Updated Food Pyramid for Older Adults Offers Graphic

By Judith Groch
BOSTON, Dec. 20 -- Patients 70 and older seeking sound nutritional advice have been given their own food pyramid, complete with suggestions for ways to reduce extra trips to the grocery store.The goal of the food pyramid for older patients is to make the information accessible on paper for those who may not be adept in computers and Web sites, where the standard USDA MyPyramid resides. The older-adult version also has small but important differences that distinguish it from the standard pyramid.For instance, the new "Modified MyPyramid for Older Adults" emphasizes packaged, canned, or frozen fruits and vegetables in addition to the fresh variety, Alice H. Lichtenstein, D.Sc., of Tufts University here, and colleagues reported online in the Journal of Nutrition. The new graphic will be published in the January issue.
Bags of frozen pre-cut vegetables that can be resealed or single-serve portions of canned fruit may be easier to prepare and have a longer shelf life, while dried fruits are an excellent source of fiber, the Tufts team wrote.
Such factors, the researchers added, are important when age or weather make shopping less likely. For a number of reasons, these forms may be better suited to older adults.
Patients older than 70 have unique dietary needs, Dr. Lichtenstein said. They may need fewer calories because they are less physically active and their metabolic rates slow, yet their bodies still require the same or higher levels of nutrients.
Furthermore, she said, they may need additional guidance about the forms of food that can best meet their needs and about the importance of sufficient fluid intake and physical activity.
The Tufts version of the pyramid in graphic form is not intended to substitute for the standard MyPyramid, which is now an Internet-based program allowing for the calculation of individualized food-based dietary choices and providing supplemental information.
However, the Tufts researchers wrote that they were concerned about issues related to computer availability, Web access, and Internet literacy among older adults, suggesting that a graphic version of MyPyramid was needed.
Thus, the Modified MyPyramid for Older Adults appears in a colorful illustrated format consistent with the familiar standard MyPyramid drawing.
The Modified MyPyramid stresses nutrient- and fiber-rich foods and food sources for nutrients rather than supplements. Fluids and physical activity icons appear at the foundation of the Pyramid.
A flag to maintain awareness of a possible need for supplemental forms of calcium, and vitamins D and B-12 waves from the top of the pyramid.
The major features in the Modified Pyramid graphic that differ from the standard food guide pyramid are the expanded presentations of food icons throughout the pyramid highlighting good choices within each category. A row of water glasses and little drawings of physical activities, such as walking, and house and yard work, run along the base of the illustration.
The flag at the top of the pyramid suggests that some older adults, due to biological changes, may need supplemental vitamins B-12 and D, and calcium, if the person's health care provider agrees. However, the researchers emphasized that the majority, if not all, of the nutrients should come from food and not supplements.
The graphic icons in the pyramid emphasize physical activity and fluid intake (including soup), plus foods in the following categories:
Whole, enriched, and fortified grains and cereal, such as brown rice and 100% whole wheat bread
Bright colored vegetables, such as carrots and broccoli
Deep-colored fruit, such as berries and melon
Low- and non-fat dairy products, such as yogurt and low-lactose milk
Dry beans and nuts, fish, poultry, lean meat, and eggs
Liquid vegetable oils and soft spreads low in saturated and trans fat.
"We do not intend the graphic to accomplish all the functions that the interactive computer program does or substitute for it. The intent is to incorporate icons within the graphic that serve to raise awareness of the unique needs of older adults and how to meet them," the researchers said.
The researchers reported no conflicts of interest.
This study was supported by a grant from the Ross Initiative on Aging at Tufts University and the USDA.
Primary source: Journal of NutritionSource reference:Lichtenstein A, et al "Modified MyPyramid for older adults" J Nutr 2008; 138: 5-11.