How should your nutrition and fitness change as you get older? What types of foods and exercises are most important for older adults? Nutrition Diva's guest is healthy aging expert Dr. Christine Rosenbloom.
May 27 is National Senior Health & Fitness Day. And joining me today to talk about healthy aging is Dr. Christine Rosenblum.
Dr. Rosenbloom is a registered dietician and a nutrition professor emerita of Georgia State University in Atlanta, where she taught and held various administrative positions over her 30-year university career. Since retiring, she's written a book called Food and Fitness After 50 along with Dr. Bob Murray and she continues to blog about healthy aging at ChrisRosenbloom.com.
We've all heard the jokes about 50 being the new 30, and 70 being the new 50, and so on. And as we age, I think it's natural that what we think of as “old” continues to mean “just a little bit older than us.”
But at the same time I do see some truth to this. The Baby Boomer and the Gen X generations seem to be aging differently than our parents and grandparents did. We have different expectations of what it means to get older, and to a certain extent, we are experiencing middle- and old-age differently. Why do you think this is? Have we gotten better at aging, or is this just a state of mind or attitude?
I think it's a combination of many things. One of those is that we are living longer. When you're 65, your life expectancy is another 20 years. So I think as people realize, “I've got a lot more years ahead of me," they're thinking about "What can I do with fitness? What can I do with my diet? What can I do to stay healthy?”
We're not ready to just sit down and start rocking on the porch anymore when we retire from our careers. You've launched a whole new career after your 30-year university career, right?
Instead of giving somebody a rocking chair when they retire, give them a great pair of running or walking shoes.
Absolutely. And I saw one author say instead of giving somebody a rocking chair when they retire, give them a great pair of running or walking shoes, help them get active, give them a Y membership, things to keep us really active.
Are there parts of it that we might be getting wrong out of our unwillingness to go gently into old age? Are we more likely to be injuring ourselves or over-exercising in this quest to stay young?
I don't see that too much. I think people are being pretty careful with it. I mean, there are always some in any age group that push themselves too hard or don't get themselves enough time to recover and repair after hard exercise. But for the most part, I see people doing things that they enjoy. So they may not be running marathons anymore, although there are some who certainly are, but they may get a lot of out of gardening and working in their yard, and that can be a great physical activity as well.
I think there comes a time where it's much less about competition. And maybe more a little about the enjoyment of it as well.
Sometimes, when people do retire, let's say from their first careers, they actually have more time to devote to fitness or activities that they enjoy. They may actually be able to make it a bigger priority in their life and get a little bit more traction than maybe they could when they were really in the thickest part of their professional lives.
Oh, absolutely. I'm in a small rural community in North Georgia and the local Y is quite the hotbed of activities, whether it's people doing TRX or playing pickleball or doing group fitness classes. People are really enjoying that and they have time to do it. Sometimes I'll think, “Do I really want to drive 20 minutes to the Y to do an 8:00 a.m. class?” And then I say to myself, “Yes! That's why you retired.”
So, you have the time to do these things and you can make a priority for your health and fitness that maybe took a back seat when you were working full time and raising a family and doing more things for your family, especially for women in this age group.
Despite our denials, our bodies, of course, are changing as we age. What are some of the ways we need to adjust our nutrition and our exercise to accommodate—or maybe even compensate for—the ways in which our bodies are changing?
I think one of the things that I hear the most from people, especially women, is that they even though they're active and they say that they're eating as healthfully as they were before, they see some body composition change. And that's very normal.
We're going to have a little bit more body fat, maybe not as much muscle mass, but there's something we can do about that.
We're going to have a little bit more body fat, maybe not as much muscle mass, but there's something we can do about that. So when we're thinking about our diet and what we should be eating, I like to focus on key areas for folks.
- I think we should have an inclusion of all of the energy nutrients. We need some carbohydrates, we need protein, we need fat. I don't advocate no-carb or all-fat or some of these popular diet plans that are out there.
- We need to focus on nutrient-rich foods. As we get older, we need fewer calories. Therefore we don't have as much room in our diet for a lot of empty calories. So we want to make sure we're choosing foods that really pack in a lot of nutrients.
- We do need to have a concern for disease risk and management. 80 percent of older adults have at least one chronic disease and 68 percent have at least two or more. So whether it's osteoporosis or high blood pressure or Type 2 diabetes, we have to think about how can we use diet to manage those conditions.
- Enjoy meals and mealtimes. I still find some people are so fearful of food that they stop enjoying it. I think that's such a shame because food and mealtime is something that should be enjoyed. You know, even in this time where we're social isolating, we should still get some pleasure and enjoyment out of our meals.
I love that you include as one of your four focuses that we should remember that food can be a source of pleasure. That's wonderful. But let's back up a minute. You said that our calorie needs decrease somewhat as we age and so we'd have less room for those discretionary or recreational calories. And interestingly though, our protein needs may actually increase as we get older. That suggests to me that, if anything, the percentage of our calories coming from protein might actually need to go up a bit as we age. What's your thought on that?
Absolutely. Let's say we're trying to maintain our muscle mass. We have something—the anabolic resistance of aging muscle—meaning that our muscles don't take up the protein as well as they did when we were younger. So we need more protein to keep that muscle strong and to keep that muscle functioning so we don't lose our muscle mass. One easy way to do that is just to think about how much protein you're getting at every meal instead of a percentage. Try to get, depending on your body size, 20 to 30 grams of protein at every meal.
Try to get, depending on your body size, 20 to 30 grams of protein at every meal.
Americans tend to have very little protein at breakfast, then we backload all of our protein at dinner. So spreading that out throughout the day along with doing some resistance exercises—you still have to do the exercise to keep your muscle mass—but spreading that protein out throughout the day can really help your feed your muscles as they're active so that you can take up those building blocks of protein to build and repair muscle.
You also mentioned that we need to pay attention to any conditions we may be managing and factoring that into our dietary choices. You mentioned osteoporosis, and I hear from so many women who are worried about not getting enough calcium. There's this enormous focus on calcium.
I suspect that calcium may be a little bit overrated, or at least valued to the exclusion of all the other things that would be supportive of healthy bones. What are your thoughts on that? Do you feel like women are getting enough calcium, could they be getting too much calcium?
I think it would be hard to get too much calcium from your diet but would be easy if you're taking supplements. And I think what you said at the beginning of that was really important. It takes about 17 different nutrients to make healthy bones. Yet we tend to zoom in on just that calcium intake. You need protein to make a healthy bone. You also need vitamin D. Without sufficient vitamin D, only 10 to 15 percent of that dietary calcium gets absorbed.
So there's this interplay with many nutrients to make a healthy bone. Which is why I really like a ‘food first’ kind of approach to make sure that you're getting sufficient calcium from your diet. And that can be in a variety of ways: from dairy products as well as from nuts, dark, leafy green vegetables. We can get a variety of nutrients from those foods that also contain calcium.
Chris, you wrote a book a few years back about healthy aging with Dr. Bob Murray, whose training is in exercise science. What did you learn about fitness after 50 in the process of writing that book with Bob?
It gets back to a question everybody always asks: “What's the best exercise or what's the best diet?” What I learned from Bob was that there's no “best.: You really need three things:
- Endurance exercise to keep your heart and your lungs strong,
- Strength training to preserve your muscle mass and your bone health,
- And then we need to really focus on the balance and coordination and agility because we tend to lose those things as we get older. And that's really important to or prevent falls.
I thought more about the endurance exercise—walking, running or things to keep your heart and lungs strong. I didn't really appreciate the strength training as much or the agility, balance, and coordination.
I think we need to think about exercise like a balanced diet. Am I exercising from all the different fitness groups on a regular or even daily basis?
I think that's a really great way to look at it because people tend to gravitate to what they like to do and what's fun. So some may like dance aerobics and so they do that three or four mornings a week, but they hate lifting weights. Others live in the weight room, but yet they don't want to do any of the cardio or the endurance exercise. And then they totally forget about the balance and the coordination and agility stuff. So I think it is really important to think about all of those.
You said you were thinking more in terms of cardiovascular exercise before and now you've expanded your repertoire a little bit. How do you get your strength training in? What's your favorite way to do that?
Well, when I was a little bit younger I loved going to the Y because they had machines hooked up to little computers that would measure your strength and you could plot it out. And I like routine, so I liked doing that a lot. As I've gotten older, I don't tend to do that as rigorously, but I do use TheraBands a lot and some free weights.
I keep those things in sight—especially now that we're not as able to get out—so that I can get up and do some dumbbell presses with eight or 10-pound weights just to keep those muscles going. I love to walk. I have dogs, big dogs, so I walk a lot with dogs. And I do love to do group fitness classes. So those are the things that I really like to do. I kind of have to push myself a little bit more to do the weight training.
As we are taping this interview, we are still very much going through a global pandemic and as many regions around the world are now beginning to ease restrictions or look at easing their restrictions in an effort to restart our economies, what about older people? Do they, in your opinion, need to be viewing this re-entry differently? What, what sort of questions are you hearing from older adults about how they should be navigating this current crisis?
That's a really great question. I try to follow the CDC advice instead of my neighbors! I think I'd be a little bit more cautious. Each community is opening up things in a different way. I know that my YMCA is opening but without group fitness classes. They're opening the track to walk or the rooms for strength training with just a few people at a time.
I'd really advise to follow what the CDC guidelines are about exercise. If you can walk outdoors where you live, that's a wonderful activity for older adults.
On the nutrition side, I'm starting to get asked a lot of questions about vitamin D. We're starting to see information in the media about vitamin D and the virus. Now these are just associations or correlations and not causation, but there have been some reports that people have less severe infections when they have a higher blood level of vitamin D.
And there are groups like the International Osteoporosis Foundation that recommend older adults get about a thousand IUs of vitamin D a day. So I think looking at where your vitamin D intake is: Are you getting some sunshine? How much vitamin D are you getting from the sun versus the food choices that you have?
That's somewhat parallel to data that we already had showing that people of all ages with higher vitamin D levels seem to have lower infection rates with other normal respiratory infections that we see in the winter. So that does make sense. And, of course, it is kind of hard to get those levels of vitamin D from foods unless you are living in Alaska and eating only fish. So a combination of some moderate exposure to sunshine without sunscreen for a few minutes a day and then maybe a supplement. The good news is that vitamin D supplementation appears to be exceedingly safe.
And very inexpensive. You mentioned sunshine, and where we really get concerned are those folks who are in assisted living or nursing homes who cannot get outdoors. My mother-in-law turned 90 this week. She's in assisted living and we couldn't visit her, but we went and looked through the glass. But in the last couple of weeks they have started taking one resident outside for 30 minutes a day to sit in the courtyard. I'm glad that they're thinking about that. Not just for the vitamin D, but just the general aspect of being outdoors and how good that can make you feel.
You know, we started out our conversation talking about how today's generation of older adults is definitely experiencing aging differently—almost refusing to age, and determined to do what they can with fitness and nutrition to stay healthy longer, to enjoy that extended lifespan with a high level of health and function. I’m curious if you see people who are being left out of the healthy aging revolution. Are there populations that are not experiencing old age in this new way?
Absolutely. And I think it plays into things that we're seeing with the virus. There are great health disparities in this country. There is a growing divide between the haves and the have nots. Some people have the money and the ability to get good health care. But we're seeing that's really a problem for many, many people—often people in lower socioeconomic groups and people of color. So we definitely are seeing those disparities.
There are great health disparities in this country—often people in lower socioeconomic groups and people of color.
Along with that, we see that a lot of older adults are raising their grandchildren, so they're not having the same opportunities for leisure time or the free time that a lot of people have to be active. I think this whole virus is really putting a light on something that all of us in the healthcare industry have known for a long time: There are a lot of health disparities especially as we age. It makes it even a little more visible.
Dr. Chris Rosenblum is a registered dietician and the coauthor of Food and Fitness after 50. Her Fit to Eat blog, which focuses on healthy aging can be found on her website.