We Will Be What We Eat: Dietary Changes to Make as You Age

How your diet might protect against 7 common diseases and conditions of aging.

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If your mental image of an older person is someone frail and thin, it may be time for an update. For the generation currently moving through middle age and beyond, a new concern is, well, growing: obesity. "We're already seeing a large number of obese elderly, and if we don't do something, that figure is sure to rise," laments David Kessler, former commissioner of the Food and Drug Administration and author of The End of Overeating. Government figures show that Americans in their 60s today are about 10 pounds heavier than their counterparts of just a decade ago. And an even more worrisome bulge is coming: A typical woman in her 40s now weighs 168 pounds, versus 143 pounds in the 1960s. "People used to start midlife [at a lower weight] and then lose weight when they got into their 50s, but that doesn't happen as much anymore," Kessler says. 

If you're entering that danger zone now, be aware that it's not going to get any easier to lose weight, because people need fewer calories as they age. Blame slowing metabolism and the body's tendency starting in midlife to lose muscle mass—a process known as sarcopenia—and gain fat, especially around the abdomen. (Fat burns fewer calories than does muscle.) "All that conspires to make it harder for people to maintain the same body weight when they eat their usual diets," says Alice H. Lichtenstein, director of the Cardiovascular Nutrition Laboratory at Tufts University. "People have fewer discretionary calories to play with, so they need to make better food choices."

Why do those choices matter? First, carrying an extra 20 or 30 pounds with you into old age doesn't bode well for attempts to head off the myriad diseases that strike in midlife and later and are linked to weight—including diabetes, arthritis, heart disease, and some forms of cancer. (It's probably not a coincidence that one recent study finds that people in their 60s have more disabilities than in years past.) 

But paying attention to what you eat isn't only about controlling weight; the need for some vitamins and minerals increases with age. One is calcium, necessary to protect bones. Another is B12, since some older adults make less of the stomach acid required to absorb the vitamin. More vitamin D also is required. "The skin gets less efficient at converting sunlight into this vitamin, so more is needed from other sources," Lichtenstein says. Fewer than 7 percent of Americans between 50 and 70 get enough vitamin D from the foods they eat, and fewer than 26 percent get enough calcium. 

Staying lean and eating right are both crucial for maintaining health through the years. (Kessler recalls a fellow researcher at Yale who, upon realizing the panoply of diseases linked to body weight, promptly lost 30 pounds.) If weight is a problem, it is especially important to cut back on the processed foods that combine sugar and fat. Studies with rats indicate that when the two are added to chow, animals can't easily stop eating, says Kessler. This happens in humans, too, he says, and food manufacturers have taken note and added sugar and fat to many products. So what should people eat? A healthful diet at midlife is the same as for younger adults—it's just that the stakes may be higher. The focus should be on fruit, vegetables, whole grains, low- and nonfat dairy, legumes, lean meats, and fish. For someone whose current diet is far from this ideal, Lichtenstein suggests starting small: Swap dark green lettuce for iceberg, load more veggies on the dinner plate, eat more skinless chicken or beans in place of hamburger. And exercise. Walking briskly for at least 30 minutes every day makes it easier to get away with the occasional cookie. With some further fine-tuning of that basic healthful eating plan, you can greatly improve your odds of staving off the major barriers to a vital old age: 

Bone loss. No nutrient can stop bones from losing mass over time, but consuming sufficient calcium and vitamin D can slow the deterioration, says Felicia Cosman, an osteoporosis specialist at Helen Hayes Hospital in West Haverstraw, N.Y., and clinical director of the National Osteoporosis Foundation. Once a person reaches age 50, calcium re­quirements jump to 1,200 mg per day (from 1,000 mg). Cosman recommends adding up the number of dairy and highly calcium-fortified products (such as juice and cereal) eaten in a typical day and multiplying that by the 300 mg each likely supplies. Add another 200 to 300 mg for the combined trace amounts in leafy green vegetables, nuts, and other sources. Then get the remainder in a supplement. By midlife, adults also need at least 800 to 1,000 IU of vitamin D to help the body absorb calcium and, possibly, prevent other dis­eases, according to the NOF. Sources include fatty fish such as salmon (also important for heart health), egg yolks, and fortified foods, but most people need to supplement.