Eating is Tough for Those with Alzheimer’s

It’s highly likely that you know someone who has or is suffering with Alzheimer’s disease; it’s the most common type of dementia. Four million Americans have the disease; most are over 65. The loss of mental function has a direct bearing on the nutrition of the individual who has the disease.

In early stages of Alzheimer’s, a person may be able to feed himself but cannot eat in a setting that’s not familiar. In this situation, verbal cues are important for reassurance, so that proper nutrition is maintained.

As the disease progresses, however, the issues become more serious. Loved ones may forget how to perform certain functions relevant to eating, such as how to hold silverware, how to chew, when to swallow – all of which can mandate the need for mealtime coaching. In its final stages, Alzheimer’s robs our family members of the ability to swallow, and with less consumption of food, there can be, of course, a serious lack of nutrients for the body.

Nutritionists don’t have a set plan as we follow individuals with Alzheimer’s disease. Certain things can be more helpful, such as incorporating finger foods, to prolong independent eating. Therapeutic diets relevant to other chronic diseases are usually considered, because dietary intake is key: weight loss and low body weight are predictors of morbidity.

Offering his or her favorite foods and a variety of textures and flavors decreases the likelihood of “food fatigue.” At all times, and through all dietary challenges, the family member’s dignity must also be considered. Without dignity, the will suffers, and willpower is key to survival.

Victims of Alzheimer’s also build intolerance to change; new routines are hard on them, as are new environments. If your loved one has been transferred to a hospital or assisted living facility, then is when they will especially be prone to higher frustration levels over diminishing ability to perform simple tasks. A formerly simple act, such as opening a container or carton, can create rage in a new setting, so mealtimes are particularly treacherous during and after a transition.

In this situation, refusal to eat can actually be stemming from frustration over packaging or mechanics, without it being verbalized that way. Unfortunately, 75 percent of those with Alzheimer’s are admitted to resident care facilities within five years of diagnosis, so the gauntlet of a new environment is hard to avoid.

There are a couple of nutrition-related myths surrounding Alzheimer’s. One has been hanging on since the 1960s, when it was suspected that drinking from aluminum cans could lead to the disease. While experts have failed to find any evidence that this is true, the resulting “fear of aluminum” spread, and people have wondered about the safety of aluminum pots and pans, antacids and even antiperspirants.

Again, no evidence has been presented which justifies these fears, although as a registered dietitian and nutritionist I would prefer you drink nearly anything other than sodas, which are nutritionally devoid and can have high sugar levels.

The thought of diet sodas leads me to the second Alzheimer’s myth: that Aspartame causes memory loss. While all sorts of health concerns have come up about the artificial sweetener found in Equal and NutraSweet, the FDA’s findings – based on experiments by 100 clinical studies – find no evidence of an Alzheimer’s connection.

The subject of sugars and sweeteners is one I’ll save for another day.

Kitchen Wall Color has Diet Impact

Your kitchen is the center of your nutritional hub. It’s where you make your decisions on how (and how often) to fuel your own body, and the bodies of others you may be responsible for feeding. For some of you, it’s also the place where meals are served and consumed: at a bar or island, for example, or a casual kitchen table.

You’ve already taken control of what goes in your refrigerator; now summer’s your chance to take control of the mood your kitchen sets. Believe it or not, the color of your kitchen walls can have an impact on your diet. Perhaps it’s time to evaluate how you want your kitchen to make you feel, and seize the day.

First of all, there’s a reason that McDonald’s, Burger King and every fast food restaurant known to man incorporates red and yellow in their logos and décor. Want to guess why?

Let’s start with yellow. This cheery hue is good for optimism and hope. But it also stimulates the appetite, pure and simple. You just thought you wanted a salad … now you want a Big Mac with fries.

Yellow is happy, but to overweight people, it can also be a tad dangerous when applied to kitchen walls. Better to let a good workout stimulate the appetite than the mere presence of a color. Unless, of course, you are underweight.

Need to beef up? Head for the yellow section of the paint store and slather it on. Think butter, egg yolks, lemons … mmm, I’m getting hungry already. But yellow helps the memory, so it could be useful if mom’s not available for a recipe consult.

Orange stimulates learning. If you’re a new cook, or aspiring chef or nutritionist, opt for orange.

As for red, it is a complex color, perhaps the most of all. Red engages us and brings out our emotions. Here’s the amazing thing about this color: to calm people, it is exciting, in a good way, a little thrilling. But for folks who are more anxious in nature, red is disturbing. The last thing you want is to be disturbed eight to 12 times a day, so be honest with yourself about your nature, and that of others with whom you may live.

Red walls trigger the release of adrenaline (which can be good for cooking, I suppose). And like yellow, it also stimulates the appetite, while simultaneously stimulating the sense of smell. Red walls can also increase your blood pressure and breathing rate.

Blue is opposite of yellow, on the color wheel, and in terms of appetite. It decreases blood pressure, the breathing rate, and the desire to eat, as do indigo and violet. So if you’re determined to drop 20, 30, even 40 pounds … coat your walls in hues of blueberries, grapes or plums. This will also remind you to eat antioxidants, which is a good thing. You win on two counts!

Pink is also proven as a winning weight-control color, at none other than prestigious Johns Hopkins Medical University in Baltimore.

Violet is known for its ability to create balance. So as you’re planning your menus or dishing out portions of lean protein, fresh veggies and multigrain bread, look to your walls for inspiration. (Violet is also good for migraine sufferers).

This brings us to green, the color of all things fresh and good for our bodies. Green is relaxing, and also creates a sense of balance. It relaxes the body, and helps those who suffer from nervousness, anxiety or depression. Green may also aid in raising blood histamine levels, reducing sensitivity to food allergies. Antigens may also be stimulated by green, for overall better immune system healing.

Placing your sunlit fresh herbs near a green wall brings the outdoors in. That might also make you think about starting a garden, going for a walk or run, or cycling around the neighborhood.

Brown enhances a feeling of security, reduces fatigue and is relaxing. Black is a power color. If you have six-packs and you know it, raise your hand. Gray is the most neutral of all colors for the kitchen: not much happening there. Brighter hues inspire creativity and energy, while darker colors are peaceful and lower stress. Beige and off-white are “learning” colors.

Make good choices, on your walls, as well as your plate. What color should your kitchen be?

Get Creative and Grill Your Way to Healthier Meals

Now that summer is almost here, it’s a perfect time to fire up the grill instead of the oven. May is even National Barbecue Month.

Barbecuing also offers plenty of health benefits, depending upon what you’re throwing over the flames. Groceries and farmers markets are full of fresh, locally grown produce, and Southwest Florida is blessed with an abundance of seafood.

But no matter what your favorite protein is, one thing always holds true: Grilling lends itself to a healthy diet.

Veggies never taste better than when grilled. That fresh, flavor-bursting taste is complemented by that magazine-cover grilled veggie “look” and it’s all good. It’s also nearly impossible to ruin a vegetable on the grill, so relax and experiment. You’re likely to wind up with a flavorful al dente version of corn, zucchini, peppers, onions or even something more unusual.

For something different, try grilled endive. (Joseph’s Table in Taos, N.M., serves a delicious version, with a gorgonzola sauce).

Marinating is a wonderful way to enhance veggies; they tend to caramelize when marinated. Use a large Ziploc-type bag to give them this advantage, if you have the time and inclination.

But once you’re ready to grill, avoid coating veggies (or anything else) with anything too sugar-intensive. Ingredients such as molasses, brown sugar and fruit juice tend to make foods burn in high heat. Most vegetables do best when cut into 1/4-inch to 1/2-inch-wide pieces.

You can choose to put your vegetables directly on the grill – including speared on kebabs – or you may opt to put them in foil and lay that on top of the heat. Experiment and see what suits you.

Also, adding a dash of salt to veggies really draws out the flavor by drawing out the moisture inside them. Add the salt and any other seasonings you choose, after brushing them with a little oil. Then grill; veggies only need a few minutes.

Chicken with the skin on has a much higher fat content than that without: nearly double. So take it off before you marinate. Leaner cuts of meat can also trim up to half the fat calories overall, while still providing that yummy grilled taste. This frees you up to “spend” your calories on salad dressing, a cocktail, a simple dessert or something else.

Leaner cuts will require a marinade, however, as they can be tougher. Opt for thinner cuts of meat; marinade will penetrate only to about a quarter of an inch. Score the meat before covering it in marinade. And choose something with higher acid content, to help break down the fibrous nature of the meat.

Fish is always lean. Grilling is a great time to add salmon or tuna to your diet (tuna doesn’t want to be grilled for long). It’s very important to keep fish on ice or refrigerated until ready to grill in order to avoid food poisoning.

Depending on your meat, here are four low-calorie choices of marinade: Worcestershire sauce (2 tablespoons has only 30 calories); low-sodium soy sauce (2 tablespoons contain 120 calories), or tomato paste (2 tablespoons contain 40 calories), work really well.

For chicken, I like a tropical marinade of stone-ground mustard, honey and Key lime juice.

The sides that typically accompany a grilled dinner are where you can run into trouble. Save a lot of calories by avoiding creamy salads such as cole slaw, macaroni or potato salad; try brown rice or whole-meal pasta instead. If you plan to use bread, avoid white breads and pick up a nice whole-grain option. Fresh fruit salad is also a great substitute for potato salad, and can double as dessert.

Grilled pineapple is another delicious dessert option. Brush it with a little oil the same way you do with veggies and enjoy this delicious treat. For something really different, grill bananas!

Make sure any kids in your household understand how to be safe around a grill. And then get them involved in the process: shucking corn, skewering veggies, brushing on marinade or oil. This fun activity can become a lifelong habit, one that enhances nutrition and health.

Copyright 2010 Elaine Hastings, RD. Heath and Wellness, Nutrition Expert
Elaine Hastings is a registered dietitian and owner of Associates in Nutrition and Sports Specialty in Florida. Hastings can be contacted at info@elainehastings.com or by visiting AssociatesinNutrition.com. Visit her blog for the latest information on nutrition and great tips for staying healthy: AssociatesinNutrition.com/wordpress. Take the Challenge, Change your Life!

Mercury Risk from Fish Varies

Posted May 6th, 2010 by Elaine Hastings, RD - Nutrition Expert and filed in Food Safety, health, In The News, Meal Tips

Last week I wrote about omega-3 fatty acids, and how they play a critical role in brain function, growth and development, and may reduce the risk of heart disease. They’re found in seafood and shellfish, and no doubt, some of my better-informed readers are weighing the risk of contaminants like mercury against the benefits of omega 3s.

You’ve possibly read about the dangers of mercury, which can occur in some types of fish. So let’s go over the facts. The most important one is this: the FDA says women who are pregnant, want to become so, or are nursing should avoid the fish most likely to have mercury contamination. This rule applies to young children, too.

Mercury levels are generally higher in older, larger, more predatory fish and marine mammals. That’s why I recommend (for people outside the aforementioned groups) consuming no more than one fishmeal per week from predatory fish like shark, tuna and swordfish. The FDA agrees, recommending no more than 7 ounces of fish from the high-mercury-potential list per week.

Do add other seafood meals to your menu, but I recommend no more than two per week from non-predatory fish (sardines, salmon, shrimp, etc.). Oily seafood such as fatty sardines, trout, herring and salmon are rich in omega-3 fatty acids. They are thought to reduce the risk of death from stroke, heart attack, and other cardiovascular disease. The American Heart Association also recommends four to six ounces, twice a week, of these types of fish.

Eating a variety of fish also cuts down on any negative effects caused by environmental pollutants. To decrease potential exposure from these types of contaminants, simply remove the skin and surface fat from a fish before cooking. If you know where your fish comes from, specifically, you can also check with local and state authorities in regard to potential contamination of local watersheds.

Here’s the good news: postmenopausal women and men middle-aged or older can relax about mercury consumption. For them, the benefits of eating fish far outweigh any potential risk. The main negative effect from mercury in fish is high blood pressure.

So, as with so many other things in life, moderation is the way to go. Unless you’re in the category of pregnant/nursing/trying or that of young children, a little fish can go a long way toward your heart health and brain function. And it tastes great! Coastal residents are particularly lucky to have easy access to the freshest of fish from local fish markets, retailers and restaurants. Find one or two sources you can rely upon, and support them.

Be aware of watershed issues if eating locally caught fish, and otherwise, simply enjoy this heart-healthy choice. Seafood is lean and low in saturated fats. It’s a great entrée in the evening, too, when that too-full feeling is particularly troubling. A good piece of fish is hard-pressed to make a diner feel he or she has over-indulged, unless it’s stuffed with something and doused in a rich sauce. Fish is also great on top of a salad, whether grilled or blackened.

As summer temps heat up, the added bonus of fish is that it can be cooked outside on the grill. Save on your air conditioning while doing something good for the bodies you feed. It’s a win-win.

Elaine Hastings is a registered dietitian and owner of Associates in Nutrition. Hastings can be contacted at info@ElaineHastings.com or by visiting AssociatesinNutrition.com. Visit her blog for the latest information on nutrition and great tips for staying healthy: AssociatesinNutrition.com/wordpress.

Take the Challenge, Change your Life!
©2009 Associates in Nutrition. All Rights Reserved.

Seafood, Shellfish Important for Adults, Kids

Posted April 27th, 2010 by Elaine Hastings, RD - Nutrition Expert and filed in The News-Press Column

Fish: A Four-Letter Word for Healthy!

Fish and shellfish are an important part of a healthy diet, and nowhere is fresh fish easier to find than the coast. Increase your odds for a long and healthy life with a simple, tasty change: add fish to your weekly menus.

Here are some nutrition facts to motivate you. Fish is a lean, low-calorie source of protein and a great source of critical omega-3 fatty acids. These play a crucial role in brain function, as well as growth and development, and may even reduce the risk of heart disease.

But here’s the catch: the body can’t make them. We must go to the source for omega-3s, and in a seafood-centric environment, that’s easy. They come from fish – such as salmon, tuna, and halibut; other seafood, including algae and krill; some plants; and nut oils.

A well-balanced diet that includes a variety of fish and shellfish can contribute to the whole family’s well-being. Just remember, you don’t have to go overboard to reap the benefits. A little bit of “daily catch” goes a long way. The American Heart Association recommends eating fish at least twice a week (especially fatty fish like trout, herring, sardines, tuna and salmon) at least twice a week. I personally recommend consuming no more than one fish meal per week from predatory fish (shark, tuna, swordfish, etc.) and no more than two per week from non-predatory fish (sardines, salmon, shrimp, etc.). Very few palate-challenged people will be overwhelmed by this schedule.

Some of you are thinking ‘I know fish is good for you, but my family doesn’t really like it.’ There are many recipes that you can use which will increase the appeal. Look for salmon stuffed with crab and breadcrumbs, or use a tasty pesto to enhance the flavor (Costco offers one of the best I’ve found, in its refrigerated section) . Add grilled fish to a salad loaded with other items. Throw some shellfish into your marinara. Be creative and research ways that might make your family happy when consuming fish or shellfish. Here are two seafood recipes which will help:

Easy, tasty tuna salad
1can (12 oz) water-packed solid white tuna, drained
1/3 cup Yoplait® Fat Free plain yogurt
1can (4 oz) crushed pineapple, drained; or grapes
1 stalk celery, finely chopped (1/3 cup); or sweet onion
¼ cup chopped pecans
1 teaspoon yellow mustard
1/8 teaspoon ground cinnamon

In a medium bowl, mix tuna, yogurt, pineapple, celery, pecans, mustard, and cinnamon.
1 serving has approximately 180 Calories, Calories from Fat 50; Total Fat 6g (Saturated Fat 1/2g, Trans Fat 0g); Cholesterol 25mg; Sodium 420mg; Total Carbohydrate 11g (Dietary Fiber 1g, Sugars 9g); Protein 22g.

Shrimp tomato sauce over pasta; makes 4 servings
1 tablespoon olive oil
1 small bunch scallions, chopped
2 garlic cloves, minced
1 can (28 ounces) crushed tomatoes
¾ cup dry white wine or nonalcoholic white wine
1 tablespoon sugar
¾ cup chopped flat-leaf parsley or basil
12 fresh or frozen and thawed jumbo shrimp, peeled and de-veined
8 ounces spaghetti
¼ cup grated Parmesan cheese

1. Warm oil in a medium saucepan over medium heat. Add scallions and garlic. Cook 10 minutes, or just until scallions begin to turn golden.
2. Add tomatoes, wine, sugar, and 1/2 cup parsley or basil. Heat to boiling. Reduce heat to low, cover, and simmer 20 to 25 minutes, or until sauce is slightly thickened.
3. Add shrimp and return to a summer. Cook 4 to 5 minutes or until shrimp is opaque.
4. Meanwhile, cook spaghetti according to package directions. Drain and transfer to a large bowl. Add sauce and toss to mix.
5. Sprinkle with Parmesan and remaining 1/4 cup parsley or basil.
Approximately 1 serving has about Calories 380, Calories from Fat 60; Total Fat 7g (Saturated Fat 2g, Trans Fat 0g); Cholesterol 65mg; Sodium 650mg; Total Carbohydrate 59g (Dietary Fiber 6g, Sugars 10g); Protein 19g

Next week, I’ll share some insights about mercury in fish. We’ll sort the truths from the rumors so you can relax at mealtime.