at processing it, which can lead to insulin resistance and, eventually, diabetes.
       According to the American Diabetes Association, it is important to get regular blood sugar check-ups. Look for a fasting blood glucose (FBG) under 100, a pre-diabetes FBG between 100–125, and a diabetes FBG of more than 125. Among the other simple things older Americans can do to control blood sugar levels:
• Choose higher-fiber foods, such as vegetables, whole fruits, and whole grains.
• Do not skip meals. Eat meals and/or snacks every three to four hours to keep blood sugar stable.
• Aim for at least 30 minutes of physical activity a day.

3. Monitoring Blood Pressure

       Elevated blood pressure is likely to occur as the aging population becomes more sedentary until the pounds pack on. The incidence of high blood pressure (> 140/90 mm/Hg) is so common for older Americans that the National Heart, Lung, and Blood Institute (NHLBI) reports that persons with normal blood pressure at age 55 still have a 90% lifetime risk for developing high blood pressure.⁶
       How can we combat high blood pressure as we age? One of the most effective ways is to follow NHLBI’s Dietary

Table 1

Approaches to Stop Hypertension (DASH) Diet. DASH emphasizes foods that are low in total fat, saturated fat, cholesterol, and sodium and high in vegetables, fruits, whole grains, and fat-free and low-fat milk and milk products. DASH includes whole grains, fish, poultry, and nuts. The diet is also rich in potassium, magnesium, calcium, protein, and fiber. (See Table 1 for a specific breakdown of the DASH diet plan based on a 2,100-calorie intake.)

4. Limiting Alcohol Use

       Not only is alcohol considered empty calories but research has shown older persons are more sensitive to its effects (ie, intoxication happens more quickly). The dangers posed by alcohol magnify in persons over the age of 65 who, on average, take at least two medications, according to the National Institutes of Health’s (NIH) Institute on Aging. If mixed with alcohol, the medications can contribute to a deadly combination. Also, alcohol has been found to exacerbate medical conditions, such as high blood pressure, ulcers, and diabetes.
       From a nutritional standpoint, alcohol can hinder the absorption of nutrients and lead to malnutrition if used in excess. It also robs the body of hydration. Coupled with the fact that our thirst response diminishes with age, drinking alcohol can threaten lives. Therefore, it is best for a person to not imbibe alcohol if his or her goal is for healthy aging.

5. Managing Triglycerides

       Heart health, especially as we age, should be our top priority; healthy aging relies on managing the amount of fat in our blood as well as in our diet. The danger in elevated triglycerides, which are the chemical form in which most fats exist in food as well as in the body,⁷ is heart disease and the risk of untreated diabetes. Triglycerides are either derived from fat in foods or made from another energy source like carbohydrates (ie, breads, pasta, rice, and sweets).
       How do you know if your triglycerides are too high? A simple blood test, which should be done after an overnight fast from food and alcohol, at your physician’s office is all you need. According to the National Cholesterol Education Program, here are the triglyceride guidelines (based on fasting blood levels):
• Normal: less than 150 mg/dL
• Borderline-high: 150–199 mg/dL
• High: 200–499 mg/dL
• Very high: 500 mg/dL or higher.

Nutritional Interventions to Lower Triglyceride Levels

       If you are overweight, this is the time to restrict calories to lose weight. The math of weight loss is simple: 3,500 calories equals one pound. In order to lose a pound a week, subtract 500 calories from your daily caloric intake. It may be as simple as cutting out that morning muffin or sugary coffee drink, but however you do it, try to balance the calories you get from fat, carbohydrates, protein, and, if necessary, alcohol. (Note: A reduction in alcohol intake can decrease triglyceride levels significantly).
       Become fat savvy by reducing the bad types (eg, saturated fat, trans fat, and cholesterol) and increasing the good ones (ie, monounsaturated and polyunsaturated fats, such as olive oil, canola oil, nuts, avocado, and flax seeds). Remember that it is important to measure all fats, though, as they are still high in calories. Eat cold-water, oily fish, which are high in omega-3 fatty acids (a heart-healthy fat) instead of meats high in saturated fat, such as beef, bacon, and the dark meat of poultry. Good choices include mackerel, lake trout, herring, sardines, and wild salmon.

Conclusion

       The bottom line is that by combining research and common sense, we can all live disease-free, robust lives well into our 80s. Key to that is maintaining a healthy weight, keeping tabs on our vitals (blood pressure, blood sugar, and blood lipids) by choosing healthful meals and snacks, and getting regular physical activity. By doing so, we can all impact the statistics on aging—for the better.