WHOLE: Wellbeing and Healthy Choices for Older Adults and their Carers

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WHOLE: Wellbeing and Healthy Choices for Older Adults and their Carers Bowel Health in Older Age This dietary information fact sheet

It is not a substitute for proper medical diagnosis or dietary advice given by health professionals.

Nutritional Content by Aisling Snedkar RD Editing and design by Emma Murtagh Proofreading by Amanda Ramirez and Rose Snyder On behalf

1 WHOLE: Wellbeing and Healthy Choices for Older Adults and their Carers Bowel Health in Older Age This dietary information fact sheet is intended for informational purposes only. It is not a substitute for proper medical diagnosis or dietary advice given by health professionals. The information was correct at time of publication in Nutritional Content by Aisling Snedkar RD Editing and design by Emma Murtagh Proofreading by Amanda Ramirez and Rose Snyder On behalf of ProActivate Ireland Project number: DE02-KA This project has been funded with support from the European Union. This publication reflects the views only of the author, and neither the Commission nor the National Agency can be held responsible for any use which may be made of the information contained therein.

WHOLE: Wellbeing and Healthy Choices for Older Adults and their Carers Bowel Health in Older Age INTRODUCTION The bowel is at the heart of an individual s digestion and nutrition and so supporting a

2 WHOLE: Wellbeing and Healthy Choices for Older Adults and their Carers Bowel Health in Older Age INTRODUCTION The bowel is at the heart of an individual s digestion and nutrition and so supporting a healthy bowel is vital to overall health and wellbeing. As we age, the bowel like many other areas of the body can start to slow down, leading to an increase in instances of constipation. Bowel movements may also be affected by other conditions, such as diverticular disease, Crohn s disease, or coeliac disease. Various medications can also slow down the bowel. Constipation can be very uncomfortable and troublesome. The range of normal bowel habits varies greatly, from three times per day to just three times per week. A healthy bowel produces formed, big, soft, and normal stools. If your bowel habit is less frequent than three times per week, it may be because the waste is moving through your system too slowly and allowing too much water to be reabsorbed, resulting in very uncomfortable, small, hard stools. By Cabot Health, Bristol Stool Chart ( [CC BY-SA 3.0 ( via Wikimedia Commons 1

Taking care of your digestive system promotes efficient absorption of nutrients and can lend towards managing the effects of conditions or medications that may negatively impact it.

3 Taking care of your digestive system promotes efficient absorption of nutrients and can lend towards managing the effects of conditions or medications that may negatively impact it. The key areas to focus on in terms of bowel health are eating and drinking habits and fibre intake. FIBRE Fibre, very simply, comes from plants, not animals. There are many different types of fibre that are important for health. They are split into two main groups: soluble and insoluble fibre. SOLUBLE FIBRE Soluble fibre is found in some varieties of: Beans and lentils, including baked beans, kidney beans, black beans, and split peas; Vegetables, including carrots, parsnips and potatoes; Fruits, including blueberries, bananas, strawberries and apples; Grains, including oats, barley, rye, quinoa and buckwheat; Seeds, including flaxseeds or linseeds and chia seeds. Soluble fibre is fantastic for overall health. It dissolves in water and forms a gel in the gut, which helps to keep stools soft and easy to pass. Most people think that fibre s main purpose is to prevent constipation but it actually has many different functions, including heart health and protection against diabetes. 2

INSOLUBLE FIBRE Insoluble fibre is found in: High fibre breakfast cereals, wholemeal breads, grains, pasta and rice; The skins/outer layers and pips of vegetables and fruits, including potatoes,

4 INSOLUBLE FIBRE Insoluble fibre is found in: High fibre breakfast cereals, wholemeal breads, grains, pasta and rice; The skins/outer layers and pips of vegetables and fruits, including potatoes, cucumbers, grapes, apples, and peas; Nuts and seeds, including flaxseed, which contains both soluble and insoluble fibre and as such can be very helpful for keeping the bowel healthy. Insoluble fibre is great for making you feel fuller for longer and helps to hold water and form bulkier stools that are easier to pass. WHY IS FIBRE IMPORTANT? High fibre foods contain B vitamins and folic acid, essential fatty acids (Omega 3), Vitamin E, selenium, and many micronutrients. Fibre helps to remove waste quickly through our digestive tract, therefore reducing the time that potentially harmful waste substances are in contact with the bowel wall. It also functions as a prebiotic, which is food for our friendly gut bacteria. Fibre helps with weight management, reducing the risk of heart attacks, strokes, and type 2 diabetes. Good fibre intake can only have these effects when combined with a healthy diet and lifestyle. 3

5 A TYPICAL DAY OF EATING THE HIGH FIBRE WAY We need 24g-35g of fibre every day to keep support our digestion and health. Meal Food Portion Fibre content Breakfast Porridge oats 1 medium bowl 3 g + mixed milled seeds 1 table spoon 3 4 g average Snack Lunchtime Snack Evening meal 1 banana (average size) Tuna sandwich on wholemeal bread 1 apple (average size) 1 orange (average size) 1 jacket potato with white fish mixed salad (average) 1 medium 2.5 g 70 g (2 slices) 80 g 4.7 g 1.8 g 80 g 1.1 g 180 g average 138 g 6.5 g 1.7 g Snack Handful of almonds g g (approx.) 4

6 EATING AND DRINKING HABITS DRINKING HABITS Drink adequately and beneficially; Try to have less than 4 cups of caffeinated coffee or tea each day or swap completely to decaffeinated drinks; The best drink is plain water. If you find it difficult to drink, try it chilled and add a few slices of lemon or try herbal teas; Avoid carbonated drinks as they can cause gassiness and bloating. EATING HABITS Eat three regular meals each day; the bowel likes routine; Avoid skipping meals or having long gaps between meals; Take the time to eat and chew food well; If you are trying to improve your overall bowel health, plan your meals in advance each day and try to ensure that you are going to be hitting your targets for fluid, fibre, fruit and vegetables; Aim for at least 5 7 portions of fruit and vegetables every day. A portion is 80 g. Consult the table below for more information on portions; Some people find that limiting fruit to no more than three portions per day is best as excessive fruit can cause bloating. If you want to work out how much you need to drink specifically, use one of these equations: Under age 65: Weight in kg multiplied by 35 ml Over age 65: weight in kg multiplied by 30 ml 5

7 What counts as a portion of fruit? (Aim for 2 3 portions per day) 1 medium apple, orange, banana, pear or similar size fruit 2 small fruits - plums, kiwis or similar size fruit What counts as a portion of vegetables? (Aim for 3 or more portions per day) 4 dessertspoons of any cooked vegetables fresh or frozen 3 sticks of celery ½ a grapefruit ½ a small aubergine berries, grapes or cherries ½ a red, green, or yellow pepper 4 dessertspoons of cooked fresh fruit, fruit tinned in own juice or cooked 1 bowl of homemade vegetable soup frozen fruit 1 small glass (150 ml) of 1 small corn on the cob or 4 unsweetened fruit juice or a heaped dessertspoons of smoothie made from only fruits sweetcorn or vegetables 2 slices of pineapple 5 cm piece of cucumber 1 medium tomato or seven cherry tomatoes 6 8 Brussels sprouts ½ a mango ½ a large courgette 1 slice of melon Cereal or dessert bowl full of salad leaves 1 medium onion or 8 spring onions 6

8 PROBIOTICS OR LIVE CULTURES Probiotic a type of live culture yoghurt may or may not help you. If trying probiotic yoghurt for its digestive benefits, it is recommended to incorporate it into your diet daily for at least four weeks. If you notice improvements at this point, it may be working. If, after four weeks, there is no difference, consider trying another brand for another four weeks. Some people take probiotics in the form of fermented milk drinks or yoghurts, but you can also get them as capsules or tablets. TOP TIPS TO RELIEVE CONSTIPATION Always have breakfast Breakfast is a great time to start the day s intake of fibre. People who skip breakfast are more likely to have low fibre intake compared to those who do eat breakfast. Go for a high fibre breakfast cereal look for cereals with 6 g of fibre per 100 g of cereal or more. You can also choose wholegrain bread or toast. Add seeds All kinds of seeds are high in fibre. You can try them whole or milled. Aim to get 2 tablespoons of seeds every day. Add them to breakfast cereals, yoghurt, soups, homemade bread, or sprinkle them over salads. Important note! If you have diverticular disease, only consume seeds and nuts that have been milled or ground. 7

9 Increase your vegetables Have soup or salad at lunchtime and a lot of vegetables at dinnertime. Frozen vegetables are just as good as fresh and are cheap and quick to prepare. Eat fruit A piece of fruit provides about 2 g of fibre. Aim to have 2 3 pieces of fruit everyday this can add 4 6 g of fibre to your diet. Try slicing a banana over your breakfast cereal, chopping an apple into a salad, or just enjoy an orange or a pear as a mid-afternoon snack. Choose wholegrain over white Although white bread and pasta do have some fibre, you can really boost your fibre by switching to wholegrain instead. Wholegrain does not just provide fibre, it also protects against heart disease and some types of cancer. TOP TIPS TO RELIEVE DIARRHOEA Make sure to stay hydrated; Try to avoid having very high fibre foods such as wholegrain breads and cereals; Limit caffeine intake from tea and coffee to no more than three drinks per day; Avoid sugar-free sweets, chewing gum and foods containing sorbitol, mannitol or xylitol. It is important to pay attention to your bowel health. If you are worried in any way, experience a change in your bowel habits, or pass dark stools or blood, consult your doctor. 8

DIETARY ADVICE FOR CONSTIPATION

Leicestershire Nutrition and Dietetic Services DIETARY ADVICE FOR CONSTIPATION What is constipation? Constipation is one of the most common digestive complaints and it can affect people of all ages. Bowel