Eating well through the decades: enjoy optimal nutrition at every age - includes related article on essential ingredients of a good diet

A LOT OF NUTRITIONAL advice takes a "one-diet-fits-all" approach. Watch your cholesterol. Eat more calcium. Boost your fiber intake. Such broad generalizations, though, don't address your day-to-day eating habits--exactly what foods should you emphasize and why? And even more specifically, how does your age affect what food choices you should be making? Human beings are complex and evolutionary, growing from curious toddlers to energetic teenagers, to time-pressed adults. Each stage comes with its own joys, demands, risks and rewards, and each stage has its own unique nutritional needs. How can you figure out what those needs are? Read on for a nutritional trip through the ages and stages of life, complete with tips on how to create a diet that's fit for you.

BIRTH TO AGE 10

THE FORMULA MAKERS may not like it, but even they admit it in their ads: Human milk is the best food for babies. Period. "Breast milk alone provides not only all the essential nutrients, but it also provides immunological factors and possibly growth factors," says Frances Stewart, M.S., R.D., chief of clinical nutrition at Children's Hospital in Los Angeles. "We don't know for sure yet, but some studies have indicated that breast milk fosters intellectual growth as well as gastrointestinal development." Breast milk also may help prevent both environmental and food allergies, and breastfed babies have fewer ear infections than formula-fed babies.

Stewart is thrilled to see those rare women who breastfeed their babies for at least a year (less than 6 percent of all mothers); in a perfect world she'd have them nurse two to three years. "There's a stigma in the United States about breastfeeding for more than a year, and we need to remove that," she says, citing such benefits as stronger mother-child bonds, effective comforting and continuing immunological protection for as long as you nurse.

At four to six months, most babies start tasting the foods of their future. About this time, some parents start worrying that their adorable little pudgeball will be every bit as chubby on his 21st birthday. Not to worry, say the experts; before age 2, you'll do your child more harm than good if you restrict his intake of fat. "I've seen cases of what we call failure to thrive, or retarded growth, because of what was basically malnutrition [from restricting fat intake]," says Stewart.

Accept that your toddler needs a higher percentage of fat in his diet than you do, to foster growth of his brain and body. If you intend for your child to have dairy products, whole milk is best between the ages of I and 2. (Experts advise against giving cow's milk to any child younger than 1, because it is so commonly allergenic; milk also has been linked to the development of diabetes in genetically predisposed infants.) If you'd rather not give your child milk, then avocadoes, peanut butter and other nut butters are healthful high-fat foods to try.

After age 2 the growth rate slows and the seeds of heart disease are already being sown--arterial fatty deposits have been found in children as young as 3--so it's time to watch fat intake. The American Academy of Pediatrics recommends that children 2 and older consume no more than 3 0 percent of their calories from fat; however, the Washington, D.C.-based consumer-advocacy group Center for Science in the Public Interest believes that 2 5 percent (the same recommendation it makes for adults) is a more healthful limit.

Make sure to keep mealtimes high on variety and pleasure, and low on bribes and clean-your-plate rules. "Pressuring kids to eat something just doesn't work," says Stewart. Offer children very small portions of new foods--a big mound of spinach is an off-putting sight to suspicious eyes--and let them see you eating the same food with gusto. Rewarding children with dessert when they've eaten their vegetables is a blueprint for poor adult nutrition--the message is that healthy food is something you must suffer through to reach your sugary goal. Several studies have shown that children who repeatedly are offered new foods are more likely to eat them and that over the course of a few months, a 2-year-old will get all the nutrients she needs if she is allowed to choose from an array of foods at each meal. She may eat only tortillas one day and pears the next, but after a week or so, it all averages out.

Stewart says that children presented with healthful foods generally don't need supplements. But she has seen a fair amount of iron deficiency and anemia in children under 3, and says that both vegetarian and non-vegetarian families need to pay close attention to this issue. Vegetarian foods especially high in iron include beans, eggs, peas, nuts, dried fruit, enriched pasta and bread, fortified cereal and leafy greens. Heme iron, found only in meat, is more readily absorbed than non-heme iron, found in plant-based foods, but "you can increase the absorption of non-heme iron by drinking orange juice or getting some other source of vitamin C [at the same time]," says Stewart.

During these bone-growth years, calcium is a critical nutrient; the U.S. Recommended Dietary Allowance (RDA) for children this age is 800 milligrams to 1,200 milligrams (mg.) daily. Some good calcium sources include plain low-fat yogurt, skim milk, tofu made with calcium sulfate (it will say so on the label), fortified orange and apple juices, fortified soymilk and fortified cereal. If winters are bleak where you live, vitamin D, which is essential for the absorption of calcium, may be an additional concern, because sunlight causes the body to manufacture this nutrient; if your child doesn't consume any D-fortified foods, you may want to consider a D supplement during the winter months. And to ensure a healthy intake of vitamin A, an essential building block that helps develop vision and prevent infections and disease, offer lots of dark green and orange-yellow foods, including sweet potatoes, cantaloupe, spinach, tomatoes and carrots.

AGES 11 T0 20

"TEENAGERS AND YOUNG adults need to be hit over the head with the calcium message," says Christine Rosenbloom, Ph.D., associate professor of nutrition at Georgia State University in Atlanta. Between ages 11 and 17, kids gain 50 percent of their adult weight, and bones are rapidly growing longer and denser, on their way to peaking in density somewhere between ages 25 and 35 Rosenbloom says a great many high school and college-age girls diet constantly, depriving their bodies of the calcium that is so essential to creating strong bones that will resist crippling osteoporosis later on. At 1,200 ma. a day, the RDA for the 11-to-24 group is considerably higher than for older adults, and the National Institutes for Health would like to see that number increased to 1,500 mg. Besides the foods already mentioned for younger children, other good calcium sources include turnip greens, soybeans, kale and broccoli. (Cheese has plenty of calcium, but it's also high in animal protein, which causes the body to excrete calcium.)

Rosenbloom says that while girls and young women often skimp on calcium, boys and young men are often deficient in vitamin A and its related antioxidant, beta carotene, which converts to vitamin A in the body. "Studies show low intakes of vitamin A in young men, who don't get enough fruits and vegetables," says Rosenbloom, who advises boys to eat at least a couple of daily servings of A-rich foods.

Although most Americans consume much more protein than necessary, Rosenbloom says one group is at risk for deficiencies: high school and college-age girls, many of whom are weight-conscious--and many of whom try out vegetarianism. "Their idea of going vegetarian is to just increase their carbohydrates and delete animal products, but they don't do anything else," she says. "They don't eat any legumes, or vegetables with protein, just fruit and pasta and vegetables like broccoli. Their main goal is to eat low-fat, not balanced." She has these girls fill out food records and tabulate their own nutritional breakdowns, so they can discover deficiencies themselves. "I see more and more young women turning to vegetarianism," she says, "but many of them need help to become informed vegetarians."

To help teens stay the course through the years of junk food, diets and fad eating, Stewart strongly advises families to gather for one meal a day, to reinforce healthful eating habits and the pleasures of the table. Eating together regularly also can help parents watch out for signs of eating disorders, 76 percent of which appear between the ages of 11 and 20. Although a psychological illness more than a nutritional one, anorexia nervosa makes itself known at the dinner table. If your child is avoiding meal time, is intensely afraid of gaining weight, denies hunger, refuses to eat shows signs of abnormal weight loss; seek professional help.

AGES 20 TO 35

AS THE CAREFREE DAYS of childhood slip away and you take on the responsibilities of work and family, chances are your life has become much busier. You might be pregnant, or contemplating it. You may be up for 3 a.m. feedings, then off to the office at 8. You could be trying to fit in graduate school, trips to the grocery store, home maintenance projects, get-togethers with equally time-pressed friends...and yoga classes to help you cope with it all. To keep your energy up and stress down, you need to eat. It sounds obvious, but, it's easy to forget. "When you're stressed, you forget to honor your own body, to feed your body," says Evelyn Tribole, M.S., R.D., co-author of Intuitive Eating (St.Martin's Press, 1 995), which debunks dieting and teaches readers to get in touch with their bodies' natural appetites and needs. "Remember to never go more than five hours without eating, to keep your blood sugar and your energy stable."

If you're a woman, chances are these will be your childbearing years. If you're even remotely considering conception, you need to make sure that you get 400 micrograms (mcg.) daily of folic acid, a B vitamin found in beans, spinach, brewer's yeast, fortified cereals, orange juice, wheat germ, asparagus and romaine lettuce among other foods. In 1992, a Hungarian study (New England Journal of Medicine, 327: 1832-1835) proved a clear link between low folic acid intakes and neural tube defects in fetuses, resulting in spine bifida, anencephaly and other birth defects. Since this tube is busy forming before pregnant, all women in this age group should keep up the folic acid.

For that matter, everyone in this age group and beyond should try to get 400 mcg. of folic acid. "Folic acid intake is associated with lower homocysteine levels, and lower homocysteine levels reduce the risk of heart disease," says Jeffrey Blumberg, Ph.D., professor of nutrition at Tufts University in Medford, Mass. Homocysteine is an amino acid that is just beginning to get a lot of attention; researchers theorize that it is somehow toxic to the vascular system.

If you're in your 20s, you may feel full of boundless energy, and the thought of facing heart disease, cancer or osteoporosis may seem unfathomable. But during these years you'll be laying the railroad track that will take you full-speed into middle age and beyond, when disease looms ominously. If you gradually become more sedentary, as many Americans do, the dreaded middle-age spread will appear, and your cholesterol may creep up. Both factors increase your risk of heart disease, and extra pounds have been linked with various cancers, including those of the prostate, colon and breast--so now is the time to establish or reinforce exercise and low-fat eating habits.

AGES 35 TO 45

BY NOW you've probably got parents who are senior citizens. No matter how healthy your lifestyle, even long-time vegetarians may be more than a nervous the possibility of inheriting a parent's heart disease or breast cancer. Although antioxidants are important throughout life, now is when many people begin to think about aging and get serious about loading up on vitamins C and E and beta carotene. These antioxidants, found in fruits and vegetables, help neutralize the damaging free radicals that might lead to cancer in the not-too-distant future. The Washington, D.C.-based Alliance for Aging Research reports that some 120 studies conducted from the mid-1970s to the present showed a significant reduction in cancer risk with high consumption of fruits, vegetables and antioxidant supplements. Consequently, the National Cancer Institute recommends that everyone eat at least five servings a day of fruits and vegetables; seven to nine servings are even more protective.

These superhero antioxidant vitamins seem to fight more than just cancer. The Nurses' Health Study, a long-term study of approximately 87,000 female nurses, found a 22 percent lower risk of heart disease in those who consumed the most fruits and vegetables that were high in beta carotene; it also found a 36 percent lower risk of heart disease in those who took 100 IUs of vitamin E in supplement form per day (New England Journal of Medicine, vol. 328, 1444-49). Another study of 39,000 men showed similar results (New England Journal of Medicine, vol. 328, 1450 56). "The link between reduced risk of heart disease and beta carotene is probably not a direct result of beta carotene intake, but rather a high intake of fruits and vegetables and all their phytochemicals and phytonutrients," points out Stephen Inkeles, M.D., M.P.H., director of clinical nutrition at Pritikin Longevity Center, in Santa Monica, Calif. Sweet potatoes, carrots and cantaloupe are beta carotene powerhouses; other good sources include broccoli, spinach, tomatoes, squash and apricots. Aside from citrus fruits, vitamin C is found in strawberries, peppers, tomatoes, cabbage, potatoes, spinach and many other fruits and vegetables. Vitamin E is a popular supplement, but it can be found in a number of foods, particularly vegetable oils, wheat germ, almonds, walnuts and whole wheat flour.

Fruits, vegetables, legumes and other plants are also rich in phytochemicals, naturally occurring plant chemicals whose properties have only recently attracted scientific interest. But the early findings are so promising that the National Cancer Institute has funded a major program to research their role in fighting cancer. For example, studies have found that the indoles found in broccoli, brussels sprouts and other cruciferous vegetables slowed the growth of certain cancers and that the polyphenols found in green tea may be effective antioxidants.

AGES 45 TO 55

DURING THIS STAGE of life, millions of women experience menopausal symptoms. Fluctuating hormones can lead to a host of side effects, including hot flashes, mood swings and insomnia. In addition to aggravating insomnia, the stimulant effect of caffeine can increase the number of hot flashes you suffer, or make them more intense, so consider quitting coffee or at least cutting back to no more than a cup a day. Anecdotally, many practitioners of natural medicine have found that flaxseed oil and evening primrose oil alleviate hot flashes for some women, and so does vitamin E, in either supplements or foods. And the sugar cravings and mood swings caused by unstable hormones can be managed by eating your normal amount of protein, hut in small portions throughout the day instead of having it at just one meal. You can also stave off cravings with snacks of fresh or dried fruit.

The most promising news for menopausal women comes from the soybean, which contains phytoestrogen. This plant chemical is similar to the estrogen produced by the body but has only a fraction of its strength. Research indicates chat phytoestrogen blocks the effects of human estrogen by binding to the body's estrogen receptor sites; because it is so weak, however, it doesn't have the effects of human estrogen. Japanese women, who consume lots of soyfoods, report fewer menopausal symptoms than American women; a study in the Australian journal Maturitas (April 1995) found a 40 percent decrease in menopause symptoms with a daily intake of 45 grams (about 2 oz.) of soy flour.

"I'm not fully sure about this study, since there was also a 20 percent decrease in the control group, which ate wheat flour," says nutritionist Mark Messina, Ph.D., a specialist in soyfoods and vegetarianism. "But I tend to believe it's true. Anecdotally, I hear a lot of evidence that it helps." Several other studies are now being conducted, and Messina expects more reliable results by the end of 1996. In the meantime, he says, "I suspect a serving a day of a soyfood would help--one cup of soymilk or one-half cup of tofu. Try one serving a day first, then add another if you don't see an improvement."

In addition, says Anne Patterson, R.D., a consultant for the Illinois Soybean Association, based in Bloomington, many studies have shown that soy protein lowers high levels of LDL cholesterol, a common health risk in this age group. True, to achieve the results found in the best-known study, you'd have to eat 47 grams of soy protein a day, the equivalent of seven cups of soymilk. But when you consider the decline in menopausal symptoms, the low incidence of certain types of cancer in soy-dependent countries, the osteoporosis-fighting calcium in tofu, and the possible anti-cancer effects of soy's phytoestrogen, you've got a potent case for making soyfoods part of a midlife diet.

AGES 55 TO 65

DURING THIS PERIOD, heart disease--the nation's number one killer--becomes more prevalent, and once past menopause, women are at as much risk of developing the disease as men. Too often, however, women are unaware of this risk. "Women get diagnosed later and when [heart disease is] much more severe," says cardiologist Daniel Eisenberg, M.D., clinical associate professor of medicine at the University of Southern California and president of the Los Angeles chapter of the American Heart Association. "They're often either misdiagnosed or not diagnosed at all, until they finally have a heart attack."

For unknown reasons, says Eisenberg, women often display different symptoms of heart disease from men, and these symptoms are too often dismissed as nothing more than indigestion or a minor ailment. What's the best way to prevent heart disease? "My number one advice would be to continue to be a vegetarian," says Eisenberg. "You also have to exercise, and remember that you can still get way too much fat in your diet [even if you're eating a plant-based diet]. You want to get your overall cholesterol to about 160, and don't be happy until you get there."

The likely appearance of reading glasses on your nose will reinforce the importance of eye health as you age; if you need yet another reason to eat your greens, consider a study published in the Journal of the American Medical Association (vol. 272, no. 18). Participants who consumed the greatest amount of carotenoids, which are plentiful in dark, leafy greens, had a 43 percent lower risk for age-related macular degeneration, the leading cause of irreversible blindness in adults. The risk of high blood pressure increases with age, so take note that populations with low intakes of calcium have high rates of hypertension, and a diet rich in potassium (found in oranges, bananas, yogurt and potato skins) may protect some people from developing hypertension.

AGES 65 AND UP

CONGRATULATIONS: You've made it to the good years, when stress levels typically go down and most people have more time to enjoy life. To be sure you stay healthy through your older years, you need to make more of an effort than ever to keep yourself nourished.

Katherine Tucker, Ph.D., a nutritionist and researcher at the USDA Human Nutrition Research Center on Aging, says nutritionists are discovering that people over 60 need more nutrients than previously thought. "Older people often eat less, because they are less active, but their requirements for [vitamins and minerals] do not go down," she says. "And the use of medications may even increase the need for nutrients." More than 75 percent of Americans over 65 take at least one prescription drug, and some drugs can interfere with the absorption of nutrients. Consequently, Tucker and her colleagues are pushing the National Academy of Sciences to add a category of RDAs for older people (they currently stop at 51+).

Tucker says low intakes of zinc, calcium, magnesium, [B.sub.6] and folic acid are common in the elderly. "The nutrient we're really concerned about now is [B.sub.12]," she says. "There have been several studies that show a [B.sub.12]-related neurological function loss, even with a normal [B.sub.12] intake. We attribute it to atrophic gastritis, a condition that affects older people." This ailment--which involves degeneration of the stomach's mucous membrane lining, leading to decreased absorption of nutrients--does not produce any symptoms, so she recommends a routine [B.sub.12]screening for people over 65, and oral supplements if a deficiency is discovered.

Jeffrey Blumberg of Tufts voices concern over low intakes of vitamin D, essential for the absorption of calcium. "As many as 80 percent of women in their 60s are getting less than two thirds of the RDA of vitamin D, he says. If it were an infectious disease, it would be considered a terrible epidemic." If you spend winters indoors and don't consume D-fortified foods, Blumberg strongly advises a vitamin D supplement, along with an ample intake of calcium. Though the RDA for calcium at this age is 800 mg., Blumberg advises all seniors, both women and men, to consume 1,200 mg. a day; he recommends that postmenopausal women who are not receiving hormone replacement therapy, which slows bone loss, take in 1,500 ma. per day. Even this late in life, generous calcium intakes have proven to significantly reduce bone loss.

Tucker is wary of depending on supplements at the expense of a nutritious diet, but admits that a supplement containing 100 percent of the RDA for all nutrients can be essential for some seniors. "Older people often have a decreased desire and ability to cook for themselves and shop for fresh food," she says. Malnourishment is common in the elderly; nearly one-half of all older hospital patients and two-fifths of nursing home residents are malnourished. So an extra effort must be made to eat as heartily as possible, including plenty of foods rich in calcium and antioxidants. And since disorders of the digestive tract cause more hospital admissions in the elderly than any other group of diseases, you'll need to keep eating 25 to 35 grams of fiber daily, to keep aging bowels functioning and to continue protecting against cancer. If weak teeth and gums limit chewing, you can find fiber in such soft foods as oatmeal, stewed and canned fruit, beans and brown rice.

After age 60, many men are bothered by prostate enlargement, which can lead to difficult and frequent urination. According to Commission E, the German government's herb-research division, berries of the herb saw palmetto can reduce the symptoms of an enlarged prostate, though they don't actually reduce the enlargement. (For dosage information, check the label.) If you're a sufferer, you should also cut back on caffeine, which can increase the need to urinate.

Finally, keep in mind that although you still need plenty of calories and nutrients, as your body ages, it can handle fewer of our favorite vices. The liver and kidneys are shrinking, so they process alcohol and caffeine more slowly and less effectively. And you'll be more sensitive to salt, which can aggravate hypertension, kidney disease and congestive heart failure. Admittedly, it may not be easy to give up these things after a lifetime of enjoying them--but good health is one of the greatest pleasures of all.

RELATED ARTICLE : LIFELONG COMPANIONS

Each stage of life has its own nutritional requirements, but certain nutrients are important no matter how old you are. Following are several things you should emphasize in your diet from early childhood through the golden years.

CALCIUM: This mineral is critical to building strong bones from early childhood through the 20s. Once peak bone mass is reached, bones gradually lose density as we age, accelerating rapidly around the menopause years for women and about a decade later for men. Keeping calcium intake high can slow bone loss and ward off osteoporosis.

ANTIOXIDANTS: This group of vitamins plays an important role in many body functions. Beta carotene, a precursor to vitamin A, is key to creating and maintaining healthy eyes and tissues throughout the body, especially the skin. Vitamin C is key to forming and retaining connective tissue, and it also appears to stimulate the immune system. Both these vitamins, as well as vitamin E, fight cancer, and research indicates they protect against heart disease too.

SOY: For children and young adults, soyfoods such as tofu, tempeh and soymilk are full of protein, essential to developing and maintaining healthy tissues, including muscles, skin and internal organs; protein is also important to forming the antibodies that fight infection. As we age, soyfoods can cool the hot flashes of menopause, and possibly ward off cancer and heart disease.

FIBER: Consuming high-fiber foods, like whole grains, legumes, fruits and vegetables, can prevent constipation, cancer, heart disease and obesity.

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