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Ailing may need more calories and nutrients


I had lunch the other day with a friend who, at 78, is bright, charming and articulate. Like most of us, he is still 16 in his heart and determined to enjoy every moment of his life to the fullest. He is also waging war against progressive paralysis and crippling arthritis.

These conditions, like many other illnesses, have neither a nutritional cause nor cure. They do, however, create a nutritional problem.

People with such limiting conditions find it especially difficult to shop for food and to prepare and eat meals. They struggle to open cans and packaging, have a hard time holding a knife and fork and have difficulty chewing and swallowing food. Meals become a chore and many fall prey to the "tea and toast syndrome," that is, eating only small amounts of the least nutritious foods. Unplanned weight loss, a warning sign of malnutrition, follows.

And studies do show a high incidence of malnutrition among older arthritis sufferers. Consequently, they have more illnesses, greater loss of body function and more hospitalizations than their friends who are eating well.

To halt this downward spiral and get more pleasure out of life, eat more and eat better. Let these ideas guide your food choices:

* Eat calorie-dense foods. Choose substantial soups like bean, potato, split pea, tomato or creamed soups instead of broth-based soups. Adjust the thickness by adding evaporated skim milk or half and half.

Select high-starch vegetables like potatoes, yams, avocado, butternut squash, creamed corn and carrots. Serve whipped with milk or glazed with brown sugar.

Choose dense cereals like oatmeal or cream of wheat instead of fluffy flakes. Add a banana during cooking. Thin with milk.

* Have fish more often. There is some evidence that omega-3 fatty acids found in oily fish help reduce the swelling and pain of rheumatoid arthritis. Salmon, anchovy, mackerel, sardines and bluefish are especially rich sources and are tender and moist when cooked gently. Make salmon into croquettes.

* Add a sauce. If you suffer from dry mouth or swallowing difficulty, add a sauce. Use applesauce, apple butter or pear butter on breads, rolls or pancakes.

Add white sauce, barbecue sauce or gravy to cooked ground beef, chicken, turkey, lamb or pork.

Dress fish with lemon sauce.

Moisten vegetables and potatoes with white sauce, curry sauce or creamed corn.

* Eat your fruits and vegetables. If fresh fruits and vegetables are too hard, switch to canned. Their softer texture makes them easier to eat, and they do provide a little fiber and some vitamins and minerals.

* Have nutrient-dense desserts

Try custard, rice pudding or bread pudding served with ice milk, instead of eating cookies or cake. If cholesterol is a problem, use egg substitute and evaporated skim milk.

Colleen Pierre, a registered dietitian, is the nutrition consultant to the Union Memorial Sports Medicine Center in Baltimore.

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