Interview With Nutritionist Alexandria Hardy, Part 1

Alexandria Hardy webinar header

Read part 2 of her interview here.

Can you tell us a little bit about your background and how you got to where you are?

“I have been a registered dietician for about 15 years now, and I have had the privilege of getting to work in a number of different settings. My first job right out of school, my internship, was in clinical research, which is never a place I thought I would see myself, and I ended up loving it… I fell in love with the population that I was working with, which was primarily underserved individuals who were willing to sign up to get some additional healthcare benefits. And then also individuals who were diagnosed specifically with Type 2 diabetes later in life.

That was a really fun population for me to learn how to communicate with some of these older adults and try to figure out, what do they know, and what do they not know? And what I discovered was that they were extremely receptive to new information and really had a lot of desire to change some of their current eating habits because they had a lot of motivation to live well in the last third of their lives.”

With the webinar this month, can you give us a preview of what you’re going to be discussing, what people can expect, and what they should be looking forward to when they sign up?

“I’m hoping to cover a lot of material at a high level. And so the objectives for the webinar are going to be looking at the healthy eating and the healthy aging index, and just briefly explaining what those are and why those tools are helpful.

Also, looking at how dietary needs change as we age, specifically once we hit that 60, 65 mark, and talking a little bit about fat, protein, carbohydrate and fluid intakes, and then touching on some of the nutrients of concern, which are identified by the dietary guidelines and going through those.

And then we’ll end with, what does this look like? Big picture, it’s great to talk about fat and carbs and protein, but how does that translate when I’m actually shopping and cooking and eating? And so looking at a couple of different diet patterns like the Nordic diet and the Mediterranean diet that are proven over and over again through research to just support healthy and vibrant aging.”

You mentioned earlier older adults being ready to change some of their habits. A lot of people, when they think of seniors, they think of people who are set in their ways and don’t want to change. Can you talk a little bit more about that and what that process is like for you, and what you see from seniors in that regard?

“Of course you’ll find someone every now and then that is, ‘I’ve eaten meat and potatoes all my life and I’ve had three sodas a day and that’s how it’s going to go.’ But I do think especially in the age of social media and information that is so easy to access, it’s really easy, especially for younger generations, like my generation included, to think that we are experts at everything.

Millennials are not always the easiest to connect with in that way, or maybe they’re not quite as receptive to change, where I feel like older adults are humble enough to realize, ‘Hey, there are some things that I don’t know, or maybe I did this and it worked really well for me for two decades, but now I’m 67 and I’ve gotten a diagnosis and I really don’t know how to handle it. But my doctor is saying maybe if I change some of my protein intake or I worked on upping my fluids, that would help.’

And I find at least, especially with some of the patients that I work with, they’re really motivated by their families. Maybe their grandkids are involved, maybe they’re moving into a stage of life where they’re retiring and they want these years to be great years. They’ve looked forward to this for a really long time, and they want to be healthy, they want to be vibrant, they want to be thriving.”

What are some common misconceptions about nutrition as we age?

“I think the main one that I’m seeing is that people think the nutrition needs that you had when you were in your 40s and your 50s are going to be the same ones in your 60s, and that’s just not true.

As our bodies change, not only does our metabolism slow down, but our bone mass starts to recede. Our muscle mass typically decreases, which means that fat mass is increasing. Sleep hygiene and all of our sleep needs are changing.

And so it sounds so common sense, but sometimes we don’t think to tweak our intake… It’s often really difficult for older adults to meet fluid needs because they’re not used to either carrying around a big Stanley bottle of water throughout the day. Maybe they have some mobility issues, and for them it’s difficult to twist on and off a top of a bottle or to carry around a heavy water jug.

And so coming up with some really creative ways for them to boost that fluid, maybe through soups or increasing fruits and vegetables to help meet some of those needs is also key.”

You mentioned mobility, what are some other issues that seniors commonly face when it comes to challenges they might have meeting their nutritional needs, even if they want to?

“Budget is a big one, because sometimes people are living on a fixed income. And then also depending on where seniors are living, whether that is the home that they have been in for 20, 30, 40 years or if they’ve had to make a shift, maybe they’re living with a family member now, maybe they’re living in an assisted living community, maybe they’re not the ones in charge of preparing their meals anymore.

So that can also be a struggle, maybe that sense of autonomy and independence that they once had isn’t there. And I know some clients that I work with, they don’t always want to ask their caregivers, especially if it’s their adult children, to purchase specific things for them at the store. And so they’re kind of at the mercy of a new pattern of eating, maybe even new times that they’re eating during the day. And that doesn’t always fit well with either maybe preferences, but then also medication needs.”

What are some things that family members and caregivers can look for in their loved ones as far as making sure that they’re meeting their nutritional needs?

“Just checking in and asking. My grandmother lived alone until she passed at 97, and every day my family members would go over and check in and she would often say, ‘Oh, I’m eating. I’m fine. I have enough.’ But then you would look in the refrigerator, in the pantry and there was no new food coming in, especially once she was relying on other people to bring those groceries in for her.

People don’t always like to ask for help, especially when there’s a financial piece related there. And so asking, but then also just looking around and checking to see, is this an environment where they can safely prepare food? Are the knives sharp enough that they’re not going to slip if they’re chopping something and cut themselves? Do they have cutting boards that are non-stick that aren’t going to move around on the counter when they’re putting a vegetable or fruit down to cut?

Even the refrigerator and the freezer: are they set at the correct temperatures? Are they clean? Because those are things, especially with mobility issues, a lot of seniors aren’t going to get down on their hands and knees and clean out a produce drawer, or they might not catch a spill from the condiments or something like that. And you don’t want that dripping down onto healthier foods or fresh foods.”

On a day-to-day basis, or as people are doing some meal planning, what are some nutritional basics that seniors need to keep in mind as they’re looking ahead?

“A website that is very basic, but that I always love to recommend is just myplate.gov. It’s a great feature because it’s so simple, and I use it with kids too, but it’s just got your five food groups in a plate, and it’s just a great visual check to see, okay, at breakfast today, did I get at least two of these food groups?

Because it’s not realistic to expect that anyone’s going to be getting all five at every food group, especially a senior who might be eating smaller portions more frequently throughout the day or might be snacking a little bit more to help meet needs. But that can be a great way for them just to look and think, okay, maybe protein is something that the doctor has recommended that I really need to work on increasing. And so trying to get a protein in at every single meal, whether that’s eggs or if it’s nuts, if we don’t have any dentition issues, if that’s yogurt, cottage cheese, whether that’s meat, something like that could be really helpful.”

Reminder: Sign up today for the webinar we’re hosting January 25 with Alexandria!