Help the Aged Information and Advice Healthy Eating This leaflet was written in association with the Nutritional Advisory Group for Elderly People (NAGE) of the British Dietetic Association (BDA). Web: www.bda.uk.com If you would like this leaflet in another format, such as large print or audio tape, please contact the Information Resources Team on 020 7278 1114. ==================================================================== Contents Section 1. The eatwell plate Section 2. Eating habits Section 3. Meal ideas Section 4. Store cupboard ideas Section 5. A poor appetite? Section 6. Enjoying your food Section 7. Alcohol Section 8. Salt Section 9. Fats Section 10. Food safety Section 11. Help in the kitchen Section 12. Winter tips Section 13. Keeping active Section 14. Useful information ==================================================================== Section 1. The eatwell plate Eating well means enjoying your food and having plenty of variety. Here is a guide to the foods you should try to eat each day. Fruit and vegetables Try to eat a variety of fruit, vegetables and salads. They are full of vitamins, antioxidants, minerals and fibre. Aim to eat five portions a day. Frozen, tinned, dried fruit and vegetables, and fruit juice count too. Use fruit and vegetables that are tinned in water or their natural juice instead of in syrup or oil. Try to include some fruit and vegetables at each meal and use fruit as a snack between meals. Meat, poultry, fish, eggs, beans, lentils and nuts Eat a portion of any of these foods at two of your meals each day. All these foods contain proteins which build and repair your body. You do not need to eat meat or fish every day – cheese, well-cooked eggs, beans or lentils or tofu can be eaten instead. Foods containing fat and sugar Sugary and fatty foods provide us with energy and can make meals taste better, but use them sparingly if you are watching your weight as they are high in calories. Don’t eat these foods at the expense of other more nutritious foods. Bread, other cereals and potatoes Try to have a serving of starchy food (such as bread, breakfast cereal, potatoes, rice, noodles or pasta) with every meal. These foods give energy. Wholegrain cereals have more B vitamins, minerals and fibre, which keep us well and helps prevent constipation. Milk and dairy foods These foods contain calcium which helps to keep bones strong. Try to have three servings a day. A serving can be: * 1 cup of milk * 1 yoghurt or fromage frais * 25g (1oz) cheese * a small pot of cottage cheese Low-fat dairy products still have all the goodness in them, they just have less fat and less calories. Drinks Drink at least 6 to 8 glasses of liquid every day to keep you hydrated and help digestion. These could include water, tea, coffee, fruit juice, fruit squash, milk and milky drinks, or occasional fizzy drinks. Enjoying and eating a good variety of food is important. If you eat well, you are likely to feel healthier, stay active for longer and protect yourself against illness. ================================================================================ Section 2. Eating habits Eating regular meals and snacks is a good habit. If you get used to missing meals, or eating unhealthily, you may start to feel tired, depressed and cold. Check your eating habits against the following questions and answers. 1. Do you always eat three meals a day? * breakfast * lunch (midday meal) * tea (evening meal). Good regular eating patterns are essential to keeping well. This means three meals or snack meals daily. 2. If you don’t manage three meals a day, what do you tend to replace meals with? * tea and biscuits * bread and jam * nothing. Instead of missing meals, you could try some of the simple snacks and meals suggested later in this leaflet. 3. Over the last year: * Have you lost over one stone in weight without trying? * Have you stayed around the same weight? * Have you put on more than one stone without trying? Check your weight regularly (for example, monthly). If you gain or lose weight without trying, see your doctor. 4. Are your bowels regular? Eating a diet with plenty of fibre is important for good health and well-being. It also helps prevent constipation. Wholegrain breakfast cereals, wholemeal bread and pasta, brown rice and chapattis are all good sources of fibre. So are fruit, vegetables, beans and lentils. But avoid adding raw bran to your food as it can prevent you from absorbing some of the goodness in your food. Drinking plenty of liquid helps to keep your bowels healthy and prevent constipation. Aim for at least 6 to 8 glasses a day. 5. Do you eat the following foods which are rich in iron? * red meat, including liver and kidney * eggs (particularly the yolks) * ‘fortified’ breakfast cereals containing added iron * green vegetables such as spinach, broccoli and okra * baked beans, lentils and other pulses such as kidney beans. These foods are rich in iron and will help prevent anaemia, which causes tiredness and shortness of breath. Eat fresh fruit and drink fruit juices or vitamin C enriched drinks with meals to help your body absorb iron. Don’t drink tea with meals, because tannin in tea can reduce the amount of iron you absorb from your food. 6. Do you eat the following foods rich in vitamin D? * oily fish such as salmon, sardines and pilchards * eggs * dried milk and evaporated milk with added vitamin D * margarine and low-fat spreads. Vitamin D, which helps to keep the bones healthy, is found in all these foods. Your body can also make vitamin D when your skin is exposed to sunlight. If you can’t leave the house and are unable to sit outside, or are covered up all day, you may need to take a vitamin D supplement. Ask your doctor for advice. Our free advice leaflet Healthy Bones gives more information about looking after your bones. ================================================================================ Section 3. Meal ideas Try to eat regularly, at least three times a day. You may not always feel like cooking – if you don’t, there are a wide variety of tinned, chilled and frozen ‘ready meals’ available. Stews and soups are particularly easy to make and you only need one pot to cook them in. Eating healthily doesn’t have to be expensive. Try to buy seasonal fruit and vegetables to keep costs down. Most fresh fruit and vegetables are sold loose, so you don’t need to buy large quantities of one item. All food, whether hot or cold, provides warmth and energy. A snack can be just as nourishing as a more traditional meal. Here are some suggestions: Breakfast foods * toasted currant teacake and a milky drink * fruit – fresh, tinned, dried (or fruit juices) * crumpets, muffins or toast with butter and jam or cheese * peanut butter or banana sandwich and fruit juice * hard boiled egg and toast * cheese and tomato on toast * yoghurt (try it with muesli, honey and fresh fruit) * pancakes with grilled bacon and tomato * wholegrain breakfast cereal, for example, porridge, muesli, Shredded Wheat, Bran Flakes. Main meals * spaghetti bolognaise with green salad * corned beef hash with green vegetables * roast chicken with potatoes and vegetables * cauliflower or macaroni cheese with bread and salad * boiled bacon with parsley sauce and broad beans * steamed or baked fish with potatoes and vegetables * spinach and potato curry with chapattis or boiled rice * omelette with potato and vegetables * meat or bean casserole with swede and cabbage * liver and onions with mashed potatoes and carrots * shepherd’s pie or fish pie with peas and green beans * vegetable stir-fry with noodles. Quick meals * sandwiches – try tuna, cheese, corned beef, peanut butter, hummus, ham or egg and salad- and use different breads for variety. * toast – with pilchards, well-cooked scrambled egg, baked beans, creamed mushrooms or tinned spaghetti * jacket potato with cottage cheese or grated cheese and baked beans * soup containing meat or pulses (such as lentil, beef broth or pea and ham) with grated cheese and wholemeal or rye bread * fish fingers, oven chips and peas with bread and butter * sausages, baked beans and instant potato * kippers or smoked haddock with bread and butter * pitta bread with hummus, pepper, celery and carrot * pasta and bean salad (try using kidney beans, chickpeas, butter beans, tomato and lemon juice). Puddings and desserts * fresh, tinned or stewed fruit * fruit crumble or pie with custard or cream * ice cream * cake * jelly or mousse * yoghurt * sponge and custard * rice pudding. Snacks If you feel like a snack during the day, you might like to have fruit, a small handful of unsalted nuts or seeds, breakfast cereal with milk, cheese and crackers, rice cakes, or cake. You could also try toast with low-fat butter or margarine, jam, cheese or peanut butter or have a milky drink. Or you could have a fruit smoothie – try blending a banana and other soft fruit such as peaches or strawberries with some orange juice, milk or yoghurt. ================================================================================ Section 4. Store cupboard ideas It’s useful to have a store of basic foods, in case you can’t get to the shops because of bad weather or illness. Here are some suggestions: * milk – long-life, dried or evaporated milk; tinned milky puddings * meat and fish – tinned corned beef, ham, sardines, salmon, pilchards, mackerel and tuna * fruit, vegetables and fruit juice – a variety of tinned fruit and vegetables (including baked beans), dried fruits, lentils and other dried beans and peas, long-life fruit juice, instant mashed potato and frozen vegetables * cereals – breakfast cereals, wholegrain crackers, plain biscuits, pasta and rice * drinks – tea, coffee, cocoa, malted milk * other – tinned and dried soups; yeast extract (for example, Bovril, Marmite or Vegemite); stock cubes. If you have a freezer, you could use it to store a small supply of foods you enjoy. For example, frozen mince and chicken pieces, frozen vegetables, a selection of ‘ready meals’, frozen seasonal fruit and ice cream. Cooking large batches of meals, for example, stew or homemade soup, and freezing individual portions is a good idea. You can then defrost the meal for eating when you feel like it. Only buy food that you will use. Store cupboard foods don’t keep forever, so use them occasionally and replace them with new ones. Don’t let things go out of date. ================================================================================ Section 5. When should you worry about a poor appetite? Unwanted weight loss gradually causes tiredness, depression and a general lack of energy. People who are run down suffer more from infections such as flu and colds. If your appetite is poor and you are gradually losing weight without trying, you should see your doctor. If you only feel like eating a little, it is important that the food you do eat is nourishing. Try some of the smaller meal ideas on pages 8–10 rather than eating biscuits or sweets. And if you can only manage light meals try to eat more often. If you are able to get out and about you may find that a walk in the park or around the area you live can help improve your appetite. Missing an occasional meal does not usually cause harm. Milky drinks and meal replacement drinks can provide a nutritious alternative. These enriched drinks are sold in a range of flavours at chemists. You can drink them between meals or occasionally have them instead of a meal. Always let your doctor know if you can’t drink or keep liquids down as you can get dehydrated quite quickly. ================================================================================ Section 6. Enjoying your food Eating in company can increase your enjoyment of food. Sharing meals with friends and neighbours helps to cut the cost of shopping, cooking and heating. You will be able to share recipes and try new foods. Being a guest next time cuts out the work for you! Why not see if there are any lunch clubs in your area? Some cafes and pubs may offer meals at special rates for older people. Food may not taste as appetising as you grow older. Why not try using different herbs and seasonings? You may like to experiment with flavours and foods from abroad. Your local library will have recipe books. ================================================================================ Section 7. Alcohol For many people, having an alcoholic drink is a pleasant social activity. The sensible drinking limits are up to 3 or 4 ‘units’ a day for a man, and 2 to 3 for a woman. A ‘unit’ is half a pint of standard strength beer or lager, or a pub measure of spirit. A glass of wine is about 2 units. Keep some days alcohol free and remember that too much alcohol can damage your health. Check with your doctor that it is safe for you to drink if, for example, you are on any medication. When you’re out, remember not to drink and drive. ================================================================================ Section 8. Salt Eating too much salt can increase your risk of getting high blood pressure. Whilst we do need some salt, it is best not to have more than a teaspoon per day (6g). This includes salt that is already added to the food we buy. Processed foods, such as some breakfast cereals, soups, sauces and ready meals can contain a lot of salt. You can cut the amount of salt you eat by: * only using a small amount of salt in cooking; * not adding extra salt at the table; and * checking food labels for salt and going for lower salt choices. ================================================================================ Section 9.Fats While it is important to cut down on saturated fat, many people don’t know that it is also equally important to make sure you replace saturated fat with unsaturated fats. Unsaturated fats help the body to absorb some vitamins and are a good source of energy and essential fatty acids. Omega 3 fatty acids have been shown to help protect against coronary heart disease. Oily fish is the best source of omega 3 fatty acids. They are also found in eggs and vegetable oils such as linseed, flaxseed, walnut and rapeseed. Saturated fats Saturated fats increase the amounts of cholesterol in the blood, which increases the chance of developing heart disease. Foods that are high in saturated fats include: • meat pies and sausages • butter and lard • biscuits and cakes • pastry • hard cheese • cream. Unsaturated fats Unsaturated fats can actually reduce cholesterol levels and provide essential fatty acids that the body needs. These foods are high in unsaturated fats: • oily fish • avocados • nuts and seeds • vegetable oils • sunflower and olive oil margarine. Tips for cutting down on saturated fats • Grill, bake, poach or steam food rather than frying, so you don’t use any extra fat. • Choose lean cuts of meat. • Try to replace beans and pulses in casseroles in place of meat. • Don’t use margarine in sandwiches if the filling is moist or switch to a low fat margarine. • Buy low fat milk or yoghurts instead of full fat ones. =================================================================================================== Section 10. Food safety A few simple precautions can prevent food poisoning. Take care to store food properly and prepare food as hygienically as possible. * When buying food check the ‘use by’ date. Don’t buy any food that you won’t eat before this date. * Take frozen or chilled foods home as soon as possible. * Keep your fridge at the correct temperature (below 5?C) and check regularly for out-of-date foods. * Store raw foods on the lower shelves of the fridge, and keep food covered. * Don’t re-freeze food which has already thawed. Prepare and eat it or throw it away. * Always wash your hands well before touching and preparing food. * Reheat food thoroughly (until piping hot), and never reheat more than once. * Avoid dishes containing raw eggs, such as homemade mousse or mayonnaise. Always cook eggs well until the yolk is solid. * Keep worktops and utensils clean with hot, soapy water. * Keep pets out of the kitchen. ================================================================================ Section 11. Help in the kitchen Many kitchen appliances can be adapted to make the controls easier to use if you have arthritis or are disabled. If you are sight impaired or seriously sight impaired, studded or brailled controls are available. Contact your gas supplier or your electricity company to see what adaptations are available. Our free information sheet no. 15, Equipment for Daily Living, gives information on gadgets available to help perform daily tasks. The Disabled Living Foundation can also advise you on adapted kitchen appliances, utensils and equipment. Contact: Disabled Living Foundation 380–384 Harrow Road London W9 2HU Helpline: 0845 130 9177 Textphone: 020 7432 8009 Email: advice@dfl.org.uk Web: www.dlf.org.uk ================================================================================ Section 12. Winter tips Frequent hot drinks are comforting and warming. Try keeping a flask by your bed so that you can have a hot drink without getting up in the night – but be careful you can’t knock the flask over. Eating regular meals can give you warmth and energy. If it’s too cold to go out, use store cupboard foods (see page 10). Drinking alcohol may feel warming, but it actually lowers your body temperature. ================================================================================ Section 13. Keeping active Enjoying a regular activity can improve your health and well-being. It can help to improve your appetite, keep your bones strong and your joints flexible. Most of all it can give you the chance to enjoy fresh air, new experiences and make new friends. For ideas on staying active even if your mobility is restricted, see our free advice leaflet Keeping Mobile. ================================================================================ Section 14. Useful information The following books provide cooking tips and ideas for recipes. Your library or bookshop will probably stock many others. You may also find some leaflets and information at your health centre or local supermarket. * Cooking for One by Molly Perham (publisher: Foulsham; ISBN: 978-0572026943) * Cooking for Two by Cornelia Adam (publisher: Silverback Books; ISBN: 1930603770) * Leith’s Cooking for One or Two by Polly Tyrer (publisher: Bloomsbury Publishing; ISBN: 978-0747541080) * Man Alone Cook Book by Don Tibbenham (publisher: Elliot Right Way Books; ISBN: 978-0716021780) * One is Fun! by Delia Smith (publisher: Coronet Books; ISBN: 978-034038959) The Vegetarian Society has vegetarian recipe ideas on its website www.vegsoc.org Nutritional information The Food Standards Agency is an independent Government department set up to protect the public's health and consumer interests in relation to food. It has produced a leaflet called The Good Life, to encourage people over 50 to have a healthy diet. Call 0845 606 0667 for a copy. Its website gives information on the nutritional needs of older people at www.eatwell.gov.uk/agesandstages/olderpeople NAGE (the Nutritional Advisory Group for Elderly People) is a specialist group of the British Dietetic Association. It produces a number of booklets, leaflets and videos on eating and nutrition for older people. For further details see www.bda.uk.com The Research into Ageing team at Help the Aged also produces some helpful information on nutrition which is available online at www.helptheaged.org.uk The What’s Inside Guide provide information about Guideline Daily Amounts (GDAs) which now appear on a lot of food products and tell you how many calories and how much sugar, fat, saturates and salt there is in what you're about to eat. Visit www.whatsinsideguide.com Lunch clubs and cooking classes Setting up and running a meal club provides practical guidance on developing a meal club, price £15 inc P&P. Available from the Mail Order Unit, Age Concern England, Astral House, 1268 London Road, London SW16 4ER. Tel: 020 8765 7203. Cooking classes are often run by local adult education institutes and voluntary organisations. Your local library should be able to give you details of what is available. ================================================================================ Help the Aged 207-221 Pentonville Road London N1 9UZ Tel: 020 7278 1114 Web: www.helptheaged.org.uk January 2007