A low fat diet is sometimes used for people recovering from a heart attack. But are they necessary for the elderly? There are many times an elderly resident is admitted from the hospital and the transfer diet is “low fat/low cholesterol”. Now comes the sticky part, what if the resident is 85 years old, do we really want a resident with advance age on such a restrictive diet?
Some people older than 65 years of age can benefit from a healthy lifestyle to reduce their risk of cardiovascular disease. But some older adults are resistance to diet restrictions and want quality of life more than adhering to a heart-healthy diet.
A low fat diet may help to lower blood lipid levels, such as total cholesterol and low-density lipoprotein (LDL) cholesterol (the “bad” cholesterol). If these blood lipids are deemed too high, it can create an increased risk for a heart attack of stroke.
What is the “normal” level for total cholesterol, LDL and HDL or high-density lipoprotein? Medical professionals recommend that even the elderly should keep their total cholesterol below 200 milligrams (mg)/deciliter (dl), LDL cholesterol below 100 mg/dL, and high-density lipoprotein (HDL) cholesterol (“good cholesterol”) above 40 mg/dL.
Older adults should eat vegetables, fruits, grains, breads, rice, pasta, cereal without too much added fat. Low fat milk and lean meats are also recommended. Liquids oils such as olive oil or canola oil are best. Limit saturated fats and Trans fats. Foods high in saturated fats include: fatty meat, poultry skin, bacon, sausage, whole milk, cream, lard and butter. Trans fats are found in stick margarine, shortening, some fried foods and packaged foods made with hydrogenated oils.
Foods high in cholesterol include: egg yolks (one egg yolk has about 187 mg of cholesterol), fatty meats, whole milk, cheese, shrimp, lobster and crab.
Medical judgment plays a big part in deciding if an elderly person should be prescribed a low fat diet. If their food intake is poor, then liberalizing the diet should be considered and recommended. Liberalizing the diet will often improve food intake. Too restrictive of a diet such as a “low fat” diet in elderly can affect their quality of life. If food intake and weight status are negatively impacted, then a less restrictive diet is more important for the resident. The dietitian and the medical doctor need to have open lines of communication to provide the best nutrition therapy for the elderly.
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Dorner B, Friedrich EK, Posthauer ME; American Dietetic Association. Position of the American Dietetic Association: individualized nutrition approaches for older adults in health care communities. J Am Diet Assoc. 2010; 110(10):1549-1553. http://www.eatright.org/About/Content.aspx?id=8373. Accessed December 31, 2013.National Institutes of Health, National Heart, Lung, and Blood Institute. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), Final Report. http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf. Bethesda, MD: National Institutes of Health; 2002. NIH publication 02-5215.
Williams MA, Fleg JL, Ades PA, et al; American Heart Association Council on Clinical Cardiology Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention. Secondary prevention of coronary heart disease in the elderly (with emphasis on patients ³75 years of age): an American Heart Association scientific statement from the Council on Clinical Cardiology Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention. Circulation. 2002; 105(14):1735-1743. http://circ.ahajournals.org/cgi/content/full/105/14/1735. Accessed April 3, 2014.