Journal of Gerontological Nursing

Guest Editorial 

Bigger Is Not Always Better

Susan Noble Walker, EdD, RN, FAAN

Abstract

Nearly 25 years ago, a landmark report was published that laid the foundation for major public health policy initiatives focused on illness prevention and health promotion in the United Sutes (U.S. Department of Health, Education, and Welfare [DHEW], Public Health Service, 1979). In it, the U.S. Surgeon General asserted

the long-term goal of a health promotion and disease prevention strategy for our older people must not only be to achieve further increases in longevity, but also to allow each individual to seek an independent and rewarding life in old age, unlimited by many health problems that are within his or her capacity to control (p. 71).

Those words still hold true today.

Life expectancy has increased since 1979; women who reach age 65 now can expect to live 19 more years, and men can expect to live 16 more years (Centers for Disease Control and Prevention [CDC], 2002). But what will those added years be like? Approximately 80% of older adults have one chronic condition, and 50% have two or more. However, the potential disability and premature death associated with these conditions are not inevitable - if individuals engage in healthy lifestyle behaviors with support from their families and their nurses.

One of the most serious threats to health for older adults, as well as for those with ambition to one day become healthy and functional older adults, is overweight and obesity. A little more than a year ago, the Surgeon General declared that overweight and obesity have reached epidemic proportions nationwide and issued a call to action to prevent and decrease them (U.S. DHHS, 2001). The prevalence of obesity has doubled among adults since 1980. Only 36% of adults 60 and older are at a healthy weight, while 40% are overweight and 24% are obese (U.S. DHHS, 2000).

Bigger isn't better. The most potent weapons available to reduce this threat are healthy eating and physical activity. It has been asserted that "there is no single segment of our society that can benefit more from regular exercise and improved diet than older adults" (Drewnowski & Evans, 2001, p. 5).

Older adults have far to go to meet the Healthy People 2010 objectives for the current decade in these areas (U.S. DHHS, 2000). Many have sedentary lifestyles. Approximately half of adults ages 65 to 74 and two thirds of those ages 75 and older engage in no leisure time physical activity. Only one third of adults age 65 and older engage in moderate physical activity for 20 minutes 3 or more days per week, and only half as many do so for 30 minutes 5 or more days per week, as recommended.

In the area of healthy eating, only one third of adults 65 and older eat five or more servings of fruits and vegetables daily, and fewer than 40% consume less than 30% of calories from fat as recommended. Bigger isn't better in serving sizes, either. The "super-sizing" of servings marketed by the fast food industry and adopted increasingly by restaurants has become an expectation of many and a habit often extended to eating at home. Strides toward healthy eating can be accomplished by reducing serving sizes without giving up preferred foods entirely. It is never too late to make changes in healthy lifestyle behaviors, and gerontological nurses can assist older adults toward such goals.…

Nearly 25 years ago, a landmark report was published that laid the foundation for major public health policy initiatives focused on illness prevention and health promotion in the United Sutes (U.S. Department of Health, Education, and Welfare [DHEW], Public Health Service, 1979). In it, the U.S. Surgeon General asserted

the long-term goal of a health promotion and disease prevention strategy for our older people must not only be to achieve further increases in longevity, but also to allow each individual to seek an independent and rewarding life in old age, unlimited by many health problems that are within his or her capacity to control (p. 71).

Those words still hold true today.

Life expectancy has increased since 1979; women who reach age 65 now can expect to live 19 more years, and men can expect to live 16 more years (Centers for Disease Control and Prevention [CDC], 2002). But what will those added years be like? Approximately 80% of older adults have one chronic condition, and 50% have two or more. However, the potential disability and premature death associated with these conditions are not inevitable - if individuals engage in healthy lifestyle behaviors with support from their families and their nurses.

One of the most serious threats to health for older adults, as well as for those with ambition to one day become healthy and functional older adults, is overweight and obesity. A little more than a year ago, the Surgeon General declared that overweight and obesity have reached epidemic proportions nationwide and issued a call to action to prevent and decrease them (U.S. DHHS, 2001). The prevalence of obesity has doubled among adults since 1980. Only 36% of adults 60 and older are at a healthy weight, while 40% are overweight and 24% are obese (U.S. DHHS, 2000).

Bigger isn't better. The most potent weapons available to reduce this threat are healthy eating and physical activity. It has been asserted that "there is no single segment of our society that can benefit more from regular exercise and improved diet than older adults" (Drewnowski & Evans, 2001, p. 5).

Older adults have far to go to meet the Healthy People 2010 objectives for the current decade in these areas (U.S. DHHS, 2000). Many have sedentary lifestyles. Approximately half of adults ages 65 to 74 and two thirds of those ages 75 and older engage in no leisure time physical activity. Only one third of adults age 65 and older engage in moderate physical activity for 20 minutes 3 or more days per week, and only half as many do so for 30 minutes 5 or more days per week, as recommended.

In the area of healthy eating, only one third of adults 65 and older eat five or more servings of fruits and vegetables daily, and fewer than 40% consume less than 30% of calories from fat as recommended. Bigger isn't better in serving sizes, either. The "super-sizing" of servings marketed by the fast food industry and adopted increasingly by restaurants has become an expectation of many and a habit often extended to eating at home. Strides toward healthy eating can be accomplished by reducing serving sizes without giving up preferred foods entirely. It is never too late to make changes in healthy lifestyle behaviors, and gerontological nurses can assist older adults toward such goals.

REFERENCES

  • Centers for Disease Control and Prevention, National Center for Health Statistics. (2002). Data warehouse on trends in health and aging. Retrieved March 18, 2003, from http://www.cdc.gov/nchs/about/otheract/ aging/ trenddata.htm
  • Drewnowski, A., & Evans, WJ. (2001). Introduction. Journals of Gerontology: Biological Sciences and Medical Sciences, 56/4(Special Issue II: Nutrition, Physical Activity, and Quality of Life in Older Adults), 5.
  • U.S. Department of Health, Education, and Welfare, Public Health Service. (1979). Healthy people: The Surgeon General's report on health promotion and disease prevention. Washington, DC: U.S. Government Printing Office.
  • U.S. Department of Health and Human Services. (2000). Healthy People 2010 (2nd ed.). With understanding and improving health and objectives for improving health (2 Vols.). Washington, DC: U.S. Government Printing Office. Retrieved March 18, 2003, from http://www.healthypeople.gov
  • U.S. Department of Health and Human Services. (2001 ). The Surgeon General's call to action to prevent and decrease overweight and obesity. Rockville, MD: U.S. DHHS, Public Health Service, Office of the Surgeon General.

10.3928/0098-9134-20030501-03

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