This chapter will describe ways to support a healthy lifestyle. Sections include: keep active for a longer, healthier life; what is physical activity?; active at any age; USDA my pyramid; steps to a healthier you; staying healthy by practicing prevention; and information about common health concerns of older adults.
KEEP ACTIVE FOR A LONGER, HEALTHIER LIFE
What's the secret to a long and healthy life? While genes play a role, your lifestyle has the biggest effect on how healthy you are and how long you live. That includes what you eat and drink, how active you are, whether you smoke, and how you handle stress.
After smoking, lack of physical activity, along with poor eating habits, is the largest underlying cause of death in the U.S., according to the National Institutes of Health. A little physical activity goes a long way. At least 30 minutes of activity five or more days a week can improve your overall health. Researchers continue to uncover health benefits from being physically active. Some of these include:
People who are physically active also tend to have healthier diets, which is also very important for good health.
WHAT IS PHYSICAL ACTIVITY?
Physical activity simply means movement of the body that uses energy. Walking, gardening, briskly pushing a baby stroller, climbing the stairs, playing soccer, or dancing the night away are all good examples of being active. For health benefits, physical activity should be moderate or vigorous and add up to at least 30 minutes a day. Moderate physical activities include:
Vigorous physical activities include:
Some physical activities are not intense enough to help you meet the recommendations. Although you are moving, these activities do not increase your heart rate, so you should not count these towards the 30 or more minutes a day that you should strive for. These include walking at a casual pace, such as while grocery shopping, and doing light household chores.
Active at Any Age
If you aren't active or haven't done any physical activity in a while, don't worry it's never too late to start. Even people in their 90s can benefit from physical activity. The more active you are, the more health benefits you'll enjoy. Here are some tips to get you started or keep you going in the right direction:
There are no guarantees in life – staying active doesn't mean you'll automatically live to 100 and never be sick. But with regular physical activity, you'll increase your chances of living a longer, healthier, and more independent life. Source:& www.aarp.com
The Dietary Guidelines are jointly issued and updated every 5 years by the Departments of Agriculture (USDA) and Health and Human Services (HHS). They provide authoritative advice for Americans ages 2 and older about consuming fewer calories, making informed food choices, and being physically active to attain and maintain a healthy weight, reduce risk of chronic disease, and promote overall health. On January 31, 2011, the food pyramid was replaced by "ChooseMyPlate" and the new 2010 Dietary Guidelines for Americans.
These new 2010 Dietary Guidelines focus on balancing calories with physical activity, and encourage Americans to consume more healthy foods like vegetables, fruits, whole grains, fat-free and low-fat dairy products, seafood, and to consume less sodium, saturated and trans fats, added sugars, and refined grains.
The four key components of these recommendations are: Build a Healthy Plate: Cut Back on Foods High in Solid Fats, Added Sugars and Salt: Eat the Right Amount of Calories for You: and Be Physically Active Your Way.
Build a Healthy Plate
Cut Back on Foods High in Solid Fats, Added Sugars and Salt
Eat the Right Amount of Calories
Be Physically Active Your Way
For more detailed information on these recommendations, log on to www.chooseMyPlate.gov
STAY HEALTHY — PRACTICE PREVENTION
Working with your doctor to stay healthy is as important as getting the right treatment when you're sick.
Preventive care or care to prevent illness and disease, includes health tests/screenings, vaccines, and health counseling. Regular preventive care can help you stay healthy and live longer.
Like exercise, eating right, and other things you do to keep healthy, preventive care is up to you. Talk to your doctor about which tests and vaccines you need and how often. Keep a record of all the tests you have and when, as well as the results. Mark the dates you need to get tested again on your calendar.
Some tests can help find problems or diseases before you start to have symptoms. Treating a health problem sooner rather than later improves your chances of getting better - it even can save your life. Your doctor will recommend tests – and how often you should have them – based on your:
Your doctor might want you to get some tests sooner or more often than other people if you're at risk for a certain illness based on your family or medical history.
If you're a woman age 50 or older, talk to your doctor about testing for:
If you're a man age 50 or older, ask your doctor about:
If you're past age 50, you should get a flu shot every year. Once you reach age 65, you should get a pneumonia vaccine. You also need a tetanus/diphtheria shot every 10 years. In addition, ask your doctor about vaccines for hepatitis B and chickenpox (varicella).
Unfortunately, many doctors just don't have the time to talk with patients about behaviors and lifestyle habits that could hurt their health. Here are some of the things your doctor should ask you about. If any of them cause you problems or concern, ask about them on your own if your doctor doesn't bring them up:
It's a good idea to make a list of all your medicines, the doses, and how often you take them so you don't forget. Bring the list with you to the doctor's office. Medical advances and technology have greatly improved our ability to catch illnesses and diseases earlier and to save lives. Make preventive care part of your healthy lifestyle plan. To promote health, practice prevention! Source: www.aarp.org
SOME NUTRITION GUIDELINES
COMMON HEALTH CONCERNS OF OLDER ADULTS
Osteoporosis is a bone thinning disease that gradually weakens bones making them increasingly fragile and more likely to break. Some bone loss is normal with aging but osteoporosis is not a normal part of aging. Osteoporosis is more likely to occur when you reach a low peak bone mass. Peak bone mass, your maximum bone density is usually reached by the time you are 25. Your gender, race, and family history as well as your overall health, diet, and lifestyle choices determine whether you reach your peak bone mass. Osteoporosis can also happen when bone loss is greater than normal. Risk factors for bone loss include certain medical conditions or treatments, smoking, lack of physical activity, inadequate calcium or vitamin D intake, and excessive alcohol consumption. A decline in estrogen production, brought on by menopause, either natural or surgical, leads to bone loss. Early menopause before age 45 puts a woman at increased risk for osteoporosis.
Osteoporosis is a major cause of broken bones (fractures) of the spine, hip, wrist, and other bones. Of people in the United States aged 50 and over, 1 of 2 Caucasian and Asian women, 1 of 4 Black women, 1 of 4 Caucasian men and 1 of 8 Black men will have an osteoporosis related fracture in her/his remaining lifetime. People of other ethnic backgrounds are at lesser, but substantial, risk of fracture.
A warning sign of osteoporosis is loss of more than 1 ½ inches of height, which may occur when weakened bones of the spine compress. Over time, spine fracture and collapse can result in stooped posture, difficulty breathing, abdominal discomfort, and other systemic symptoms. The good news is that osteoporosis can be diagnosed. A bone mineral density test (BMD test) measures bone density and can help predict your risk for fracture. A prescription is necessary for a BMD test. It is recommended that all women aged 65 or older and all men aged 70 or older have a BMD test. A BMD test is recommended earlier for men and women who have fractures with minor trauma or other significant risk factors for osteoporosis. Your doctor or healthcare provider can advise you about the right time for you to have a BMD test.
A bone healthy diet for adults under the age of 50 should contain 1000 milligrams of calcium daily. After age 50 this should be increased to 1200 milligrams daily. Dairy foods are rich in calcium along with many other nutrients necessary for strong bones. It is best to choose low fat and nonfat dairy foods as part of a healthy, low fat diet. Eight ounces of skim milk has about 300 milligrams of calcium. Nondairy sources of calcium include certain green leafy vegetables and canned fish eaten with bones. Fortified foods are foods with calcium added and include soymilk, rice milk, juices, and cereals, among others. It is possible to get all of the calcium you need from food alone. You only need a calcium supplement if you cannot meet your calcium needs from your diet. If you need a calcium supplement, be sure to take only the amount of calcium you need. For example: If you need 1200 mg of calcium a day and get 600 mg from food, you will need 600 mg of calcium from a supplement. Your body uses calcium best in small amounts of 600 mg or less. Consider having a calcium rich food at each meal or snack.
Vitamin D is very important to help your body use calcium and to promote strong bones. The body makes vitamin D when skin is exposed to the sun. However, New Yorkers do not get enough vitamin D during winter months or whenever using sunscreen as recommended to protect skin from sun damage. There are only a few natural food sources of vitamin D, most of which are high in fat and not commonly eaten. Fatty fish, eel, catfish, herring, halibut, light tuna, mackerel, oysters, salmon, and sardines provide 200 IU to over 1000 IU of vitamin D per 3 ounce serving. Fortified foods that have 100 IU of vitamin D added per 8 ounces include all cow’s milk, most soymilk, some rice milk, some juices, and only a few types of yogurt and cheese. Many adults are unable to get enough vitamin D from diet alone, but can get additional vitamin D from multivitamins (most contain 400 IU), in combination with some calcium supplements, or alone as a separate vitamin D supplement.
Eating a well-balanced diet, including the recommended intakes of calcium and vitamin D will help you achieve and maintain strong bones. For most healthy individuals, nutrients such as magnesium, potassium, vitamin C, vitamin K, and others needed for healthy bones can be easily met by consuming a wholesome diet including enough whole grains, lean protein, and at least five servings of fruits and vegetables per day.
Exercise is also important to promote strong bones throughout life. An ideal program combines weight bearing, muscle strengthening, postural training, and balance exercise/activities. Weight-bearing activity such as walking, or dancing is excellent for skeletal health and should be done 3-5 days per week, at a brisk pace, for at least 30 minutes. The goal for those who have osteoporosis is to prevent bone loss and to improve muscle strength for fall prevention. It is important to check with your doctor before starting any new exercise program. If you already have osteoporosis or a fracture you may want to meet with a physical therapist to determine the right exercises for you.
Fall prevention should include education about risk factors, strength and balance exercises, safety in your home and surroundings, and assessment of medications to minimize side effects that impact balance. If you have osteoporosis, your home can be organized to prevent common falling risks. Remove loose floor wires, cords, and rugs to minimize clutter and prevent falls. Keep your room arranged so that it is familiar to you. Make sure that carpeting on the stairs is firmly tacked and that stair handrails are secure. Your tub and shower should be non-skid and equipped with a grab bar. Place nightlights in strategic places to be sure your home is well lit in all areas.
The strategies to promote strong bones are necessary for all individuals, but may not be enough for everyone. You may need to take a medication to reduce bone loss and prevent fractures. If you are diagnosed with osteoporosis speak with your doctor, there are many osteoporosis medications approved by the Food and Drug Administration. It is never too late to prevent further bone loss or fractures related to osteoporosis.
Poor eyesight is not inevitable with old age, but some physical changes do occur during aging which can cause a decline in visual acuity. Over the years, the eye loses ability to keep images focused at close range (presbyopia).You should have brighter lights for tasks such as reading, cooking, sewing, and driving. It may take longer to adjust to changes in brightness. With good care, most older adults can maintain adequate eyesight throughout their lives.
Eye disorders and disease can be prevented by regular health checkups to detect hypertension and diabetes, which may affect the eyes. A complete eye exam by an eye doctor, or an ophthalmologist, every two years is important. This should include a vision evaluation, check of the eye muscle, glaucoma check, and a complete inner and outer eye exam.
A free catalog that has products for people with different types of vision problems can be obtained from:
The American Foundation for the Blind
2 Penn Plaza, Suite 1102
New York, NY 10121
For someone who is legally blind, the Talking Books program is available. Participation requires documentation from an ophthalmologist. Arrangement for this service can be made through your library.
Hearing is an area in which more disabilities are related to aging than any other factor. It is often first noted as the inability to hear high-pitched sounds. Often, people are too self-conscious about their looks or frightened to admit they have a hearing problem. Approximately 30 percent of adults over age 65 and about half of those over 75 suffer some hearing loss. If hearing problems are ignored they may get worse, interfere with normal social interaction, and reduce pleasure from leisure activities. If you can’t hear well, it is tempting to withdraw socially to avoid embarrassment.
If you experience any hearing problem, your doctor can refer you to a hearing specialist (otologist or otolaryngologist), who can diagnose and treat the problem. Common signs of hearing impairment may include difficulty in understanding words, inability to hear high pitched notes or sounds, hearing noises that sound muffled, and less enjoyment at social events. The causes can range from excess earwax to actual nerve deafness. Treatment ranges from simple flushing of the ear canal to remove wax, to prescribing a hearing aid or possible surgery. For most people, all or some hearing may be restored.
Information about hearing and hearing loss can be obtained from:
The Deafness Research Foundation
641 Lexington Avenue, 15th Fl.
New York, NY 10022-4503
Self-Help for Hard of Hearing People
7910 Woodmont Avenue
Bethesda, MD 20814-7022
As you grow older, you may be faced with new problems in the care of your mouth. This may involve loss of teeth, adjusting to dentures, or problems with gums. Poor dental hygiene, missed dental checkups, missing teeth, and improperly fitting dentures can all cause problems. Approximately half of the people in the United States are toothless by the time they reach age 65. This can affect self image, not to mention ability to chew food properly. As a result, the diet may be limited to soft foods which may not provide essential nutrients and fiber. Speech can be affected by loss of teeth, and that can make people too embarrassed to interact socially.
Most tooth loss results from periodontal disease, inflammation of the gum tissues surrounding and supporting the teeth, and bone factors like osteoporosis.
Because removing the teeth aggravates osteoporosis, it is best to try to keep them, if possible. Yearly dental checkups help prevent dental problems in later years.
There are dentists who specialize in problems that occur most often in the older adult. Further information on such dentists can be obtained by writing to:
The American Society for Geriatric Dentistry
2160 First Avenue
Maywood, Illinois 60153
Older people often complain their feet hurt. Since your feet bear a weight of several million tons over the course of your lifetime, this is not surprising.
Common foot problems can be related to a variety of things, such as fungal and bacterial conditions, warts, ingrown toenails, corns, calluses, dry skin, ill-fitting shoes, poor circulation, and disease. You should have your feet checked regularly by a family member or do it yourself in order to note any visible changes. Prevent some foot problems by wearing proper fitting shoes, cutting toenails straight across, wearing foot covers, and soaking feet in warm water to relax and soothe them.
A foot checkup by your doctor can help diagnose diseases such as diabetes or circulatory problems. In the case of diabetes, a person is more susceptible to sores or infections on the feet. If you have diabetes, you must give immediate attention to cuts or bruises because you are prone to healing more slowly. Avoid extremely hot or cold temperatures for your bath or swimming, and don’t use an electric blanket. Feet should be kept clean and dry.
To prevent problems with your feet as you age, keep active to improve circulation. Avoid sitting or resting for long periods. Smoking reduces blood flow to the feet, as does crossing legs, tight socks, or garters, and exposure to cold temperatures. In addition to exercise, standing, stretching, and foot massage improve circulation.
Staying Mentally Active
The latest in brain research shows that regular mental stimulation, along with other healthy habits, can help keep you mentally sharp, as you grow older. One way to get that mental stimulation is to be a life-long learner, always challenging yourself to master new skills and acquire new information. Other excellent sources of mental stimulation are leisure pursuits that require planning details like gardening, traveling, and needlework crafts. Don’t forget about regularly playing cards and doing crossword puzzles. Those kinds of games that provide a bit of mental challenge can become increasingly valuable tools for keeping your mind nimble. Staying socially active and engaging in good conversations on a regular basis also plays a part in keeping you mentally agile. While our brain and our muscles are obviously quite different, both definitely require exercise in order to stay in good shape!
Coping With Loss
Loss is a major part of the emotional challenge of aging. Many people experience retirement as a loss of status, relationships, and meaningful activity. Many friends and relatives move away or die during the retirement years. Moving itself, even when it’s a happy occasion balanced by gains, can be traumatic. Disability or chronic illness that results in diminished independence and personal control is experienced as a loss, and is accompanied by the same grief as if a beloved person had died. This grief may be expressed by anger, depression, or refusal to cooperate in treatment. Medical evidence suggests that minorities tend to develop chronic illness at a younger age and at a higher rate. Loss and its pain can be a very real part of retirement. The courage and creativity you demonstrate in dealing with a loss can help you deal with the pain.
Landing On Your Feet
Loss is hard to talk about. Loss of a partner presents a particular challenge which needs to be addressed. People who have survived loss don’t have much of a chance to share their experience with those who could benefit from it.
It is important to admit that loss is painful. People who bury their feelings don’t stop feeling the pain. It manifests itself in some other way, ranging from anger to illness. Those who do best admit the pain of loss and express themselves clearly, firmly, and positively. Many local Offices for the Aging or mental health clinics offer free or low-cost counseling or support groups. The American Association of Retired Persons (AARP) offers a widowed persons program in some areas.
It is also important to keep in touch with your community or even to "reinvent" your life. We never outgrow the need to meet new people and try new things. Senior centers and senior meal sites offer activities, from art lessons to hot meals, and a chance to make new friends. Employers and volunteer centers are actively looking for retired workers, and offer meaningful involvement and social contacts. Being a mentor, passing on skills to younger people, is one of the special rewards of the retirement years.
HealthStyle - A Self Test
This brief test, developed by the Public Health Service, is all about changing lifestyle. Its purpose is to tell you how well you are doing to stay healthy. The behaviors covered in the test are recommended for most Americans.
WHAT YOUR SCORE MEANS TO YOU
Scores of 9 and 10
Excellent! Your answers show you are aware of the importance of this area to your health! More important, you are putting your knowledge to work for you by practicing good health habits. As long as you continue to do so, this area should not pose a serious health risk. It’s likely that you are setting an example for your family to follow. Since you got a very high test score on this part of the test, you may want to consider other areas where your scores indicate room for improvement.
Scores of 6 to 8
Your health practices in this area are good, but there is room for improvement. Look again at the items you answered with a "Sometimes" or "Almost Never." What changes can you make to improve your score? Even a small change can often help you achieve better health.
Scores of 3 to 5
Your health risks are showing! Would you like more information about the risks you are facing and about why it is important for you to change these behaviors? Perhaps you need help in deciding how to successfully make the changes you desire. In either case, help is available.
Scores of 0 to 2
Obviously, you were concerned enough about your health to take the test, but your answers show you may be taking serious and unnecessary risks with your health. Perhaps you are not aware of the risks and what to do about them. You can easily get the information and help you need to improve, if you wish. The next step is up to you!
You Can Start Right Now!
In the test you just completed were numerous suggestions to help decrease your risk of disease and premature death. Here are some of the most significant.
Cigarette smoking is the single most important preventable cause of illness and early death. Persons who stop smoking reduce their risk of getting heart disease and cancer. So if you’re a cigarette smoker, think twice about lighting that next cigarette. If you choose to continue smoking, try decreasing the number of cigarettes you smoke and switching to a low tar and nicotine brand.
Follow Sensible Drinking Habits
Alcohol produces changes in mood and behavior. Most people who drink are able to control their intake of alcohol and to avoid the undesired and often harmful effects. Heavy, regular use of alcohol can lead to cirrhosis of the liver, a leading cause of death. Also, statistics clearly show that mixing drinking and driving is often the cause of fatal or crippling accidents. So if you drink, do it wisely and in moderation. Use care in taking drugs. Today’s greater use of drugs – both legal and illegal – is one of our most serious health risks. Even some drugs prescribed by your doctor can be dangerous if taken when drinking alcohol or before driving. Excessive or continued use of tranquilizers (or "pep pills") can cause physical and mental problems. Using or experimenting with illicit drugs may lead to a number of damaging effects or even death.
Almost everyone can benefit from exercise, and there’s some form of exercise almost everyone can do. (If you have any doubt, check first with your doctor). Usually, as little as 15-30 minutes of vigorous exercise three times a week will help you have a healthier heart, eliminate excess weight, tone up sagging muscles, and sleep better. Think how much difference all these improvements could make in the way you feel.
Learn To Handle Stress
Stress is a normal part of living; everyone faces it to some degree. The causes of stress can be good or bad, desirable, or undesirable (such as promotion on the job or the loss of a spouse). Properly handled, stress need not be a problem. But unhealthy responses to stress – such as driving too fast or erratically, drinking too much, or prolonged anger or grief – can cause a variety of physical and mental problems. Even on a very busy day, find a few minutes to slow down and relax. Talking over a problem with someone you trust can often help you find a satisfactory solution. Learn to distinguish between things that are "worth fighting about" and things that are less important.
Be Safety Conscious
Think "safety first" at home, at work, at school, at play, and on the highway. Buckle seat belts and obey traffic rules. Keep poisons and weapons out of the reach of children and keep emergency numbers by your telephone. When the unexpected happens, you’ll be prepared.
WHERE DO I GO FROM HERE?
Start by asking yourself a few frank questions: Am I really doing all I can to be as healthy as possible? What steps can I take to feel better? Am I willing to begin now? If you scored low in one or more sections of the test, decide what changes you want to make to improve. You might pick that aspect of your lifestyle where you feel you have the best chance for success, and tackle that one first. Once you have improved your score there, go on to other areas.
If you already have tried to change your health habits (to exercise regularly or stop smoking, for example), don't be discouraged if you haven’t yet succeeded. The difficulty you have encountered may be due to influences you’ve never really thought about – such as advertising – or to a lack of support and encouragement. Understanding these influences is an important step toward changing the way they affect you. There’s help available!
RETIREMENT CHECKLIST - Health and Wellness
As you approach retirement it is useful to determine what you know, what you’ve done, and what you need to find out or do.
Read each of the questions below and circle your answer, "YES" or "NO". Next, for each "NO" answer you gave, write down a few words in the space provided that will help you find the answers. You may want to use the same space to record other personal questions about this topic.
1. Do I use some type of exercise regularly? YES NO
2. Am I careful to eat balanced meals daily? YES NO
3. Do I get an annual checkup? YES NO
4. Do I understand the main effects of stress on the body? YES NO
5. Can I identify several healthy ways to deal with stress? YES NO
6. Have I taken a diet survey to determine what I actually eat? YES NO
7. Do I know how to purchase foods for nutrition value? YES NO
8. Can I describe all the personal benefits of regular exercise as I grow older? YES NO
RESOURCES - Health & Wellness
The NYS Office for the Aging
The Federal Government
The USA Dept. of Health & Human Services web site directory
The Mayo Clinic
The National Women's Health Information Center
International Council on Active Aging
American Association of Retired Persons
American Heart Association, American Heart Association Low Fat, Low Cholesterol Cookbook: Heart-Healthy Recipes that Taste Great, 2nd edition, Clarkson Potter, 2001.
American Heart Association Quick & Easy Cookbook: More Than 200 Healthful Recipes You Can Make In Minutes, Clarkson Potter, 2001.
Armentrout, Jennifer S. The Professional Chef’s Techniques of Healthy Cooking, 2nd Edition, John Wiley & Sons, 2000.
Brewer, Sarah, M.D. The Essential Guide to Vitamin, Minerals, and Herbal Supplements, Right Way, 2010.
Larson-Duyff, Roberta, The American Dietetic Association Complete Food & Nutrition Guide, 3rd edition, John Wiley & Sons, 2006.
Nelson, Miriam E, Ph.D., Strong Women Eat Well: Nutritional Strategies for a Healthy Body and Mind, Putnam Publishing Group, 2001.
Willet, Walter C., M.D.; Skerrett, P.J.; Giovannucci, Edward L., M.D., Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating, Simon & Schuster, 2001.
Somer, Elizabeth, Age Proof Your Body: Your Complete Guide To Looking & Feeling Younger, McGraw Hill, 2006.
Starke, Rodman D,. American Heart Association Low-Salt Cookbook: A Complete Guide To Reducing Sodium and Fat In The Diet, 3rd edition, Clarkson Potter, 2006.
Weil, Andrew M.D., Eating Well For Optimum Health: The Essential Guide To Food, Diet and Nutrition, Knopf, 2000.Stress & Mental Fitness
Benson, Herbert, M.D. & Miranz Klipper (contributor), The Relaxation Response, Wholecare, 2000.
Bloomfield, Harold H., Healing Anxiety Naturally, Harper Collins, 1999.
Cohen, Michael, 1 Sure Way To Relax: Journey to Tranquility, Audio Educators, 1999.
Davis, Martha, Ph.D.; Robbins–Eshelman, Elizabeth; McKay, Matthew, Ph.D., Relaxation and Stress Reduction Workbook, 6th edition, New Harbinger, 2008.
Hendrickson, Kyle, Mental Fitness Puzzles, Orient Paperbacks, 2006.
Sloane, Paul; MacHale, Des; Cunning Lateral Thinking Puzzles, Puzzlewright, 2006.Physical Fitness
Cousins O’Brien, Sandra, Exercise, Aging, and Health: Overcoming Barriers To An Active Old Age, Taylor & Francis, 1998.
Heidrich, Ruth E. Ph.D., A Race For Life: A Diet and Exercise Program For Super Fitness and Reversing The Aging Process, Lantern Books, 2000.
Hodgson, Harriet, Smart Aging: Taking Charge of Your Physical and Emotional Health, John Wiley & Sons, 1999.
Appendix for Chapter 3
Quick Links to Resources:
Back to the Table of Contents