A healthy diet can not only improve quality of life but can also help you live longer.  Health Canada produces Canada’s Food Guide to Healthy Eating to assist in making food choices to ensure optimum food intake.  Key to this is a new focus called total diet approach, emphasizing that foods are no longer labeled as good or bad, but that the overall pattern of eating is important for long term health.  Issues such as energy balance, fat content, starch and fibre content, along with moderated intake of salt, alcohol, refined sugar and caffeine, are also considered and highlighted in five key messages that define healthy eating:
  - Enjoy a variety of foods
  - Emphasize cereals, breads and other grain products, vegetables and fruits
  - Choose lower-fat dairy products, leaner meats and foods prepared with little or no fat
  - Achieve and maintain healthy body weight by enjoying regular physical activity and healthy eating
  - Limit salt, alcohol and caffeine

Food Labels
A common challenge in making healthy food choices is a lack of consistency in food labels.  Examples of common terms:
  - Serving size: indicates both the measure of one serving and how many servings per container per package
  - Calories: includes both total calories per serving and fat calories per serving
  - Percentage of Daily Values: shows both grams per serving of specific nutrients and the percentage of daily value, usually based on daily intake of 2000 kcal.
  - Common nutrient terms;
  - Reduced or less fat: at least 25% less fat per serving than the regular food cited on the label
  - Low fat : less than 3 grams per serving
  - Fat free: less than 0.5 g per serving
  - Light or lite: at least 50% less fat or one-third fewer calories per serving than the “regular” food cited on the label
  - Reduced or less sodium: at least 25% less sodium per serving than the “regular” food cited on the label
  - Source of fibre: at least 2 g of fibre per serving

The phrase “You Are What You Eat” emphasizes the vital and diverse role nutrition plays in our lives. An adequate and balanced diet is central to growth and maintenance as well as good health.  Carbohydrate, protein, fat, vitamins, water and some minerals found in foods are considered essential nutrients.  They are required to sustain life and must be obtained from external sources.  A nutritious and balanced diet provides variety, adequate nutrients and maximum protection against chronic disease.  The need for an adequate diet for the Canadian population is recognized by the establishment of a recommended nutrient intake (RNI) value for most nutrients.  The RNIs have been designed to meet the needs of the majority of the healthy population and are intended to be the basis for planning a healthy diet.   Canada’s Food Guide to Healthy Eating was developed to address current nutrition issues and recognize changes in Canadian eating patterns.  This food guide essentially addresses the nutritional needs of the majority of Canadians 4 years of age and older.

When it comes to keeping seniors healthy, happy and independent, good nutrition along with regular exercise provides seniors with important health benefits.  These include improved resistance to illness and disease, faster recovery from illness and injury, a stronger immune system, increased mental acuity, higher energy levels and improved management of chronic health issues.  Proper nutrition also has been shown to reduce the risk of falls. And yet an estimated 5-10% of elderly people living in the community, 60% of hospitalized seniors and 35-85% of those living in long-term care facilities are malnourished.  Many more seniors are at risk of malnutrition because they are not following healthy food guidelines.  According to a recent Canadian Community Health Survey:
  - 56% of people aged 71+ reported consuming less than the recommended daily minimum servings of fruits and vegetables.
  - 82% of those aged 71+ consumed less than the recommended minimum servings of dairy products daily

Nutrition for seniors is different!  Achieving nutritional goals is a greater challenge for the elderly than it is for younger adults. Aging reduces the body’s ability to absorb and utilize nutrients.  As well, a smaller body mass means fewer calories are required, so seniors must consume foods with a higher concentration of nutrients to maintain the required level of vitamins and minerals.  Aging also brings with it many physiological lifestyle and economic changes that increase the risk of malnutrition. Physical limitations make it difficult to go food shopping and prepare meals.  Appetites are often diminished by a reduced sense of smell and taste or difficulty chewing and swallowing.  Living alone may reduce the motivation to eat regularly, and living on a fixed income can result in fewer, smaller meals.

Malnutrition can result in serious health issues, loss of independence and early institutionalization.  It has been shown to hasten the decline of the immune and sensory functions, reduce cognitive functioning and aggravate chronic diseases like cancer, diabetes and osteoporosis.  It can also lead to problems with the heart, lungs and digestive system.  Seniors who do not eat properly can experience fatigue, dizziness and a reduction in strength, balance and endurance that increases the risk of falling and the possibility of injuries.  This has been a very general overview of an increasingly complex subject.  As a pharmacist, I am often asked about the need for vitamin/mineral supplements.  Inquiries vary based on medical condition (eg. gluten allergy), stage in life (pregnancy, post-menopausal, sports nutrition, aging, etc.) or general health benefits.  In future issues, I will address some of the typical daily inquiries such as:
  - How much Vitamin D do I need?
  - Do I need a multivitamin?
  - How much Calcium do I require?
  - How much is too much of Calcium, Vitamin D, Iron, etc.?
  - How much iron do I require?
I will prioritize any topic(s) of interest to you in future publications based on your feedback and I welcome your inquiries and concerns at any time you frequent the pharmacy!

Norm Corriveau, B.Sc. Phm.

Patient Self-Care, Helping patients make therapeutic choices, 2012
Non-prescription Drug Reference for Health Professionals, General Principles of Nutrition, Canadian Pharmaceutical Association, 2011Drugstore Canada,
General Nutrition, September 2011 Public Health Agency of Canada, Report on the State of Public Health Canada
Public Health Agency of Canada, Nutrition and Healthy Aging, 2011