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Fat, calories, protein, and carbs: Exceptions to the dietary rules

Consumer Reports News: June 11, 2010 10:14 AM

When it comes to fat and calories, the official advice is usually "less is better." But for some people, it can actually make sense to get additional amounts of both, as long as it’s done with care. And others may want to tinker with the recommended balance of carbohydrates, fat, and protein depending on their health and dietary preferences.

More fat and calories. Older people often consume too few calories, not too many, perhaps because of a diminished sense of taste and smell, chronic disease, social isolation, lost teeth, or ill-fitting dentures.

People with certain conditions, such as Alzheimer’s disease, as well as those undergoing certain treatments, such as chemotherapy, frequently experience the same problem.

In those cases, "It’s best to get calories into people and not worry too much about where the calories come from," says Jeannie Gazzaniga-Moloo, Ph.D., R.D., of the American Dietetic Association.

Fat can help since gram for gram it has slightly more than twice the calories of carbohydrates or protein, and thus makes it easy to consume a lot of energy in manageable portions. Moreover, fat often goes hand-in-hand with foods that most people, including those who are older or ill, find tempting, such as cake or ice cream.

Caregivers may need to overcome misgivings about the healthfulness of the food they offer. "If they want a milk shake, even for breakfast, don’t worry about it," Gazzaniga-Moloo says.

Here are some other ways to encourage someone’s appetite:

  • Boost flavor by adding citrus juices, herbs and spices, small amounts of butter or bacon, or sweeteners like maple syrup.
  • Have several options at each meal.
  • Serve smaller, more frequent meals, and lots of snacks.
  • Serve ground meats, canned fruits, and desserts like yogurt if chewing is difficult.
  • Offer milk or juice instead of water.

More protein. While most people in the U.S. get plenty of the nutrient, some research suggests that older people need more than usual to offset the loss of muscle mass that accompanies aging and to compensate for decreased immunity.

The current recommended daily amount for protein works out to about 63 grams for men and 50 grams for women (a 3-oz. serving of chicken or salmon has about 26 grams and 21 grams, respectively). Some experts recommend boosting that substantially, to perhaps about 95 grams or more for men and 75 grams or more for women.

While it’s still too soon to say that older people should definitely aim for those higher amounts, it does make sense for them to make sure they include lots of healthy sources of protein in their diet, as should pregnant and breast-feeding women. In addition to chicken and fish, good sources include beans and legumes, lean red meat, low-fat dairy products, and tofu and other soy products.

Fewer carbs. People are generally told to get 50 to 65 percent of their calories from carbohydrates. But cutting back to 45 percent is OK provided you choose them carefully. That means mostly fruits, vegetables, and whole grains, not nutritionally weak processed or sugary foods such as white bread or cookies.

Reducing carbohydrates actually helps some people. Those with diabetes, for example, need to watch the total amount of carbohydrates they consume. And while a low-carbohydrate diet by itself probably won’t lead to long-term weight loss, it may help some people in that effort if it helps them cut calories.

This article first appeared in the April 2010 issue of Consumer Reports On Health.

Aaron Bailey


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