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Obesity
Risk for Elderly Overlooked
As growing rates of obesity in children and adults grab headlines,
a doctor says another segment of the population is facing the
same problem but has been largely overlooked: elderly people,
particularly those in retirement communities and assisted care
facilities.
Take three square meals a day (often
high calorie, large portion affairs), combine that with little
exercise and the dynamic of eating in group settings, and the
end result often is weight gain that can affect health and shorten
life, said Dr. Carl Wenzel, a Warminster Hospital physician who
treats elderly patients.
"We've got a major problem and
it's going to get worse" as the U.S. population gets older, Wenzel
said. In recent years, he said he has seen a marked increase in
older patients with diabetes, high blood pressure, high cholesterol,
heart disease and joint problems — ailments often related
to weight gain.
The prevalence of obesity among
people age 50 and older increased 85 percent from 1982 to 1999,
the most recent figures available from the National Center for
Health Statistics of the U.S. Centers for Disease Control and
Prevention. The rate of obesity falls as age increases, but is
still markedly higher in recent years.
For example, the percentage of
obese people 85 and older rose from 4.1 percent in 1982 to 8.3
percent in 1999, and the percentage of obese people age 75 to
84 rose from 7.7 percent in 1982 to 15.1 percent in 1999.
Meals in retirement communities
and assisted care facilities are often lavish and large, and many
elderly people have difficulty burning off those calories because
of arthritis and other ailments that slow them down.
Add to that the phenomena in which
people tend to eat more in group situations when they're enjoying
the camaraderie of others at the table, and you have a recipe
for what Wenzel calls the "senior 15" — weight gain of 15
pounds or more in elderly patients.
In an effort to address what he
calls a potential epidemic, Wenzel has started visiting retirement
homes and assisted care developments to educate residents and
staff about portion control and nutrition.
Among the places he's visited are
Ann's Choice, a 375-resident retirement community in Bucks County
that has retooled its meal plans to provide options that are low
in fat and sodium, plentiful in fresh fruits and vegetables and
feature heart-smart items like grilled fish and salads.
"We're trying to help people with
their diets by having heart-healthy food that people will enjoy,"
said Mark Diller, Ann's Choice executive chef. "We meet weekly
with residents to see what they want and what they don't, and
they definitely want healthy options."
That doesn't mean that burgers
and mac-and-cheese have been sent packing, however. As long as
people opt for those kinds of foods, they'll be available, Diller
said.
"One solution is self-restraint,
reminding people that they don't need to eat everything that's
in front of them," Wenzel said. "We also encourage people to get
as much exercise as they're capable of doing, even if it's going
to the mall and walking."
Possibly the most difficult lesson
to convey to older people, Wenzel said, is diet change.
"We want people to eat less meat
and bread and more fruits and vegetables," he said. "But many
people of this age group grew up on the traditional meat and potatoes
diet. That's how they've always eaten."
Monitoring diet in such large facilities
is admirable but there are weightier issues in the battle of the
bulge, said Dr. Lesley Carson of the University of Pennsylvania
Health System's department of geriatric medicine.
"We really need to address obesity
in the young," she said. "With geriatric patients who are obese,
often the damage has already been done."
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On the Net:
Ann's Choice: http://www.ericksonretirement.com/ach
Warminster Hospital: http://www.warminsterhospital.com
CDC "Trends in Aging" reports:
http://www.cdc.gov/nchs/agingact.htm
Reference
Source 102
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