When a panel of health and nutrition experts ranked 35 diets for Best Diets, they considered not only weight loss, but also whether diets were heart healthy, good for controlling diabetes and easy to follow. Now, two panel members discuss which U.S. News-ranked diets make the most sense for seniors.
Fewer Calories/More Protein
For Amy Campbell, a registered dietitian and diabetes educator, the DASH, TLC and Mediterranean diets stood out as smart choices for older adults, because they’re good for weight loss as well as controlling conditions such as diabetes and high blood pressure.
As with anyone, overweight and obesity can be issues for seniors, Campbell says. “People are living longer, so we’re seeing more of it in older adults.” And, she says, “As we get older, our calorie needs go down. People don’t need to eat as much as they did when they were 20 or 30.” Older women generally need anywhere from 1,600 to 2,200 calories per day, depending how active they are, Campbell says, while younger women need about 1,800 to 2,200 daily. For older men, the range is 2,000 to 2,800 calories per day, compared with 2,200 to 3,200 calories for younger men.
Frail elderly people face different issues. “One concern for older people is getting enough protein,” Campbell says. “We need more as we age.” A lack of protein puts people at risk for lower immune function and osteoporosis.
You don’t necessarily have to follow a specific diet, she says, “just a well-rounded diet with extra protein.” That means making the most of the calories you take in, she says, not just eating a bowl of cereal for dinner or making entire meals of toast and tea. “You don’t need animal protein in every meal,” says Campbell, who praises lentils, beans and chickpeas as great sources of inexpensive protein to round out meals.
Campbell says a very low-fat plan like the Ornish diet might be less appropriate and harder for seniors to follow. Similarly, she says, the Biggest Loser diet would not be ideal, and the phases could be hard to comprehend.
“For diets in general, it’s best to try and make it easy and fit comfortably into a person’s life,” Campbell says. “Ones that promote good health but are as easy to follow as possible.”
Simplicity And Balance
Michael Davidson, director of preventive cardiology at the University of Chicago Medical Center and a Best Diets panelist, says Weight Watchers and diets with similar structures score well because of their simplicity. With Weight Watchers, for instance, foods are assigned different points, which you add up daily to stay at your personal target, which is based on your sex, weight, height and age. “You don’t have to do a lot of thinking about what type of balance of foods or menu plans,” Davidson says, which may be somewhat more challenging for seniors.
Long-term compliance was an important factor in ranking diets, Davidson says: “What can be a lifelong change instead of just a short-term fix for the patient?” Therefore, he says, “it’s really more about variety and food choices, as opposed to portion sizes, that are applicable to an elderly individual. So it’s the kind of diet I prefer for those patients.”
Davidson sometimes sees iron deficiency in frail older patients. “They don’t eat enough red meat; they don’t get enough iron in the diet,” he says. Although the paleo diet was lower-ranking among the Best Diets, he says “it could be a good diet. It’s had a little bit of a hype to it, but the principles are not far off, such as people eating more complex carbohydrates and more lean meats.” He points out that constipation can be an issue for seniors on low-carb, low-fiber diets.
Heart Health and Diabetes
“Of the ranked diets, both DASH and the Mediterranean diet can help people with both diabetes prevention and management,” Campbell says. They work because they encourage a variety of foods and make people aware of the carbs they consume, she adds. Both diets are mentioned in the latest nutrition guidelines from the American Diabetes Association.
Davidson says people with high cholesterol do better with low-saturated fat diets that call for low-fat dairy sources, lean red meats and fish. It’s important for seniors with high cholesterol to avoid sweet baked goods with trans fats, he says: “We now recognize that trans fats as especially bad among all the fats we can consume.”
“We’re all creatures of habit,” Campbell says. So, she says, imagine you’re 75 years old and have to change your habits and incorporate new foods like tofu. Although most diets offer plenty of online and printed resources, they can be overwhelming. “It’s hard sometimes to pick up a book and say, ‘what should I be eating,'” she says. For older adults, it can help to work with dietitians.
Davidson says the Weight Watchers point system works well, because it makes eating balanced meals easy. Others that provide prepared meals throughout the day, such as Jenny Craig and Nutrisystem, “keep caloric content low but steady throughout the day,” he says. “And those work for the elderly quite well.”
Cost can be a problem. Jenny Craig foods cost an average $15 to $23 each day, plus enrollment and consultation costs. Weight Watchers’ nonfood expenses can reach nearly $70 per month, plus the cost of either Weight Watchers-brand or outside foods. “You can try and mimic the Weight Watchers diet and find prepared meals that work for patients [when expense] is an issue for the elderly,” Davidson says. His office provides a seven-day meal plan with menus and counseling for patients.
Fruits And Veggies
U.S. News also ranks Best Plant-Based Diets, with the Mediterranean and Flexitarian diets in the top spots. Seniors often fall short when it comes to fruits and vegetables, Campbell says.
It’s possible to eat healthy produce on a limited budget. “Frozen fruits and vegetables can be cheaper and sometimes even healthier than fresh, depending where they’re shipped from,” Campbell says. Canned produce can be OK, she says, if there’s no added salt.
Sense of thirst can decline with age, so drinking enough water is important for preventing dehydration. Fluids such as soda or fruit juice add a lot of calories, Campbell notes, and it’s not good for people with diabetes to drink juice all day. Instead, she suggests flavored water or water with a slice of lemon. She has good news for coffee and tea lovers: Caffeine is not as dehydrating as once thought.
Davidson says with the Atkins diet, especially in the induction phase, patients on diabetes medications can experience low blood sugar and diuresis (they may urinate more). While he generally supports very carb-restrictive diets, he says moderate programs are better for many seniors.