Monthly Archives: November 2020

Vegetarian and vegan diet: five things for over-65s to consider when switching to a plant-based diet

Vegetarian and vegan diet: five things for over-65s to consider when switching to a plant-based diet

Plant-based protein sources.
A well-planned, plant-based diet can support good health at every age. Tatjana Baibakova/ Shutterstock

Plant-based diets continue to grow in popularity, worldwide. There are plenty of reasons people switch to a plant-based diet, including ethical and environmental reasons. However, a growing number of people are shunning meat for health reasons. Evidence shows that plant-based diets may help support the immune system, lower the risk of heart disease and stroke, and may be good for overall health.

While a well-planned plant-based diet can support healthy living in people of all ages, our nutritional needs change with different life stages, so people over the age of 65 may need to take more care when opting for a plant-based diet. They may have specific nutritional needs and may need certain nutrients, vitamins and minerals to stay healthy.

Here are some things over-65s may want to consider when switching to a plant-based diet:

1. Eat enough protein

Older adults need more protein compared to the general adult population in order to preserve lean body mass, body function and good health. While most adults only need around 0.75g of protein per kilogram of body weight a day, it’s recommended that healthy older adults should increase their daily protein intake to 1.0-1.2g per kilogram of body weight. This is even higher for older adults who are malnourished or have a severe illness, as these conditions trigger a hypermetabolic state, where the body needs more energy and protein to function.

To ensure adequate protein intake, make sure meals and snacks contain plant-based proteins, such as chickpeas, tofu, black-eyed beans, kidney beans, lentils, quinoa, wild rice, nuts and seeds, nut butters and soya alternatives to milk and yoghurt. Eggs and dairy products are also good protein sources if you’re including these in your diet.

2. Include calcium and vitamin D

Calcium and vitamin D both play an important role in maintaining good bone health, which is extremely important in older age as osteoporosis and associated fractures are a major cause of bone-related diseases and mortality in older adults.

Most adults need 700mg of calcium per day. However, women past the menopause and men over 55 should have 1200mg of calcium per day. There’s a wide range of non-dairy food products that contain calcium for those who are plant-based, including calcium fortified soya milk and almond milk, calcium fortified cereals, pitta bread, chapatti and white bread.

For those who include fish in their diet, fish such as whitebait, and sardines and pilchards (with bones) contain good amounts of calcium per serving.

Older adults are also recommended to get 10 micrograms (mcg) of vitamin D daily. Not only is vitamin D important for bone health, it’s also one of the nutrients involved in supporting the immune system and helping it to function properly. Older adults are more vulnerable to deficiency as they may have less sunlight exposure, and their skin is less able to synthesise vitamin D.

Mushrooms grown in sunlight, fortified spreads, breakfast cereals, and dairy alternatives are all good sources of vitamin D.

Having said this, it’s hard to get vitamin D from diet alone, so a supplement of 10mcg a day (especially in the winter for those who may not get outside often), is recommended. It’s worth noting that some vitamin D supplements aren’t suitable for vegans, as they may be derived from an animal source, so vitamin D2 and lichen-derived vitamin D3 may be used instead.

3. Get your vitamin B12

Vitamin B12 is essential for making red blood cells, keeping the nervous system healthy, and providing energy. Older adults need 1.5 micrograms of vitamin B12 per day, similar to younger adults. But many older people may be at risk of vitamin B12 deficiency, affecting an estimated one in twenty people aged 65 to 74 and one in ten people over 75.

Those who don’t eat meat, fish or eggs may not be getting enough vitamin B12, as it’s found abundantly in animal-based food sources. Some plant-based sources of vitamin B12 include fortified breakfast cereals, yeast extracts (like Marmite), soya yoghurts, and non-dairy milks. People may consider taking a Vitamin B12 supplement. Taking 2mg or less a day of vitamin B12 in supplements is unlikely to cause any harm. However, they should consult their doctor or registered dietitian first.

4. Eat iron-rich foods

Low iron intake can be an issue for those who don’t have a varied diet, especially for men aged 65 and over living in residential care homes and women over 85.

Iron is essential for making red blood cells, which carry oxygen around the body. It’s also essential for physical performance, wound healing, supporting the immune system, cognitive development and function and thyroid metabolism. Older adults need 8.7mg of iron a day.

Citrus fruits.
Foods containing vitamin C – such as citrus fruits – may help the body absorb iron better. Alexandra Anschiz/ Shutterstock

Plant sources include wholegrains, green leafy vegetables like spinach, seeds, pulses and dried fruits. Since iron in plant foods is absorbed less efficiently compared to iron in animal proteins, having vitamin C-rich foods like citrus fruits, green pepper and broccoli can help iron be better absorbed.

5. Make every bite count

Some people find their appetite decreases as they get older. This can be caused by difficulties with chewing and swallowing, constipation, acute illness, impaired taste, vision and smell. But reduced appetite can contribute to unintentional weight loss and nutritional deficiencies. It’s therefore important to find ways to get adequate nutrition in every meal, especially when plant-based, such as:

  • Including protein in each meal.
  • Eat small meals and snacks in between throughout the day.
  • Include plant-based milks (such as soya, almond, or coconut milk) in your tea, coffee or smoothie.
  • Add olive, vegetable or sunflower oil to your favourite meals.
  • Mix plant creams or vegan cheese in mashed potatoes, soups and stews.
  • Add nut butters to bread, dairy-free yoghurt and smoothies.

No matter your age, switching to a plant-based diet may have many health benefits if planned properly. Consulting with a registered dietitian before making the switch may help you develop the best plant-based diet tailored to your specific needs.

Cervical, breast, heart, bowel: here’s what women should be getting screened regularly


Cervical, breast, heart, bowel: here’s what women should be getting screened regularly

October 28, 2020 5.32am AEDT


  1. Jenny Doust Clinical Professorial Research Fellow, The University of Queensland
  2. Gita Mishra Professor of Life Course Epidemiology, Faculty of Medicine, The University of Queensland

Disclosure statement

Jenny Doust is a member of the RACGP and receives grant funding from the NHMRC.

Gita Mishra receives funding from NHMRC, Commonwealth department of Health


University of Queensland

University of Queensland provides funding as a member of The Conversation AU.

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Throughout the COVID-19 pandemic, many have felt anxious about going to the GP and other health facilities, believing these places have had a greater risk of transmission. A lot of us have also had to juggle work, childcare and home-based education.

So it’s not surprising the number of women attending for preventive health checks dropped alarmingly. For example, 145,000 fewer breast cancer screenings were done between January and June this year than in the same period in 2018. It’s important, however, not to let the pandemic lead to avoidable poor health.

Here are some of the main health checks the the Royal Australian College of General Practitioners (RACGP) recommends for women. These checks are advised for women at average risk, but women who have a strong family history of any of these conditions should ask with their GP if they should start screening earlier or seek different types of testing.

Cervical cancer screening

The National Cervical Screening Program recommends cervical cancer screening every five years for women aged between 25 and 74.

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In December 2017, a new test was introduced for cervical cancer screening in Australia, and the testing interval changed from two years to five years. The change in testing interval was recommended because the new test is able to detect changes earlier. This means fewer women are tested each month, with the decline starting from December 2019.

Even accounting for this, the number of women tested in April and May 2020 fell sharply. There was some recovery in June, although rates in Victoria remain low. It used to be common practice to do a pelvic examination at the same time as a cervical screening test to look for problems in the uterus and ovaries, but this is no longer recommended due to its poor accuracy.

Number of Medicare claims for routine cervical screening tests in Australia 2019-20. MBS Statistics Online

Breast cancer screening

Breast Screen Australia recommends an x-ray of the breasts, called a mammogram, every two years for women aged 50-74. Breast screening services were paused in April, but are now open again in all states, including Victoria.

Evidence for the benefits and harms of breast screening has been highly contested, so it’s important women make an informed choice. Cancer Australia states that for every 1,000 women screened for 25 years from the age of 50, around eight will avoid dying of breast cancer. On the other hand, eight women in every 1,000 diagnosed by screening will be treated unnecessarily (usually with surgery) for cancers that would never otherwise have been diagnosed.

Screening works by finding a cancer before a woman has any symptoms, but it also finds cancers that grow very slowly or even regress, and that would never have caused symptoms. More sensitive tests, such as MRI, find more of these “overdiagnosed cancers” than other tests.

Breast cancer survival has improved significantly in the past few decades, but most of this seems to be due to improvements in treatment rather than improvements in screening.

Ovarian cancer

Unfortunately, there is no method for early detection of ovarian cancer and the symptoms can be vague, often leading to late diagnosis.

The most common symptoms are abdominal bloating, abdominal or pelvic pain, appetite loss, feeling full quickly, indigestion, urinary frequency or urgency, constipation, unexplained weight loss or gain, and unexplained fatigue.

Women who have any of these symptoms for more than a few weeks should see their GP.

Sexually transmitted disease

About 1 in 20 women in their 20s will have a chlamydia infection and 1 in 200 will have gonorrhoea. These increase the risk of pelvic inflammatory disease and infertility. HIV, Hepatitis B and syphilis are less common, but important to detect early.

There is no formal screening program but the RACGP encourages sexually active women younger than 30 to have regular testing, especially if there has been a change in sexual partner.

Cardiovascular disease and diabetes

The leading causes of death in women in Australia are dementia, heart attacks, strokes, and lung cancer. The risks of these can be reduced with good preventive health.

A health worker taking an elderly patient's blood pressure
Women shouldn’t forget to get their blood pressure and cholesterol regularly checked. Shutterstock

The RACGP recommends women have their blood pressure checked every two years from age 18, cholesterol every five years from age 45, and checks for diabetes and kidney disease when at risk (for example if you have a family history). GPs recommend a general health check for those aged 45 to 49, or a heart health check for those over 45, or Aboriginal or Torres Strait Islander people over 30.

Treating high blood pressure and cholesterol and reducing smoking rates has prompted a massive decline in Australian heart disease deaths since their peak in the 1960s. However, women are less likely to have all risk factors for heart disease checked, and younger women are less likely to be put on blood pressure or cholesterol-lowering medication than men with the same risk level.

Bowel cancer

Bowel cancer screening is recommended by the National Bowel Cancer Screening Program for all Australians every two years between ages 50 to 75. This is done by a stool sample test, using a kit mailed by the National Bowel Cancer Screening Program and returned by post. This screening reduces deaths from bowel cancer by 16%.

GPs have worked hard to ensure their patients’ safety during the COVID-19 pandemic. But it’s also important the recommended preventive health checks are not delayed unnecessarily.

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