February 23 (Wednesday) 17:15 President
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What kind of diet would you like to have for a long life? Dr. Atsushi Sasaki, a doctor, said, "It's dangerous to lose weight when you're old. It's better to actively eat side dishes and bento boxes that are mainly fried or meat dishes to get plenty of calories and protein."*This article is a partial re-editing of Atsushi Sasaki's "Eat when you get older taught by a home medical expert" (Asuka Shinsha).
Photo = iStock.com/runin *The photo is an image - Photo = iStock.com/runinAs you get older, it can be a hassle to prepare three meals a day. Especially if you live alone, it is not uncommon for you to find it difficult to cook just for yourself.
It's okay to cut back on cooking, but don't cut back on the amount of calories or protein you eat.
The quickest thing is to eat ready-made side dishes and lunch boxes.
Of course, you can eat out or take delivery, but it is troublesome to go to the store and order each time, and it is economical to use eating out and delivery frequently. It's also expensive, isn't it? On the other hand, if you buy side dishes and lunch boxes at supermarkets and convenience stores, you can easily procure meals.
When selecting these side dishes and bento boxes, elderly people should choose foods with high calories and plenty of protein as much as possible.
For side dishes, we recommend fried foods such as fried chicken, tonkatsu, croquettes, fries, and tempura, as well as Chinese-style side dishes that use plenty of fat. For bento, we recommend the rich meat-filled bento, such as yakiniku bento, sukiyaki bento, and chinjaorose bento.
On the other hand, please avoid selections such as "I'm fine with just a salad today" or "Let's just have one rice ball today".
Eating these low-calorie, low-protein diets can lead to weight loss, muscle loss, and accelerated physical weakness. Instead of saying, "I don't have much appetite, so I don't have to eat," think about, "How can I eat well and enjoy it?"
In addition, no matter how troublesome it is, it is strictly forbidden to skip meals. This is something that older people should never do.
Even if you don't have an appetite, try to eat something that looks like a meal when it's time to eat.
If it's too much trouble to make, and if it's too much trouble to go shopping at the supermarket, you can buy instant cup noodles. There is no problem at all if you eat it "occasionally" instead of every day.
Cup ramen is quite high in calories, so it is a useful food for the elderly. Above all, cup yakisoba is a very high-calorie food, with a normal size serving 500-600 kcal.
However, cup ramen and cup yakisoba don't have enough protein.
But if you eat "canned mackerel" together, you will be able to take in the ideal amount of calories and protein.
Alternatively, it might be a good idea to eat cup ramen and a boiled egg together, or drop a raw egg into cup yakisoba and eat it to "add a little" protein.
Here, let's check the situation based on medical data to see how thin Japanese elderly people are.
There is BMI as a standard index for whether you are fat or thin. This can be calculated by dividing your weight by the square of your height in meters. In general, if this BMI exceeds 25, it is "obese", if it is below 18.5, it is "thin", and 22 is considered to be "normal body type" because the risk of illness is the lowest.
When we surveyed the BMI of elderly people using home-visit nursing care nationwide, it became clear that as many as 60% of them were underweight, with a BMI of less than 18.5. Among them, 28% were "severely underweight" with a BMI of less than 16.
For women, those with a BMI of less than 16 are 2.6 times more likely to die than those with a BMI of 22. Even if you have a BMI of 18.5, you're still quite thin, but at a BMI of 16, you've already lost muscle and become skinny.
I think that the low weight trend among the elderly in Japan is a "dangerous level".
Because the amount of food is insufficient, I have invited myself into a vicious cycle of "undernutrition → muscle mass loss → pneumonia / fracture → hospitalization → further muscle mass loss".
Some people may not understand the risk of being underweight, but in the case of elderly people, many studies have shown that being thin increases the risk of death, while being overweight decreases the risk of death. It is clear. A study conducted in the United States also found that the lower the BMI, the higher the risk of death in the elderly, and the lowest risk of death was found in the elderly with a BMI of 27, which is slightly overweight.
A BMI of 27 means obesity (1st degree), and it has been reported that the risk of death is 29% lower in elderly people compared to people with a normal body type (BMI of 22). . In the case of the elderly, it is surprising that even a person with a BMI of 40, who is very obese, has about the same risk of death as a normal-sized person.
"Huh? A BMI of 22 is supposed to be the healthiest, so why not?" In fact, the ideal BMI should be considered separately for the young and the elderly.
Because BMI22 is an index derived from health checkup data for 5000 people aged 30 to 59, that is, the elderly are not counted at all. In other words, it is a physique index created without the elderly, so it is better to think that "22 is the best" does not apply to the elderly.
Let's talk about "snacking" here. Is it okay for the elderly to eat between meals?
The answer is yes. Especially for elderly people who eat small amounts of food, it is better to eat a little less white rice but eat three more side dishes and eat more snacks and desserts than a style of eating three meals a day and white rice. , I think you can get a solid amount of calories in total. So, when you're a little hungry, don't worry about snacks or mandarin oranges and pick up whatever you like.
When I was young, I might have been warned for eating too many snacks, but that was only when I was young.
Once you're old, it's actually good for you to have high calories and gain weight easily. So potato chips, rice crackers, okaki, karinto... you can eat whatever you like.
Surely, for those who like sweets, it may be a dream situation to be able to eat anything without hesitation. However, if you eat a lot of these foods between meals, even if you get enough calories, you tend to lack protein. Please keep in mind.
Speaking of snacks, I think there are many people who are not fond of "sweet things". Cakes, cream puffs, eclairs, puddings, daifuku, dorayaki, steamed buns, etc. Elderly people can eat whatever they want.
Photo = iStock.com/chikaphotograph *The photo is an image - Photo = iStock.com/chikaphotograph Once you become aware of your decline, I think you should prioritize eating well and maintaining your weight over blood sugar levels.If you are under treatment for diabetes, of course you can ignore blood sugar control. There is also the idea of matching insulin.
By the way, convenience store sweets are becoming more and more popular these days. For example, there are many different types of puddings, some with fresh cream, some with fruit, some with high-quality ingredients, etc., so you can choose according to your taste.
Atsushi Sasaki "Eat when you get old, taught by a home medical expert" (Asuka Shinsha)Of course, you can choose what you like, but the amount of food is small and you gain weight easily. do not have. For such people, it would be a good idea to choose something small but high in calories.
For reference only, Western sweets such as cakes and cream puffs tend to be higher in calories than Japanese sweets such as steamed buns because they contain milk fat such as fresh cream. So, if you are unsure, it might be better to choose Western sweets rather than Japanese sweets.
I think there are many people who enjoy snacks every day no matter how old they are.
Now that the curse of not being fat is gone, how about enjoying the daily “joy of eating” while trying various sweets?
If you have a chronic illness or are in poor physical condition, you will need to consume more calories because the illness will drain your energy. When you say, "I feel a little feverish today" or "I don't feel well," you have to work harder and consume more calories.
Even so, there are times when you just can't get enough of your appetite. What should I do when I can't eat as usual?
The best thing to avoid is skipping meals. So, even if it's a small amount, please eat as much as you can. And it is a good idea to try to put "a small amount of high-calorie food" in your mouth as much as possible.
My recommendation is chocolate and ice cream. Both can ensure high calories in small amounts. One bar of chocolate gives you about 400kcal, and half of it gives you 200kcal. A mini cup of ice cream with a lot of milk fat is about 260 to 300 kcal. Eating these will give you a decent amount of calories.
In particular, ice cream melts quickly in your mouth and makes your tongue and throat feel cold, so I think it's easy to eat even when you're feeling hot or have a sore throat.
In addition, Karinto is a small amount and high in calories when it comes to snacks. Eating 100g gives you about 450kcal. If you think you can eat sweets even when you have no appetite, you should actively use these foods.
If you don't like sweets, you can also eat nuts.
Almonds and peanuts are also 60 kcal per 10 grains. Nuts such as cashews, pistachios, and walnuts are all high in calories. If you pinch it little by little, you will be able to take in a lot of calories.
When you get old, no matter how much you lose your appetite, it's important to put in your mouth as much as possible something that can give you "heat" or "power".
On the other hand, “porridge” is not really recommended. Porridge is definitely lacking in calories. Normally cooked rice is about 200 kcal per bowl, but porridge is half that, about 100 kcal.
Even if you have a fever and your body temperature rises by 1 degree, that alone consumes about 200 kcal. If it rises by 2 degrees, it is about 400 kcal. In other words, the 100 kcal of rice porridge cannot even cover the amount of calories consumed by this heat rise.
If an elderly person stays in such a state for several days, he or she may become malnourished while lying in bed with a cold.
Of course, when you're so sick that food doesn't go down your throat, it's all you can do to drink water and eat porridge. However, if you can eat it, please abandon the idea of "no appetite → porridge" from now on and try to wear "no appetite → chocolate & ice cream" as a new health common sense.
----------Jun SasakiMedical Corporation Yushokai Chairman and Medical Director Born in Kyoto in 1973. After graduating from the University of Tsukuba School of Medicine in 1998, he joined the social welfare corporation Mitsui Memorial Hospital as an internal medicine resident. In 2004, entered the doctoral program at the University of Tokyo Graduate School of Medicine. I encountered home medical care at a part-time job while in graduate school. Dropped out of graduate school in 2006 and opened a home care support clinic. Incorporated in 2008, current position. ----------
(Atsushi Sasaki, Chairman of the Medical Corporation Yushokai, Director of Medical Treatment)