Realistic, sustainable and one small bite at a time.

Consultant Dietitian Indra Balaratnam describes the basis for a workable nutritional and dietary plan that anyone can effectively follow, whether for medical needs or just general wellness.

It is indisputable that Malaysians love their food but this time-honoured passion is also the cause of many lifestyle diseases. 

“It is not a bad thing to love food, especially in Malaysia where food is accessible an affordable. This is very convenient for the senior community who do not want to cook all the time for themselves. 

“To have a good dietary plan does not always mean to restrict,” Indra explains that the field of dietetics has many areas and clinical is one that people meet in the hospital. Some dietitians work in the community and some work in a community. Foodservice dietitians who work in companies where food is provided for on large scales such as in hospitals catering and airlines

“Transfering nutrition science onto the plate has always been my area (of expertise).To me, that’s the missing gap.”

She believes that it is not enough to counsel a patient on what food is not good for him, “After knowing all that information he needs to know how to translate that into his daily life because as soon as he leaves the hospital he would be tempted by all the food around him and confused by all the advice from his family and people around him. That is the missing gap.”

Indra who has a private practice, Indra Balaratnam Nutrition, makes house calls for her consultations to enable her to engage with her patients in their environment. Since the Covid lockdown, her younger patients have taken to online consultation while seniors prefer face-to-face. 

She readily acknowledges that while the wealth of information online has helped Senior citizens learn about health issues, it has also caused much confusion as the sources of information are not always credible and hard to discern.

“It is crucial for anyone in their mid-30s moving on to their 40s to pay more attention to nutrition and diet. Besides this, he should also go for check-ups with a regular physician who would know about his health and lifestyle. This could lead to building a good foundation for active ageing.”

Indra likened that to tending to a garden and planting seedlings in good healthy ground. “By the time you are in your sixties your ‘plants’ will thrive. That’s how it should be to build a long-term health foundation that is not based upon diagnosis of an illness and you would try to eat right to make up. 

“But as human nature would have it, when things are going well you don't want to think about it. They should instead consider eating well while in good condition to enhance their health. This will fill in the gaps that might be missing.”

At what age, in particular, should we start to pay attention to nutrition and diet?

It should start at any age but it becomes increasingly crucial as individuals approach retirement age. Reasons are:

• Foundation for health - Establishing healthy eating habits early lays a solid foundation for long-term health
• Prevent chronic diseases - Heart disease, diabetes and osteoporosis become prevalent with age. A balanced diet rich in fruits, vegetables, whole grains, lean proteins and healthy fats helps mitigate the risk factors.
• Maintain muscle mass - This tends to decline with age, leading to decreased strength and mobility. Adequate protein intake with regular resistance training exercises can help preserve muscle mass and function.
• Support bone health - Osteoporosis is a common concern among seniors. Calcium and vitamin D in foods like dairy products, leafy greens and fortified foods can help to maintain bone density and reduce the risk of fractures.
• Manage weight and metabolism - Metabolism slows down with age making weight management challenging. Individuals need to be mindful of portion size, choosing nutrient-dense foods and to stay physically active.

Indra advocates mindful eating practices by listening to hunger cues to prevent overeating and promote healthier eating habits.

There are myths surrounding the diet for individuals in their 50s and beyond. What are some of them?

Myth :  ‘You need less protein as you age.’

I had a client in her late 50s who believed that reduced protein intake as she aged would be better for her health. And that too much protein would strain her kidneys. After discussing her lifestyle and health goals, she agreed on a balanced diet plan that gave her adequate protein intake with chicken, fish, tofu and legumes. Her muscle strength increased and she felt more energetic throughout the day.

Kidney function may decline with age but it doesn’t mean that older folks should skimp on protein. Older adults may even require slightly more protein to counteract age-related muscle loss and support tissue repair.

Myth : Carbohydrates are bad and should be avoided.

My client, a retired businessman in his early 60s was concerned about his weight and blood sugar levels as he had been following a low-carb diet. After reading about it in a magazine he was convinced that carbohydrates were not good for him. He became low in energy and had trouble maintaining his dietary restrictions. After talking with him about his lifestyle and preferences, we came up with a plan that incorporates healthy carbohydrates like whole grains, fruits and vegetables into his meals. He became more energised and his blood sugar level stabilised. He was also able to sustain his weight loss more effectively.

Carbohydrates are an essential source of energy especially for older adults who may need them for daily activities and to maintain muscle mass. It is about choosing the right type of carbohydrates and portion sizes rather than avoiding them altogether.

Myth : Supplements can make up for a poor diet

A 55-year-old retiree believed that taking a handful of supplements each day could compensate for her less-than-ideal diet. However, despite the supplements, she often felt fatigued and her hair and nails were becoming brittle. Upon evaluating her diet, we found that she lacked essential nutrients such as calcium, vitamin D and Omega-3 fatty acids. Her energy level and overall well-being began to improve after filling her gaps with a nutrient-dense diet rich in fruits, vegetables, lean proteins and healthy fats.

Whole foods provide a diverse array of nutrients and phytochemicals that work synergistically to promote health and prevent chronic diseases. Supplements should be used as a complement rather than a replacement for healthy eating habits.

What does “eat all foods in moderation” mean? 

I believe this is a valuable guiding principle for individuals particularly those aged 50 and above. Moderation entails consuming a balanced variety of foods while being mindful of portion sizes and frequency of indulgence. However, it does not mean you can consume anything you want without regard to nutritional value.

Moderation should be defined within the individual’s health goals, dietary needs and medical condition. This also involves paying attention to hunger and fullness cues, savouring flavours and cultivating a positive relationship with food. Consulting with a healthcare provider or registered dietitian can provide personalised guidance to specific circumstances. 

How and when should one pay more attention to eating healthy and our overall diet without compromising on our enjoyment of living?

As much as it is crucial to pay attention to a balanced diet as we age, it is equally important to strike a balance between health-conscious choices and the enjoyment of life.

Rather than focusing on what they can’t eat, I encourage them to explore the variety of nutritious food available and to savour the flavour, texture and experiences that come with them. Mindful eating practices allow for occasional indulgences in favourite treats.

To make sustainable changes to dietary habits is to take it a step at a time gradually by incorporating more fruits and vegetables, choosing wholegrains over refined grains and opting for lean protein sources. 

Ultimately the goal is to enjoy the golden years to the fullest by finding a balance of nutritious eating and the enjoyment of life’s pleasure.

Catch the next episode with Indra Balaratman walking through a menu of tempting dishes in a restaurant and how to have a great meal without overindulging.