Action to improve nutrition for the elderly

The core of nutrition improvement for the elderly has never been to follow the trend and buy high-priced health products or copy the dietary standards of young people. Instead, it is to anchor the physiological characteristics and individual differences in basic diseases of the elderly, and use low-threshold and highly adaptable landing actions to truly incorporate nutritional supplements into the daily diet. Do less useless work and don’t waste money.

I was particularly impressed by Aunt Zhang, whom I met at a community free clinic last week. She saved up her three-month pension and brought back two cans of an imported protein powder that was said to "repair immune cells." After half a month of eating it, she developed gout. Only when she went to the hospital did she find out that the main raw material of that protein powder was soy protein isolate, and its purine content was much higher than that of animal protein. She had a five-year history of high uric acid, and rarely touched soy products. This was a huge shock. In fact, there are many elderly people like Aunt Zhang who equate improving nutrition with "buying expensive supplements" and end up with eating problems. We can encounter three or four cases a month.

Speaking of which, I have to mention two completely different execution ideas in the industry. Most colleagues in the clinical nutrition department of the hospital prefer "precision intervention": first conduct a complete set of MNA simple nutrition assessments for the elderly to find out the weight changes, food intake, and activity ability in the past three months, and then customize a meal menu based on basic disease conditions, and use special medical formula foods when necessary. It is targeted at the elderly who have experienced sarcopenia, postoperative recovery period, and dysphagia. The accuracy is high and the improvement effect is fast. However, most colleagues in the community public health line feel that this method is too difficult to promote in ordinary communities: most elderly people cannot even eat one egg a day, and they have to undergo screening and meal preparation, which costs money and time.

In fact, both ideas are correct, but they are suitable for different groups: the elderly who have just undergone surgery and have lost more than 5 pounds in three months, it is indeed safer to take the path of precise intervention. For the elderly who are usually healthy and have no serious diseases, it is completely sufficient to have a basic dietary balance in place first.

Previously, we conducted a pilot project in a community in the west of the city for half a year and encountered many pitfalls. At the beginning, a nutritionist from a tertiary hospital was invited to give lectures. The PPT was very professional and the macronutrients and micronutrients were explained clearly and clearly. The half-hour lectures were held three times. By the end of each session, less than half of the elderly people were left in the venue. The nutrition manuals that were handed out were immediately taken away to place on the vegetable basket. Later, we changed the game and held a "community specialty dish competition" and asked the elderly to bring their favorite dishes. The nutritionist squatted next to him and commented like a nagging: "Uncle Li, your braised pork is really bad. Just put 3 grams less salt next time and throw in a handful of dried mushrooms. They are very fresh and can supplement selenium." Don't tell me, this method is very receptive to the elderly. Later, we made a batch of palm-sized refrigerator magnets with three sentences printed on them: drink 7 cups of warm water every day, eat enough vegetables and half a jin of fruits every day, and eat deep-sea fish twice a week. There is no need to remember complicated things, just stick them on the refrigerator door and you can see them when you open the door. When we came back three months later, the implementation rate was more than 60% higher than when the manual was distributed.

Another topic that has been controversial for a long time is whether the elderly should eat particularly light meals. Many cardiologists will advise the elderly to eat less oil and less salt to avoid increasing the burden on blood vessels. ； However, colleagues in the nutrition department always say that many elderly people nowadays are overly bland and eat white porridge with pickles all year round. Their protein intake is seriously insufficient, their muscles are lost quickly, and their walking legs are weak. On the contrary, they are prone to falls and fractures, and the risk is no lower than that of high blood pressure. In fact, this matter does not need to be black and white at all: elderly people with a history of cholecystitis and pancreatitis do need to control their fat intake, but elderly people who are healthy and have good teeth do not need to eat any red meat. Eating 1-2 taels of lean pork and beef every day will help them gain strength and walk more steadily.

Many people always think that improving nutrition for the elderly is a matter for the government and the community. We have been working on this for so long, but the deepest feeling is that children play a greater role than anyone else. There used to be an 82-year-old Grandma Wang who was always reluctant to eat eggs and said she would leave them for her grandson who came back from vacation. We came to her door many times to persuade her, but to no avail. Later, her granddaughter went to school in another place. Every time she made a video call, she had to watch her eat the eggs before hanging up the phone. Now Grandma Wang obediently cooks one every morning and eats even the yolk, which is more effective than any of our words.

In fact, there is no unified standard answer when it comes to improving the nutrition of the elderly. It does not mean that eating specific foods will definitely lead to a longer life. In the final analysis, it means following the living habits of the elderly and making slight adjustments to make them happy and comfortable. This is more effective than any high-standard menu.