by Jane Fonda
If we all ate the recommended amounts of fruits, vegetables, and other nutrient-rich foods, we probably would not need most vitamin and mineral supplements. The Dietary Guidelines for Americans advise us to get our vitamins and minerals directly from foods because foods also contain more than nine hundred naturally occurring substances—such as fiber, carotenoids, flavonoids, polyphenols, anthocyanins, isoflavones, resveratrol, and protease inhibitors, the phytonutrients described earlier—that may protect us from chronic health problems.
That said, most of us don’t eat such healthful diets, and as we age and our appetites diminish, we can find it hard to consume enough food to provide the necessary nutrients. On top of that, most of the fruits and vegetables sold in supermarkets are transported long distances and stored before being put on sale. That gap from field to table results in nutrient loss and, in some instances, may require that we take a multivitamin and/or mineral supplement and consume certain fortified foods.
Vitamins are either water-soluble or fat-soluble. The water-soluble vitamins—C and the B family—are not stored in the body, so we must eat foods that provide them every day. The fat-soluble vitamins—A, D, E, and K—are stored in the fatty tissues and are absorbed and used by the body only if we eat appropriate amounts of fat with our meals.
Because of their low intake of protein and because they don’t absorb it well, many older people suffer from a deficiency of B12, which causes anemia and neurologic disorders. The Dietary Guidelines recommend that people over fifty consume foods to which vitamin B12 has been added, such as fortified cereals, or take the crystalline form of vitamin B12 supplements.
By age eighty, 35 percent of men and women suffer from a wearing out of the intestinal lining. This causes lower levels of acid secretion, leading to a decreased absorption of folic acid, iron, calcium, and vitamins B6 and B12. To counter this, obtain folic acid by eating uncooked leafy vegetables, yeast, and fruits daily, supplemented with 400 micrograms of folic acid.
VITAMIN A
Liver, fish oils, eggs, and whole milk are sources of vitamin A, but the best sources (free of cholesterol and saturated fat) are carrots, sweet potatoes, and dark leafy green vegetables. Plants don’t actually contain vitamin A itself but, rather, carotenoid precursors that the body can turn into vitamin A. Vitamin A is important for good eyesight and a strong immune system, but people should not take supplements that contain vitamin A itself because it can build up to a toxic level in the liver. On the other hand, beta-carotene and other carotenoids are safe at any dose.
VITAMIN D
Vitamin D is necessary for our bodies to absorb calcium from food, to strengthen bones, and to prevent fractures. Recent research shows that 50 percent of women over fifty in the United States are deficient in vitamin D. That is dangerous for a host of reasons.
We are designed to get vitamin D from the sun. In fact, anyone living north of a line drawn between Los Angeles and Atlanta is almost certainly not getting enough vitamin D from sunlight during much of the year. Modern lifestyle changes—including more indoor activities and sunscreen usage—have reduced or eliminated sun exposure for just about everyone, especially older people, causing unprecedented vitamin D deficiency, rickets, and bone breaks in children and adults alike. Compounding the problem of reduced sun exposure is the fact the there are so few food sources for vitamin D. An adequate intake simply cannot be obtained from food. Hence, a supplement is necessary for most people, especially since we know that too much sun exposure—normally the main source of vitamin D—is correlated with skin cancer.
Poor bone health is not the only consequence of inadequate Vitamin D. Evidence is starting to show that vitamin D may be important for every cell and every organ in your body, and that a deficiency may contribute to a host of diseases, from the common cold and the flu to cancer, hypertension, insulin-dependent diabetes, and even multiple sclerosis.
How much vitamin D is enough? That’s debatable, as even the scientists cannot decide!
Foods with vitamin D are fortified milk and oily fish from the sea (such as salmon and mackerel), egg yolks, liver, and fish liver oil. It is difficult to get enough vitamin D from food sources alone, so people up to age seventy should supplement with at least 600 IU daily. For those over seventy, 800 units daily is recommended, with a safe upper limit of 4,000 units. To find out what you should be taking, get your vitamin D blood levels tested at your next doctor’s appointment. Blood levels of at least 32 to 40 nanograms per milliliter or higher are recommended. When choosing a supplement, look for vitamin D3 (cholecalciferol), not D2 (ergocalciferol). You can usually get vitamin D as part of a calcium supplement.
CALCIUM
Sources of calcium are dairy products, broccoli, kale, and collards, as well as calcium-fortified foods like orange juice, soy milk, breakfast cereals, and tofu. Assuming we are getting about 700 milligrams of calcium from our daily diet—a big assumption for most people—doctors recommend that in order to help protect our bones, we should supplement this with 500 milligrams of calcium. The new guidelines from the Institute of Medicine recommend a total of 1,200 milligrams of calcium for women fifty-one and older and men seventy-one and older. Too much calcium can result in kidney stones and heart disease; the institute says that the upper limit of safety for men and women over fifty-one is 2,000 milligrams. Calcium supplements need to be taken along with 800 to 1,000 IU of vitamin D—or more—to help with absorption and to reduce bone loss and prevent fractures. (More on calcium in Appendix IV.)
I used to think that vitamin E, vitamin C, and selenium were the antioxidant supplement superstars. I was wrong! There are, in fact, no well-controlled trials showing that supplementing our diets with vitamin E or selenium does any good … and it may do harm.
VITAMIN C
Vitamin C is an important antioxidant, synthesizes collagen, helps boost iron absorption, and plays a role in our hormonal and nervous systems. The recommended dietary allowance is 75 milligrams per day for adult women and 90 milligrams per day for men. When a person eats up to 120 milligrams daily, 80 to 90 percent is absorbed. As supplemental vitamin C intake goes up, absorption declines. There is no evidence that older people need megadoses, and everyone should avoid doses greater than 2,000 milligrams daily, which may cause diarrhea, nausea, abdominal cramps, and nosebleeds.
Food sources include citrus fruits, peaches, strawberries, peppers, broccoli, Brussels sprouts, papayas, kohlrabi, mangoes, pineapple, kiwifruit, peppers, cauliflower, cabbage, kale, potatoes, asparagus, and raspberries.
Both vitamin and mineral supplements (with the exception of calcium) should be taken with meals. This way they are absorbed into the system more efficiently and are digested more easily.
Water
Water is the largest single constituent of the human body and makes up two-thirds of our body weight. It is required for almost every function, from digestion to regulating our temperature to transporting nutrients to removing bodily wastes. It’s good for mental function, aerobic power, endurance, physical work capacity, the heart, and the bowels. Many older men and women complain about constipation; much of the time, it’s because they don’t drink enough water. Too little water may also increase the risk of painful kidney stones.
Drink plenty of fluids. The National Academy of Sciences’ most recent report stated that most adults naturally, based on thirst, consume enough fluid from a combination of foods, such as fruits, vegetables, and grains (from which we get about one-third of our water), and beverages, so most people don’t need to focus on a particular amount. Though the scientists made no specific water recommendation, they concluded that the elderly may experience a diminished sense of thirst. Their recommendations for an adequate daily intake is nine cups for women over fifty and thirteen cups for men; this refers to total beverages, including water, milk, juice, coffee, and tea.
While drinking water may or may not curb the appetite, it’s good for you! And there is plenty of evidence that eating water-containing foods, s
uch as fruits, vegetables, and soups (low-calorie and broth-based, of course), will curb your appetite, reducing what you eat at meals, and thus your overall calorie intake. So, if you’re trying to lose weight, eat a piece of fruit—for instance, an apple or some berries—or a salad or broth-based veggie soup before a meal to curb your appetite. Or turn your meals into soups or salads by adding veggies or broth. You’ll feel full with fewer calories, and studies show that it may save you from eating 100 excess calories—and that could keep you from gaining several pounds in one year.
We need to learn to eat smaller meals and snack only when necessary. Our blood sugar tends to drop at certain times of the day. To avoid grabbing the nearest cookie or doughnut to satisfy our craving and keep us from feeling dizzy, we should always eat a balanced breakfast and lunch, each composed of, ideally, about one-fourth to one-third of our day’s caloric needs. Also, be prepared to have midmorning and afternoon snacks on hand, such as red grapes, an apple, a low-fat piece of string cheese, yogurt, some unsalted nuts, or raisins. Apples vary greatly in flavor, so try different ones until you find varieties whose flavors appeal to you. I’m partial to the Honeycrisp, Stayman, Gala, and Fuji varieties. Foods grown locally and in season, picked at peak ripeness, have more flavor and nutrition, making them more enjoyable and healthier. Choosing them also means you’re using fewer natural resources, and helping to save the environment.
When I’m away from home, I carry tasty and filling snack foods with me. The natural sugar in the fruits and proteins will raise my blood sugar level, appease my hunger the natural way, and give me energy without the high jolt of refined sugar and the precipitous drop that follows.
When to Eat
It’s a good idea to distribute your meals, calories, and nutrients evenly through the day. This way, you fuel your body in a way that improves your nutrient absorption (particularly protein) and your concentration; stabilizes your blood sugar, your mood, and your energy; and reduces cravings. For most people, that means: Don’t skip breakfast! Studies show that people who eat more food earlier in the day end up consuming fewer overall calories, and vice versa; people who eat more of their food later in the day tend to consume more overall calories, which may explain why people who skip breakfast are often fatter, according to the studies. As a bonus, people who eat breakfast take in more essential nutrients than people who don’t, and people who lose and maintain weight never skip breakfast! If you don’t feed yourself properly during the day, you’ll be more prone to overeating later, and to impulsively choosing less healthy foods. So eat a good, balanced breakfast and lunch, have planned healthy snacks in between, and snack only lightly in the evening … at least three hours before you go to bed. Don’t snack after dinner if you can avoid it, and if you must, choose something light, such as herbal tea, a serving of veggies or fruit, or a cup of yogurt or hot cocoa made with skim or soy milk.
One final word of advice: Never go to a restaurant or shop for food when you’re hungry. Instead, try eating an apple and drinking a glass of water before you go, and always shop with a list so you won’t find yourself improvising in the fatty-food aisles.
You will find more details about a healthy diet in Appendix IV.
CHAPTER 8
You and Your Brain: Use It or Lose It
“Can’t you give me brains?” asked the Scarecrow.
“You don’t need them,” said the Wizard. “You are learning something every day. A baby has brains, but it doesn’t know much. Experience is the only thing that brings knowledge and the longer you are on earth the more experience you are sure to get.”
—The Wonderful Wizard of Oz
THERE WAS THE DAY I WAS SUPPOSED TO BE AT A TELEVISION station to be interviewed about the First Annual World Fitness Day in Atlanta. I was seventy-two at the time, and I felt a huge weight of responsibility on my shoulders. What if the event wasn’t successful? I hadn’t slept well for quite a while, worrying about all the terrible things that could go wrong. I was halfway to Culver City for the interview when I called my office to get the address of the station only to discover that I was supposed to be in Burbank—over the mountain and in the valley, in the exact opposite direction! I knew I was supposed to be in Burbank! My office had told me that several times! Why was I headed the wrong way? Because I forgot, that’s why!
That same day I sat on my glasses, destroying them; I forgot the name of the doctor I was supposed to see that afternoon; and, to top it off, I lost my MasterCard. Had I not been deeply into brain research for this book, I would have sworn I was developing Alzheimer’s disease.
But I knew better. All these mishaps were the result of stress on an aging brain. When I was younger, I probably could have managed it fairly well. Sleep deprivation might have caused me to head in the wrong direction even in my thirties, but I probably would have remembered the doctor’s name and not lost the credit card—and I wouldn’t have needed glasses! I’d been feeling stressed for a while, and I knew that stress causes the adrenal glands to produce high levels of cortisol, which dulls the effects of the brain’s hippocampus, where memory is stored and retrieved. The neurons that transmit messages are destroyed. I swear I could feel my neurons disappearing by the minute!
No wonder I experienced one mishap after another. Once the stressful Fitness Day was over—and, as it turned out, very successful—and once I got back to working out and sleeping well, such problems no longer occurred. They will again, I’m sure. But because of what I’ve learned about maintaining a healthy brain, I make a concerted effort to minimize stress in my life through exercise and meditation. If nothing else, perhaps the desire to protect your brain will motivate you to do the same. (See Appendix V, “Guide to Mindful Meditation.”)
Stress isn’t the only thing that’s bad for the brain. So are hypertension, heart disease, diabetes, high cholesterol, mini-strokes, exposure to environmental toxins, severe head injuries, smoking, drinking too much, using recreational drugs, eating an unhealthy diet, and inactivity. While we may be genetically predisposed to heart disease and high cholesterol, for example, choosing a healthier lifestyle that includes body and brain workouts can do much to improve our cognitive function. “Cognitive function” means thinking—reasoning, remembering, processing what we see and feel, planning, and sending signals out to our limbs.
The good news is that clear evidence from functional imaging shows that the brain has great reserves of plasticity. It is capable of adaptation and reorganization, acquiring new skills, absorbing new data, and changing its circuitry in response to the cognitive demands placed on it. Moreover, where there has been a lessening of certain cognitive functions, such as inductive reasoning, spatial orientation, and short-term memory, these functions can be restored with training.
As we age, our brain volume declines, but some parts are more susceptible to loss of volume than others. I learned from the late Dr. Robert Butler, at the International Longevity Center, that there are many pathways for processing thought. “The circuitry in your brain is interconnected in multiple ways,” he told me, “resulting in what neurologists call ‘neural redundancy.’ Think backup systems: When one goes down, another is at hand to help carry the load.” As certain neural networks are broken, the brain searches for new networks. If cognitive functions that have been handled by certain regions of, say, the left frontal lobe are impaired, the right frontal lobe may be recruited to help its neighbor. In stroke victims, for instance, other parts of the brain take over the recovered functions from the parts that are damaged. This is known as “compensatory recruitment.” And it’s good news, because it provides evidence for the elasticity and adaptation of the brain.
While younger people use one side of their brain for a given functional task—the right frontal cortex, for example—older folks will often use both sides to perform the same task. Their cognitive processes may be slower, but that doesn’t mean they have functional impairment. Are you one of those people who panics every time you call your son by your brother�
�s name, or your grandson by your son’s name, or when you can’t think of something you should know well—like your stepson’s name—and see it as a sign that you’re about to get Alzheimer’s? Don’t worry, things like forgetting names are not predictive of Alzheimer’s. When I forget a name or a fact, rather than furrow my brow and try to force myself to remember, I let it go—and often as not, it comes to me later. When I think I’ve lost something, rather than panic, I go about my business, and sure enough, it’ll turn up in the purse I carried yesterday, or in the backseat of my car, where I put it two days ago. I’ve learned to relax into memory, if you will.
Brain-imaging technology shows “that not only is normal brain shrinkage less than we feared, but much of what is lost may be judicious ‘pruning,’ ” says Dr. George Vaillant, director of the Harvard Study of Adult Development. He likens this to an attic that has filled up carelessly over the decades but now, with age, we clean it out and select only the most cherished, meaningful items to keep. Dr. Denise Park, director of the Center for Vital Longevity at the University of Texas at Dallas, puts it this way: “You may lose a bit of horsepower, but you are highly efficient as you rely on your knowledge and experience instead. Maybe this is the Prius model of cognitive aging.”1
Exercise and the Brain
Science shows us that seniors who have remained fit and who continue to exercise continue to have good brain functioning. Cardiovascular fitness is perhaps one of the best things we can do to maintain our brain health. Even when older people who have never been particularly active engage in moderate exercise, they see their cognitive functioning improve. This is because physical exercise causes an increase in a chemical nerve growth factor that allows brain cells to grow, stimulates the connections between them, and helps in memory function.
