108th Congress

Fitness and Nutrition: The Prescription for Healthy Aging—Hearing Before the Senate Special Committee on Aging

March 11, 2003

Members Present

Senators Larry Craig (R-ID), Chairman; John Breaux (D-LA), Ranking Member; Ted Stevens (R-AK); James Talent (R-MO); and Thomas Carper (D-DE)

Witnesses

Panel One:

• Dr. Judith Salerno, Deputy Director, National Institute on Aging
• Alfred Maguire, Idaho/National Senior Games Association, Twin Falls, ID
• Sam Ulano, Jazz Musician and Author, New York, NY

Panel Two:

• Linda Netterville, President, Meals on Wheels Association of America, Lee's Summit, MO
• Dr. Jane White, Professor, Department of Family Medicine, Graduate School of Medicine, University of Tennesse-Knoxville, Knoxville, TN

Panel Three:

• Lynn Swann, Chairman, President's Council on Physical Fitness and Sports, Sewickley, PA

Purpose of Hearing: The hearing examined the importance of fitness and nutrition in the aging process. Witnesses discussed the significance of maintaining an active, healthy lifestyle at any age.

Summary: The witnesses and the members of the Senate Special Committee on Aging emphasized the importance of nutrition and physical activity with respect to the aging population.

Opening Statements:Chairman Craig opened the hearing by expressing the importance of physical activity, healthy eating, and proper nutrition for the elderly. He said that the hearing is timely because the Meals on Wheels Association of America (MOWAA) is holding its "March for Meals" campaign throughout the month of March. Chairman Craig also said that many people think that physical decline in old age is inevitable. He cited his 85 year old father as an example of someone who continues to be very active and healthy.

Senator Carper indicated that he exercises every day. He mentioned a European study that found that people who exercise experience less depression. Senator Breaux said that the National Senior Games are a good opportunity for seniors to get the message about what they really can do.

Statements of Witnesses:

Panel One:Dr. Salerno told the Committee that NIH research has demonstrated the positive benefits of physical activity. She indicated that older exercisers are more likely than non exercisers to live longer and remain independent. Exercise and diet are the most effective methods for reducing the risk of diabetes in high-risk older people. Studies have also found that moderate exercise can reduce the number of falls among older people, and it can effectively reduce stress and sleep problems. Dr. Salerno described the National Institute of Aging's (NIA) national exercise campaign for people over 50 years of age. NIA has produced a book and a companion video entitled, "Exercise: A Guide from the National Institute on Aging." The book addresses exercises for endurance, strength, balance, and flexibility. Dr. Salerno also showed the Committee a recently-introduced NIA public service announcement to promote physical activity for older people.

Alfred Maguire has participated in several Senior Games. He said that people should eliminate saturated fats from their diets and make sure that they eat appropriate carbohydrates. Mr. Maguire indicated that exercise helps seniors to stay healthy and remain independent. He said that seniors who remain independent, even for just one additional month, save the Government millions of dollars. Mr. Maguire said that the existence of the Idaho State Senior games has helped him to remain active. He thanked Senator Breaux for his support of the National Senior Game Association (NSGA) and encouraged other members of the Committee for support the NSGA.

Sam Ulano told the Committee about his experience with weight loss and exercise. (In 1960, he weighed 320 pounds; today, he weighs 168 pounds.) Mr. Ulano described his daily exercise routine that involves light weights and stretching. Mr. Ulano's experience with weight loss and improved nutrition inspired him to write a book entitled, The Sam Ulano Body Development for Senior Citizens and the Young Who Will Eventually Become Senior Citizens.

Panel Two:Linda Netterville was introduced by Senator Talent. She told the Committee that MOWAA members provide nutrition, education, and opportunities for activity for seniors. This year is the 31st anniversary of the inclusion of senior meals in the Older Americans Act. In honor of this occasion, MOWAA has launched the "March for Meals" campaign to raise funds and public awareness about senior meals programs. Ms. Netterville expressed particular concern for seniors with short term needs. She indicated that 41 percent of all home-delivered meal programs have waiting lists. As a result, those in need of short-term interventions may not receive any services.

Dr. Jane White was introduced by Senator Craig, who mentioned that his wife is a dietitian. Dr. White testified that nutrition interventions can be a cost effective treatment alternative and can be used to manage chronic diseases and reduce hospitalizations. Dr. White said that only 36 percent of doctors discuss nutrition with their patients. Meanwhile, 85 percent of older patients say that they want nutrition information from their physicians.

Panel 3: Lynn Swann said that we need to set better examples for younger and older people. He said that many older people have never worked out before. If senior citizen do exercise they have a better quality of life and they have stronger bone density. He recommended that everyone do at least 30 minutes of exercise per day. He said that our country spends $250 billion per year on obesity-related diseases that are preventable. Mr. Swann said that this money could be better used elsewhere.

Questions:

Senator Craig:

• To Dr. Salerno: Are you aware of any outreach efforts for family caregivers? Dr. Salerno said that NIA provides information for family caregivers through the Alzheimer's Disease Education and Referral Center.
• To Mr. Maguire: How do we teach seniors about the benefits of physical activity? Mr. Maguire said that we have to teach seniors to eat correctly, and we need to give seniors the opportunity to get out and exercise with others.
• To Mr. Ulano: How do you stay motivated to exercise? Mr. Ulano said that "we have to learn to motivate ourselves."
• To Ms. Netterville: How does MOWAA nutritional screening work? MOWAA uses a checklist to determine appropriate nutrition interventions. MOWAA also conducts reassessments on an annual basis.
• To Dr. White: How does private insurance integrate nutrition in disease programs? Dr. White said that many private insurance companies follow Medicare and Medicaid guidelines. Senator Craig also asked her what a state of the art Medicare nutrition program would look like? Dr. White said that an ideal program would include routine screening, referrals to appropriate social services, and reimbursement for nutrition services. Dr. White said that Medicare should cover nutrition intervention for diabetes and other chronic diseases. Some private plans do cover nutrition services, but it is not universal.
• To Mr. Swann: How is the President's Council promoting the President's Challenge? The Council is engaging in partnerships with corporate America and YMCA's to convey the importance of physical fitness. The 20 members of the Council also go out across the country to encourage physical activity. Senator Craig asked what the Committee can do to help promote physical fitness for seniors? Mr. Swann said that it is necessary to give seniors the tools for working out.

Senator Breaux:

• Senator Breaux reemphasized the importance of exercise for quality of life and he indicated that regular exercise saves society money because seniors will be healthier. He also said that he would resist adding requirements for the Medicare program without reforming it first. He said that Medicare and Medicaid are outdated and the programs shouldn't have to come to Congress to ask for permission to cover services such as nutrition.
• To Mr. Swann: How do we encourage the young and the elderly to exercise? Mr. Swann said that we can encourage youth to exercise through the school systems by sending information out to children and schools. He also said that corporations are helping to make information available at YMCA's and Boys and Girls Clubs. Senator Breaux expressed concern that more and more schools are not requiring physical education. He said that if schools don't recognize physical education, then the challenge may be insurmountable. Senator Breaux also is concerned that people are not engaging in enough physical activity because technological advancements have made it so that people do not have to move around as much. Mr. Swann said that Illinois is the only state that mandates physical education. He said that exercise has to be a priority for people and that we need to engage senior citizens. Senator Breaux encouraged Mr. Swann to promote the National Senior Games. Mr. Swann offered to work with Senator Breaux on this endeavor.

Senator Talent:

• To Dr. Salerno: Is there a way to encourage groups to send a concentrated message encouraging seniors to exercise? Dr. Salerno said that a multi-pronged approach is necessary. For example, NIA distributes its exercise videos and books to 250 community health centers throughout the country. She also recommended that seniors seek out an "exercise buddy" to help motivate them. Dr. Salerno also highlighted the importance of senior centers and other facilities that are interested in having NIA materials as part of their programs.

Prepared by Dina Dairotis, OLPA
March 12, 2003