Health maintenance and service issues

Nutrition, diet, and exercise

Conventional wisdom has it that, as we age, we need less food and more exercise, less sleep and more rest. Few of today’s older workers received any advice about diet and nutrition during their early lives. Nonetheless, research suggests that older workers are likely to have a greater understanding of nutrition than younger workers.26 Evidence from the USA suggests that the most successful education interventions are aimed at families, neighbourhoods, and communities, especially when supported by legislation, the media, and marketing efforts. Within the ageing population, those with greatest health needs include members of minority groups and recent immigrants. These groups are often overlooked when designing and implementing health promotion programs.2728

During the 1960s and 1970s, government health education encouraged the UK population to reduce salt, sugar, and fat in their diets. Quality protein, salads, and fruit were then more expensive than foods containing high concentrations of saturated fats. Ready-to-eat meals, containing large quantities of salt, sugar, and saturated fats, became popular with the spread of home microwave ovens. The widening food and lifestyle habits of the different socio-economic groups in the population resulted in wealthier groups eating a healthier diet. This divergence is seen in today’s poorer older workers, in higher rates of heart, lung, and liver disease, diabetes and bowel disorders and in reduced life expectancy. Only those with particular eating habits (e.g. vegetarians and vegans) have bucked the trend of a widening gap between the life expectancy of rich and poor.

In the past 30 years, year-round salads, fruit, and frozen food became available to almost all of the population. However, habits (and atheroma) developed in the 1960s and 1970s have been hard to change, with those in the poorer socio-economic groups changing least. Smoking has continued longer in these same (poorer) groups, reducing average life expectancy still further. Toxins, such as the breakdown products of tobacco and alcohol, weaken the body’s defences and addiction to them worsens the user’s chances of a long and healthy life.

There is evidence that workers over 50 have more positive health behaviours, stronger beliefs about the value of healthy behaviour and better self-assessed health. In addition, they are more likely to hold attitudes associated with participation in worksite health promotion activities. Physical activity should continue in older workers, even though strength may diminish. Regular exercise is key, at least three times a week, to raise the heart rate according to age, taking due account of concurrent medical conditions. There is evidence that those with a body mass index of 30 or more die earlier and that all age groups benefit from regular exercise. The BMI should ideally be kept under 25, even though there is a natural tendency for body weight to move centrally, with age. Accumulation of omental fat inside the abdomen is especially prominent in men.

Daily fruit and vegetables, adequate supplies of protein and a good intake of water (said to be ideally 1.5 L per day, although there is no empirical evidence to support this recommendation) are essential for good health. For the older worker, keeping the immune system healthy, active, and effective against viruses, bacteria, and early cancers, may well be a matter of life and death, and the advice of a qualified nutritionist or dietician should be considered.29

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