How Important is Diet for Old People?

On April 1, I presented a talk at a drug therapy conference in Vancouver in which I critiqued the evidence for benefit from healthy eating. Long story short, there is shockingly little evidence. And this is for all ages. Fat, sugar, and salt in the diet make almost zero difference to real health outcomes, according to good-quality studies. Antioxidants and fiber likewise.

If you add to that the fact that frail old people are almost never represented in studies, and that their differences from younger people, and from one another, make it almost impossible to generalize about prevention of any kind for them, the case for feeding them “healthy” food starts to look pretty weak.

Anybody who has tried the food in most nursing homes, especially where there is an enthusiastic nutritionist on the job, could be forgiven for deciding not to go back. And elderly people’s taste buds don’t work as well as they did when they were younger, so if we remove the sugar from the deserts, the salt from the stews and steaks, and the fat from everything including the ice cream, problems with weight loss and depression will only be made worse.

My conclusion: feed old people what they like! If you believe in multiple vitamin supplements, fine, add those, but it seems to me verging on criminal to take away one of the last and most easily accessible pleasures from these folks whose lives may most benefit from a little bit of comfort. And while we’re at it, it might be worth taking a look at our own eating habits and asking a few questions about why we don’t eat exactly what we like.

About John Sloan

John Sloan is a senior academic physician in the Department of Family Practice at the University of British Columbia, and has spent most of his 30 years' practice caring for the frail elderly in Vancouver. He is the author of "A Bitter Pill: How the Medical System is Failing the Elderly", published in 2009 by Greystone Books. His innovative primary care practice for the frail elderly has been adopted by Vancouver Coastal Health and is expanding. Dr. Sloan lectures throughout North America on care of the elderly.
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2 Responses to How Important is Diet for Old People?

  1. Neil Mudde says:

    Having worked in a Long Term Care Home as a cook for 40+ years, taking great pride in my work. In Toronto and in the rest of the province of Ontario Long Term Care Homes are now regulated by the Provincial Government and I experienced in my early cooking days, when “anything went” to now in the past years having nutritional meals being served to our residents. I find the term “old people” a bit of a put down, why not use “seniors”
    I was fortunate to work for the City of Toronto Homes, which operates 10 homes in the city, which always had a higher standard of living for seniors in everything including nutritious foods, unlike the many privately owned “homes” and I use that term loosely, that provided minimum care, and little nutrition, but a high profit margin for the owners, macaroni and cheese several times a week, with freshie etc makes for a good profit.
    Presently our Provincial Government overlooks all Long Term Care Homes in the province, to assure a top level of service is being provided, including a monthly 4 week menu cycle which includes items perhaps considered not healthy for example, bacon, or sausage for breakfast, and other comfort foods, including sweets of all sorts, in fact there are penalities involved up to and including closure for those homes not living up to the provinces standards. Government Dieticians are able to walk into any home at any time, and this happened often, check out the available menu, making sure that each item on the menu was in fact being offered, as would be one additional choice. Long Term Care Homes ought to provide comfort, and from my experience food is an important aspect of this comfort, and realizing the fact that to please everyone is totally impossible. I agree with the idea that
    I believe this is a case were government involvement across the boards is beneficial to all.
    There could be improvements on our Provincial Governments running the program of those seniors being able to stay at home and being given home care, but it is there, we do not live in a perfect world.
    We have in our city several “High Class Facilities” which provide luxury for those people who have the funds to pay them, however the alternative is a comfortable life for every senior resident who requires more care then the family is able, or in some cases willing to provide at home.
    Having retired I now volunteer at one of our homes, one job is to run the Tuck Shop, at which we provide all those wonderful “bad sweets” & chips……etc. and see how residents are provided 3 good meals a day, with coffee/tea in the morning + treats, or special events in the afternoon all filled with snacks which our residents enjoy, once a month there is a special dinner served to those residents unable to get out and go to a restaurant, I believe we are fortunate that our homes in the province are regulated and that the standards are up for scrutiny at any time.
    I realize some of our neighbours in the States see Canada as a “social state”, however when I read some of their horror stories, and how you can loose your last penny paying for yourselves, or your elders I believe we have a better and fairer system, as I happen to believe that the well being of any human being including seniors, is a human right.

    • John Sloan says:

      Thanks for your comment. It’s nice to know that some professional food people share my controversial views about “comfort food”.

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