Food Choices for Healthy Aging

University of Nevada, Reno
Southern Area Cooperative Extension
Seniors CAN

Lesson Plan

Lesson: Food Choices for Healthy Aging

Lesson Number: N-1

Introduction:

This “Food Choices for Healthy Aging” lesson is designed to help older adult Learners organize their approach to eating, with specific attention to seniors’ unique needs, incorporating the USDA’s dietary guidelines and MyPlate and Tufts University’s modified nutrition guide for older adults over the age of 70.

Learning Overview: The Learner will participate in a lesson designed to teach him/her to make better nutritionally-based choices.

Lesson Objectives:

  1. During the lesson, the Learner will be exposed to the following concepts about food:
    • a. Proportion
    • b. Variety
    • c. Moderation in salt, alcohol, sugars, fat saturated fat and cholesterol.
  2. During the lesson, the Learner will engage in group discussion regarding food choices, describing with clarity at least one example from his/her life experience.
  3. During group discussion, either spontaneously or in response to Facilitator request, the Learner will state with clarity that s/he has selected at least one idea presented during the lesson, what that idea is, and that s/he will try this idea during the following week to see if it works for him/her. Alternatively, the Learner will state with clarity that s/he does not want to try out any of the ideas presented, and the reason for the decision.

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Set up at previous meeting:

Next week, we will be exploring dietary guidelines and food choices.

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Set up immediately prior to this meeting:

Facilitator assures that lighting is appropriate for Learners to see lesson handouts.

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Materials:

Provided by Facilitator:

Note: Facilitator should review lesson plan for this week, last week and next week because information provided at the beginning of each lesson plan is needed for smooth transition between lessons.

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Optional Activities:

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References:

United States Department of Agriculture, & United States Department of Health and Human Services. (June 2011). Let's eat for the health of it. USDA Publication number: Home and Garden Bulletin No. 232-CP. Washington, DC: U.S. Government Printing Office.

United States Department of Agriculture (2005). ChooseMyPlate. Retrieved June 7, 2011 from http://www.choosemyplate.gov/index.html

Duyff, R. L. (2006). The American Dietetic Association’s Complete Food & Nutrition Guide, Revised and Updated. Minneapolis: Chronimed Publishing, 3rd edition.

Russell, R. M., Rasmussen, H., & Lichtenstein, A. H. (2008). Modified MyPyramid for Older Adults. Journal of Nutrition, 138: 78-82.

LESSON

Begin Lesson:

Transition from last week

Last week we talked about (name of last week’s unit). Each of us selected one idea to try out. Let’s talk about how those worked (or didn’t work) for us, and also what we learned from last week’s meeting.

Anticipatory Set:

Today we will explore dietary guidelines and food choices. There are three reasons that we think this topic is important:

  1. Nutrition and the food choices you make have a major impact on your life.
  2. There is a lot of news coverage about nutrition and it can seem confusing. Yet what you need to know about is quite simple.
  3. Just a few key principles unlock the secrets to healthy eating.

Share the Objective:

  1. We will be talking about how the USDAs Dietary Guidelines help us to understand basic concepts of nutrition. These are:
    1. Proportion:
      1. MyPlate and/or Tufts' modified nutrition guide
      2. Food categories
      3. Recommended daily servings from each category
      4. Serving sizes
    2. Variety
    3. Moderation:
      1. Moderation in salt, alcohol, sugars
      2. Moderation in fat, saturated fat, and cholesterol
  2. During this lesson, I will be providing information, but it is also important that we share information and ask questions in group discussion. I would appreciate it if each of you could bring up at least one example from your life experience.
  3. Also during the lesson today, I’m going to ask each of you to select one idea from the lesson to try out on your own over the next week. I’ll pick one, too. Then each of us can share with the group next week how it worked out.

Share the Handouts:

These summarize the main ideas we will be discussing today. [Pass out the lesson materials]

Input:

I. Proportion: This is understood using the food groups and recommended daily amount to eat from each. [Refer to MyPlate and/or Tufts' modified nutrition guide]

  1. Current dietary guidelines for Americans:.
    1. The Dietary Guidelines for Americans are set by a group of educators, nutritionists, scientists and others, along with the U.S. Department of Agriculture and the U.S. Department of Health and Human Services.
    2. Dietary Guidelines are updated every few years as we learn more about human nutrition.
    3. The Dietary Guidelines are developed for health promotion and chronic disease-prevention, which we will talk about more in another lesson [N-2]. They also emphasize the value of a healthy body weight and that we should balance our food intake with physical activity to achieve or maintain a healthy weight.
    4. Today, we will be focusing on foods, not exercise, but we should be aware that physical activity is also part of the equation for good health. MyPyramid emphasizes this by the pyramid steps and the person climbing them.
  2. We need to eat foods from five food groups to be healthy. MyPlate is a reminder to eat healthier and illustrates these food groups using a familiar mealtime visual, a plate on a place setting.
    1. The orange/brown plate section represents the grain group.
    2. The purple plate section is the proteins food group.
    3. The green plate section is the vegetable group.
    4. The red/pink plate section is the fruit section.
    5. And off to the side of the plate is a bowl/cup in blue representing the dairy group.
    6. The food groups are shown in a plate like this to help us understand the relative amounts of foods from each group we should consume each day.
    7. MyPlate can also be tailored to each person’s caloric needs by visiting the ChooseMyPlate website and entering information such as age, gender and activity level.
      • a. As people get older, they don’t need as many calories per day as they once did. However, older people’s need for nutrients does not decrease but may actually increase. Therefore it is important to select foods that have a high nutritional value—foods that give you lots of nutrition for the calories that you take in.
      • b. Typically, most seniors need a daily intake of 1,600 calories. Others may need 2,000 or more if they are very active or have a larger body size. It is recommended they print their personalized “path to good health” from the website www.choosemyplate.gov.
  3. The recommended daily number of servings for the average 2000 calorie diet include:
    1. Make half your grains whole. From this group we find foods high in fiber and include breads, rice, cereal, pasta and crackers. The Guidelines state that we should have 6 ounces from this category each day. How to count:
      1 oz. = 1 slice of bread, ½ cup cooked pasta/rice, 1 cup of breakfast cereal, 3 cups of popcorn, OR 5 whole wheat crackers
      Helpful tip: 1 muffin = a light bulb,
      1 pancake = a hockey puck or CD
    2. Make half your plate fruit and vegetables. The general recommendation for the vitamin, mineral and fiber rich foods are 2 ½ cups of vegetables and 2 cups of fruit every day. How to count:
      1 cup = 1 small apple/1 large banana, 1 cup raw/cooked veggies, 1 cup of fruit, 2 cups leafy greens, 1 cup 100 % juice, OR ½ cup of dried fruit
      Helpful tip: 1 medium size fruit = tennis ball
    3. Notice that if we look closely at MyPlate, we can see that the majority of the foods we should be eating each day are grains, vegetables and fruits. Notice also that these foods are from plants, not animals.
      • a. Be aware that fruits, vegetables and grain products contain a lot of fiber. As you probably know from TV, newspapers and magazines, fiber is good for you and will be discussed in another lesson [N-2]. Caution:
        1. It is best to talk to your doctor before you increase fiber in your diet (1) if you are older than age 65, and/or (2) if you have had surgery on any part of your stomach, intestines, colon or rectum.
        2. Be sure to add fiber to your diet slowly and gradually. And be sure you drink an adequate amount of water – at least 8, eight-ounce glasses per day. Otherwise, you may have problems like diarrhea or constipation. Diarrhea is especially dangerous because it can result in dehydration which can send an older adult to the hospital. Also, suddenly adding fiber could result in a flare-up of diverticular disease or cause you to feel very uncomfortable.
    4. Switch to fat-free or low-fat (1%) milk. The milk group consists of calcium-rich foods like milk, yogurt, and cheeses. When possible, choose low-fat or fat-free products. For those who are lactose intolerant, fortified soy milk, Lactaid® or rice milk are good substitutes. The recommendations are
      3 cups each day from the milk group. How to count:
      1 cup = 1 cup of milk,
      1 - 8 oz. container of yogurt,
      1 ½ oz. of natural cheese,
      2 cups of cottage cheese,
      OR 1 ½ cups of ice cream
      Helpful tip:
      1 ½ oz. of cheese = 2 dominoes
    5. Vary your protein choices. Protein foods include meat, poultry, fish, dry beans, eggs and nuts. Choose low-fat or lean meats and poultry while including more fish, beans, peas, nuts and seeds. It is recommended that you eat 5 ½ ounces every day. How to count:
      1 oz. = 1 oz. of lean meat/poultry/fish,
      ¼ cup of cooked dry beans,
      ½ oz. of nuts or seeds,
      1 egg, OR 1 tbsp. of peanut butter
      Helpful tip:
      3 oz. of cooked meat, poultry, fish = a deck of playing cards
    6. Oils are fats that are liquid at room temperature. Most Americans consume enough oil in the foods they are already eating, such as nuts, fish, cooking oils and salad dressings. No more than 5-6 teaspoons of oil are recommended.
    7. There is a saying that nutritionists use when they talk about the nutrition guidelines: “All foods can fit.” That means you can still eat your favorite food, you just have to eat in moderation, a piece of pie, not a whole pie. Build a healthy plate.
      • a. Enjoy your food, but eat less. Avoid oversized portions.
      • b. Cut back on foods high in solid fats, added sugars, and salt.
      • c. Make half your plate fruit and vegetables.
      • d. Eat the right amount of calories for you.
      • e. Be physically active in your way.
    8. The Dietary Guidelines also include serving sizes.
      1. (Show food item models and use Portion Distortion.) These food item models are approximately one serving size each. Notice how small a serving of chicken is compared to what you might be served in a restaurant. The serving size of chicken can also be compared to a deck of cards.
      2. In general, many people need to decrease the serving sizes of their meat (as well as their fat, which we will talk about in a moment) and increase their daily servings of fruits, vegetables and grain products. Some of our ideas about serving sizes may change as we learn more about nutrition.
      3. Try using measuring spoons and cups when putting food on your plate. This will allow you to see the proper portions sizes compared to what you are used to.
  4. Show food model items. Use Portion Distortion and discuss.
    1. How does what we eat now differ from 20 years ago?
    2. These food item models are approximately one portion each (formerly referred to as serving size).  Example: Notice how small a portion of chicken is compared to what you might be served in a restaurant.  The portion size of chicken can also be compared to a deck of cards.
    3. Try using measuring spoons and cups when putting food on your plate.  This will allow you to see the proper portions compared to what you are used to.

II. Variety.  Another Dietary Guideline illustrated by MyPlate, using the color plate sections, is variety.

  1. Foods from each group are needed each day for good health. Also, you should eat a variety of foods within each food group. It probably won’t surprise you that ½ cup of broccoli does not have exactly the same vitamins and minerals as ½ cup of corn, or that a serving of rice and a muffin don’t have the exact same nutrients.
  2. Eat a variety of foods to get the whole range of nutrients that you can get within each particular group.

III. Moderation. The Dietary Guidelines also include the idea of moderation.

  1. Choose foods moderate in sodium, salt and sugar.
    1. Look for “low sodium” or “less sugar” food items.
      • a. Compare sodium in foods like soup, bread, frozen meals and choose the foods with the lower numbers.
      • b. Drink water instead of sugary drinks; select fruit for dessert; choose 100% fruit juice.
    2. However, keep in mind that flavors in foods are important for seniors. Try lemon juice, vinegar and flavorings such as extracts or butter flavorings. Also, try adding herbs. Be careful with spices, as they can irritate your stomach, but use them if they don’t give you problems. We’ll be talking more about making food more flavorful and interesting in another lesson.
  2. If you drink alcoholic beverages, do so in moderation. Moderation is defined as no more than one drink per day for women and two drinks per day for men. What counts as one drink:
    1. 12 ounces of beer
    2. 5 ounces of wine
    3. 1.5 ounces of 80 proof spirits
  3. Choose a diet low in fat, saturated fat and cholesterol.
    1. Normal weight seniors should get 30 % or less of their total calories from fat calories. There are several types of fat: saturated and unsaturated, as well as trans-fat.
    2. One gram of fat has 9 calories.
      • a. If a person’s required average daily intake is 2,000 calories, then fat should be limited to 67 grams.
      • b. 1,600 calories per day is more typical of seniors’ diets. This would then mean that no more than 53 grams of fat per day should be consumed.
    3. You don’t need to count fat grams with MyPlate. If you make low fat choices from all the groups you will come close to the recommended 30% of daily calories from fat.
      • a. Choose lean cuts of poultry or meat and fat-free or low-fat milk, yogurt anc cheese
      • b. Make major sources of saturated fats occasional food choices, such as cakes, cookies, ice cream, cheese, pizza, sausage and hot dogs.
      • c. Switch from solid fats to oils when cooking.
    4. You should also be aware that “low fat” isn’t necessarily for everyone. An older adult who is underweight should be followed medically by a doctor and see a Registered Dietitian as well. Being underweight is potentially a dangerous situation for the elderly.
    5. Unsaturated fats are the best type for you to consume. [Refer to handout entitled “Comparison of Dietary Fats and Oils.”]
    6. Also avoid foods with trans-fatty acids. These are found in foods that list “partially hydrogenated” oils on their ingredients. These types of fat, found in hard margarine, fried foods, many bakery products and some packed foods, are linked to heart disease.
    7. The body makes the cholesterol it requires. Dietary cholesterol comes from animal sources such as egg yolks, meat, poultry, fish and higher fat milk products.
    8. You can keep your cholesterol intake at the recommended daily level of 300 mg or lower by eating more grain products, vegetables and fruits and by limiting intake of high cholesterol/ fat food products especially from animal sources.

You should be aware that this is general information for the average older adult. If your doctor or dietitian has put you on a special diet due to a medical condition, it’s important to follow it. You can ask that person about some of the ideas we are talking about here, but don’t make changes in your diet without consulting with your doctor or dietitian if you are on a diet for medical reasons.

Monitoring / Discussion:

Q: How have the food groups changed much from what you were taught years ago?

Q: How do recommendations from MyPlate (and the Dietary Guidelines) compare to how you currently eat?

Q: How do recommended food portion sizes compare to meals served in restaurants?

Q: If you were going to make changes in your food choices that were more in line with the dietary guidelines, which changes would be the easiest? Which ones might be the hardest for you?

Optional Modeling and Guided Practice:

Let’s go into the kitchen and create a simple, healthy snack made of fruit, low-fat cheese and low-fat crackers. Facilitator and Learners should first all wash their hands. Divide slicing chores among Learners. Attention should be paid throughout to proper serving sizes of fruit, cheese and crackers.

Independent Practice:

This can be done at any time during the lesson. It seems to work better when it is not done in the rush at the end of a meeting.

"I’d like for each of us to select at least one idea, from what we're learning, to try out this week. Let’s choose something easy to experiment with. Next week we can all compare our experiences and see what worked and what didn't."

Closure/ Transition:

Look at next week’s lesson plan for: “Set up at previous meeting.”

It begins: “Next week, we will be exploring . . ..”