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This page should be read with some knowledge of the background. The recommendations are a historic accident, rather than scientific. Be aware of the evidence of people eating primitive diets, who were more healthy than modern people. Long before American exceptional confidence in anything American, led to some completely wrong ideas, that took us off track in the 1960's, prior to WWII there was good nutritional science in Europe, and even among older specialists in the USA. But Cardio Vascular Disease was rising and in a panic to "do something" mistakes were made.

Current Dietary Guidelines (for Older People) in New Zealand (Edited)

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Choose a variety of healthy foods every day from the following four food groups:

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1. Vegetables and Fruit

Vegetables and fruit provide carbohydrates (sugar and starch), fibre, vitamins and minerals. ("Low in fat" removed. Fruit is problematic. Fruit in season, would be better. Most fruits are too high in sugars if you need to lose weight. )

Eat plenty of vegetables and fruit. Choose fresh, ripe varieties when they are in season.(YES)

Limit fruit juice and dried fruit – they are high in sugar. (YES)

To get the best nutritional value from cooked vegetables, cook them quickly until they are just soft enough to eat. (You should also drink the vegetable water, perhaps using it in the pan the meat was cooked in, and then salted to taste, before drinking.)

Eat at least five servings of vegetables and fruit each day – at least three servings of vegetables and two servings of fruit. (Fruit can be a problem, one serving probably better. There is also a school of thought and experience that claims that many people develop an allergy or autoimmune reaction to the chemicals in vegetables, that the plant makes to protect itself.)

(Potatoes and root vegetables are carbohydrate dense. Potatoes in particular are avoided in the Banting Diet. Think green and coloured vegetables.)

2. Breads and Cereals

Breads and cereals provide carbohydrates (sugar and starch), fibre, and nutrients such as B vitamins and minerals.

Eat plenty of breads and cereals, including rice, pasta, breakfast cereals and other grain products. Open Future Health believes this diet is excessively energy dense with carbohydrates, quick burning calories. That creates belly fat if the energy produced is not burnt. On the other hand saturated fats give you energy that burns more slowly, and in the context of a low carbohydrate diet, is unlikely to be stored as fat.

Choose wholegrain varieties – they provide extra nutrients and fibre and also help prevent constipation. For most people that may be right. Many people have gluten or wheat intolerance problems, that are likely to get worse as you get older. (Carbohydrate intolerance may be developing.) Strangely, if people eat a diet with little of no fibre, that also prevents constipation. Open Future Health thinks that the idea that we need more fibre, may just be an old wives tale.

Choose at least six servings of breads and cereals each day. (They recommend about 600gm a day.) If you are eating six servings a day, that's breakfast, morning tea, lunch, afternoon tea, dinner, and supper. Insulin is ON all day. When insulin is "on" you can't burn fat. Open Future Health believes that this recommendation is wrong, if you need to lose weight. It's also wrong if you are concerned about type II diabetes or Alzheimer's disease. You might now be interested in weight loss diets.

If you reduce your carbohydrate intake to about 100gm a day you should begin losing weight, but you will probably not achieve nutritional ketosis. That may not be your aim of course.

The Banting diet recommends 50gm of carbohydrate a day or less to be in nutritional ketosis. That may have special health benefits for some of us.

3. Milk and Milk Products

Milk and milk products provide protein, vitamins, calcium and other nutrients.

Choose reduced or low-fat milk, yoghurt and cheese if you need to lose weight. There is NO reason for choosing the low fat product. Many low fat milk products have added sugar, but are labeled "healthy."

Choose whole-milk products if you are underweight or need additional energy. Actually, that's confused. Farmers feed skim milk to their pigs, and the lactose in milk converts to sugar. Skim milk fattens. On a Banting Diet, in the absence of insulin, fat gives you energy. Drink cream for energy and eat saturated fats.

Choose at least three servings each day of milk or milk products. The recommended low-fat products often include products that are sweetened. You should be drinking the cream. Buy milk in small bottles only. Note the yoghurt and ice cream, are usually sweetened.

4. Lean Meats, Chicken, Seafood, Eggs, Beans, Peas and Lentils, Nuts and Seeds

This is the only section that significantly changed in these new 2021 guidelines.

This wide range of foods all provide protein, vitamins and minerals to your diet.

Red meat, chicken and fish contain iron in a form that your body can easily absorb. Oily fish (eg salmon, tuna, sardines and mackerel) are good sources of omega 3, which may reduce your risk of heart disease and stroke. Open Future Health disagrees abut the "lean meat" idea. If you are eating low-carb you need energy and it has to come from fats. The natural fat on the meat or the fish is what you need. Also, entirely avoid fake meats that are now entering the market. They will not prove healthy in the long run.

Legumes, nuts and seeds also contain fibre and are a nutritious addition to your diet.

Choose at least one serving of red meat, chicken, fish or eggs OR at least two servings of legumes, nuts or seeds every day. Banting would, agree but suggest twice a day, and preferring animal foods if you can afford them.

Open Future Health believes that the recommended quantities of protein are too low. About 150gm a day is the same as the Banting Diet. Banting is NOT a high-protein diet. For older adults, eating more high quality protein seems to be essential.

Other General Health Recommendations

Choose and Prepare Foods Low in Fat, Salt and Sugar

Choose polyunsaturated or monounsaturated margarine rather than butter or dripping and spread it thinly. This assumes that saturated fats are bad for you. Open Future Health believes that this is quite wrong. Choose butter and lard as your preferred fats.

Choose foods rich in polyunsaturated fat and omega-3, including, nuts and seeds, oily fish either canned or fresh (tuna, sardines, salmon, mackerel, warehou and eel) and oils (soybean, canola, flaxseed and walnut). The really bad fats were trans-fats, the fats created from vegetable oils and hydrogenated to make them semi-solid, for products like Crisco, and margarine. (These were once considered healthy options.) Soybean, and canola oil are now also considered bad oils. We do need some omega-6 oils in your diet, but only a small amount. They were once recommended because they were useful in lowering cholesterol, but today it's understood that the "cholesterol causes heart disease" idea is wrong. (What causes heart disease? remains a good question.) The omega-6 vegetable oils in excess are not healthy.

Here is a list of common polyunsaturated, omega-6 seed oils, to be avoided: Sunflower, Canola, cotton seed, soybean, or anything labeled "vegetable oil." Sounds healthy, but beware.

Choose lean meats – trim off the fat, skim fat off stews and the top of boil ups, remove skin from chicken after cooking – and eat more grilled, baked, poached or steamed fish. Notice the instruction to "trim off the fat." We need to instruct our butcher to leave the fat on, and you need to eat it.

Grill, steam, microwave, boil or bake foods without adding fat. More lipophobia. Bad advice. One day it will change.

Limit sausages or processed meats (such as ham, bacon and salami), which can be high in fat and salt – and grill rather than fry those you need to cook. Even more lipophobia. Fry your food, and use butter or lard as the fat.

Grill, steam, microwave, boil or bake foods without adding fat. Again.

Reduce the amount of sugar or salt you add when cooking foods and eat meals without adding extra salt. Open Future Health believes that the story about excess salt causing high blood pressure is also wrong.

Buy frozen or canned fruit and vegetables with no or little added salt or sugar.

The Banting Diet recommends zero sugar. If you are on 50gm of carbohydrates a day, you actually need additional salt. Your blood pressure will come down anyway.

Many fast foods, takeaways and processed snacks are high in fat, salt and/or sugar. These include fish and chips, fried chicken, hamburgers, pies, salami, chocolate bars, muesli bars, potato chips or other salty snacks, doughnuts, cream cakes, lollies and fruit leathers. Cordials and soft (fizzy) drinks contain a lot of sugar. Choose these foods and drinks only occasionally (less than once a week). Open Future Health recommends that we try to avoid these entirely. But the biggest problem is the soft drinks, and the sugar free versions have other problems, so don't.

Modern people are used to being fed every day, usually more than three times a day. That's unusual, and not typical of human history. Nutrition is the keystone of basic good health. Sadly, the "healthy diet" most of us eat, and is still being recommended isn't healthy, as demonstrated by the Women's Health Initiative, (1991-1999, but published in 2006.) the only long running dietary study (8.5 years), with very good supervision and control, and large numbers of participants (19,541). (Also hugely expensive, it will never be repeated.)

The New Zealand Ministry of Health says, "High blood pressure, diabetes, heart disease and arthritis are common among older people. If you are overweight, losing a little weight can help to keep these conditions under better control." They are telling us that Metabolic Syndrome is common in New Zealand. We agree. The solution is the one Gerald Reaven, advises us to do, to change your diet.

Calcium

Calcium is an important mineral that helps keep bones strong and reduces the risk of osteoporosis. Food is the safest, cheapest and most effective way to get calcium.

Three or more servings of milk or milk products per day will provide the calcium you need. Calcium-rich milk, yoghurt, cheese, ice cream, canned salmon or sardines (including the bones) are excellent sources of calcium.

If you are unable to eat calcium-rich milk or milk products, talk to your doctor or dietitian before taking any supplements. Open Future Health agrees that if you drink milk, drink real milk. (Cows, goats, sheep, camels.) Pretend "milk like products" made from almonds, soy or oats should be avoided.

Vitamin D

If you don't get outside every day, you may not be getting enough vitamin D. Vitamin D is absorbed from sunlight on the skin. It is also found in eggs, fish and seafood. In special cases, frail older people may need a Vitamin D supplement, but for most people it is better to have short regular exposure to the sun. Vitamin D is essential to help your immune system fight viral infections. Typically older people lack vitamin D. Of course we have been told for a lifetime to avoid the sun and to use sun-block. Perhaps we've overdone that.

A daily walk or some other form of physical activity in the early morning or late afternoon is recommended. In general, over summer sun protection is recommended (shade, clothing coverage and a hat that shades the face and neck, sunscreen and sunglasses) especially between 10 am and 4 pm. Over the winter months some sun exposure is important. A daily walk or another form of physical activity in the hours around noon, with face, arms and hands exposed, is recommended.

If you think you may not be getting enough vitamin D, talk to your doctor or dietitian before taking a Vitamin D supplement.

Drink Plenty of Fluids Every Day

Older people need to drink plenty of fluids to reduce the risk of constipation. Drink at least eight cups of liquid each day to replace the fluid that is lost from the body. Open Future Health is sure that some people take this far too far. Drinking every 10 minutes while exercising for instance. You can easily exercise for over an hour without needing to drink.

Professor Tim Noakes wrote a book called "Waterlogged" where marathon runners (all women) drank too much and some died (13). When they collapsed, the medics on hand, assumed dehydration and often gave them even more water, making the situation worse. Marathon runners used to drink once half way, then they started to have drink stations every 10km, and sometimes every 5km. It's excessive and not needed.

Water is refreshing – keep a jug of water in the fridge or maybe have a cup of warm or hot water instead of tea or coffee.

Tea and coffee add flavour, but don't overdo the caffeine. Limit your daily intake to six cups of tea or four cups of coffee.

Drink more water when the weather is hot and humid or when you are doing a lot of physical activity. Open Future Health says if you need a drink have a drink. Don't force yourself to drink, and in preference avoid soft drinks entirely.

If you find getting up during the night is a problem, try having most of your fluid earlier in the day. Open Future Health isn't sure that this works, although it sounds sensible. When you sleep is the best time for the body to produce urine. As your body slowly burns fat overnight, it creates energy and a byproduct is water.

Preventing Constipation

You can prevent or reduce constipation by eating high-fibre foods, drinking plenty of fluids and being physically active. Open Future Health wonders how useful that advice is. If there is no fibre in your diet you won't have constipation. People who choose to eat only meat never have that problem.

Eat plenty of high-fibre foods, such as wholemeal or wholegrain breads, breakfast cereals, vegetables and fruit. Prunes and kiwifruit are particularly useful.

Increase daily fluid intake to 8–10 cups. This includes tea and coffee.

Have some regular activity every day, such as walking.

Healthy Weight in Older People

If you need to lose weight

High blood pressure, diabetes Type II, heart disease and arthritis are common among older people. If you are overweight, losing a little weight can help to keep these conditions under better control. Open Future Health says there is excellent scientific evidence about how to do that. Exercise is not the key, especially if you are more than 5kg overweight. See "Weight Loss Diets."

Fresh fruit and vegetables and bread and cereals are lower in energy (calories) than high-fat, high-sugar foods. Seasonal vegetables and fruit are usually good value for money.

Eat regularly (three meals a day) but avoid high-energy snacks. Follow the suggestions for choosing and preparing foods low in fat, salt and sugar. Open Future Health recommends intermittent fasting. Don't eat after 7pm at night. Don't eat breakfast. Have a small lunch ideally about 2pm, focus on the quality protein in that meal. Eat very well at dinner-time.

Increase your physical activity. Aim to be physically active for at least 30 minutes every day. (You can break this into three 10 minute spells.) I have been using an online fitness program daily for almost 3 years. I do recommend that, although the quality of the programs on offer varies significantly.

Drink less alcohol – it is high in energy.

Alcohol and Your Health

As you get older, your body’s ability to handle alcohol changes and you may need to limit how much you drink, or not drink at all. Open Future Health has seen many people who had surgery to reduce weight, begin to drink alcohol in excess. They then get fat again.

If you are taking medication, check with your doctor. Alcohol can make some medicines stronger or weaker, or make their side-effects worse.

Drinking alcohol can also make any existing health problems, such as diabetes, worse and cause new health problems. I like to have ONE glass of wine before or after dinner. Sometimes we have Kombucha, or cider for a change. If I'm with beer drinkers I'll drink one 330ml dark beer or stout.

You should not drink alcohol if you feel unwell, depressed, tired or cold as it could make things worse.

You can reduce the alcohol you drink by alternating between non-alcoholic and alcohol drinks, and by drinking low-alcohol beverages.

If you're having trouble stopping or cutting back on how much alcohol you drink, talk to your doctor or another health professional. There is a history of alcoholism in my family. Not me, and any stage, but I've seen it happen.

Alcohol is high in energy, so drink less if you need to lose weight.

Be Physically Active

Physical activity is just as important for older people as it is for everyone else. Physical activity keeps muscles toned and improves circulation and appetite. It helps you maintain a healthy body weight, sleep better and feel fit and well. It can also reduce your risk of falling.

Be physically active by taking every opportunity to move. Try to include 30 minutes of physical activity on most if not all days of the week.

Walk whenever you can. Walking is excellent exercise – just make sure that you have comfortable well-fitting shoes. If you prefer to walk with others, walk with a friend or join a walking group or a tramping club.

Open Future Health recommends intermittent fast walking, or running if you can, lamp post to lamp post, or 20 seconds at a time. Try to maintain you walking speed and endurance. Hill walking and stairs are also a good challenge, so long as you can come down safely.

Other activities, some of which give you social contact as well as physical activity, include:
Swimming or aqua aerobics (impact-free exercise in water).
Sports such as bowls, croquet, golf or tennis.
Cycling – outdoors (remember to wear a helmet!) or indoors on an exercycle
Old time or line dancing, tai chi or yoga.