Food and meals
Meals and life style
Planning meals, shopping, cooking and laying the table, followed by eating and then clearing
away the remnants of the meal, are all parts of the ever recurring events of a family. To
some people activities around meals are among the most important and meaningful of
tasks. Time is well spent preparing food, and eating adds structure to the day. To others
eating is a necessary business that must be over with fast and without too much fuss.
Our personal attitude to meals also tells a story about general habits and life style. In
Denmark the meals often serve as a rallying point for the entire family with discussions in
the morning about the oncoming day and in the evening about how everybody’s day has
been. Food is invariably present as an ingredient, when Danes meet socially.
To-day, focus is very much on the influence of the nutritional content on the health of the
consumers and on prevention of illness. Less focus is on the contribution of meals to
conserving elderly peoples’ preferred habits – e.g. their daily contact with the staff of their
favorite shops, working in the kitchen with meals, the odeur of food in the house and,
eventually, having family and friends round for a meal.
Nowadays, most Danish municipalities will offer to pick up groceries or meal delivery to the
very old who still live at home, but who find the chores around meals increasingly difficult to
carry out on their own. The problem with this kind of arrangement is that it may become
difficult to respect the various tastes and habits of individual recipients in connection with
the meals.
Culture, habits, and public health
The Danish health authorities recommend having three meals a day, plus 2-3 little snacks,
because the body prefers regular energy influx. We are all strongly encouraged to eat more
fruit and vegetables and to consume less sugar. We should also eat fish at least once a week,
or, even better, every day. The so called epidemic of obesity, feared by many nutrition
experts, will also affect the coming generations of elderly people. Particularly elderly males
are too heavy, which is the reason that exercise has now become one of eight official diet
recommendations. http://www.foedevarestyrelsen.dk/english/Nutrition/Pages/default.aspx
Practices around meals reflect cultural differences. In Denmark the day starts with a rather
heavy meal of either bread with jam and cheese or cereals, and the meal in the evening
should not be eaten too late, as that is supposed to interfere with the sleep. In Spain
customs are almost the opposite: The morning meal is most frugal and a large meal is eaten
just before bedtime.
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Japan
In Japan food is very important and there is scientifically no doubt that the long life
expectation of the population is connected with eating primarily healthy food with low fat
content. In Japanese recipes animal products like meat and milk play a minor role. Fish and
seaweed are instead everyday food ingredients, spiced with soy sauce and with dishes of
grated or salted vegetables. The food also contains tofu and miso-soup, both rich on
proteins, eaten with white rice and green tea.
Apart from the healthy composition of the food itself it is customary in Japanese culture to
take only little from the different items offered, and although servings are much smaller
than in Denmark, the food is also eaten in very small morsels. It is considered a virtue only to
nibble at the food – at least for women.
Japanese TV stations run daily programmes on how to compose and prepare healthy meals,
including ways of preparing attractive, healthy and varied Bento’s –the Japanese lunch pack.
In contrast, European TV stations also focus enormously on food programmes, but with the
attention primarily on taste and other culinary aspects – more than on the healthiness of the
products.
Various victuals have long been considered remedies of ill health. If you have a cold, lemon
juice in tea – or maybe a glass of red wine or a rum toddy is helpful; camomile tea will make
you sleep better; ginger is good for arthritis; hot milk with honey will ease a cough;
geranium will ease a pain in the ear; and if you have vomited it is a good idea to eat toasted
bread, a grated apple or oat meal porridge.
Particularly elderly women want to eat healthier food
The eldest people in Denmark usually have three meals a day. Particularly women also have
small meals in between. Compared to the younger generations elderly people rarely go
without breakfast. They drink less milk, but use more butter and cheese on the bread. They
also eat more fish than young adults.
When you ask the population in general if they want to eat healthier food, it turns out that
the eldest – particularly men – less frequently want to change their eating habits than the
young. In spite of saying they want to eat healthier food, many elderly women also refrain
from changing their food habits, because they do not want to appear affected or self
centred in front of their friends – or do not want to be a problem for their hosts, when they
are invited out.
Barriers like this to a healthy life style will hopefully die out one day. New generations of
senior citizens will be much more aware of what is healthy and what is not, and there will be
greater tolerance about peoples’ special food wishes and traditions.
Food at old age
Elderly people, with a normal appetite, who do not weigh too much or too little, are invited
– like all other ages – to follow these eight official diet recommendations:
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1. Eat fruit and vegetables – six a day
2. Eat fish – at best several times a week
3. Eat potatoes, rice or pasta and wholemeal bread - every day
4. Save on sugar – particularly candy, sodas and cakes.
5. Save on fat – particularly from dairy products and meat
6. Eat varied – maintain your normal weight
7. Quench your thirst in water
8. Be physically active – at least 30 minutes a day
Vitamin D
Vitamin D, which is of vital importance for bones and muscles because it allows the intake
and transformation of calcium, mainly stems from the ultraviolet rays of the sun and is taken
up by skin exposed to the sun. With increasing age less calcium is taken up by the skin, and it
may become harder to have your need of calcium satisfied alone through food.
Lack of vitamin D will lead to weaker muscles and fragile bones. In Denmark there is an
official recommendation that elderly people, who don’t get much outdoors or who always
cover their arms or legs when they do go out, take vitamin D tablets, preferably mixed with
calcium – unless they drink and eat many dairy products.
Reduced appetite and thirst.
Elderly people usually eat less than younger adults. The explanation is that the energy
needed by the body is reduced, when muscles and bones begin to shrink with age. However,
the need of a large number of nutritional ingredients is unchanged, thus making it important
that elderly people focus on food that is rich with proteins, vitamins, minerals and rich in the
healthy omega-3 fatty acids.
With age the body begins to act less flexibly to changed circumstances. If the chemical
equilibrium of the body is disturbed it is more difficult for the old than for the young to
regain the balance. This is felt after periods of illness or prolonged grief.
Loss of muscle mass may also lead to a lower level of activity – everything feels heavy and
difficult – again leading to diminished appetite. But with reduced intake of food it becomes
harder for the body to rebuild the lost muscle tissue.
If the well and active elderly person happens to fall and, as is often the case, breaks a thigh
bone he or she will evidently have to stay inactive for quite some time. This may again result
in general weakening and loss of weight, and the risk being that the person will never really
get back his/her former level of functioning.
The appetite is also reduced if a person is physically inactive and simply does not spend
enough energy. Of course, loss of appetite may also come as a negative side effect of
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Side 3
medicine. Or it could indicate that one is ill. Thus, it is very important to talk to your
physician, if you lose weight and you cannot yourself find a reasonable explanation. There
are several ways to-day of getting help to make a diet plan with the clear object of regaining
your normal weight and appetite.
Small portions whet the appetite
As a rule of thumb for people who have begun to eat very little it is recommended that they
eat very small portions but have many small meals in the course of a day – up to maybe 6 or
8 - and if one has become too thin it is recommended to stimulate the appetite with little,
energy-filled morsels – e.g. a piece of cake with the coffee; a small dessert; some ice-cream;
or cheese on biscuits between the main meals. It would be a good idea also to swap some of
coffee or tea you drink with energy rich drinks like cacao milk, yoghurts or a malt beer.
Elderly people who have become too thin are advised to eat more fat – but the healthy fats
from plants or from e.g. avocados, fish and nuts. Likewise, some elderly people can no more
feel thirst. They should try to pay attention for a while to their daily liquid intake – 1½ to 2
liters being optimal – consisting of fruit juice, non-fat milk, coffee, tea and water.
Elderly people who do not get enough liquids may become constipated and feel dizzy, which
may again lead to falls. Major dehydration, leading to confusion, mainly happens to weak
elderly persons, or to persons who take diuretic medicine.
The meal and the activities around it
Although people have very different thoughts about the importance of meals and their
preparation, this is, after all, one activity that we keep doing until very late in life. Food, of
course, keeps us alive and but at the same time it keeps us busy. The meal holds a number
of rather concrete chores and challenges: Decisions must be made about what to eat; and
then about the necessary ingredients: Are they in the house or is shopping necessary? Later
the food must be prepared and the table set. Finally follows clearing the table and storing
remnants away.
People who always liked cooking are never in doubt: They want to keep at it as long as they
can – even if it becomes difficult and they need a hand with some of the things. Others have
always been less involved in cooking, but making a meal may still entail a bit of daily activity.
One must leave the house to buy the necessary ingredients, maybe bumping into old friends
and neighbors and having a little chat; also sensing what the weather is like and enjoying the
movements of the body and returning home feeling more alive.
Even for the person who can no more do these things, planning the meals may very well fill
the day: An elderly lady who was unable to go outside because of arthritis, relates how she
spends the day looking through newspapers for bargains and finding out how to have the
selected groceries brought to her. To her, using the public meal-on-wheels system, would
feel like a loss – not only of self determination but also of meaningful cognitive activities,
including the planning part that to her was a kind of a mental fitness exercise.
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Surveys of a large number of 85-year old persons, mainly women, showed that the vast
majority of them still cooked their own food. However, surprisingly few of them wanted to
cook for visitors – this was the case for some even very experienced house-wives. They said
they felt out of habit cooking for others. They would get stressed, having to see about
everything round the meal. Yet, many of them had found solutions. Their advice:
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Invite children and grandchildren for a meal in town – maybe for brunch
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If you do invite, then for lunch with prepared sandwiches
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Have one or more of the guests arrive earlier to help
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Tell each of the guests to bring a little something with them
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Order meals from a catering company.
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Have people over only for coffee/tea and cakes.
Food for one instead of for two
Routines around meals will change when one lives alone – because of divorce or of
becoming a widow/widower. Many elderly men have to learn to cook for themselves,
including filling up the fridge and thinking about nutritional values, but the countless
evening classes about cooking for men seem to be enormously popular and they are often
the beginning of friendships and dinner clubs. Many join the classes year after year and
some have even developed into regular culinary studies.
The problem with cooking only for yourself is that you may miss company during the meal so
much that in the end you lose the inclination to cook at all. It is a good idea then to arrange
regular meals with others – going out or having people come over. Eating regularly in little
groups has become very popular among the elderly.
Tastes are very different. Some people enjoy the company of radio, TV or a newspaper,
when they eat. Others find a beautiful spot away from home – beach, wood or park – to
enjoy a sandwich and a cup of coffee from the thermos. Each in his or her own way finds
ways of combining meals with the things they like doing. One 90-year old woman said it like
this: - One must spoil oneself, as long as one has got oneself!
Make sure you get outside regularly
Major studies over the years have shown that the life of “young” pensioners is extremely
active and filled with social enterprises. Helping one’s family, especially minding the
grandchildren – this goes for men as well as for women – and taking part in various
voluntary activities, are very healthy ways of spending your days.
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However, with rising age elderly people tend to give up external and social activities.
Concentration is on house, garden and close family and you want to have visits instead of
going visiting yourself. This is very fine, of course, if that is how you want to spend your
days. However, it is less propitious if you feel cut off from going out and from doing the
things you want.
Many elderly people carefully use the traditional occasions to see others – either at home or
outside – and find creative ways of enjoying them in spite of difficulties. Disruptions,
however, of these habits are often seen in connection with moving, loss of spouse, or when
one is ill or generally weakened. Then it becomes imperative to rebuild the old social
connections as soon as possible or to make new acquaintances. Annual and other regular
events are also a part of life when one is old, as is being part of a family and of a community.
This is valuable and should be continued as long as possible.
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