February 2009 Issue

Nutrition for Health and Longevity
By Dina Aronson, MS, RD
Today’s Dietitian
Vol. 11 No. 2 P. 40

A perfect diet doesn’t guarantee health and longevity, but why not help your clients have a better chance at both by encouraging them to eat foods that research has shown are the best for bodies at any age?

If you work closely with older adults, chances are you’ve been asked about foods that increase longevity and help keep aging people looking and feeling young. Fortunately, more studies are showing that diet can powerfully affect longevity, and more people are seeing exciting results from simple dietary changes. It’s never too late to make positive changes. Older adults can make changes today that will improve their health tomorrow and may actually help them live longer in better health.

Nutrition and medical researchers have identified persistent inflammation as one of the worst offenders in aging, as its factors predict the risk of virtually all chronic diseases. And since chronic diseases cause the majority of early deaths, eating a diet that minimizes inflammation and the risk of chronic disease is key to increasing longevity and quality of life.

Studies have shown that even people in their 70s and 80s who change their diets and other lifestyle factors show improved markers for disease risk, particularly heart disease.1,2 Thus, everyone, even those already at risk from years of unhealthy eating, can benefit from improved eating habits: consuming more nutrient- and fiber-rich fruits, vegetables, whole grains, and legumes and less fatty meat, high-fat dairy, and refined, processed foods.

First Things First: Eat a Balanced Diet
As people age, they tend to eat less food and fall into eating patterns that may minimize variety. This is due to many factors, including loss of appetite, taste changes, teeth/denture issues, side effects from medication, eating on a budget, and/or dependence on institutional meals. So it is especially important to maximize nutrient-dense foods in the later years.

Last year, researchers at Tufts University’s Jean Mayer USDA Human Nutrition Research Center on Aging in Boston published the new Food Pyramid (MyPyramid) for Older Adults. This eating guide emphasizes the importance of consuming nutrient-dense foods, sufficient fluid intake, and specific recommendations for the basic food groups. It advises brightly colored vegetables, deep-colored fruits, lean proteins, and healthy types of fat. A diet that adheres to these guidelines will help lower the risk of chronic disease yet provide plenty of health-protective nutrients. For more information, visit http://nutrition.tufts.edu/docs/pdf/releases/071220_ModifiedMyPyramid.pdf.

One noteworthy recommendation is consuming packaged (frozen and canned) fruits and vegetables in addition to fresh produce. Many people believe that only fresh fruits and vegetables are healthy; on the contrary, packaged varieties (without added salt or sugar) may be just as healthy as their fresh counterparts and perhaps even more so since the food is processed soon after harvesting. This early processing protects the food from nutrient losses due to heat, oxygen, and light.

“These choices are easier to prepare and have a longer shelf life, minimizing waste,” says Alice H. Lichtenstein, DSc, researcher and author of the paper announcing the recommendations. Canned and frozen fruits and vegetables are often less expensive than fresh varieties, and they’re readily available when it’s more difficult for people to get to a grocery store.

Centenarian Study: Lean Is Key
The New England Centenarian Study at the Boston University School of Medicine is the largest, most comprehensive study of centenarians and their families. One goal of this study is to observe lifestyle factors that study subjects have in common to try to determine the “secrets” of a long and healthy life. To date, no specific foods have been noted, but the study has shown that almost all people who reach the age of 100 are lean, particularly men. Obesity may be considered an actual risk factor for early death, so maintaining a healthy weight is one of the most important dietary goals.

Lessons From Okinawa
Okinawa, a group of 161 Japanese islands located between the country’s main islands and Taiwan, boasts the world’s longest living people. They enjoy the lowest rates of heart disease, stroke, and cancer, the three leading killers in the United States. The average Okinawan woman lives to the age of 86 and the average man to 78 compared with 79 and 72, respectively, in the United States. And they typically die of natural causes rather than disease. What’s their secret?

A 25-year study on Okinawa, detailed in the book The Okinawa Program: How the World’s Longest-Lived People Achieve Everlasting Health — and How You Can Too by Bradley J. Willcox, MD; D. Craig Willcox, PhD; and Makoto Suzuki, MD, reveals myriad lifestyle factors, including diet, that lead to better health and longer life. Obviously, native Okinawans follow their diets over a lifetime, so an open question is whether an older American can derive any benefit from adopting an Okinawan diet plan. Studies are underway to determine the diet’s significance later in life. In the meantime, it certainly wouldn’t hurt to try mimicking the eating style that produces the world’s oldest and healthiest people.

Okinawans eat an average of seven servings of vegetables and fruits daily, along with seven servings of grains, two servings of soy products (rich in healthful flavonoids), omega-3 fatty acid-rich fish several times per week, very few dairy products, and little meat. Specific healing foods and herbs appear to maximize the healing power of the traditional Okinawan lifestyle, according to the study. See the sidebar for a summary of the Okinawa Program’s 10 healing foods and herbs.

Water: Tried and Still True
Drinking plenty of fluids promotes cleansing, flushes toxins, ensures hydration, and helps maintain healthy skin, helping people look and feel younger. In addition, adequate water intake reduces constipation and stress on the kidneys. Seniors whose thirst mechanism has declined may need extra reminders to drink up.

Nuts for a Long Life
Researchers tracked 34,000 Seventh-Day Adventists in California beginning in the 1980s.3 After 12 years, they linked the subjects’ consumption of nuts five to six times per week to a longer-than-average life expectancy. Frequent nut consumers lived 1.5 to 2.5 years longer than nut avoiders, controlling for other factors. This could be due to the protective fatty acids, excellent mineral content, wealth of phytonutrients, or the impressive overall profile of nuts as a regular part of a healthful diet. However, many worry about weight gain. While it is true that they are high in fat, nuts have not been shown to contribute to weight gain when eaten in moderation.

Mediterranean Diet: Worth a Try?
In 2007, the Archives of Internal Medicine reported the results of the National Institutes of Health-AARP Diet and Health Study, which followed the lifestyle habits of 380,000 people to determine which people died when, how, and why. This study found that the closer a person’s diet conformed to the traditional Mediterranean eating plan, the lower the risk of death. In fact, mimicking the traditional diets of Greece and southern Italy cuts the risk of death from all causes by 20%.

Note that the Mediterranean diet is not only about eating lots of fish and olive oil. A healthful Mediterranean diet focuses on vegetables, legumes (dried beans and peas), fruits, nuts (especially walnuts), whole grains, fish, and a high monounsaturated-to-saturated fat ratio and deemphasizes alcohol and meat. Swapping burgers for fish and loading up on fruits and veggies really can make a difference.

Seeing Green
Age-related macular degeneration affects the macula, the center of the retina’s inner lining. This progressive disease gradually compromises sharp vision, making it difficult to see details and recognize faces. While there is no cure, research has demonstrated ways to help prevent, as well as slow, the progression of the disease.

Many studies have shown a protective effect of lutein, a phytochemical found mainly in leafy green vegetables and in some other foods. “Think of these foods as sunblock for your eyes,” says Kate Geagan, MS, RD, director of IT Nutrition in Park City, Utah. Geagan recommends leafy green vegetables, especially dark ones such as kale, collards, and chard, on a regular basis for their lutein, as well as their wealth of other disease-fighting properties.

The Age-Related Eye Disease Study, designed to determine risk factors and prevention strategies for macular degeneration and cataracts, showed that a supplement combination of beta-carotene, vitamin C, vitamin E, zinc, and copper can reduce the risk of developing advanced age-related macular degeneration by about 25% in those patients who have earlier but significant forms of the disease.4 The team is currently investigating the effect of supplementing with lutein, zeaxanthin, DHA, and EPA on disease progression.

Since certain supplements taken in pill form may be harmful (particularly vitamin E and beta-carotene), we should recommend that patients maximize foods rich in these nutrients. This strategy is supported by the fact that low levels of nutrients is one of the risk factors for the disease. These nutrients are abundant in healthy diets with plenty of fruits, vegetables, whole grains, beans, seeds, and nuts.

Spice It Up
Many recent studies have focused on herbs’ and spices’ health-protective properties. For example, sage, oregano, turmeric, cloves, and cinnamon have all been shown to lower fasting blood sugar levels in people with diabetes. Better blood sugar control means prolonged health and lower risk of damage from diabetes-related maladies.

Dried Fruit: Nature’s Candy
Dried fruits such as figs and dates are chock-full of fiber and potassium, which help regulate blood pressure. They pack in many times more antioxidants than other fruits. A 2004 Harvard study showed that eating three or more servings of high-antioxidant fruit per day lowered the risk of age-related maculopathy by 36% in people aged 50 and older. To check the antioxidant content of common foods, consult the Oxygen Radical Absorbance Capacity database at http://ars.usda.gov/services/docs.htm?docid=15866.

Keeping the Brain Sharp With Açai and Other Berries
Age-related diseases of the brain such as Alzheimer’s and Parkinson’s disease have no cure, but research suggests that diets rich in antioxidants and anti-inflammatory polyphenolic compounds may lower the risk of developing age-related neurodegenerative diseases. Such compounds, notably anthocyanins, are abundant in berries and may lower oxidative stress and inflammation, thereby promoting brain health. Açai berries (available dried, frozen, as juice, and as a powder) have the highest level of antioxidants but, of course, they’re not a miracle cure (nor are they very tasty solo). It’s not about choosing from only the top of the antioxidant list; it’s about choosing an abundance of antioxidant-rich foods daily. Strawberries, blueberries, blackberries, raspberries, and others are good choices, along with other high-antioxidant foods.

Ginger for Healthy Joints
Older adults at risk of or suffering from arthritis may want to try ginger to extend pain-free years. Ginger is known to exhibit anti-inflammatory effects that work directly on the joints to help relieve arthritis. One Danish study shows that among patients taking ginger, more than 75% experienced relief in pain and swelling from arthritis.5

Go Fish?
Researchers from the Harvard School of Public Health recently weighed the risks and benefits of consuming fish. The researchers concluded that the disease risk-reduction benefits of consuming one to two servings of fish per week outweighed the potential harm from mercury exposure, possibly helping to extend healthy years.

Myriad studies have focused on the beneficial effects of the omega-3 fatty acids found in fish. These fats help reduce inflammation and protect the integrity of cell membranes from free radical damage.6 Omega-3 fatty acids may help protect people from age-related neurodegenerative disease, cognitive decline, arthritis, and cardiovascular disease. For those who dislike fish or are vegetarians, other excellent sources of omega-3 fats include flaxseed and flax oil, canola oil, walnuts, soybeans, hemp seeds, and large amounts of leafy green vegetables.

Green Tea Covers the Bases
Scientific literature includes studies on the benefits of green tea. Green tea drinkers reap the potential benefits of the prevention of and/or treatment for cancer, heart disease, skin conditions, atherosclerosis, stress, viruses, arthritis, and type 2 diabetes. Theoretically, these bioactive chemicals protect the body from oxidative damage and help maintain the integrity of the cells’ DNA and membrane structure. No wonder so many healthy older adults worldwide drink green tea.

The Big Picture
We all want long, healthy, disease-free lives. And we all know that healthy eating, stress management, exercise, and other positive lifestyle habits help us move closer to this goal. As nutrition professionals, we can help our clients and patients take advantage of myriad healthful and interesting foods known to improve health and help them incorporate the science of disease prevention and longevity into their eating habits.

— Dina Aronson, MS, RD, is a nutrition consultant, a freelance writer, and a speaker specializing in dietetics-related technology and vegetarian nutrition.

1. Klieman L, Hyde S, Berra K. Cardiovascular disease risk reduction in older adults. J Cardiovasc Nurs. 2006;21(5 Suppl 1):S27-S39.

2. Andrawes WF, Bussy C, Belmin J. Prevention of cardiovascular events in elderly people. Drugs Aging. 2005;22(10):859-876.

3. Fraser GE, Shavlik DJ. Ten years of life: Is it a matter of choice? Arch Intern Med. 2001;161(13):1645-1652.

4. SanGiovanni JP, Chew EY, Clemons TE, et al. The relationship of dietary carotenoid and vitamin A, E, and C intake with age-related macular degeneration in a case-control study: AREDS Report No. 22. Arch Opthalmol. 2007;125(9):1225-1232.

5. Srivastava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypotheses. 1992;39(4):342-348.

6. Spitellar G. The important role of lipid peroxidation processes in aging and age dependent diseases. Mol Biotechnol. 2007;37(1):5-12.

The Okinawa Program’s 10 Healing Foods and Herbs
1. Turmeric: Its anti-inflammatory actions and bioactive compounds make this a popular and tasty seasoning for soups, salad dressings, and curries.

2. Goya (bitter melon): The main ingredient in goya chample, a favorite Okinawan dish, this curved squashlike vegetable is available in Asian markets throughout the United States. It is a good source of curcurbitacin, a phytochemical thought to play a role in cancer prevention. Some studies support its ability to lower blood sugar in people with diabetes. Cooking it with other vegetables and seasonings can offset its bitter flavor.

3. Hechima (vegetable sponge): Strange but true, this spongy vegetable tastes like a sweet zucchini and is available in most Asian markets. Studies have suggested immune-enhancing properties of this family of vegetables.

4. Huchiba (mugwort): An herb available in liquid and tea forms or dried for cooking, huchiba is best known for treating an upset stomach. Chemically active compounds in this herb have been shown to treat and prevent several different conditions, ranging from atopic dermatitis to bacterial infections.

5. Tofu: Okinawans consume an average of 3 ounces of soy products daily; their tofu is the extra-firm variety. Tofu’s flavonoids have shown anticancer and cardiovascular-boosting effects. Use tofu as a meat substitute in stir-fries, salads, and grain dishes. Aim for two servings of soy per day.

6. Imo (purple or sweet potato): The imo is a main source of carbohydrates for Okinawans. It is rich in disease-fighting carotenoids (especially the dark orange or purple flesh varieties), fiber, and vitamin C. Use them as you would white potatoes or add cooked, mashed imo to batters and soups.

7. Jasmine tea: Jasmine tea is the most popular beverage among elder Okinawans. It is made from green tea leaves mixed with jasmine flowers. The tea’s artery-cleansing flavonoids are effective against the development of heart disease, stroke, and cancer. Replace daily coffee or tea with jasmine tea; the effects appear to be dose dependent.

8. Kudzu (arrowroot): This innocuous, bland starch is used as a flour and/or a thickening agent. It is an excellent source of an isoflavone called daidzin. Use as a tea simply by dissolving in hot water, and use as a thickener in place of cornstarch. It can also be used as a main ingredient in pudding.

9. Konnyaku: This is a neutral-tasting root extract from a type of yam. It is an excellent source of glucomannan, a type of dietary fiber. Its water-absorbing properties make it a possible weight loss aid, and it has shown promise for preventing heart disease, high cholesterol, and type 2 diabetes. It is available as a brown-gray, gelatinous cake about the size of a deck of cards, in noodle form, or as a powder. It is available in many Asian markets. As is true for any isolated fiber, don’t overdo, as it may cause loose stools and gas.

10. Seaweed: Available in more than 2,500 varieties, seaweed is extremely rich in minerals, most notably iodine, zinc, and calcium. Many types (kelp in particular) are good sources of lignans, which may protect against certain cancers. Use different seaweeds in soups and salads, as toppings for noodles, and in sushi. High in sodium, seaweed should be used with caution in salt-sensitive people. Due to its iodine content, people with thyroid issues need to consult their doctors or dietitians regarding the use of seaweed.

— DA