Electronic textbook on nutrition and dietary health for the elderly, second edition

The core value of "Electronic Textbook of Nutrition and Dietary Health for the Elderly, Second Edition" is to completely get rid of the problem of "one size fits all" in the past dietary guidance for the elderly, and break down the theoretical nutrition standards into operable plans that adapt to different health states, regional eating habits, and family accessibility. It is not only a teaching tool for community nutrition workers, but also a dietary guide that ordinary elderly people and their families can directly use.

I have been doing community nutrition education for the elderly for almost 6 years. When I used the first version, the biggest headache was that the elderly always said "I can't afford/can't bite/can't get used to eating the things you mentioned" - for example, the old version repeatedly emphasized the need to eat more whole grains. The last time I met Uncle Li who lived alone, he only had 7 good teeth left. After eating steamed corn for three days, he suffered from acid reflux for a whole week, and finally went back to eat his white porridge with pickles. I flipped through the second edition of this edition as soon as it came out, and there was a "list of substitutes for soft whole grains": boil corn grits for 40 minutes to make a thick porridge, beat oats and yam together to make a paste, and mix buckwheat flour with 20% white flour to make soft steamed cakes. It retains dietary fiber and does not scratch the stomach. I tried the oatmeal and yam paste for Uncle Li. After drinking it for half a month, his old problem of constipation was mostly cured.

What’s interesting is that this edition does not avoid controversial topics that are currently hotly debated in the nutrition circle. Instead, it clearly lists the views of different schools without forcing a “standard answer”. Take for example “should the elderly supplement protein powder” that everyone is concerned about. There is a consensus among clinical nutrition departments: elderly people with hypoalbuminemia, postoperative recovery period, and grip strength lower than 28kg for men/18kg for women do need additional supplements. 10-15g per day is enough. ； There are also reminders from traditional health schools: If you can eat enough 1 egg, 200ml milk, and 2 taels of lean poultry/fish and shrimp, there is no need to take extra supplements. Taking too much will increase the metabolic burden on the kidneys. I met an aunt who had just had a hip surgery two months ago. My son Xiaoshun bought several cans of imported protein powder, and she drank three spoons a day. After half a month of drinking, the creatinine was found to be over the standard. Later, according to the stratification standards in the textbook, I reduced the protein powder to one spoon a day, paired with 1 tael of lean beef and 1 box of yogurt a day. After a follow-up test in less than a month, the creatinine returned to the normal range, and the albumin level also increased.

Oh, by the way, this edition also specifically corrects a lot of dietary misunderstandings that have been spread for more than ten years, the kind that old people ask about every day. For example, everyone always said before that "elderly people should eat less meat and more vegetarian food to live longer." The book clearly states that the appropriate BMI for people over 70 years old is 20-26.9, which is much higher than the standard for young people. Instead, they need to supplement more high-quality protein, otherwise they will lose muscles quickly and easily break bones if they fall. There used to be an uncle in our community, Mr. Chen, who had been vegan for 3 years. Last winter he slipped and fractured his femoral neck. During the blood test, the albumin was only 29g/L. Later, he adjusted according to the plan in the book and added 1 tael of minced lean beef and 1 box of sugar-free yogurt every day. After 3 months of reexamination, not only did the index return to 36g/L, but his grip strength increased by 3 kilograms. Now he can walk downstairs with crutches.

There was also a lot of quarrel on the Internet before about "Can the elderly drink porridge?" This version did not take sides and directly gave a scenario-based solution: it is okay for healthy elderly people to drink it occasionally, but not every day.； If you have poor teeth and can only drink porridge, add minced eggs, minced meat, and blanched green leafy vegetables to the porridge to increase the nutritional density. ； If you have diabetes, switch to mixed bean porridge. The proportion of brown rice and mixed beans should not be less than 1/3, and the cooking time should not exceed half an hour. The glycemic index can be reduced by half compared to white porridge. Several people with diabetes in our community have tried it. After drinking and measuring their blood sugar after eating, it is indeed not as high as before.

After all, it is an electronic textbook, which is much more convenient than the paper version. If you want to find something, you can just search it with keywords. For example, if an elderly person in your family has gout, you can search for "gout" and you will get a list of prohibited, restricted, and recommended ingredients, as well as a week's recipes for different tastes. You can also watch a 3-minute practical video by scanning the code, such as how to make chyme of the right consistency for an elderly person with dysphagia, and how to use a beer cap to estimate daily salt intake. Even the elderly person can understand it wearing reading glasses. Last time, I showed some tips for reducing salt in the community to some northeastern aunties who love to eat pickled vegetables: soak the pickled vegetables for 2 hours in advance, cut them and then rinse them with warm water, which can remove 60% of the salt. When stir-frying, add ginger, garlic, and a little dried shrimp skin to enhance the flavor. No additional salt is needed. When they went home and tried it, they all came to me and told me that the salty flavor was enough after eating, and their blood pressure was no longer as high and low as before.

To be honest, I have been using this version of the textbook for more than half a year. The biggest feeling is that it was not compiled by sitting in an office and looking at documents. It was revised after going to dozens of communities and asking thousands of elderly people about their real needs. You can tell at a glance that many of the details were written after they were really asked by the elderly - for example, the residents in the text were asked about their real needs. Of course, there are also particularly down-to-earth content such as "How to use semi-finished dishes to prepare a nutritionally balanced meal when your children are not at home" and "How do elderly people who love milk tea choose low-sugar substitutes"? There is no sense of superior guidance, but more like an old neighbor who understands nutrition, chatting with you about how to eat more comfortably and avoid getting sick.