Joan and Bob, both 65, live in a posh Beverly Hills home where a butler-cook prepares sensible, nutritious meals for the couple and their dinner guests according to the guidelines established by Joan. She is a knowledgeable, nutritionally conscious eater and tries to reduce use of fats, sodium and calories in their diet. Joan and her husband are in excellent health. They not only watch their weight and know how to manage their diet, but exercise daily by playing tennis, taking long walks or swimming. The prognosis for a healthful, long life? High.
Emil Le Beau, 65, a retired chemist living in Leisure World in Laguna Hills, has lived alone for several years. A cardiovascular problem some years back turned him on to exercise as a life style activity. He now jogs daily, avoids fats, sodium, sugar and cholesterol, eats no desserts and cooks his own casseroles to help control his diet. When he eats out, the menu includes fish.
Senior Exxie Jones, a native of Kentucky who loved fried chicken and pot roast and gravy, discovered she had high cholesterol and triglyceride levels along with being overweight. A nutrition class at Leisure World, where she lives, helped her change her ways. Now she walks two miles, rides a stationary bicycle for 30 minutes and takes an aerobic class every weekday. She's feeling much better now, calls up a friend to join her for dinner and is living a good life.
But Joan, Bob, Emil and Exxie are rarities among the 20 million-plus seniors living in this country.
There is Hanna K., one of the many estimated 35,000 homeless in the city, who hunts for her meals in garbage cans and street curbs. Her nutritional status is poor. Prognosis for good health longevity, dim.
Roy Swarthout, 77, is slightly better off. He eats haphazardly, sometimes stopping at the Union Rescue Mission in downtown Los Angeles for a meal. While the meals, in general, leave much to be desired nutritionally, they do provide nourishment to the 1,500 participants daily. His nutritional status is also poor. And it will continue to be poor.
Then there is Frank Yamada, 73, who has been a daily participant of a government nutrition program commonly referred to as Meals On Wheels in Little Tokyo since the federal government allocated funds nine years ago through the Older Americans Act for persons 60 years and older. His meals, to which he contributes $1, are ethnically satisfying and nutritionally sound. But the Little Tokyo site stands in jeopardy of extinction if allocations are not increased.
The nutrition picture of the elderly is, at best, precarious, as far as existing programs and health status go.
From a practical point of view, length of life of human societies is basically determined by diet and climate, prevention and treatment of infections, level of sanitation and level of housing, according to Dr. Jerzy Meduski, assistant professor of neurology at USC School of Medicine.
There are 20 million persons older than 65 living in the United States, give or take 3 to 4 million, making up 11% of the total population. It is expected that by the year 2030 the elderly population will double, with the population of persons older than 75 growing at the fastest rate. The challenges facing the nation and each individual in maintaining high health status are enormous. The question is, are the challenges being met?
Although improved health care and nutrition education systems in the past 10 years have staved off the horrendous effects of the chronic killer diseases among middle and old age groups, nutritional surveys measuring the dietary intakes of nutrients of the elderly have suggested that nutritional deficiencies exist in at least 50% of the elderly population living independently, with the homeless and those on low or fixed income at greatest risk.
So far, several population studies have found that intakes of certain vitamins, protein and calories fall well below the Recommended Dietary Allowances, but it is not clear how these findings correlate to disease or death rates.
The four leading causes of death in the United States are diseases of the heart, cancer, cerebral vascular lesions and accidents. The elderly are at greatest risk for arteriosclerotic heart disease, and cancer occurs most frequently in the 60- to 65-year-old age group. The elderly are also at highest risk of accidents.
"All humanitarian considerations aside, the cost of taking care of the elderly is going up all the time. Anything one can do to increase quality and decrease morbidity will have a good effect on society and family resources," said Stanley Gershoff Ph.D., dean of Tufts University School of Nutrition.
During 1975, of the $103 billion spent on the nation's heath care, 29% or about $30 billion went to the health care of the elderly, according to a report in the American Journal for Clinical Nutrition.