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Sunday, December 28, 2014

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Keeping kosher as we age

Tags: Health
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We all have our traditional kosher favourites – and for many this means Ashkenazi fare such as slow-roasted brisket, matzah ball soup, lockshen kugel, and perhaps cholent and blintzes. Unfortunately, such kosher classics aren’t the best choices for us as we get older.

Toby Smithson is a spokesperson for the Academy of Nutrition and Dietetics and founder of DiabetesEveryDay.com. “Age 50 appears to be the time when some of our nutritional needs change,” she said. “Our metabolisms begin to slow down, so we need fewer calories – yet at the same time we still need food that is high in nutrients.”

The challenge, then, is to get all the nutrients we need without overeating. If you are physically active, great – though most people are not scaling the same number of mountains at 60 or 70 that they were at 30. There are also specific vitamins and minerals we need more after we hit 50, Smithson says, notably potassium, calcium and vitamins B12 and D. We also need fibre, but slightly less than we do when we’re younger.

Sodium is a concern in the opposite direction – too much can contribute to high blood pressure, and we need to significantly reduce consumption as we get older, to about three-quarter teaspoon per day (1,500 milligrams). That includes both what we add to our plate and what occurs in foods naturally. Unless specifically made for seniors, prepared kosher foods can be high in sodium.

Too much sodium may increase blood pressure, and potassium helps blunt sodium’s affect, Smithson says. Calcium, coupled with vitamin D, helps with bone strength, and vitamin B12 protects against anemia. Fibre serves multiple purposes. It helps with digestion and heart health, and can help prevent certain kinds of cancer. Good sources include fruits and vegetables, as well as whole grains like oatmeal and brown rice.

For many in their 50s and above, choosing meals and preparing their own food may not be an issue. But as the Jewish population ages, more and more people are living on their own, with family far away. Jewish organizations in several cities around the country offer services to this group. Kosher meals on wheels supplies a daily meal to older adults who cannot easily get out of the house.

In Skokie, Ill., Ted Starcevich is the program manager of home-delivered meals and Kosher to Go for CJE SeniorLife, an organization that serves older adults in a variety of ways. The organization delivers 300 to 400 kosher meals daily. Deliveries are often made by volunteers who visit with their clients when bringing the food, which provides a third of their daily nutritional requirements.

The menus, which are all taste-tested by Starcevich and his staff, are sent to a state dietitian for approval. “Sometimes the state dietician will come back and will tell us to switch the apple on Tuesday with the orange on Thursday, for nutritional balance,” he said.

Neal Drobnis is co-ordinator of  the Kosher Nutrition Program of Jewish Family Service of Rhode Island. The program provides both home delivery and a Senior Café. “The Jewish federation has been really supportive of this program,” Drobnis said. It offers kosher lunches daily for a $3 donation and provides transportation. Most guests are in their 80s.

Café meals are all kosher, as are the delivered meals, and meet federal guidelines in terms of nutrition. “Seniors try to stay away from salt and use salt alternatives,” Drobnis said. “Everything is low sodium. In general, they stay away from sugar as well. We try to have a balance of proteins, carbohydrates, fruits and vegetables. For carbs – grains, pasta, bread –we try to use whole grains when we can. It can be very difficult with the budgetary limits to have brown rice or whole wheat pasta.”

Zan’s Kosher Delicatessen Restaurant runs a similar program in Lake Grove, N.Y., supplying delivered kosher meals for area townships. The Supper Club 60 is offered in the afternoon Mondays through Thursdays, according to Anthony Ruggiero, who owns the business with his brother, Pat. The $4 donation offers a choice from a daily menu. For seniors, Ruggiero says, “We make everything with less salt.”

The National Osteoporosis Foundation indicates that our vitamin D needs can almost double once we hit 50 – those under a half century need 400 to 800 IU daily, while those over need 800 to 1,000 IU.

“Vitamin D is needed to help keep bones strong along with calcium,” Smithson said. The primary natural source of vitamin D is sunlight, but how our skin absorbs it can depend on where we live, if we use sunblock, and how much time we spend inside, an issue for shut-ins.

If you don’t spend much time in the sun, you may need vitamin D supplements; check with a health-care provider for the best balance. Kashrut can be an issue for some vitamin D supplements. Smithson said that there are two kinds, D2 and D3, and “D3 is derived from ultraviolet irradiation of a substance derived from sheep’s wool.”

In general, the most efficient sources for the nutrients we need as we get older is food, rather than supplements; supplements should do just that – help with what we’re getting from food already. Food has the added advantage of being good for multiple nutrients. Dairy products, for example, contain both calcium and potassium.

Other good sources for potassium include beans (think cholent) and fruit, including dried apricots, prunes and raisins (tzimmes, anyone?). Dates are also a good source, along with pistachios and other nuts. (Nuts can be high in fat, so moderation is key.)

Fortunately, it’s easy to fit a healthy diet into a kosher diet – for the most part. Brisket isn’t the leanest cut of meat, but it can be reserved for special occasions “Unfortunately, the leanest cuts of beef are not kosher, so we need to have a stronger focus on cutting back on our sources of fats, especially saturated fat,” Smithson said.

“Many traditional dishes can be modified,” she said. “Dishes like lockshen kugel can be made with a heat-resistant sugar substitute and egg whites to make it more heart-healthy and diabetes friendly.”

“The best advice is to modify recipes, watch portion size, and add more vegetables to your meals,” she added.

Good advice as we head into our 50s, 60s, 70s and 80s. And if we make it to our 90s, that may be the time when we no longer have to worry about moderation, and we can have a second helping of brisket.

 

Suggested kosher menu for a day

 

Toby Smithson suggests the following sample kosher menu.

Breakfast: oatmeal, a glass of skim or one per cent milk; one cup of berries, and a slice of whole grain toast with tub margarine, almond butter or peanut butter

Lunch: tuna fish salad with reduced fat mayonnaise; one slice low fat cheese; two slices whole-grain bread, one cup baby bell peppers, one peach or nectarine.

Snack: three graham cracker squares, six ounces low-fat vanilla yogurt sprinkled with cinnamon and chopped almonds.

Dinner: three ounces baked skinless chicken breast with rosemary; one medium sweet potato; one cup green beans; an orange.

 

Suggested Shabbat meal

 

Shabbat: chicken soup with whole-grain noodles; cholent with more beans than meat; a green leafy salad with bite-sized raw vegetables; baked sliced apples with cinnamon and sugar substitute.

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