August 1994: (11)S5oS51

Keys to a Longer, Healthier, More Vital Life Irwin H. Rosenberg, M.D.

Current research shows that good nutrition coupled with a regular program of aerobic and strength- building exercises can have a beneficial effect on the health of almost all older people. Of course, this same program is recommended for much younger populations, and in general the earlier in life it is instituted the better for the long run. However, cur- rent research also shows that it is never too late to begin. In the middle years and beyond, simple changes in activity and eating habits can delay-r even reverse-many problems and symptoms as- sociated with the aging process.

In this symposium, much of the emphasis has been on what we need to know about the physio- logical, psychological, and environmental influenc- es on individual aging. As new evidence is devel- oped, more specific recommendations can be adopted and methods can be devised to apply them in clinical and societal settings. In the meantime, the following general points can be offered elderly patients and the older population in general as keys to a pattern of eating and exercise that can prolong vitality and health well into the senior years.

0 Establish good eating patterns and stick to them. Good nutrition can and should be habit-forming, and the quality of the diet becomes even more important with aging, as the appetite declines. With a decrease in the quantity of food, all too often there is a concomitant decrease in nutrient intake. The right mix of food is crucial: five daily servings of fruits and vegetables, generous doses of grains and legumes, low-fat dairy products. So is the right mix of tastes and textures to make the meal enjoyable, and, often, the seasoning of good companionship as well.

0 To combat infection and chronic disease, the diet should be high in foods that contain nutrients that help protect the immune system, such as vitamins E and B, and the trace mineral zinc. A nutrition-

Dr. Rosenberg is Jean Mayer Professor of Nutrition and Medicine, and Director of the USDA Human Nu- trition Center on Aging at Tufts University, 71 1 Wash- ington Street, Boston, MA 021 11, USA.

ally balanced diet, enhanced by these valuable nutrients, may help maintain or even boost the immune response. Focus on whole grains and le- gumes, green leafy vegetables, seafood, lean meats, and unsaturated margarines or vegetable oils.

0 To prevent bones from becoming porous and brit- tle, choose foods &h in vitamin D and calcium. Bone growth slows in adolescence and reverses in the mid-30s, when demineralization begins. After age 60, the body’s ability to absorb calcium (the most important of the bone-building miner- als) decreases at a faster rate. Vitamin D helps to absorb calcium more effectively. Low-fat dairy products (milk, yogurt, cheese) are good sources of calcium; vitamin D is found mainly in fortified milk and fatty fish.

0 To ensure a healthy, active, and regular digestive system, include at least 20 g of fiber in the diet each day. Good fiber sources are fruits, dark leafy vegetables, grains, and legumes.

0 To help safeguard vision and delay problems such as cataracts, increase intake of vitamins C, E, and the provitamin A, P-carotene. Antioxidant nutri- ents such as these help combat damaging effects of oxidation in the body, one of which is cataract formation. Excellent sources are citrus fruits and orange, yellow, and green vegetables.

0 To reduce the risk of cardiovascular disease, limit fat, dietary cholesterol, and sodium in meals and focus on food sources of vitamins B,, B,,, and folate, as well as soluble fiber, calcium, and po- tassium.

0 To help keep the mind alert and the nervous sys- tem functioning at its best, vitamins B,, B,,, and folate should once again be on the dietary check- list. Aging is not necessarily synonymous with memory loss, “cloudy” thinking, or numbness in the arms and legs. Some of these changes may be directly attributable to a deficiency of certain nutrients. Plenty of grains and leafy vegetables help to maintain high levels of these critical vi- tamins.

0 To maintain ideal body weight and keep off ex- cess fat, stay active and choose a diet low in fat

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and high in complex carbohydrates and dietary fiber. Keeping a balance between energy con- sumed and energy expended is an increasing challenge as people age. Muscle tissue tends to decline, and with it the ability to utilize all the energy in foods. The stored energy means weight gain and excess body fat, which can hasten dia- betes, heart disease, arthritis, and other problems. The key: tip the balance with physical activity and a healthy diet.

0 To keep appetite hearty and muscles strong, mix aerobic exercises (walking or swimming) with simple muscle-strengthening activities (lifting and carrying). Important muscle tissue is lost with aging, and also muscle strength. Newer re- search shows that it is never too late to rebuild and strengthen muscle with the right kind of ac- tivity and exercise. Muscle mass (more muscle)

also determines basal metabolism, which directly affects the appetite, and this translates into more nutrients for the body. Exercise, exercise, exercise. To the body, exercise is what location is to real estate: the promise of a rewarding future. Who said that people should take it easy as they age? Bed rest and inactivity for prolonged periods hasten the aging process and promote problems associated with the diges- tive and cardiovascular systems, bones, and mus- cles. Exercise does the opposite-and, as a bo- nus, can even diminish the risk of diabetes. The bottom line: Research has shown no better way to slow or even reverse the progress of aging itself and of all the age-related degenerative con- ditions than through the combination of aerobic and strength-building exercise and a balanced, nutritious diet.

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