Nutrition and Dementia

The type of food we eat affects our health and our quality of life. Poorly nourished people get sick more often and recover from injury and illness more slowly. Poor nutrition is a major health problem for many older people.

For people with dementia, maintaining good nutrition presents extra challenges. A person with dementia may:

  • Experience a loss of appetite
  • Develop an insatiable appetite or a craving for sweets
  • Forget to eat and drink
  • Forget how to chew or swallow
  • Experience a dry mouth, or mouth discomfort
  • Be unable to recognise the food and drink they are given

Daily nutritional balance

The nutritional requirements of someone with dementia will be similar to other people of their age. However some people with dementia experience increased physical activity such as pacing, which means they will need larger amounts of food to prevent them from losing weight.

Common nutritional problems

Forgetting to eat

What to try

  • An alarm clock, or a phone call, may be a useful reminder at mealtimes
  • Snacks that are easy to eat and don’t need to be refrigerated can be left out where they can be easily seen

Can’t or won’t prepare meals for themselves

It can be particularly difficult for people with dementia who are living alone when they  can’t or won’t prepare meals for themselves.

What to try

  • Meals should be shared social occasions whenever possible
  • Delivered meals such as meals-on-wheels. However these may not provide all of a person’s daily nutritional needs or may not be what the person is used to eating
  • Home support to assist with meal preparation, serving and to discretely prompt with eating
  • Pre-prepared meals from the supermarket
  • Family and friends helping to prepare meals and or eating together
  • Preparing large quantities of food, then freezing into meal size amounts
  • Home delivered ready-to-eat food from restaurants or fast food outlets
  • Eating out. However check first that the person with dementia will be comfortable with the venue and food
  • Stocking up on healthy snacks such as yoghurt, cheese or dried fruit that do not need preparation or cooking



Adolescents and nutrition

One for the teenagers in your lives.

As your body is still growing, it’s vital that you eat enough good quality food and the right kinds to meet your energy and nutrition needs.

Being a teenager can be fun, but it can also be difficult as your body shape changes. These physical changes can be hard to deal with if they aren’t what you are expecting. There can be pressure from friends to be or look a certain way, and this might affect the foods you eat. It’s not a good time to crash diet, as you won’t get enough nutrients, and you may not reach your full potential. Following a sensible, well-balanced diet is a much better option, both for now and in the long term.

What should I eat

Eating three regular meals a day with some snacks will help you meet your nutrition needs. Skipping meals means you will miss out on vitamins, minerals and carbohydrates, which can leave you lacking energy or finding it hard to concentrate.

  1. Breads, grains and cereals are carbohydrates that provide energy for your brain and muscles. They’re also an excellent source of fibre and B vitamins. Without enough carbohydrates you may feel tired and run down. Try to include some carbohydrates at each mealtime.
  2. Fruit and vegetables have lots of vitamins and minerals which help boost your immune system and keep you from getting sick. They’re also very important for healthy skin and eyes. It’s recommended you eat two serves of fruit and five serves of vegetables a day.
  3. Meat, chicken, fish, eggs, nuts and legumes (e.g. beans and lentils) are good sources of iron and protein. Iron is needed to make red blood cells, which carry oxygen around your body. During your teenage years, you’ll start to menstruate, or get your period, and this leads to loss of iron. If you don’t get enough iron, you can develop anaemia, a condition that can make you feel tired and light-headed and short of breath. Protein is needed for growth and to keep your muscles healthy. Not eating enough protein when you are still growing, or going through puberty, can lead to delayed or stunted height and weight. Not enough protein is common when you go on strict diets. Include meat, chicken, fish or eggs in your diet at least twice a day. Fish is important for your brain, eyes and skin. Try to eat fish 2 to 3 times a week.

    If you are vegetarian or vegan and do not eat meat, there are other ways to meet your iron needs, for example, with foods like baked beans, pulses, lentils, nuts and seeds.

  4. Dairy foods like milk, cheese and yogurt help to build bones and teeth and keep your heart, muscles and nerves working properly. You’ll need three and a half serves of dairy food a day to meet your needs.
  5. Eating too much fat and oil can result in you putting on weight. Try to use oils in small amounts for cooking or salad dressings. Other high-fat foods like chocolate, chips, cakes and fried foods can increase your weight without giving your body many nutrients.
  6. Fluids are also an important part of your diet. Drink water to keep hydrated, so you won’t feel so tired or thirsty. It can also help to prevent constipation.






Choose your supplements wisely

Bio-availability refers to the bodies ability to absorb and use a particular substance or nutrient.

Vitamins and minerals are manufactured from either ‘organic’ or ‘inorganic’ materials.  Minerals in the form of sulphates, oxides, carbonates or artificial chelates are  inorganic, meaning they  rarely occur naturally in the plant or animal kingdoms.  Minerals in the form of  gluconates, phosphates, citrates, lactates are called ‘organic’ minerals because they do occur in  the plant and animal kingdoms.  Organic mineral forms are believed to be absorbed  easier by the body.


One example can be seen in the supplement calcium, in 1987 Maryland University carried out a study to investigate the different forms of calcium  and absorption since it already had been determined that the solubility of many calcium salts, depends on pH, the type of salt used, the condition of the patient and the time of administration.

Previously it was assumed that all calcium supplements were equal, as long as the amount of calcium in each supplement was the same, however it was found that calcium must be in the form of ions to be absorbed. As with many salts the solubility depends upon the pH of the solution its dissolving in.  To be of use in the body first the tablet must disintegrate, It was found that some tablets had coatings on “enteric-coated” that were insoluble in acid, these coatings are of use to other supplements where the disintegration is needed further down the digestion track, or packed too tightly together ‘bed pan bullets’  (The standard laboratory test for disintegration (part of the test known as the United States Pharmacopeia [USP] “Disintegration and Dissolution of Dietary Supplements” method <2040>), is an important test of product quality, although passing this test alone does not assure bioavailability). The research also found that calcium carbonate and calcium phosphate dissolved well at a pH of 1.01(very acidic) but their solubility reduced as pH increased, the average stomach acid  pH of a human is 1.5-3.5, therefore for bioavailability calcium citrate and calcium lactate are better forms.

Susan has a practitioner account with Natural Dispensary where she can offer her clients a 10% discount off their price list.   If you want to discuss any of your supplements, please contact Susan.







Soup is a great way to add additional veg to your diet, and fresh soup tastes far superior than tinned versions and healthier since you control any added salt and sugar.  Soups that are blended down are a great way of hiding veg, and if you slowly add vegetables that you don’t like to a soup you do like, you can slowly retrain your taste buds to like (or at least tolerate) the new foods

Stoup is another version of soup but with really chunky veg, one of Susan’s favourite is from River cottage- ‘much more veg’  a fragrant veg stoup.  This filling stoup is around 339 calories per portion, 105% of vitamin A and 53% of vitamin C and a good 26% of fibre.

There are many tasty soup recipes but many come with a long list of ingredients which puts people off, for a treat Susan purchased a soup recipe bag which came with all the ingredients apart from oil and water, and with many spices involved in this soup, it saves purchasing many different spices.  The soup bags change on a weekly basis and Susan tried their Indian Cauliflower and spinach soup – though the consistency is more of a stoup.  It was a very tasty soup, with the spicy heat not too overpowering. At around 140 calories per portion its more of a light lunch, and with two grown lads Susan would probably add a tin of chickpeas in future to make it more filling. The tomato haters in the family didn’t realise there was chopped tomato on their bowl.    A bowl provides 13% of your daily iron and 15% of your daily potassium, low in carbohydrates and 48% of your daily fibre requirements.


weight loss

How sleep can keep you reaching for the junk food

Everything about the human body is interconnected and eating habits are no different. Sleep plays an important role in not only what you eat but how much and when you eat it.

Lack of Sleep Changes Your Hormones

We get our energy from sleep or from food. People who get less sleep tend to snack on high-fat, carbohydrate-rich foods, possibly looking for the energy that they didn’t get from sleep the night before.

When you don’t get enough sleep, your hunger and satiety (fullness) hormones, including leptin and ghrelin get released in different amounts, making you more hungry and less full!

Sleep Gives You the Advantage

Getting adequate sleep 7-9 hours per night for adults, lets you work with your body rather than against it. Stress, long work hours, family obligations, an uncomfortable mattress, and insomnia are only a few of life’s challenges that may get in your way of a good night’s rest.

Here are 4 simple steps you can take to promote good sleep hygiene and get a more restful sleep:

· Turn off the screen. Televisions, laptops, e-readers, and smartphones all give off light that can interfere with your natural sleep cycle. Shut off the screens an hour before you want to go to bed to help your body recognise that it’s night-time and it should be preparing for sleep.

· Limit caffeine and alcohol. While some may believe alcohol can help you sleep, it changes your body’s sleep patterns and can lead to wakefulness. Try to avoid caffeine after lunch and alcohol at least four hours before bedtime.

· Create a bedtime routine. Help set your circadian rhythms with a relaxing bedtime routine. Read a book (not on a screen), try some gentle meditation or yoga, or take a warm bath to help relax your mind and body. As you do your routine regularly, your body recognises when it’s time to prepare itself for resting. If you find yourself dreading bedtime because you feel discomfort or pain in bed, it might be time for a new mattress.

· Go to bed at the same time every day. Try to keep the same sleep schedule every day of the week. Your body prepares to sleep and wake up long before you do. A regular bedtime helps it stay on track, which in turn helps you in your quest for a healthy lifestyle.


weight loss

Are you an emotional overeater?

Do you spend all day eating well but comfort eat when you get home? Do you eat healthily during the week but overeat on the weekend? 

You can’t just adopt more willpower to stop emotional or binge eating. Here are some of my favourite tips to stop emotional and binge eating.

1. Give yourself permission to eat the foods you want to eat.

When you don’t give yourself permission to eat certain foods, you’ll feel the need to eat that food in private, in excess and as quickly as possible in case you never get to eat it again.

When your body trusts that you aren’t being deprived, you will stop emotional eating and no longer feel the need to binge on this food.

2. Stop judging food.

Avoid referring to food as ‘good’ or ‘bad’.

When you ‘try to be good’ and avoid fattening or ‘bad’ foods, you’re only setting yourself up for more emotional and binge eating.

Feeling guilty or getting angry with yourself for overeating will only cause you to binge more – not less.

You can’t shame yourself into bingeing less.

3. Eat treats in front of other people.

Avoiding ‘bad’ foods in front of other people will only cause you to binge on them later in private.

To stop emotional eating, give yourself permission to eat your trigger foods in public.

That means order the peanut butter on toast at a café, say yes to the dessert when offered and grab an ice cream with a pal.

4. Do not eat in front of the TV.

When you eat in front of the TV, you condition your body to get hungry and feel like eating when you turn on the television.

Never eat in front of the TV or any screen, and eat. Give yourself permission to eat – and watch TV, but not at the same time.

5. Stop striving for weight loss.

Ironically, aiming to lose weight will prevent you from reaching your goals.

Shift your focus from trying to lose weight to building a healthy relationship with food.

Because when you have a healthy relationship with food – you’ll stop emotional and binge eating and your body will naturally find it’s healthiest weight.

6. See each binge as an opportunity to learn.

A binge is not a failure it’s simply your body’s way of trying to get your attention and tell you something.

Feeling guilty, angry and promising to ‘get healthy tomorrow’ will make you restrict again, causing another binge.

Stop fighting against your body and learn to listen to what it’s trying to say. This is the only way to stop emotional and binge eating.

7. Get extra support to stop emotional eating

It’s tough to stop emotional and binge eating without support.

You don’t need to ‘just try harder’ – you need to try something different.


If you want a personalised diet plan, please contact Susan for further information.




weight loss

Calories versus nutritional intake

Many people on diets when they are trying to lose weight, think about low-fat foods rather than the nutritional value of the foods they are consuming.  Some then may consume large amounts of these foods, because they may be ‘free’ on their particular diet plan, or they perceive them to be heathy, though these foods may not always be the best choice

When just calorie counting, because high fat food are calorie dense they are often avoided,  and you could end up eating a very nutritionally poor diet and even become malnourished, especially if you live on a low-fat diet for long periods of time, and take no additional supplements or minerals. The government recommended 2000 Calories for women is based on nutritional need as well as energy.

Some vitamins are fat soluble in particular A, D, E and  K, and foods that are high sources of these vitamins are often avoided in those following a low-fat diet, and small amounts of theses vitamins are required in the diet to promote growth, reproduction, and health.

Vitamin A – It occurs naturally only in foods of animal origin, such as liver, butter, whole milk, and egg yolks, but the body converts certain carotenoids (found in some fruit and vegetables), especially β-carotene, to vitamin A.

Vitamin D –  occurs naturally only in animal foods such as liver, butter, fatty fish (fish containing high levels of cholesterol or fatty acids as glycerides), and egg yolks. It is also synthesised in the body from sunlight. Vitamin D is essential for bone health since it serves to maintain serum calcium concentrations, which in turn influence bone mineralization.

Vitamin E  –  is an important antioxidant that is thought to protect polyunsaturated fatty acids from oxidative destruction in cell membranes. Vegetable oils are the richest source of vitamin E. Other good sources include nuts, seeds, whole grains, and wheat germ.

Vitamin K  – is needed in the liver for formation of several blood clotting factors. Larger amounts of vitamin K are present in dark-green leafy vegetables; lower levels are found in cereals, dairy products, meats, and fruits.

Yogurt itself is a nutritional powerhouse as part of a balanced diet,  yogurt can be a great source of protein, calcium, iodine and vitamin B12. Fermented dairy products have long been considered to be beneficial to digestive health, and yogurt has even been associated with lower risk of obesity and cardio metabolic risk in both children and adults. Natural, ‘plain’ and Greek-style yogurts were found to have a dramatically different nutrient profile from all other types of yogurt, containing much higher levels of protein, lower carbohydrates level and the least amount of sugar, with the average of five grams per 100g, largely made up of naturally occurring lactose.

Take a look at three yogurts, first a low-fat fruit yogurt.  It’s virtually fat-free, provides a good amount of calcium, but if your diet is lacking in vitamin D you won’t see the benefit. Per 100g of this product 7.1g is labelled as sugar, the source of this sugar does not have to be separated so this level will be spread between milk sugar (Lactose), the added strawberries (10% of product), and the added fructose.  A full fat plain yogurt with nothing added tends to have around 4.7g-5g of sugar per 100g, so this low fat yoghurt has over 2g of added sugar per 100g (a pot being 175g), very little of this will be from the strawberry, with the remaining added as fructose and to ensure a sweet tasting product added aspartame. The danger arises when individuals see these as healthy alternatives, they may have 1, 2 or even more per day, but with each pot containing the equivalent of around 1 teaspoon of added sugar, this can soon add up.

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A full fat organic strawberry yogurt, is nearly 100% more calories per 100g, and has 4% fat, with similar protein levels and over 3g more sugar, than a low-fat version. The fat content will help you stay fuller for longer so long-term you may only need one yogurt rather than three, and the fat will contain vitamin D to help you absorb the calcium.  This strawberry yogurt product is honest and specifies they add 4.9% of sugar per per 100g, but many do not ,they just state added sugars just total sugars, making you believe that the sugars are from fruit and therefore healthy. This yogurt is served in 100g portions so not as bad as you may think.

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The third option plain greek yogurt and add your own fruit, nuts, seed, no need to add any additional sugar.

Below, shows that a 100g of greek yogurt with 4 strawberries and 1/2 tablespoon of pumpkins seeds, this is 2g less sugar than the low fat version, but will have more strawberries, and added protein, it also gives you a little fibre. This is a higher fat and calorie version but the fat should help you to feel fuller for longer, making it a suitable breakfast. Greek Yogurts tend to be lower in lactose and higher in protein than other yogurts, but make sure you read the labels since some manufacturers add thickening agents to regular yogurt, and market it as “Greek-style” yogurt, which may not share the same health benefits as Greek yogurt.

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The three strawberry yogurts compared based on their serving size:-

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weight loss

Malnutrition in the elderly

Recent research has shown an increase in malnutrition in the elderly. Poor nutritional status and malnutrition in the elderly population are important areas of concern. Malnutrition and unintentional weight loss contribute to progressive decline in health, reduced physical and cognitive functional status, increased utilisation of health care services, premature institutionalisation, and increased mortality.

One in ten adults over the age of 65 are malnourished or at risk of being malnourished , with over 90% of these individuals living independently. Malnutrition is often due to one or more of the following factors: inadequate food intake; food choices that lead to dietary deficiencies; and illness that causes increased nutrient requirements, increased nutrient loss, poor nutrient absorption, or a combination of these factors.

When financial concerns are present, meals are often skipped and food that is purchased may not provide a nutritionally adequate diet. Declines in functional status both physical and cognitive, affect a person’s ability to shop for food and to prepare meals.

Nutritional problems are further compromised by inadequate social support networks and by the resultant social isolation, which commonly leads to apathy about food and therefore decreased intake. Late life can be a time of multiple losses. The older person has experienced change and loss through retirement, disability and death of friends and family as well as change in financial, social, and physical health status. These changes may lead to depression, a well-known cause of anorexia and weight loss. Even transient depressed mood (as with bereavement) can cause clinically significant weight loss.

Dehydration is common among older people and especially older people with dementia. People may not recognise they are thirsty, may forget to drink, may be unable to communicate that they are thirsty, or may refuse to drink because they are worried about incontinence.

Dehydration can cause headaches, confusion, irritability, falls, loss of appetite and constipation which can contribute to urinary tract infections – and these infections in turn can lead to incontinence. Older people who are incontinent need to drink more, not less, in order to encourage the bladder to empty regularly to prevent infection and to exercise the bladder muscles.

How can you help an elderly relative or neighbour?

If you have significant concerns with any sudden weight loss or other symptoms try and see if the individual would see their GP for a health check up.  An online screening tool is available which looks at the individuals weight now and three months ago to determine risk.

  • Having small, nutritious meals more often across the day can help if people have a poor appetite
  • Make sure drinks given between meals offer nutrients as well – for example, milky drinks, fresh fruit juices and smoothies
  • Make available nutritious snacks that the person can eat while moving around, for example some individuals with dementia pace around constantly and have high energy needs. Finger foods can be left out on the route that the older person may take when they wander.
  • It is important to remember that older people need to eat good food whatever their weight, and that overweight people can be under-nourished too, if they don’t get enough nutrients.
  • Ensure they stay hydrated, this can be from drinks such as tea, coffee, water, milk, fruit juice and smoothies and via the food they eat, soups, stews, fruit and vegetables, ice cream and yoghurt.
  • Older people with dementia may choose sweet foods over savoury ones and it has been shown that a craving for sweet foods is part of the clinical syndrome for dementia at some stages. If people eat only sweet foods – for example, if they just eat desserts – they will not get all the nutrients they need. However, it can be useful to add some sweet ingredients to dishes, to encourage people to eat a range of foods – for example, adding sweet apricots to a meat dish, adding fruit to salads and snacks, adding honey to porridge or milky puddings, or adding jam to peanut butter sandwiches, might encourage the person to eat the food and also make a useful contribution to nutrient intake.

If you want a personalised assessment of yours or a relative current diet and a weeks meal plan please contact Susan.










Mediterranean diet

Susan has returned from a lovely week in Crete, the original home of the Mediterranean diet, this diet has been researched for many years and has shown many positive effects for health.

For thousands of years Cretans have eaten only what their land produced – which was lots of fruits, vegetables, olives, whole grains and pulses.  Cretans consume a great deal of olive oil, significantly more than any other Mediterranean people and they don’t use any other type of oil. Todays diet can not be exactly replicated since lifestyles have changed since the 1950’s.


Fat makes up about 35%-40% of daily calories in the Cretan diet. Cretans get their fat from olive oil and olives instead of butter, meat and other oils .

Cretans ate more fruit than any of the other Mediterranean countries and much more than other countries in the study

The average Cretan consumed 9-12 servings of fruits and vegetables each day compared to the current USDA recommendations of about 4.5 servings combined. Wild Greens were popular during the study but are very hard to find now.

The main grains consumed were the whole grains barley and wheat in the form of bread, rolls and rusk. Bread was typically made from all barley or a combination of barley and wheat, rusks from a barley and wheat mixture, Bread was eaten daily (usually with lots of olive oil).

Pulses – Were consumed about 3 times per week

Nuts – Nuts consumed in Crete are most often almonds, hazelnuts, chestnuts and walnuts.

Eggs – While eggs were not a huge part of the Cretan diet, they did consume 2-3 eggs a week. The biggest difference is that the chickens that produced the eggs were all free-range chickens that instead of eating grains like chickens in the US, lived on figs, grasses, insects, worms and purslane. This not only made the chickens healthier, but meant that the eggs are excellent sources of omega-3 fatty acids

Fish and chicken is eaten a few times a week with red meat saved for special occasions.

Food is flavoured with lots of herbs, all vegetables we ate were flavoured with herbs, as with the fish. Meat portions were small, and lots of vegetable were available – The hotel made the tastiest courgette Ive ever tasted, and tomato grown in the sun tastes so different than ones grown in a green house.

Susan was there for only 6 days, having a breakfast of Greek Yoghurt and fruit, followed by a small meat free cooked breakfast. Evening meal always started with a large selection of salad, with some feta cheese. Main meal fish and vegetables and potato cooked in olive oil, since she was on holiday she did try the delicious deserts. Midday snack my sons favourite, frozen greek yoghurt with strawberries and kiwi (highly recommend Andriani’s Homemade Ice and Frozen Yoghurt) and came back 1llb lighter, I never went hungry and felt really nourished. Susan will certainly will be eating this way more at home.