Vitamin D needs are higher for those over the age of seventy. One reason for the increased requirements is that the synthesis of vitamin D from sun exposure declines with aging. In addition, calcium absorption becomes less efficient. While there is much debate about how much calcium people need at all stages of life, adequate vitamin D and calcium are both important for preventing osteoporosis in later years. The current calcium recommendation for those over age fifty is 1,200 milligrams per day, but studies suggest that amounts quite a bit higher are useful in preventing bone loss.
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It’s possible that for all older adults—vegan or not—supplements are necessary to achieve optimal calcium intake.
There has been quite a bit of discussion about protein needs as people age. Lower calorie intake results in slightly higher protein needs, and there is also evidence that protein is utilized less efficiently with aging. The FNB does not recommend an increase in protein intake for older people, but some experts suggest that protein needs could be as much as 25 to 50 percent higher for older people compared to
younger adults.
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Since vegans probably have somewhat higher protein requirements than omnivores, it’s important for older people to emphasize protein-rich foods in meals. High protein intakes along with resistance exercise, such as weight-lifting, have been shown to slow the loss of muscle mass that commonly occurs as we age.
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And protein supplements may improve bone health in older people.
Finally, the RDA for vitamin B
6
is higher for older adults. This shouldn’t be a problem for vegans as long as their diets include a variety of whole plant foods.
One other change actually makes diet planning a little easier for older women. After menopause, iron requirements drop by roughly one-half since women no longer lose iron through monthly periods.
The challenges in planning healthy meals for older people aren’t all related to changes in nutrient needs. Taste sensitivity declines with aging due to either a decline in the sense of smell or an actual reduction in the number of taste buds. It is a real phenomenon and can lead to over-salting of food or poor appetite. It’s hard to eat if food doesn’t taste good.
Changes in living situations can have a significant effect on food choices too. Older people who find themselves living alone may find that their interest in cooking and eating suffers. While most neighborhoods offer communal or home-delivered meals for seniors, they are rarely suitable for vegans. Chapter 8 lists options for simplified and convenient meals that can be especially helpful for anyone who is cooking for one.
TIPS FOR OLDER VEGANS
• Watch your calories. As calorie needs begin to decrease with aging, it’s important either to cut back on energy intake or—a better idea for all-around health—to increase physical activity.
• Limit empty-calorie junk foods. This is good advice for everyone, but if you are cutting back on calories to manage your
weight, it’s important to get the most you can from the foods you are eating. Choose plenty of whole plant foods and fortified foods to meet nutrient needs.
• Eat plenty of vitamin B
6
-rich foods like bran flakes, potatoes, tomato juice, bananas, figs, chickpeas, and veggie meats made from soy.
• Take a vitamin D supplement. It’s unlikely that older people—vegan or omnivore—can meet needs otherwise.
• Choose plenty of calcium-rich foods, aiming for at least eight servings per day from the Vegan Food Guide. If your diet regularly falls short of calcium, taking a supplement is a good idea.
• It goes without saying that no matter how old you are, a vitamin B
12
supplement (chewable or sublingual) or plenty of B
12
-fortified foods is a must for vegans.
• Give your diet a protein boost by consuming plenty of legumes, nut butters, and soy products. Choose quinoa instead of rice or barley because it is one of the most protein-rich grains.
• Seek out condiments and spices that add flavor without excess salt. If you like spicy foods, perk up meals with salsa or cayenne pepper, or add curry powder to beans.
• Don’t forget to drink plenty of water. Many older people don’t get enough liquids.
THE BUDGET-MINDED VEGAN
If, like many older people, you live on a fixed income, cutting food costs may be a priority. Some of the best vegan nutritional buys include potatoes, dried beans, frozen vegetables (which are just as nutritious as fresh), peanut butter, brown rice, and oatmeal. Refined grains are often cheaper than whole grains, and, if your budget is tight, there is nothing wrong with the occasional serving of regular pasta or white rice. You’ll find more tips for planning a healthy vegan diet on a budget in Chapter 8. The menu on page 169 makes use of lower-cost and easy-to-prepare foods.
CHANGES IN NUTRIENT NEEDS WITH AGING
PROTECTING COGNITIVE FUNCTION
Nutrition plays a role in all aspects of health as people age and that includes cognitive function. We don’t have any information about cognitive function in older vegans, but among Seventh-day Adventists, people who eat meat were more than twice as likely to develop dementia.
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Cognitive decline may be due, in part, to the production of free radicals, which are normal products of metabolism. Antioxidants, including nutrients like vitamin C and beta-carotene, as well as other plant chemicals, help neutralize free radicals and could support cognitive function. People who adopt vegan diets may have better antioxidant status according to some research.
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Higher levels of homocysteine might raise the risk for cognitive decline, which means it is important to get plenty of vitamin B
12
as well as vitamin B
6
and folate. Although the role of omega-3 fats in protecting
cognitive health is controversial, we recommend that vegans over the age of sixty take a daily algae-derived supplement that provides 200 to 300 micrograms of DHA.
Non-dietary factors also play a significant role in keeping the brain young. Exercise seems to be especially important, as is challenging your brain as much as possible by reading, doing crossword puzzles, or learning new skills.
Tips for protecting cognitive function:
• Yes, we sound like a broken record when it comes to this, but we can’t say it too often: Make sure you have a reliable source of vitamin B
12
in your diet.
• Eat an antioxidant-rich diet by consuming lots of fruits and vegetables.
• Take a daily DHA supplement of 200 to 300 micrograms.
• Exercise your body with daily walking, weight training, or an exercise class.
• Exercise your mind: Do crossword puzzles or Sudoku, learn to play bridge, or master a new language.
This sample menu for older people maximizes nutrient intake with affordable, easy-to-prepare meals.
BREAKFAST
• 1 cup bran flakes
• ½ cup fortified soymilk
• 1 banana, sliced
SNACK
• ½ whole-wheat English muffin
• 1 tablespoon peanut butter
• ½ cup grapes
LUNCH
• 1 cup homemade or reduced-sodium canned black bean soup topped with chopped avocado and tomato
• Sliced tomatoes
• 1 slice whole-wheat bread with 1 teaspoon margarine
SNACK
• 2 graham crackers
• 1 cup calcium-fortified orange juice
DINNER
• 1 small baked potato
• ½ cup baked tofu
• 1 cup steamed fresh or frozen collards
• Green salad dressed with vinaigrette
• ½ cup vegan ice cream
CHAPTER 12
PLANT FOOD ADVANTAGES
Health Benefits of a Vegan Diet
S
everal decades ago, most research on plant-based diets focused on nutrition problems associated with this “alternative” way of eating. That has changed in the past twenty years or so; now there is a significant focus on the health advantages of eliminating animal foods from menus.
Here is a quick summary of the benefits of plant-based diets:
• Plant foods provide phytochemicals. These are compounds found only in plants, some of which may reduce the risk of heart disease, cancer, and other diseases.
• Plant foods contain fiber, which is associated with a lower risk for cancer, heart disease, and obesity. Animal foods contain no fiber, and people who follow a typical American diet based on meat and dairy generally don’t get as much fiber as experts recommend.
• Plant foods contain no cholesterol. Even lean meats like shrimp and white chicken meat are high in cholesterol, and of course, dairy and eggs are loaded with it.
• Plant foods are low in saturated fat. Most of the saturated fat in American diets comes from meat and dairy foods. Replacing saturated fat with unsaturated fat or complex carbohydrates helps reduce blood-cholesterol levels.
• Some plant foods, like olives and nuts, are high in total fat, but they typically contain healthful types of fat.
• Plant foods are excellent sources of nutrients, such as folate, potassium, and vitamins C and E, all of which may be related to lower risks for chronic disease.
The research on diet and chronic disease is complex and conflicting, though, and trying to find solid proof for the benefits of vegetarian diets—and especially vegan diets—hasn’t been as easy as you might expect.
RESEARCH ON VEGETARIANS AND VEGANS
Much of the available information about the health effects of vegetarian diets comes from just a few large epidemiologic studies. (These studies are expensive, so there aren’t very many of them.)
• The European Prospective Investigation into Cancer and Nutrition-Oxford (EPIC-Oxford) in the United Kingdom has 65,429 participants including a fairly high number of vegetarians.
• A study of Seventh-day Adventists, the AHS-2, started in 2002 and had 96,194 participants as of 2007. It includes subjects from all fifty states and Canada and has provided preliminary findings based on questionnaires filled out by participants. Seventh-day Adventists are the only group of vegetarians or vegans from the United States whose disease rates have been studied. The Adventist church promotes a vegetarian diet to its members, and 38 percent of the AHS-2 study participants follow a vegetarian diet. Because Adventists also have low rates of smoking and drinking, they are a good population in which to compare vegetarians with meat-eaters.
• We also have findings from an analysis of five other studies that includes vegetarians from the United Kingdom, the United States, and Germany.
HEART DISEASE
People who eat plant-based diets consume less saturated fat and cholesterol and more of the compounds that protect against heart disease. One analysis of five large studies showed that the risk of dying from heart disease was 24 percent lower for vegetarians compared with meat-eaters.
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In addition, a number of studies have shown that adopting a vegetarian diet lowers blood cholesterol and the rate of heart disease (we’ll look at this more closely in Chapter 13). There is good evidence that vegetarians have lower blood-cholesterol levels than meat-eaters and that vegans have the lowest blood-cholesterol levels of all.
The table below compares cholesterol levels in vegans, omnivores, lacto-ovo vegetarians, and people who eat fish but no other types of meat to desirable levels recommended by the U.S. government’s National Cholesterol Education Program.
AVERAGE CHOLESTEROL AND TRIGLYCERIDE LEVELS*
The levels of LDL-cholesterol and HDL-cholesterol matter more than total cholesterol. LDL is the so-called “bad” cholesterol that is associated with a higher risk of heart disease. HDL-cholesterol is the “good” or protective form of cholesterol. The ratio of total cholesterol to HDL cholesterol is the best indicator of risk; the lower the ratio, the better.