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A CHEAP AND TASTY HEALTH PLAN

If a plant-based diet could help Meerschaert and others stay active, healthy and pain-free, you'd think that the medical establishment would recommend a vegetarian diet to all seniors. Unfortunately, not all physicians are as enlightened as Meerschaert's doctor, and many believe, even if they did recommend it, their patients wouldn't want to change. Until this widespread skepticism gives way to a more enlightened sensibility, it'll be up to individuals to tilt the alarming statistics in their favor.

To some, Meerschaert may seem to be an exceptional case -- a highly motivated person who is willing to revolutionize a lifetime of habits. That's not how Meerschaert, sees it. Adopting a new eating style gave her a new lease on life. "After fifty years of cooking the same tired old foods, it gets pretty boring. It's fun to cook all the new foods I'm discovering since becoming a vegetarian," says Meerschaert, who also takes a daily multivitamin supplement on the advice of her doctor.

Twenty years ago, the nutritional advice that Meerschaert would have gotten from her physician was to cut back on what she was eating because people need less of everything as they age. She also would have heard that supplements were a waste of money, and no diet known to science could improve arthritis.

"It was thought that nutrient needs decrease as you get older because you get smaller, your body has less muscle and bone, and you're less active," says Jeffrey Blumberg, ., associate director of the Jean Mayer . Department of Agriculture (USDA) Human Nutrition Research Center on Aging at Tufts University in Boston. "But in the last ten years, since we've actually been studying older people and not just making assumptions about them, we're realizing that many nutritional requirements increase with age," Blumberg observing.

MIND OVER MADNESS

Until recently, the idea that nutrition plays a pivotal role not only in the physical health of the elderly but in their mental state was also discounted by medical authorities. However, several recent studies published in major medical and nutritional journals have shown that symptoms such as dementia, mental disorientation and memory loss, commonly associated with senility, may actually be due to nutritional deficiencies. One such study in the American Journal of Clinical Nutrition (March, 1996) showed that an amino acid, homocysteine, found at high levels in the bloodstream of meat eaters, is linked with a type of mental disorientation frequently seen in the early stages of Alzheimer's disease. The study demonstrated that eating foods rich in folic acid such as beans, greens and brewer's yeast or taking folic acid supplements lowers blood levels of homocysteine and improves mental functioning.

Other studies implicate vitamin B12 deficiency as a cause of senile dementia in elderly people, due not just to poor diets but to poor protein digestion, a process that tends to be less efficient in older people because they produce too little stomach acid to break down protein. "Many older people have enough of a stomach acid problem to interfere with the absorption of vitamin [.12] from food," says Paul Jacques, MD, assistant chief of the Epidemiology Program at USDA's Human Nutrition Research Center on Aging in Boston. Vitamin [.12] supplements can be more easily absorbed than vitamin [.12] in food. Nonetheless, experts recommend eating foods rich in vitamin [.12] for added insurance. For vegetarians and vegans, rich sources of vitamin [.12] are fortified cereals, meat analogs, fortified soy and vegetable milks as well as nutritional yeast.

DISEASE-FIGHTING

ANTIOXIDANTS

Not only are scientific ideas about the nutritional needs of older people undergoing radical revision, so, too, are ideas about preventing and controlling widespread degenerative diseases common in people over fifty, such as arteriosclerosis, arthritis, cancer, diabetes, osteoporosis, and cataracts, all thought to be partly caused by free radicals, which aging bodies are produce in greater amounts. Free radicals are volatile chemicals formed as byproducts of metabolism and by exposure to sunlight, cigarette smoke and environmental chemicals.

Meerschaert's physician suggested a vegetarian diet because of the health benefits reported in medical journals of meat-free diets in arthritis pain relief and in protection against heart disease, cancer and many other degenerative diseases. "A diet high in animal products contains lots of free radicals that take a toll on the health of cells, leading to more cancer and heart disease," says Caldwell Esselstyn, ., head of Thyroid and Parathyroid Surgery, of Ohio's Cleveland Clinic, who uses a low-fat vegetarian diet to arrest and reverse heart disease. Esselstyn notes his patients who follow this diet not only improve their heart health but have low blood levels of homocysteine, the amino acid linked to senility.

The good news is eating a vegetarian diet rich in antioxidant vitamins helps to keep free radicals in check, neutralizing them before they can wreak their damage on the walls of arteries and the interiors of cells. Antioxidant vitamins in plant foods include vitamins C, E and beta carotene but hundreds of other food factors also have been identified in citrus, melons, greens, beets, sweet potatoes and cabbage-family vegetables. Scientists are just beginning to identify these plant factors and determine their specific roles in protecting health. There appear to be thousands of them, each with different roles. A single orange, for example, has over 170 different antioxidant chemicals. Every one of these may be critical to good health.

Antioxidants work not just on a target tissue such as the skin or an organ such as the heart. They also boost immunity. In recent years, several studies have shown the benefits of supplementing people's diets at midlife with vitamin E at levels much higher than the RDA (Recommended Dietary Allowances, published about every five years by the National Academy of Sciences in Washington, .) Simin Meydani, ., Chief of the Nutritional Immunology Laboratory at USDA's Human Nutrition Research Center on Aging has shown that when healthy elderly people take 800 international units (IU) of vitamin E daily, they improve their immune response, lowering their risk of developing cancer and viral infections. Immune function usually declines with age and vitamin E seems to help to reverse the decline.

Vitamin E also significantly lowers risk of heart attacks in older people. Good food sources of vitamin E are nuts and nut butters, vegetable oils (especially safflower and wheat germ oil), mangoes, sweet potatoes, greens, parsnips and cabbage. "We may need the [higher] amounts of vitamin E in supplements to get an optimal immune response," says Maydani who recommends a vitamin E supplement of between 100 IU and 400 IU.

While it may be a good idea to take vitamin E supplements, you can't rely on supplements to convey all the protective factors in food. They offer nutritional protection for the vitamins we know enough to include in them but that may not be enough. Christine Tully, ., a researcher at the University of Kentucky's Sanders-Brown Center on Aging in Lexington explains, "Eating fruits and vegetables is [still] the best way to get the full range of protective nutrients."

Do you really need to take supplements if you eat all your veggies? "Always," says Blumberg. "It's just common sense to me." He recommends that everyone take a general multivitamin/mineral supplement daily. Be sure it has a full spectrum of minerals, as well as vitamins, Blumberg cautions. Recent research shows that older people improve immune function when they take supplemental selenium along with vitamin B6, adding that it's not unusual for older people in this country to have one or two marginal deficiencies.

Carol M. Coughlin, ., a vegetarian, is the 1996 American Dietetic Association's "Recognized Young Dietitian of the Year."

Five Star Foods for

the Prime of Life

1. Green Leafy Vegetables. They provide lutein (an antioxidant), folate, vitamin C, beta carotene and even calcium. The calcium from bok choy is absorbed as easily as the calcium from milk.

2. Red Fruits. Tomatoes, watermelon and red grapefruit all have lycopene, beta carotene and vitamin C.

3. Soy. Fortified soy milks have calcium and vitamin D. Soy foods such as tofu, tempeh and soyburgers have plant estrogens that help keep bones strong and are good sources of protein.

4. Whole Grains. Brown rice, bulghur wheat, millet and quinoa are sources of complex carbohydrate and fiber as well as most B vitamins.

5. Citrus Fruits and Juices. Both the fruit and juice are rich sources of vitamin C, folic acid, potassium and bioflavanoids. Drink orange, lemon and grapefruit juice with supplements to enhance absorption of minerals, such as calcium and iron, and nutrients.