Healthy Eating for Midlife, from the Experts

MORE magazine gathered four nutrition experts — all midlife women and respected researchers. Over salad, pasta, and, yes, dessert, they shared their secrets on how to eat for optimum health.

By Carla Rohlfing Levy

Essential Nutrition at 40

You already know the basics of good nutrition. Fill up on veggies, limit the junk, and make sure you’re getting enough calcium. But as you navigate midlife, is that enough to stave off weight gain and disease? To find out, MORE booked lunch with four top researchers from the Jean Mayer USDA Human Nutrition Research Center on Aging and the Friedman School of Nutrition Science and Policy, both part of Tufts University in Boston. These women direct studies on everything from vitamins and immunity to soy and perimenopausal symptoms. We wanted their inside advice on how stringent women over 40 need to be about their diet, and on how they themselves stay healthy.

The setting: Lunch at the Ritz-Carlton Boston Common. On the menu: a buffet of Caesar and green salads, four-cheese pasta, seared monkfish, potatoes, vegetables, and an array of apple tarts, Boston cream pie, and chocolate-mousse cake. None of the experts touched the pasta, soda, or bread, but everybody dived for dessert — just one of many lessons they shared about spending calories wisely. Listen in for more words of wisdom.

MORE: What nutrition changes are essential as women enter their 40s?

Alice Lichtenstein: "A major issue is weight, even if you’ve never had to think about it before — it’s very difficult to lose once it’s on. The late 40s are a particularly vulnerable period. There are a lot of life changes, your metabolism slows down, and the proportion of lean to fat mass changes."

Simin Meydani: "It’s not inevitable — the research at our center shows that you can keep your muscle mass and waistline with exercise."

Margo Woods: "You should be aware that there are going to be changes and not be hard on yourself. You can look really good at 40 or 50, but you are not going to look 25."

Bess Dawson-Hughes: "You also want your diet strategy to minimize bone loss. It begins by the late 40s. So make sure you get more calcium-rich foods, like dairy, and subtract something from the diet in order not to gain. I would take away the simple carbs, the starches, and sugars, and replace them with dairy."

MORE: Is calcium from food sources preferable to supplements?

BDH: "The calcium is going to get absorbed similarly, but the nutrient package you get with calcium-rich foods is worthwhile — protein and potassium as well as calcium and vitamin D. In the interests of overall good nutrition, try to get the nutrients you need from food first, and use supplements only when nutrient intake is inadequate."

SM: "Another change to watch for after 40 is a decline in your immunity, making you more susceptible to diseases, and also everyday colds and flus. What you eat is very important for helping you reduce that change in immune response and to improve your resistance to diseases.Fermented products like yogurt can have an effect on improving immunity. There is some evidence that they can help GI infections. Then there are other factors in the diet. The micronutrients in fruits and vegetables are very important for maintaining and helping you prevent your immunity from decreasing. But as you age, there are certain micronutrients, like vitamins B6, C, E, and zinc, that you can’t easily get in the amount you need. In that case, you might think about supplements."

Dieting at 50

MORE: Is the standard five servings a day of fruits and vegetables enough to protect immunity?

SM: "It hasn’t been studied."

MORE: Can diet still make a difference after 50 if you ate poorly when you were younger?

AL: "Absolutely. Diet is crucial. It’s really after 50 that things get more interesting. As you go through menopause, your LDL goes up. Heart disease kills one in two women in the United States, although we think more about breast cancer. The reality is that you can do more to prevent cardiovascular disease as you get older than almost anything else, including cancer."

SM: "Alice and I did a study and found that women who had moderately elevated LDL and who lost just two kilograms [5-6 pounds] on average, had improvements in their blood fats and immune response."

MW: "It’s not an overwhelming amount to lose."

SM: "But it is harder — when you gain a couple of pounds now, it takes forever to lose them again."

MW: "You have to exercise. I used to do yoga, but when I turned 51, that wasn’t enough. I had to hit the gym. I go once a week, but I really need to go twice."

MORE: Are diet and exercise equally important?

AL: "It’s a combination, but I think diet is the major factor in terms of health and weight control. It takes less time to avoid eating extra calories than to burn them off."

SM: "Diet is more important to maintaining your immunity, too. Exercise makes you feel good, but it can’t really improve your resistance to infectious disease."

What About Soy?

MORE: What about soy? A few years ago, it sounded like a magic bullet for menopause, breast cancer. Now the latest reports show that it may actually raise the risk of cancer.

MW: "Well, it’s interesting — when we looked at the breast cancer risks in China versus here, we found that Chinese women had much, much lower hormone levels in their bodies. [The hormone estrogen can fuel the growth of breast tumors.] We thought soy might be one reason, because it binds with the estrogen receptors in the breast. But it is really up in the air. It may be the dose is critical, and that phytoestrogens may have both negative and positive effects. I get calls from breast-cancer patients who are on Tamoxifen [a drug that reduces the risk of recurrence by blocking the effects of estrogen], and they ask if they should be taking soy products. It’s probably not wise."

MORE: What about using soy to relieve the symptoms of menopause?

MW: "Based on the Chinese data, I did a research project with women who were having more than five hot flashes a day. We gave half of them 45 milligrams of phytoestrogens a day in a protein bar, and the others got a placebo bar. There was no difference in the number or intensity of hot flashes."

MORE: Is there a difference if soy is in a processed product versus, say, tofu?

MW: "If you’re using soy as a protein source, then the number of protein grams are pretty much the same [product to product]. But, depending on how they process soy, there will be different levels of phytoestrogens. We’ve sampled products; they vary."

BDH: "It’s hard to know what to track. There are so many compounds in soy, and nobody knows what the active agents are. Some may be active in bones and some active in other systems like hormones. It’s a free-for-all."

MORE: With soy, are we looking at an HT-type situation, where something we thought would help might turn out to be harmful?

MW: "If you are using soy as a food, as the Asian population does, I would feel comfortable with that. But, as soon as you’re using it as a ‘super supplement,’ then you wouldn’t want to do that. We keep looking for a magic food, but it really is the eating pattern that counts."

Rules for Eating Well

MORE: How would you characterize your own eating habits?

AL: "I don’t diet, but I am always aware of what I’m eating. I try to balance out a larger-than-normal breakfast or lunch by having a smaller dinner. I eat a lot of fruits, vegetables, nonfat dairy. I would never have a packaged cookie — I’m not going to blow the calories on that."

BDH: "I’ve never been on a diet, either, but I do restrict starches and fat and consume a lot of fruits and vegetables."

SM: "I have dieted a couple of times, using Weight Watchers. I tend to eat high-fiber, but not low-carb — I love rice and bread. And every Friday my family gets takeout: pizza, Chinese, sushi, Indian, or Thai. You can eat healthy with pizza, get low-fat cheese and lots of vegetables. Just don’t eat fried foods."

MORE: Any other rules that help you eat well?

MW: "I try to get as much fiber as I can, 25 to 30 grams a day. A big issue in this country is diabetes, and refined foods cause higher blood-sugar levels. You have to get a lot of fiber in your breakfast, with a cereal like All-Bran with fruit — or it’s really hard to meet the goal."

AL: "But I look at some breakfast cereals and I’m appalled. They look like crushed-up vitamin pills with sugar. With whole foods, you don’t have to deal with that. I like to go to Trader Joe’s for the dried cherries. Not the bing, but the sour—"

MW: "I love the sour ones."

AL: "—and put them in just as I’m cooking oatmeal. Let them soak, and it’s so good. But I admit, I use white rice on weekdays — even with just one child at home, who has swim practice and other activities, I simply don’t have that flexibility timewise to make brown rice. I compromise there, it’s just reality. Once we’re empty-nesters, brown rice it will be!"

MW: "For a while I became a vegetarian, to decrease my intake of fat and cholesterol and to increase my intake of fiber, micronutrients, and phytochemicals. It changed the way I look at food. I am also big on the DASH diet — it has a great Web site that talks about getting 10 to 12 servings of fruits and vegetables a day. That’s really just five or six cups, so I think about how my day will go in order to fit that in. You have to plan it out."

AL, SM (in unison): "I plan, too."

MW: "The decision point is when you go food shopping, because if you don’t have it at home you won’t eat it. It doesn’t take time to make better decisions. It does take determination to make better decisions."

SM: "I agree totally. If I buy Coke, it’s gone the next day. If I don’t, nobody misses it."

AL: "I go to the market about once a week, and I tend to buy the same things — vegetables, fruit, salad stuff, low-fat dairy, and I maintain a stash of fish and poultry in the freezer."

MORE: For so many women, food is this problem. But for you all, cooking and eating sound like sources of pleasure.

MW: "Cooking brings family together. It’s creative."

MORE: And you make the time to cook every day?

All: "Yes!"

AL: "It’s like a ritual, and you get what you want and it really tastes good. Also, it makes life easier. You can control portion size — a higher proportion of vegetables to meat, for instance. It’s helped me stay the same size. I hate clothes shopping, and keep some outfits for 15 years."

MORE: Is there a benefit to eating more nutritiously even if you are overweight?

MW: "Even if you don’t lose weight, all the data has been encouraging that eating healthier has a big impact on your risk factors and how you feel. You’re much better off than a woman who is not eating well and who is at the same weight or lighter. I would like to lose 10 or 15 pounds, but it’s hard to do. My diet, however, is healthy."

SM: "I have had several friends go on high-protein diets to lose weight. But the next time you see them, they’re right back where they were before."

MW: "I’ve talked to people who have been on high-protein diets for years, and they’re afraid if they don’t stay on it, they’ll gain all the weight back. They don’t check their cholesterol levels."

SM: "What keeps me in line is having a scale in the bathroom. I’ll check every so often, and if I gain two pounds, I cut back."

MW: "You use the scale. I use how my clothes feel."

SM: "I just had salad for lunch because my scale told me I should. I travel a lot, and with all these business lunches, it’s very difficult."

MW: "I think about choice — if I say I can’t have this or that, it’s restrictive. I make eating a positive choice."

MORE: Shouldn’t we all?(Experts exit as the photography team and writer attack the leftover four-cheese pasta, bread, and dessert. But we’ll make up for it later, right?)

Tips for Healthy Eating

Here are the top five tips we took away from our lunchtime chat:

1. Hit the storesAll the experts shop regularly for fresh produce, lean proteins, and fresh whole grains. If good stuff is in your kitchen, it will be on your plate.

2. Be a little obsessive…It takes planning to get enough fruits and vegetables; the standard recommendation is five servings a day, but our experts aim for closer to 10. An example of a healthy eating plan is the DASH diet; go to www.nhlbi.nih.gov/health/public/heart/hbp/dash/ for specifics.

3. ...But be ready to bend your own rulesA change in marital status or employment, a newly empty nest, midlife motherhood — all can affect your habits. Eating well requires ever-evolving strategies that work with your life.

4. Open your ovenHome cooking lets you control portion size as well as fat and calorie content. Brush up on quickie 30-minute recipes with a new cookbook.

5. Don’t drink your caloriesLiquid carbs — juice, soda, and alcohol — can add hundreds of calories to a day without much nutritional payoff. You’re better off drinking water and eating whole fruit, which has fiber (juice doesn’t); when you have an alcoholic drink, cut back elsewhere in your day to compensate for the calories.

Carla Rohlfing Levy writes frequently about nutrition, health, and fitness.

Originally published in MORE magazine, May 2004.

First Published Mon, 2009-04-06 17:05

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