Diabetes Cooking & Recipes for Older Adults & Seniors

• Note about Food Labels (on this page)
• Introduction (on this page)
  • How to Use This Guide
  • Managing Your Meal Plan
  • Handling Common Problems
• Recipes:
  • Optimum Breakfast Ideas
• (more coming soon)

A Note about U.S. Food Labels

Many food labels in the grocery store use terms that can be confusing. To help you shop and eat better, here is a list of the common terms as defined by the Food and Drug Administration.

Sugar

Sugar Free: Less than 0.5 gram of sugar per serving.

No Added Sugar, Without Added Sugar, No Sugar Added: This does not mean the same as “sugar free.” A label bearing these words means that no sugars were added during processing, or that processing does not increase the sugar content above the amount the ingredients naturally contain. Consult the nutrition information panel to see the total amount of sugar in this product.

Reduced Sugar: At least 25% less sugar per serving than the regular product.

Calories

Calorie Free: Fewer than 5 calories per serving.

Low Calorie: 40 calories or less per serving. (If servings are smaller than 30 grams, or smaller than 2 tablespoons, this means 40 calories or less per 50 grams of food.)

Reduced Calorie, Fewer Calories: At least 25% fewer calories per serving than the regular product.

Fat

Fat Free, Nonfat: Less than 0.5 gram of fat per serving.

Low Fat: 3 grams or less of fat per serving. (If servings are smaller than 30 grams, or smaller than 2 tablespoons, this means 3 grams or less of fat per 50 grams of food.)

Reduced Fat, Less Fat: At least 25% less fat per serving than the regular product.

Cholesterol

Cholesterol Free: Less than 2 milligrams of cholesterol, and 2 grams or less of saturated fat per serving.

Low Cholesterol: 0 milligrams or less of cholesterol, and 2 grams or less of saturated fat per serving.

Reduced Cholesterol, Less Cholesterol: At least 25% less cholesterol, and 2 grams or less of saturated fat per serving than the regular product.

Sodium

Sodium Free: Less than 5 milligrams of sodium per serving.

Low Sodium: 40 milligrams or less of sodium per serving.

Very Low Sodium: 5 milligrams or less of sodium per serving.

Reduced Sodium, Less Sodium: At least 25% less sodium per serving than the regular product.

Light or Lite Foods

Foods that are labeled “Light” or “Lite” are usually either lower in fat or lower in calories than the regular product. Some products may also be lower in sodium. Check the nutrition information label on the back of the product to make sure.

Meat and Poultry

Lean: Less than 10 grams of fat, 4.5 grams or less of saturated fat, and less than 95 milligrams of cholesterol per serving and per 100 grams.

Extra Lean: Less than 5 grams of fat, less than 2 grams of saturated fat, and less than 95 milligrams of cholesterol per serving and per 100 grams.

Introduction

How to Use This Guide

Congratulations! You’ve probably been working to manage your diabetes successfully for some time now. You’ve learned a lot about how to prepare healthy, nutritious meals, get some exercise, man age your medications, and keep your blood sugar levels in range. And now you’ve picked up this book to find out new ways to eat well as you grow older.

Senior adults with diabetes face new challenges to diabetes care. As we age, our digestive process naturally slows down, some times causing uncomfortable symptoms. Our taste buds and appetites may become less strong. Our weight may fluctuate up and down. And cooking may seem like a big chore.

This book will help you stay upbeat and on track as you cope with these changes. The first section offers helpful hints on man aging your diabetes meal plan, including how to handle loss of appetite or ability to taste, weight changes, eating out, and possible side effects of your medications. Then find great recipe ideas organized by common nutritional needs of seniors. Want to reduce sodium or cholesterol levels? Try recipes like Cream of Broccoli Soup or Meatballs in Tomato Sauce. Need more calcium or fiber in your meal plan? Make a Berry Frappe or Crunchy Chicken Salad. Food just doesn’t taste as good anymore? You’ll like Pork Medal lions with Orange Sauce.

Changing the way you have cooked for years may seem daunting. The recipes were created using simple ingredients that need minimal preparation. We’ve intentionally limited how much you need to slice, chop, and dice. We call for inexpensive convenience items such as dehydrated minced onions and garlic powder so you don’t have to hassle with peeling and chopping whole garlic cloves and onions. Sliced mushrooms, bell peppers, and other items are also available in grocery store salad bars. The recipes use dried herbs for easy preparation and quick marinade options such as fat- free salad dressings.

After the recipe section, there’s an extensive resource list to help you fine-tune your diabetes care plan. You’ll find a sample weekly menu and grocery list to show you how to plan ahead for a week of interesting, easy meals. You’ll also find out how to plan for emergency days when you may not be able to get to the grocery store for food items. An emergency food shelf is a great way to make sure you’ll always be able to make quick, nutritious food for yourself. Finally, a glossary of common nutrition terms provides concise descriptions of nutrition concepts.

Managing Your Meal Plan

You have many great options and methods for eating well with diabetes. If you are newly diagnosed, consult a Registered Dietitian (RD) to learn about your options. Some current methods include the exchange system, food pyramid model, calorie counting, point systems, and carbohydrate counting. Find out what works best for you.

Work carefully with your RD to come up with a specific meal plan that you’ll like and stick to. You can include many of your favorite foods, even if you’re eating less sodium and fat. You can learn new recipe variations and cooking techniques for your old favorites that will satisfy you just as much. Or visit your RD if you have had diabetes for awhile and are finding it difficult to stay on your plan. You may need to have your meal plan updated or find new recipes or different foods to try.

Eating right is a key factor in your successful diabetes care plan. Together with exercise, medications if needed, blood glucose monitoring, and regular physician visits, a healthy, balanced meal plan will help keep your diabetes in good control and let you live a longer, more enjoyable life.

Handling Meal Plan Changes

If you’ve just been advised to reduce your sodium, fat, or cholesterol levels or serving sizes, you may feel challenged or frustrated.

Don’t worry. Try some of the tips below and you’ll be surprised how quickly you can modify your past habits.

Reducing Sodium

• Find out how much sodium you need each day from your physician

• Read food labels carefully. Focus on the amount of sodium listed on the Nutrition Facts label rather than the ingredient list.

• Replace the salt shaker on your table with a no-sodium seasoning blend.

• In most recipes, you can reduce the amount of added salt by at least half.

• Choose fresh foods as much as possible, rather than processed and packaged ones.

• Use fewer convenience foods—they typically contain lots of sodium to prevent spoilage.

• Avoid cured, pickled, and salted items.

• Look for low-sodium recipes for ideas on breaking the salt habit in cooking.

• Try flavored vinegars on food instead of salt. Save small bottles and refill with vinegars and herbs. Then refrigerate them—most need to be used quickly.

• Experiment with herbs and spices. Try:

• Allspice (great on meats and baked products)

• Caraway (use on vegetables and salads)

• Chervil (use in salad dressings and sauces)

• Coriander (use on pork, beef, rice dishes, bean dishes, and casseroles)

• Fennel (use to flavor meat dishes or vinegar blends)

• Lemon balm (use in beverages, salad dressings, and vinegar blends)

• Winter savory (try on meats, vegetables, pastas, salads, and vinegars)

• Tarragon (good with fish, meats, vegetables, salads, and vinegars)

• Wasabi (used to flavor seafood, fish, meats, rice dishes, and vegetables)

• Do not use salt substitutes without consulting a physician before hand. It is okay to use most sodium-free seasoning blends instead.

• Reduce the amount of salt you use slowly to ease the transition.

• Watch for the health benefits of your salt reduction. These may include improved blood pressure levels, less water retention, and improved heart function. After awhile, you will also be able to taste the natural flavors of foods that were previously masked by too much sodium.

Lowering Fat and Cholesterol

If you have to cut back on fats or cholesterol, you’ve probably already consulted your health care professional to find out your body’s requirements. Find out how much fat is allowed in your meal plan—a healthy diet will still contain some fat. While diet is the primary therapy used to reduce fat levels in the blood, You may also need to exercise or take medications. Have your blood fat and cholesterol levels checked regularly to measure your success. And try the following tips.

• Learn to read labels and identify types of fat (saturated, poly unsaturated, and monounsaturated).

• Compare “light,” “low fat,” and “reduced fat” items to the regular product. Some are excellent substitutions, while others may be significantly higher in cost, or have other added ingredients such as salt and sugar that make the product less healthy.

• Learn to cook without adding extra fat. Take a cooking class or a supermarket tour for inspiration.

• Have a vegetarian day at least once a week.

• Keep the margarine bowl or butter plate off the table, especially if you have already added fats during the cooking process.

• Replace frying with low-fat cooking techniques such as grilling, broiling, and stir-frying. Use marinades, salsas, and spices for flavor.

• When eating out, ask if dishes can be prepared without fat.

• Talk to your physician and/or pharmacist before using any herbal or food supplement to reduce cholesterol. Chances are if the remedy worked, your physician would have already prescribed it.

• Stay active. Choose aerobic activities when possible.

• Control other heart disease risk factors, including smoking, obesity, and high blood sugar levels.

Reducing Portion Sizes

Since metabolism slows down as you age, your body needs fewer calories every year. Activity levels usually decrease. Portion control is one key to weight management, regardless of which meal planning method you follow. Know what your individual serving sizes should be, and read package labels to find the correct portion size for you. Although it’s tempting to buy less expensive large-size food items, choose small-size packages when they are on sale. Or repackage the food into smaller food storage bags or containers to improve your chances of maintaining proper portion control.

When you’re just beginning, teach yourself correct portions with measuring cups and spoons. You may also want to measure portions once or twice a month just to prevent portion “creep” from occur ring. Try some of the other tips below to stay on track with serving sizes.

• Avoid placing serving bowls on the table (the temptation will be to easily reach for second servings).

• Try eating on smaller plates.

• Use juice glasses (4 - 5-oz size) rather than tumblers or mugs for juice portions.

• Use the appropriate size glass for the correct portion of milk.

• Try using your hand when away from home to measure portions:

• Your palm is about the size of a 4-oz piece of meat.

• Your meat portion should be about as thick as your hand.

• Your fist size is about 1 cup.

• A handful is about 1/2 cup.

• Your thumb is about 1 tablespoon.

• Eat more slowly and chew foods well.

• Avoid common hazards to portion control:

• Eating in front of the television.

• Using large serving dishes.

• Eating while cooking.

• Going to all-you-can-eat restaurants.

• Keeping tempting items that are difficult for you to resist in the house.

Eating Out

Eating out is no longer reserved for special occasions! Most Americans eat out several times each week, so having diabetes should not restrict your ability to eat a nice meal away from home. Follow the suggestions below for a healthy restaurant experience.

How to Order

• Ask plenty of questions!

• How large are the portions?

• Is a half-size portion available?

• Can I substitute ____________ for

• Cart the chef bake/broil/grill the meat/vegetable instead of batter frying or deep frying?

• Can the sauce/topping/dressing/butter/gravy be served on the side?

• Can the chef cook the dish without adding extra salt?

• Can the chef make a lighter calorie sauce for the dish?

• Are light/low-calorie ingredients available (salad dressings, cheese, dairy products, juices, or beverages)?

• What other options are there for dessert?

• Plan ahead. If you are anticipating a large meal, consider cutting back a bit during the day. But don’t get too hungry, or you’ll be more likely to overeat.

• Know the menu. Read carefully to learn about your choices. If you like to visit the same restaurants, see if you can get a paper copy of the menu to take to your next nutrition counseling session and ask advice on what to choose.

• Ask that toppings such as cheese, potato sticks, hard-boiled egg, bacon bits, and fried items be left off your salad.

• Ask your physician about alcohol consumption. If allowed, select light beers and wine. Stick with club soda, sugar-free mineral waters, sugar-free tonic waters, and diet sodas for mixers with distilled liquor.

• Prime grade cuts of meat have the highest amount of fat marbled through the meat. Leaner selections may include tenderloin, strip steaks, and filet mignon. If the meat portions are very large, ask your waiter to cut your portion in half before serving it and box the second half to take home.

• If you don’t have time to read the menu before ordering, ask for a vegetable plate with or without a small portion of grilled or broiled meat.

Smart Selections

• Choose fresh green salads, broth-based soups, steamed seafood, or baked or grilled vegetable appetizers rather than fried vegetables, cream-based soups, fried seafood items, and potato skins.

• Choose salsas or light salad dressings rather than cheese or creamy dips.

• Choose vegetable toppings and fillings in place of meat toppings for pastas, pizzas, pita sandwiches, fajitas, and calzones.

• Stick to fresh vegetables and fruits at salad bars. Limiting potato and pasta salads, coleslaws with mayonnaise, meats, fried vegetables, shredded cheese, bacon bits, hard-boiled egg, and sweetened fruits.

• Ask for fat-free milk for coffee or tea rather than cream or powdered creamers.

• Use artificial sweeteners rather than sugar or honey. Ask whether the restaurant serves sugar-free or reduced-sugar jams, jellies, and syrups.

• Choose to have either an appetizer or dessert.

• Watch out for condiments! Stick to very low-calorie choices such as black pepper, horseradish, fresh lemon or lime juice, mustard, light soy sauce, flavored vinegar, crushed red pepper, and salsas.

• Limit cheese on sandwiches, burgers, vegetables, and as a topping on the dish. Most restaurant cheese is not low in fat or sodium.

• At steakhouses and roadhouses, bypass the peanut bucket and ask for your salad to be served right away while you wait for your meal.

• Carry sugar-free gum or mints to use after a meal rather than having dessert.

• Consult an expert. There are several excellent books on successfully eating out. Try these, available from the American Diabetes Association:

• The ADA Guide to Healthy Restaurant Eating

• The Diabetes Carbohydrate and Fat Gram Guide

• The Official Pocket Guide to Diabetic Exchanges

Proper Portions

• If you tend to overeat, do not choose the food bar option. Order from the menu to keep your portion sizes in line and avoid temptation.

• Drink liquids throughout the meal to aid digestion and help slow your eating.

• If portions are large, do not hesitate to ask for a take-home container. Save the food for another delicious meal.

• Order a senior or child portion if you tend to overeat.

• If you are taking diabetes medications, ask your doctor how you can adjust your medication for larger meals. Many medications should not be changed even if meal size alters.

• If you feel you have overeaten, try to include some extra physical activity and water during the rest of the day.

• After you’ve served yourself in a family-style restaurant, ask that the serving bowls be cleared from the table.

• Have the roll / breadstick basket removed after taking your portion to avoid temptation.

• Split dessert with your dinner partner.

Food and Drug Interactions

Most people are aware that some medications may affect the effectiveness of other medications, or may cause mild side effects. Less well known is the potential impact of some medications on nutrition. Some over-the-counter and prescription drugs have side effects that may impair your appetite, change the way your food tastes, alter digestion, cause dry mouth, affect your sense of smell, and change how your body absorbs or uses nutrients. The impact of the drugs you’re taking may be slight or substantial. It is important to ask your pharmacist about all the potential side effects of your medications.

Before a health professional prescribes a new medication, you have the responsibility to inform him or her of your other medication use, your health condition, past medication intolerances, and your typical eating schedule. If you drink alcohol, even occasionally, make sure your physician and pharmacist are aware of this. Alcohol may change the effectiveness of the medication (either increasing or decreasing its effect) or react in negative way with your medication. If you do not follow a standard eating pattern, or follow a different day/night schedule, inform your health care professional. Your morning medication may be intended for people who eat a full breakfast.

If you take medications with or between meals, follow the guide lines as written. Do not change the timing of medication for your convenience or because you want to experiment. The timing of your medication and meals has been carefully considered to pro duce the greatest therapeutic effect and reduce side effects. This is especially true for diabetes medications

Write out your medication schedule and use a daily pill box to help you stay on track. If you use pill reminder boxes, be aware some medications are not to be taken out of their original container and to be exposed to light and heat. Always read your prescription medication information insert thoroughly to find out about storage requirements. Always discard expired medications.

Set timers to help remind you if you forget to take your medications frequently. Or, plan to take them during typical daily events according to the time of day prescribed, such as right after you wake up, when the mall arrives, or during your favorite television show. If you forget a medication, ask a pharmacist before taking it at a non-prescribed time.

Below is a basic list of some potential food and drug interactions associated with some commonly used medications. This list does not imply your medication will cause a problem, nor does it list every possible side effect that a medication may have. Always cheek with your pharmacist or physician for more information about any medication you may be taking.

If you are experiencing unpleasant symptoms that you suspect may be medication side effects, consult your physician as soon as possible. Never discontinue a medication without advice from a physician. Try some of these tips to get the most out of your diabetes medications.

• Use one pharmacy to fill your prescriptions, or at least the same chain. If you use several pharmacies, they may not have complete or up-to-date records to help prevent drug/drug or nutrient interactions.

• Carry a list of your prescribed and over-the-counter medications at all times in case it is needed.

• Share information about alcohol use, herbal supplements, dietary supplements and home remedies with your health care professional.

• If medications are difficult to swallow, ask the pharmacist if the medication is available in a different form—elixirs, liquids, powders, or coated pills.

• If medications cause an unpleasant aftertaste affecting your appetite, follow the medication with a bite of dry food such as toast or a cracker to help neutralize the aftertaste. Ask your pharmacist if it is okay to brush your teeth and rinse your mouth with water after taking the medication.

• Discard any unused prescription medication after your illness has resolved—don’t play doctor by trying to reuse old prescriptions.

• Keep a small stock handy of approved over-the-counter medications for mild colds and common health problems. Always have your physician approve of all over-the-counter medications, including pain relievers, cold medications, cough syrups, decongestants, allergy medicines, and antacids.

• Ask if syrups or elixirs can be made without added sugar.

• Find out if medications you take routinely have any affect on nutrient absorption to prevent potential nutrient deficiencies.

Handling Common Problems

It may help to know that you are not alone when you experience some of the less desirable side effects of aging. We all have to cope at some point with increased digestive problems, loss of appetite, diminished ability to chew or taste foods, and stubborn weight changes. There are methods and techniques that will help; read on to find out which will work for you!

Digestive Difficulties

Digestive problems may be the result of food intolerances, poor digestion, or poor absorption. You may have a problem requiring medical treatment. From time to time, most people experience some mild form of digestive difficulty. As people age, their digestive process becomes slower, which may result in occasional uncomfortable symptoms. Some therapeutic daily medications may also cause symptoms to occur more frequently. However, it is important to seek medical attention from a physician for recurring digestive problems such as heartburn, stomach pain, vomiting, constipation, or diarrhea.

People who experience recurring digestive problems will often eat less or limit their food choices. This may lead to undesirable weight loss or lack of proper nutrient intake. Seek medical evaluation before imposing significant changes to your meal plan, and ask your RD for an up-to-date evaluation and new meal plan guidelines. For diagnosed digestive problems that occur infrequently, the following basic guidelines may help.

Gastro-esophageal Reflux

• Lose weight if needed

• Watch portion sizes

• Avoid stressful activities just after meals

• Stay upright for at least 1 hour after meals

• Avoid foods high in fat

• Avoid carbonated and alcoholic beverages

• Avoid tight-fitting clothing

• Drink 4 - 8 oz of water after a meal

Peptic Ulcers

• Avoid alcohol

• Avoid caffeine

• Limit fatty or greasy foods

• Avoid powdered meat tenderizers

• Do not take antacids without first checking with your physician

• Avoid tight-fitting clothing

Mild Diarrhea

• Initially limit intake to liquids and progress to solids as tolerated

• Try applesauce, bananas, plain cereals, breads, and crackers first before adding other solid foods slowly

• Limit high-fiber foods

• Avoid anti-diarrhea medications unless approved by your physician

• Choose lukewarm beverages and foods rather than very hot ones

• Drink fluids, especially water, every hour while awake

Mild Gas

• Limit high gas-forming foods (bran, carrots, dried beans, lima beans, cabbage, peas, onions, cauliflower, and others per personal tolerance)

• Chew food well

• Limit foods high in fat

• Avoid carbonated beverages

• Limit lactose if lactose intolerant, or use lactose-free items

Constipation

• Drink plenty of water and fluids each day

• Stay active

• Avoid sitting for long periods of time

• Increase fiber intake with fresh fruits and vegetables

• Add nuts, dried fruit, and bran granules to salads and other foods

• Try higher-fiber breakfast cereals and whole-grain bread products

• Try prune juice or warm beverages (these old home remedies can often speed relief)

• Avoid laxatives unless you have consulted a physician—try a stool softener instead

Loss of Appetite

True hunger causes physical changes that create discomfort in your body. Appetite is better defined as a desire to eat. There are times when your body may be hungry and need food, but you don’t have any appetite. Sometimes the reverse is true. Many factors influence our appetite, such as how we feel emotionally, how we eat, where we eat, available food choices, our ability to taste foods, current health status, lifestyle issues, and our food habits. Before you go any further, get a medical evaluation to find out if you have an underlying medical condition that may be contributing to or be the cause of your change in appetite.

Emotions

Some of us eat best when we are happy, and not as well when we feel sad, stressed, or bored. Others may react to stressful events by turning to food to provide some degree of control or comfort. Food is an important part of our emotional lives. From our early child hood years onward, we usually celebrate special lifetime events and holidays with special foods. Because of this, we generally associate family and social gatherings with food as well. This tie between food and emotions can last a lifetime.

When our health, lifestyle, social, financial, or family situation changes, it can affect our emotional well-being and in turn our appetite. Some common emotional problems such as depression, stress, and boredom can enhance or decrease a person’s appetite.

Depression. Depression is the most common emotional disorder in adults and can result in changes of appetite. Chronic emotional stress or distress can contribute to the development of depression.

Having a chronic disease causes physical and mental demands on you. If you feel overwhelmed because of the diagnosis or treatment for diabetes or another health condition, talk to your health care professionals. You may discover resources and support you did not know existed.

If you feel you may be suffering from symptoms of depression, such recurring lack of appetite, lack of energy, feelings of sadness, sleeping problems, concentration problems, or difficulty in controlling your emotions, seek help from a mental health professional. If you are diagnosed with depression, you will find there are many excellent resources and treatment plans to help you.

If emotional problems are affecting your appetite, it will be harder for you to control your diabetes. Poor or irregular food intake increases your risk of hypoglycemia, may result in undesirable weight changes, and may cause a downward spiral in your general health.

Here are some tips to help your appetite when you are coping with depression.

• Consider joining a diabetes support group or a social organization.

• Have regular meal times even if you eat very little.

• On days when you feel well, cook a little extra food and freeze the extra portions for other days when you may not feel as inspired to cook.

• Bring humor to your table—read the comics while you eat or an amusing book.

• Keep easy-to-fix items on hand, so the process of cooking does not further discourage you from eating.

• Try to eat with others as often as possible.

Stress. Everyone lives with a certain amount of daily stress. Stress can help stimulate us to get things done. But if stress occurs too often, is too profound, or is ongoing, it can seriously affect your health.

It is natural to seek comfort of some form or another when you are feeling stressed. Seeking comfort in food, though, will affect the course of your diabetes and make you feel worse in the long run. Try alternative forms of comfort and relaxation when possible before turning to food. Here are some strategies to help.

• Practice stress management activities daily—try relaxation exercises, deep breathing, or journal writing.

• Distract yourself with a new hobby or interest.

• Phone a friend—it is hard to eat and talk at the same time.

• Find other ways to reward yourself after difficult or challenging experiences (rent a favorite video, get your hair styled, or buy a new outfit or gift for a grandchild).

• Drink a full glass of water to fill you up when you feel like eating.

• Keep lots of fresh vegetables available to crunch on if you have to instead of high-fat and —calorie snacks.

• If you feel stress is bothering you so much you can’t take proper care of yourself, seek help from a health care professional.

Boredom. From time to time, ail of us have been bored. As an older adult, the days of raising a family, going to work, or managing a large household may be things of the past. Living alone, lack of transportation, or limited mobility can significantly impact your ability to enjoy former activities. Too many people watch TV or eat as an antidote to boredom. Try these tips to break those habits.

• Join a volunteer guild, social group, or support group to occupy your time. There are many opportunities for volunteer work that don’t even require you to leave home.

• Consider trying new hobbies where you use your hands to keep them busy.

• Follow a regular schedule of waking and sleeping to help keep your appetite on track.

• Sip on water or other zero-calorie beverages through the day rather than eating solid foods.

• Try sugar-free chewing gum.

• Keep sugar-free gelatins and sugar-free Popsicles available for snacks.

• Choose healthy crunchy or chewy items like raw vegetables and fruits rather than creamy or crispy items (think how much harder it is to eat too many carrots than potato chips).

• Chew your food slowly to enjoy the flavor longer.

• Talk to your RD about making your meal plan more flexible if you know you will snack during the day. Together you can develop a meal plan to fit in your food habits.

• Keep food in the kitchen and dining areas only—storing and eating food in other areas, such as in front of the TV, make it easy to overeat.

• Keep temptation foods out of the house. If you must have some thing, purchase only one portion at a time.

How We Eat

We eat by chewing and swallowing our food, of course. But the natural aging process creates changes in the physical condition of your mouth. Tooth loss, chewing difficulties, and less saliva production are three common physical changes known to affect food intake.

Tooth loss may directly cause self-imposed food restrictions, such as giving up fresh fruits and vegetables, despite still having an appetite for them. Poorly-fitting dentures or partials may make eating painful. Limiting intake to only soft foods may limit your intake of important nutrients and fiber as well. Seek help for tooth loss right away. Have regular dental exams and get properly fitting dentures and partials. Brush and floss each day to keep your teeth in good shape.

Poorly chewed foods may create digestive disorders, which can further impair food intake and appetite. Chew your food well to maximize the amount of time it’s in your mouth being exposed to digestive enzymes. Sip on water throughout your meal to keep your mouth moist and make up for less saliva.

If your food choices are still limited, consult a RD to make sure you are getting alternative sources of nutrients. A balanced diet should ideally include foods of many different textures and consistencies.

Where We Eat

Take a look at the place where you eat your meals—is it in the kitchen? The dining room? On the couch? Where you eat can affect how you feel about eating and your appetite as well. Since we must eat several times a day, make sure it’s in a pleasant environment!

• Use lots of light (even candle light) to brighten the area.

• Remove bills, grocery lists, and to do lists from your dining table—looking at them may not help you relax.

• Purchase discount placemats and napkins when they are on sale, then use them throughout the year to brighten the table.

• Try using paper plates with different patterns. Buy them in small quantities so you can change often to create interest. Clean is easy tool

• Listen to music to create a more pleasant environment. Try different types of music each night.

• Dine outside when possible, or near a window, and you can watch the happenings of the neighborhood.

• Place favorite photos of family or friends on the table if you dine alone.

• Place different decorations on the table every week—a fresh flower, a seashell from a past vacation, a favorite card from a friend, or a funny comic from the newspaper.

Food Choices

Most people eat the same foods and meals over and over again. These food habits can last so long our interest in eating begins to decline. Even if you are not the most adventurous eater, you can break out of boring food habits with a little effort. Here are some tips to prevent you from getting stuck in a food rut.

• Try one new food item each week.

• Open up a cookbook and find a new recipe using one of your favorite ingredients.

• Eat at a different restaurant every few weeks and examine the food choices and combinations presented. Reading restaurant menus may give you new ideas for your own kitchen.

• Prepare your favorite food item in a different way. For example, instead of plain mashed potatoes, try a twice-baked style or potato pancakes with chives. Instead of plain grapefruit, try broiled grapefruit or tropical fruit salsa.

• Add one new spice or herb to your usual recipe.

• Go along when a friend grocery shops and see what your friend’s favorite foods are.

• Buy small quantities of ten different food items rather than large quantities of two or three things.

• Plan your meals a day or two ahead so you have time to get the necessary ingredients for a new meal.

• When making a new recipe, make extra and freeze individual portions. Then you can eat a wider variety of food without preparing them each time from scratch.

Make Food Appealing

Making food attractive does not have to take a lot of time, artistic ability, or money. Yet it can help stimulate your appetite as well as provide an outlet for creative abilities! Here are some ideas to help you make food more appealing.

• If you use frozen dinners, remove the food items from the reheating plate and place on your own dinnerware before you set it on the table.

• Avoid dinners with food items that are all the same colors. Chicken, mashed potatoes, a piece of white bread, and pear halves would be a very dull-looking meal. Instead, balance lighter colors with darker ones to add interest. For example, chicken with sweet potatoes, whole-wheat bread, and a fresh apple has more eye appeal.

• Add herbs arid spices for an easy garnish—try paprika, rosemary, basil, or chives.

• Garnish your plate with a slice of fruit, a couple of fresh red radishes, or green cucumber slices.

• Try a sprinkle of low-fat grated cheese or chopped green onions on salads, potatoes, vegetables, or pasta for a bit of color and taste.

• Serve yourself on your best china from time to time—you deserve it!

Loss of Taste

Three factors work together to give us the remarkable ability to taste and enjoy foods: properly functioning taste buds, a sense of smell, and enough moisture in the mouth. The natural aging process can affect all three of these factors in a negative way, causing changes in your ability to taste food.

Special cells on our tongues allow us to taste. Known as taste buds, these cells have unique chemical receptors to identify sweet, sour, salty, and bitter flavors. As we age, cells detecting sweet and bitter flavors are more adversely affected than those detecting sour and salty flavors. This may be why your cravings for sweet foods can no longer be easily satisfied.

Taste and smell are intertwined due to cells in your nasal cavity as well as the connection between your nasal passages and your mouth and throat. Without your sense of smell, you would quickly discover that taste is as much about what happens before food enters your mouth as it is in your mouth. Have you ever tried to taste food while holding your nose? Or during your last cold, when your nose was stuffy, did you find food less appealing?

The third factor in the ability to taste is moisture, which comes from saliva production within your mouth. Aging reduces saliva production in as many of one-third of senior adults. Other factors may also impair your ability to taste your food, such as smoking, use of other tobacco products, temporary colds and viruses, and some chronic diseases. You cannot reverse physical changes if they have occurred, but you can improve your ability to taste to some degree. To help refresh your taste buds, try these suggestions:

• Do not smoke.

• Do not use smokeless tobacco products.

• See your dentist every six months for mouth, gum, and tooth evaluation.

• Chew foods longer.

• If foods smell unpleasant to you, wait to serve very hot foods until they have cooled down a bit—steam will further enhance strong vapors. Try eating lukewarm or cold items instead.

• If you can’t smell as well, serve more hot foods, and let their aroma permeate your nose before eating. Warm items such as breads and liquids to help stimulate your ability to taste.

• If your mouth is dry, sip liquids before and during meals to keep it moist.

• Change the textures on your plate. If foods are all the same texture, it may be more difficult for you to differentiate between flavors.

• Change the sequence of items eaten. Take one bite of this, then switch to a bite of something else, and so on. This practice may help your taste buds stay more stimulated throughout the meal.

• Change seasonings. Add some zest to meals with stronger herbs and hotter spices.

• Make the most out of your ability to detect sour foods—add citrus juices to vegetables, try citrus salsas as a condiment, add a bit of vinegar to vegetables, squeeze lemon into your drinking water, or try tart fruits such as cherries and blackberries.

• Try new recipes to see if spicier food tastes better now.

• Limit bland foods such as white bread, saltine crackers, and plain potatoes. Try herb breads, wheat or seasoned crackers, and a dollop of fat-free sour cream with chives on a baked potato.

Weight Changes

Older adults commonly struggle with weight changes. Many people find weight control to be very difficult. Weight excess (obesity) or weight deficit (being underweight) are challenges at any time of life, but the underlying causes of the problem may be different in an older than an younger adult.

How much should you weigh? Magazine and life insurance weight charts are commonplace tools individuals use to assess whether or not their body weight is acceptable. But a person’s acceptable body weight should not be based on just one parameter, such as height or age. Ask your RD, who will assess your body size, body structure and composition, weight history, medical condition, and activity factors, arid will also take into consideration your stage of life.

Obesity

The energy needs of the older adult are different from those of a younger adult. The need for calories decreases as we age due to physiological changes in body composition. Lean body mass (muscle mass) decreases as fat mass (adipose tissue) increases. In other words, our body composition changes to a higher portion of fat naturally as we age. Since muscle mass requires more calories (energy) than fat mass, calorie needs are lower as this body transition begins to take place.

Changes in activity will also affect metabolism. Many older adults may be less active than when they were younger due to physical limitations or lifestyle changes. Since less activity means a need for fewer calories (energy), the balance of energy changes. These two factors are common causes of steady weight gain as a person ages, even if caloric intake remains fairly stable.

Obesity may also be caused by overeating. Overeating can be due to lack of knowledge about portion control, increased frequency of snacking, emotional eating, poor meal planning techniques, and poor food choices. Obesity is a risk factor for many health problems such as hypertension, heart disease, poor circulation, arthritis, back problems, and, of course, diabetes. Having diabetes and being overweight increases your risk for diabetes complications as well.

Unfortunately, there is no magic cure or quick fix for being over weight. The cure is to eat fewer calories than is required so the body will use some of its own stored energy (fat). While this cure seems simple, implementing a meal plan for weight control that is satisfying and can be followed for long periods of time is a challenge. Not only will it prevent and control your health problems, but it will increase your energy level and improve your general well being. Here are some guidelines to consider when you try to lose weight.

• Get a physical exam from your doctor before attempting any weight loss plan. An exam can ensure you are ready for a new eating and exercise program and will also rule out any medical problem that may be contributing to your weight problem.

• Set realistic goals. If you have been heavy all your adult life, it may be unrealistic to think you will finally lose the entire 50 extra pounds you have carried for 30 years. Talk to a RD about your weight loss goals and together you can develop a reasonable plan. Any weight loss will be advantageous to your health!

• Set short-term and long-term goals to help keep you on track. Goals can help keep you focused. Don’t forget to reward yourself when you meet any one of your short-term goals. If you don’t meet the goal, redefine it and try again.

• Don’t be tempted by diets that promise quick weight loss. A meal plan developed with a RD can meet your weight and diabetes management goals. The results may take more time, but they are more likely to last.

• Make sure your weight loss plan includes your favorite foods—if not, chances are you won’t be as satisfied with it, and it could become difficult to follow long term.

• Avoid weight loss plans that require you to buy expensive specialty foods. You should be allowed to use foods from your own food pantry and items from a regular grocery store.

• Find support. Losing weight is much easier when you have a person who will provide encouragement and support to cheer you on.

• Do not attempt weight loss during stressful events. After a change in residence, loss of a spouse, or a dramatic change in health, don’t try to take on the challenge of weight loss. Wait until a stressful event has eased before trying to lose weight.

• Stay active. Weight loss is more successful when combined with a regular exercise program. If you are just starting on an exercise plan, you may find it increases your appetite just when you are trying to eat less. Keep low-calorie snack ideas (diet gelatins, fresh vegetables, diet Popsicles, and so on) available to help satisfy your appetite.

• Choose a weight loss plan that includes a wide variety of foods to help keep you interested in the plan.

• Decreasing the amount of calories you take in, and increasing your activity level, may increase your risk of hypoglycemia when you have diabetes. Talk to your health care professional about strategies to decrease your risk of hypoglycemia, and always carry hypoglycemia treatment with you.

• Keep a food journal. Write down what you eat and how you feel. Sometimes we find ourselves eating when we are under stress, bored, or sad. Once we identify these trends, this information can be used to help develop a plan to overcome these negative emotions that result in overeating. Use the food diary sample given later.

• Leave the table after eating.

• Eat low-calorie snacks before eating out or social occasions where you may be tempted to overeat.

• Take a break halfway through your meal and relax a few minutes. This may help you focus on how full you are getting and slow you down a bit.

• Stay positive. Weight loss takes time!

Being Underweight

Not weighing enough can make you feel tired and weak. It may also increase your risk for developing additional health problems, such as poor immunity against colds, viruses, and infections, as well as many nutritional deficiencies. Weight loss occurs when you eat too few calories for your body’s needs. Changes in a person’s ability to eat, poor appetite, certain chronic diseases, viral illnesses, poor blood glucose control, and side effects from medical treatments are all possible causes of undesirable weight loss.

If you have experienced unexplained or rapid weight loss (more than one or two pounds in a week), ca your doctor for a medical evaluation. You will probably need a strategy from an RD to help you gain weight back at a healthy rate without feeling forced to eat vast quantities of food. To help you gain weight, try the following ideas.

• Stay on a meal schedule to help trigger your appetite response.

• Stock up on your favorite food item—it’s not a problem right now if you eat tuna fish three times a day. If it appeals to you, it may help to keep your calorie intake up.

• Keep easy-to-prepare items available.

• Substitute milk and juices for water, tea, and coffee.

• Try six small meals a day rather than three large ones if you feel uncomfortable from eating large meals.

• Consider new recipes to help spark your interest in foods.

• Enlist friends and family to help share cooking responsibilities until you reach your goal.

• Consult a RD about the use of liquid supplemental beverages. These beverages are a great way to get extra nutrition. Since there are many different kinds, check with a nutrition expert to see what works with your meal plan and budget. There are recipes available for homemade supplemental beverages. Common ingredients may include powdered milk, fruit, yogurts, and other products you probably already have.

• Stimulate your interest in food by making it look appealing.

• Keep a food diary to help keep track of the amounts of food you are taking in. Have a RD do a calorie count to see if you are meeting your calorie goals. It takes 500 extra calories a day to gain about one pound a week!

• Chronic pain can severely affect a person’s appetite. If you are suffering from chronic pain, seek medical help to resolve the discomfort.

• Food intolerances may be affecting your intake. If you experience gas, bloating, or other digestive problems frequently, list your symptoms in your food diary to help identify problem foods.

• Do not take herbal supplements or vitamin and mineral supplements without checking with your doctor and your pharmacist. These products may interact with your other medications. Also, some supplements contain higher quantities of nutrients than what the body truly needs. You might be wasting your money.

• Expect weight gain to be a slow process, so stay positive!

Sample Food Diary

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