According to the Canadian Digestive Health Foundation, more than 20 million Canadians suffer from some form of digestive disorder every year. Even though many people are being diagnosed and treated for bowel disorders, the magnitude of the problem is likely underestimated because few people speak openly about their digestive symptoms. One of the most common age-related changes seen as people enter into their 60s and 70s are a change in bowel habits, specifically more constipation. It has been estimated that nearly 1 in 2 adults over the age of 80 suffer from constipation
Digestive Disorder Symptoms:
- difficulty passing stool
- painful and infrequent bowel movements
- hard/dry stool
There are a number of age-related factors that can cause constipation as people age. For example, the muscle contractions that move food through the digestive system slow down because there is a decrease in smooth muscle tone, causing food to move more slowly through the colon. Many prescription medications and supplements cause constipation as a side-effect. The metabolic abnormalities seen in older adults with multiple health conditions and disease states also cause digestive symptoms. For example, diabetes, stroke, dementia and depression are commonly associated with constipation. Decreased physical activity and mobility, lower fibre intake and limited fluid intake also lead to chronic constipation.
Management of constipation should begin with dietary and lifestyle modification strategies. Fibre is the most important component of food affecting digestive health, yet most people are getting less than half of the recommended amount. Health Canada recommends a daily intake of 21 to 38 grams of fibre for adults, but the average Canadian intake is about 14 grams. With such a low daily intake, it is not at all surprising that so many people suffer from constipation. What exactly is fibre? Fibre is a carbohydrate found in plants. But unlike other carbohydrates, it passes through the body undigested. This helps to keep food moving efficiently through the body, helping promote regularity. Fibre is found in a variety of vegetables, fruits, grains and legumes.
Ways to Increase Fibre in the Diet
|Low Fibre Foods||Amount of Fibre (g)||Amount of Fibre (g)||High Fibre Foods|
|Rice Krispies (1 c)||0.0||5.0||Bran Flakes (1/2 c)|
|1 slice white toast||0.9||3.2||1 slice whole wheat toast|
|Orange juice (1/2 c)||0.3||3.1||1 orange|
|Mashed potato (1/2 c)||1.6||4.0||1 baked potato with skin|
|1 apple||2.6||5.0||1 pear|
|4 Melba toast crackers||1.3||2.5||½ whole wheat pita|
|TOTAL||6.7 g||22.8 g||TOTAL|
Increasing the amount of fibre on the menu in your facility can be done easily by making small changes that will add up throughout the day. For example, try including more whole grains on your menu. This can be done by switching white bread, pasta and rice to whole wheat bread and pasta, and brown rice. You can increase the amount of fibre at breakfast by adding prunes or prune juice to the meal. Adding bran or flax to hot cereals is a way to increase the amount of fibre at breakfast without any major changes in taste. Beans and legumes are not always popular choices with residents but they are packed with fibre. Try adding beans or lentils to soups and stews. Residents are less likely to complain about legumes when they are adding to mixed dishes. You can also try using beans or chickpea flour to thicken soups and vegetables instead of using cornstarch for pureed textures. These are a few examples to get you started. Keep in mind it may take several menu cycles to gradually increase fibre on your menu.