What’s to Eat?

By Christine Eggers, Appeal to Heaven

These are observations of 35 years in nursing and are not a scientific discovery. 

When I took the Wound Care Certification course, I was surprised to learn that increased protein is not recommended. Carbohydrates are the wood for our metabolic fires. Replacing carbs with proteins causes our bodies to breakdown our skeletal muscles for fuel. This is the goal for weight loss or if you’re an athlete, but for a person with a large wound, chronic or life-threatening disease, or advanced age, this diet is counterproductive.

The only fuel any cell can burn is glucose. Remember those commercials about being “hangry”? The combination of hungry and angry? We become more irritable, confused, forgetful, and anxious when our brain cells are hungry. We feel weak and shaky when our muscles are hungry. Muscles are then broken down to manufacture glucose. That action increases the nitrogen from urea, (BUN) in our bloodstream, which can affect our ability to think clearly. Muscle breakdown leads to “deconditioning,” manifested in frailty and falls.  

What I finally recognized through a sentinel event is that carbohydrates are beneficial for the elderly and infirm. From nursing home residents who lived several years on ice cream, to a live-at-home client who was near death from self-neglect and, months later, after eating mostly mass-produced baked goods, had regained 20+ lbs., the strength to transfer and soon was walking independently. 

Food is tied to identity and culture. Which makes dietary changes very difficult. We’ve also tied food to health and morality.  “Good” people take care of themselves through “healthy” eating, “bad” people don’t. We judge food the same way we judge “medicine” vs. “drugs.” Swiss chard is medicine, Swiss Rolls are drugs. After decades of virtuous eating, it is hard to abandon rice cakes for cupcakes.   

I have used these observations with new clients who were “eating healthy” all the while their strength, mobility, memory, mood, and ability to remain at home declined. I switched them to “high-calorie” supplements or whole/chocolate milk.  I encouraged calorie-dense baked goods, and the results have been positive.  

Clients who have been unwilling or unable to make changes have not improved.  They have not regained lost weight and have continued to struggle with forgetfulness, confusion, weakness, and anxiety, even falls, and are on track to moving to residential care. 

I have also noted rapid, short-term improvement when clients who are befuddled, anxious, or weak are provided high-calorie snacks, like milk and cookies. 

We need different diets during different times of our lives. I encourage my clients to adopt a high-carb diet because I have seen improvement in the issues that are of the most concern to them. If your clothes are getting loose, if you’re weak or unsteady, if you’re more forgetful or anxious, give it a try. It isn’t necessarily about extending an already long life, but extending physical and mental independence.  

Christine Eggers RN is the owner of Appeal to Heaven LLC the Independent Nurses’ Network, bringing assisted living services into private homes since 2014.