Does old age have to be horrible?

We all know that life isn't fair. A person who eats healthily, does yoga and takes lots of exercise may die an early and painful death while a heavy-drinking smoker who takes no exercise and eats junk food may die in their sleep at 100. None the less, Margaret Moss believes that micronutrient malnourishment among the elderly makes a heavy contribution to illness and unnecessary hospitalisation.

Nutrient deficiencies among older people may be due to:
• Poor intake as a result of poverty, labour-saving packaged foods in residential homes, lack of appetite, or difficulty shopping or preparing food.
• The side effects of common drugs.
• Illnesses that deplete nutrients.
• Less time spent in the sun because of poor mobility or sight which may result in poor vitamin D levels. Synthesis of vitamin D in the skin also declines with age.
• Postmenopausal women are less efficient at absorbing calcium.
• Because we become less efficient at using protein muscle mass may decline with age.
• At least in rats, intestinal absorption of magnesium, and the level of magnesium in bone reduces with age. Magnesium is needed for bone strength, sleep, controlling blood pressure, and the strength of muscles including the heart.
Meanwhile, if an elderly person is lonely, thinks there is nothing to live for and that it is not worth bothering to cook, they are likely to become ill. Joining the University of the Third Age, a rambling club, a pottery class or a book club is a very good idea.

Healthy does not have to mean expensive

There is a misconception that living healthily has to be expensive. I have often been in trouble for saying that the best way to avoid heart disease was not to drink milk, and that would not you cost a penny.

Of course exotic vegetables and organic food cost a lot but as long as you are able to walk to the shops, buy potatoes, carrots, onions, lentils and a bone, and as long as your hands are able to peel vegetables, you can make tasty and nourishing soup.

Tinned wild pink salmon is a cheap source of the beneficial omega 3 fats. In Greece, the elderly who live longest are those who eat more vegetables and pulses, and fewer dairy products.

Nasty Minerals

The harmful minerals - lead, mercury, cadmium and aluminium - accumulate with age. Harmful minerals cause damage to the kidneys, which leads to high blood pressure.

Mercury and aluminium are associated with Alzheimer's. So avoid those silvery grey amalgam dental fillings that are about half mercury, as well as aluminium foil, pans and antacids. If you can afford it, ask an expert to remove any amalgam fillings carefully.

Have enough vitamin C to remove mercury from your body and avoid eating tuna, because it often has a lot of mercury in it. Wipe the top of wine bottles, to remove the lead before pouring out the wine.

How to look after your arteries

• One of the reasons why milk causes coronary heart disease is that one of the sugars (galactose) in milk attaches itself to cholesterol. This leads to oxidation of cholesterol and deposits in the arteries.
• Another is that one of the chemicals in the membrane round the fat globules in milk is thought to cause the blood to clot.
• Hard cheese is a healthier source of calcium than milk or cottage cheese, because the sugar has disappeared.
• Table sugar also attaches to cholesterol, but is not as bad as galactose. High fructose corn syrup should be avoided, as well as fructose, which unfortunately is sold in health food shops.
• Vegetables are generally healthier than fruits, as they are usually less sweet.
• Fish is useful, because it contains anti-clotting fat. Tinned wild salmon is cheap and useful.
• Nuts, seeds and pulses provide magnesium, which keeps down blood pressure, and reduces the tendency of blood to clot.
• For useful nutrients found in food - see table opposite. Meanwhile eat plenty of potassium in vegetables, and only a small amount of sea salt.

Most people should avoid liquorice as it raises blood pressure. Looking after the arteries also protects against strokes and declining brain power, including senility.

Taurine is an amino acid. Zinc, B vitamins, lecithin and taurine are helpful against Alzheimer's.

Cancer & diabetes

Cancers thrive on sugar, which is another reason for avoiding it. Vegetables, nuts, seeds and pulses protect against cancer. Diabetes is encouraged by sugar, but high fructose corn syrup and aspartame are worse than sugar.

Useful nutrients against diabetes are lipoic acid, chromium, magnesium, manganese, vanadium in parsley, potassium in vegetables and fruit, vitamin B3 and the B vitamin, biotin.

Osteoporosis & Arthritis

Osteoporosis can be caused by phosphoric acid in cola drinks, and excessive vitamin A consumption, for example from liver. Too much sunshine can contribute to skin cancer, but some summer sunshine provides vitamin D for the bones.

Calcium from cheese, and magnesium from leaves, nuts, seeds and bananas are needed, as is vitamin K from leaves or blueberries, and omega 3 fats from fish. Weight bearing exercise is important.

Arthritis can be caused by eating bran, whole grains and whole pulses. Molybdenum, the omega 3 fats in fish, and vitamins B2 and B5 protect us from arthritis. It helps to put a cupful of Epsom salts in the bath.

Sight

Certain sugars (galactose in milk and xylose in pears, blackberries and raspberries) can cause cataracts. Lead may also be involved. Macular degeneration appears to involve oxidative stress. So antioxidants like vitamins A, B2, C and E, copper, manganese, selenium, zinc, carotenoids and anthocyanidins are helpful. Two of the carotenoids, lutein and zeaxanthin, protect the macula from blue light. Homocysteine is involved, which suggests that folic acid, vitamins B1, B2, B6 and B12, magnesium and zinc are protective. Fried oils should be avoided, as they may damage the macula.

Drugs & deficiencies

Only take drugs if they are really essential. Many drugs cause deficiency in nutrients. For example, statin drugs deplete coenzyme Q10, an antioxidant, which is also needed for producing energy. They may also reduce selenium, vitamin E and beta carotene levels. Antacids may reduce levels of folic acid, calcium, copper, phosphate and vitamins A and B12.
High blood pressure is often due to a magnesium deficiency. Yet some blood pressure drugs cause excretion of magnesium, potassium, zinc and vitamin B1.

Beware the ‘bad garage’ school of medicine. If you take your car to a bad garage, you may find one problem solved and another one created. This can happen with injudicious use of drugs. Drug A may cause a deficiency in a nutrient but, instead of supplementing the nutrient, drug B is prescribed to counteract the sideeffects of A. If you aren't careful, B can lead to C, and C to D, and you find yourself on a dozen drugs. No one can work out the effect of such a combination.

The most important things to do for a healthy old age are to have a healthy diet, and exercise. However, Harvard School of Public Health also advises taking a nutritional supplement throughout life, and there is much research that supports this. Given that absorption of some nutrients, and efficiency at using them tends to decline, good food and supplements become more important with age. No one can guarantee you will have a long, healthy life, but these measures make it more likely.

Some sources of helpful nutrients
Omega 3 fats - Wild salmon and trout, flax seed oil
Vitamin B2 - Split lentils, avocado
Vitamin B3 - Meat, wild salmon
Vitamin B5 - Avocado, chicken, eggs, pulses
Vitamin B6 - Meat, fish, bananas
Vitamin B12 - Meat, fish, eggs, hard cheese
Vitamin C - Vegetables, fruit
Vitamin D - Sunshine, salmon, sardines, eggs
Vitamin E - Egg, sweet potato, leaves, almonds, avocado
Vitamin K - Leaves, blueberries, eggs, cauliflower
Biotin - Wild salmon, sardines, eggs, pulses
Folic acid - Leaves, avocado, banana
Calcium - Hard cheese, shellfish, leaves
Chromium - Buckwheat, puffed rice, meat, hard cheese
Magnesium - Brazil nuts, okra, leaves
Manganese - Leaves, pineapple, nuts, pulses, eggs
Molybdenum - Buckwheat, red cabbage
Potassium - Vegetables, fruits
Vanadium - Parsley, safflower oil
Zinc - Sunflower seeds, mushrooms, meat, eggs
Lipoic acid - Brewers’ yeast
Lutein - Kale, broccoli, peas, Brussels sprouts
Zeaxanthin - Maize, orange peppers, oranges, honeydew melon
Anthocyanidins - Bilberry, blueberry, red cabbage

To consult Margaret contact the Nutrition and Allergy Clinic 0161 432 0964 www.nutritionandallergyclinic.co.uk

First published in 2007