The Great Elderly Doughnut Debate

Caregivers thought they were doing their elderly clients a favor not serving doughnuts and other sweets.

But a small, vocal, group of these elderly were not amused.

“I’m 86, not 8,” says C. Michael Sibilia, a resident of the William Koehler Memorial Senior Center in Putnam County, north of New York City.

Sibilia likes his doughnuts and other assorted carbohydrates and doesn’t consider them contraband. Neither, for that matter, does the center’s management. They just became concerned by the number of breads, cakes and pastries pouring into the center as donations.

“It was disgusting the way people went after them,” says one 80-year-old center resident, who sides with management.

But Sibilia and a handful of other residents were outraged, leading one of them, a former union official, to organize a demonstration of discontented residents outside on the sidewalk.

The issue has sparked a nationwide debate over what Americans in the sunset of their lives should and should not eat.

While one nutritionist doesn’t advise the elderly and their caregivers to throw caution to the wind, he does see a middle way. As far as he’s concerned, there is nothing wrong with eating the occasional doughnut or cake, providing it is part of an overall balanced diet.

“If their overall diet is pretty good and they want to eat doughnuts on Sunday, why not let them?” asks Dr. Robert Keith, an Alabama Cooperative Extension System nutrition and health specialist and Auburn University professor of nutrition and food science.

Keith says caregivers also err in assuming that elderly nutritional needs are no different than those of younger or middle-aged adults.

“Some of the hallmarks of a nutritious diet apply to everyone, but within those broad guidelines, there are differences depending on one’s age,” he says.

Keith and other nutritionists have spent their careers warning younger and middle-aged adults to avoid packing in too many doughnuts and other high-calories foods because of the long-term risks of obesity and chronic obesity-related diseases, such as heart disease and diabetes.

But for someone who is 85, the rules work a little differently, he says.

“First of all, the fact that they’re 85 and not obese is a good indication that they’ve never been obese and probably never will be,” Keith says. “Also, the fact that they’ve made it to 85 means that they’ve been doing something right in terms of diet and physical activity or that they have some genetic safeguards working for them.”

Simply put, the general rule to eat healthy still applies but not quite the same way as it would to a younger person, he says.

Other nutritional differences also apply. Getting adequate amounts of B-12, for example, is a major issue for older people, especially those who have a hard time absorbing this vitamin or, barring that, chewing and digesting animal products, which tend to contain ample amounts of the vitamin.

“If I were advising younger people between ages 20 or 30, I probably wouldn’t even mention vitamin B-12 unless they were pure vegetarians,” Keith says. “But with someone who is 80 or older, I’d be scoping out their eating habits heavily to see if they’re getting enough of that nutrient.”

Vitamin D is another key vitamin that older people often don’t consume in adequate amounts, either because they don’t get out in the sun enough or don’t consume enough milk.

Hydration is another consideration.

“It’s a big issue with lots of elderly people, especially because their thirst receptors don’t work as well and it’s easy for them to become dehydrated,” Keith says, adding that this is a constant concern of caregivers in nursing homes.

Many of these caregivers have learned from experience that sweetened drinks such as fruit juices, iced tea or some sodas may be the only things that provide elderly patients with incentive to drink adequate amounts of liquid each day.

“The drink may have only sugar and no nutrients but the job is to keep them hydrated,” Keith says. “It may not be a good choice for a toddler or preschooler, but for elderly people, it’s an important nutritional consideration.”

Nutrition, though, isn’t the only issue, Keith stresses. All of us eat for reasons other than simply nutrition — foremost for the taste and enjoyment of food — and elderly are no exception. In fact, an abiding passion for taste often substitutes for losses in hearing and sight that often accompany old age.

“For many of them who don’t get out much, eating is one of the few pleasures they still have,” Keith says. “Mealtime becomes a very important part of the day.”

Also, as older people’s sense of taste declines along with other senses, their preferences for food may change.

“In lots of cases, the foods they used to like don’t taste as good because of their diminished sense of taste, so they may end up preferring spicier or sweeter foods to make up for it,” Keith says.

Challenges with chewing and swallowing also may be factors, which may explain the preferences for softer foods such as breads, cakes and pastries. In some cases, calories may be a concern, too.

“Elderly with chewing problems and taste depravation may not be consuming enough calories, so a doughnut — a little bit of food loaded with lots of calories — might actually be of some benefit for them.”

No, they shouldn’t be eating doughnuts all the time, Keith says. But for some elderly people facing these kinds of physical challenges, doughnuts may have a place, he says.

Posted by Jim Langcuster at September 28, 2007 01:35 PM