20. Nutrition and Healthy Aging Featuring Bob Blancato

Published March 24, 2021

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Show Notes

How does nutrition play a role in promoting healthy aging, and how can we use nutrition to improve our health? And what are some barriers that older adults face when it comes to nutrition? Here to talk about the importance of nutrition for healthy aging and to address some of these questions is Bob Blancato, Executive Director of the National Association of Nutrition and Aging Services Programs.

Episode Transcript

Sue Peschin:

Hello, everyone and welcome to This is Growing Old, a podcast from the Alliance for Aging Research. My name is Sue Peschin and I’m the President and CEO of the Alliance for Aging Research. This is Growing Old is a podcast all about the common human experience of aging, and today’s topic is one that can dramatically impact the aging process: nutrition. But how does nutrition play a role in promoting healthy aging? And how can we choose to use nutrition to improve our health? And what are some of the barriers that older adults face when it comes to nutrition? Here to talk about the importance of nutrition for healthy aging and to address some of these questions is Bob Blancato. Bob is the executive director of the National Association of Nutrition and Aging Services Programs and has been President of Matz, Blancato & Associates, a firm specializing in government affairs, association and coalition management, and advocacy services, since 1996. Bob, thank you so much for joining us today on This is Growing Old.

Bob Blancato:

Thank you very much, Sue. It’s a pleasure to be part of this series and it’s also always good to work with the Alliance for Aging Research. We’ve had a longstanding relationship, as you know and I’m glad to see you taking this topic on.

Sue Peschin:

Thanks, Bob, and right back at you. All right, can you please explain the mission of the National Association of Nutrition and Aging Services Programs for our listeners?

Bob Blancato:

Sure. And I’ll start by giving you a commendation for getting the name right because sometimes it gets a little cumbersome for people, but we are a membership organization, about 1,100 members serving about four million older adults a year with nutrition and aging services, senior centers, transportation, workforce programs, case management and many other services. Our mission is to strengthen through advocacy and education those who help older adults. Our vision is to reshape the future of nutrition and healthy aging. And our motto basically is national voice, local action. And on that point, let me note and we’re very pleased over the fact that the president’s signature of the American Rescue Plan yesterday will add $750 million in emergency funding for the Older Americans Act nutrition programs at a time when they need them desperately.

Sue Peschin:

Brilliant. And I imagine that your group was behind a lot of that advocacy.

Bob Blancato:

It was. We were proud to work with Meals on Wheels America in that effort because we have common members and we have a common mission.

Sue Peschin:

That’s amazing. Thank you so much for that really important advocacy. What are some of the common problems that older people have with nutrition? And how has the COVID-19 pandemic worsened those problems?

Bob Blancato:

Well, first of all, going to the COVID-19 issue. It’s a question always about access to good nutrition. One of the problems we have in this country is that people have access to nutrition, but not necessarily good nutrition or good food. It’s way too easy to get sort of bad food versus having nutritious food. And in the pandemic, there’s been shortages of food for periods of time, but for older adults in particular, the impact of chronic diseases and you know this as well as anybody, impacts your ability to want to have good food. Some of the chronic diseases actually could have been prevented had there been good nutrition earlier in the lifespan. We focus in particular on the growing concern of malnutrition because one in two older adults in this country is at risk of or has malnutrition, which can then also impact their immune system and their response to vaccines.

Bob Blancato:

We also know that another problem that older adults have is oral health. It’s a growing issue that we’re finally paying attention to and I hope we pay attention to the extent that in the coming years or as soon as possible that Medicare will start to cover dental services.

Bob Blancato:

And then of course, social isolation, which we’ve been focusing a great deal about and the pandemic is a huge problem. And a lot of people who are socially isolated and depressed often don’t eat as much. And that also contributes to malnutrition.

Bob Blancato:

And then I guess the last point is that the issue of medications and how medication mixes with or affects your appetite can be an issue for older adults and nutrition. And COVID-19 has made accessing food more difficult. Grocery stores requiring social contact and the concerns about going to grocery stores, the restaurants that have closed and so on, senior centers closed. It’s been a lot of things, but I would say that the nutrition network that we are proud to represent has done a very good job of maintaining service levels for older adults in home-delivered meals, providing at least a guarantee of some element of nutrition in their day to day life.

Sue Peschin:

We do a lot on the COVID-19 vaccines and a lot of the folks that you all serve are obviously low income, very fixed income, don’t necessarily have computers and can’t sign up for their vaccine in many of the traditional ways that the counties and state health departments are doing it. Are you guys working on that at all?

Bob Blancato:

Absolutely. In fact, it’s timely that you brought that up because contained in that American Rescue Plan proposal, the Older Americans Act, in general, is going to get a $1.4 billion infusion of new money, emergency money, half of which is nutrition that I mentioned, but there’s money allocated for Title III-B of the Older Americans Act, which is the broader supportive services title. And within that, it will be about providing resources to have the aging network become more involved in the vaccine dissemination process in three areas in particular. Number one, the notion of older adults needing transportation to get to sites to get a vaccine. The Aging Network has transportation facilities, but they use it for different things, but with additional resources, they could add that to what they do in terms of helping older adults.

Bob Blancato:

Information and referral, something we overlook sometimes, think about the 211 system and information and referral, they’re getting flooded with calls and they need to be able to provide information to older adults. And the rescue plan will provide additional money for information and referral.

Bob Blancato:

And the third area that we’re particularly interested in seeing expanded, we’ve already come upon examples in a couple of locations, one of which is San Antonio, where you can actually now start to vaccinate the homebound older adult, the one who can’t get out, the one who gets the meal but does not necessarily get the vaccine. There’s now new programs that allows a meal and the vaccine to sort of be delivered at the same time. And we’re looking for a large expansion of that capacity since most older adults in the nutrition program are home-bound at this point.

Bob Blancato:

Yeah, we were very sensitive to that issue and I would point out that some of our colleague organizations that you work with again, like n4a, Advancing States, as well as Meals on Wheels America and the National Council on Aging, we all came together and said, “Look, don’t overlook the Aging Network in this process. They’re out there, they’re trusted, they have resources, but they need more help to be effective.” We’re very pleased that that was included in the rescue plan.

Sue Peschin:

That is awesome to hear. I’m going to back it up a bit from the COVID-19 discussion and just ask you more generally, how do our nutrition needs change as we get older?

Bob Blancato:

A lot of different ways. There are issues related to just pure loss of appetite, which sometimes is related to isolation. I remember doing a project that we got funded from the Retirement Research Foundation to examine, this is pre-pandemic, to examine the value of socialization in the Congregate Nutrition Program.  And I would go out as part of this project and have interviews, discussions with older adults at the lunch table. And you would ask them, “What’s the main reason that you come to this program when you do?” And nine out of 10 would say, “Socialization,” or some word like that. But a lot of them would say the same thing over and over again, which is, “I don’t want to cook for myself. And when I do cook for myself, I don’t eat as much. I’m not as concerned about eating.”

Bob Blancato:

The loss of appetite that can be related to that could be related to medication and the impact of medication. That’s certainly a big issue with older adults. Now we have the COVID-19 situation where you’ve got the issue of loss of taste and smell and with the disproportionate impact of COVID-19 on older adults, we’re concerned about that, frankly. This may be contributing even more to improper nutrition on the part of older adults. As we get older, I know this to be true, you eat less. I think I eat pretty well, but I eat less. My wife and I go out now and we split an entree. We’re not doing both, each getting entrees. And as we got older that got to be more prevalent. You also need more protein to help prevent sarcopenia as you get older and you need fewer calories than you do when you’re younger. There are a lot of different factors that go into it. But the one that we’re most concerned about, particularly with respect to the COVID-19 is this issue about isolation and its impact on the day-to-day life of older adults.

Sue Peschin:

And also, disparities certainly exist when it comes to nutrition and all aspects of aging and age-related services. Can you provide an overview of the disparities related to nutrition and what can be done to address them?

Bob Blancato:

Sure. I can offer some for sure. I think one thing that I think is sort of cross-cutting is that poverty is in fact the greatest social determinant of health and those with lower limited income face disparities related solely to just the access and affordability of food. I’ll go back to a point I made earlier. It’s not right in this country that you can have all the access you want to junk food yet to find good nutritious food and to be able to afford it is very difficult for a lot of people in this country. And that balance needs to change. We have over 15 million older adults who are economically insecure and struggled to meet the rising costs of food. The disparities about oral health. Broadly speaking, Sue, I think what we have to consider as we focus on health equity, which we should, and we focus on disparities, we have to realize that an older adult may have suffered these disparities a whole lot longer than other people.

Bob Blancato:

If they happen to be an older person of color and have faced disparities because of the minority status and then they’ve had it for longer and longer, they need to get addressed as quickly as anybody else because of the length of the disparity that they’ve been facing. And I also think that we need to be looking at greater support for culturally appropriate meals to encourage eating on the part of older adults. We started on that path a little bit with the 2020 Older Americans Act reauthorization. There’s some language in there that’s going to allow for more of that to be utilized, same thing with medically-tailored meals. We have to acknowledge across the board where disparities do exist and have solutions to address them. But I’m going to go back to the point that when we focus on disparities, we got to remember that older adults may have endured them longer and we should be working to make the solutions happen faster for them.

Sue Peschin:

Oh, those are excellent points. And especially the idea that food is not just food, that it’s part of your life and you have culture in your life and things you like, don’t like, things that maybe your diet allows and doesn’t allow. Very good points. Thank you. March is National Nutrition Month. Why do you think an awareness month is important?

Bob Blancato:

Well, I think in fact, going back to just what you said a minute ago, it’s all about reinforcing the message that nutrition is health. We need to show that link. We need to show this and strengthen that link. Some of the major chronic diseases that affect older adults could have been prevented or lessened with good nutrition. And we argue that good nutrition should be something that’s practiced throughout the lifespan. And the theme for National Nutrition Month is personalize your plate in order to promote creating nutritious meals, to meet individuals’ cultural and personal food preferences. Again, this is an opportunity during March to advocate for more culturally relevant meals and their significance. And again, in fact, yesterday, they did a special webinar on malnutrition and the threat that it is to older adult health.

Bob Blancato:

And I would point the listeners here to a blueprint that our Defeat Malnutrition Today coalition released an update called the National Blueprint: Achieving Quality Malnutrition Care for Older Adults. And we have a number of points in there to address the questions of malnutrition. There are many things to focus awareness on, but as a matter of fact, we look at the fact that the Older Americans Act Nutrition Program itself turns 49 years old on March 22. And which means next year is the big 50th anniversary. And boy, you examine a program over course of time, this one has performed admirably, if not tremendously and helped millions of older adults. We’re very proud to be associated with that program.

Sue Peschin:

Yes, I’ve seen statistics on that. And the return on investment in that program is really remarkable. The National Association of Nutrition and Aging Services Programs recently hosted a webinar that I was very honored to participate in on pain management for older adults. Why is the issue of chronic pain important to NANASP?

Bob Blancato:

Well, first of all, we appreciate your contribution to that webinar. We had a good turnout for that webinar and we’re still hearing from people on some of the points that were raised by you and others. And remembering that an overwhelming majority of the older adults that we serve and our members serve, are community-dwelling, and studies indicate that as many as half of these older adults have important pain problems. You and I both know that number could be considerably more due to the problem with underreporting of pain. And it’s far more than just the pain that concerns us and we focused on during the webinar, the consequences of it can be both physical, such as increased risk for falls or psychological, including deeper social isolation. And many of our participants, mostly aging service professionals had questions about pain that their clients experience and how to help best help them manage this pain.

Bob Blancato:

And what we want to make sure that we’re able to do is make sure that in the area of pain management, that there’s a proper pain assessment, that’s done by a physician who can distinguish between general aches and actual pain. And then of course, as we talked about on this webinar, many older adults are concerned about the risks of opioid-based pain management, as are their caregivers, and we’re advocating and just did so recently in a letter to the FDA that older adults need more access to more non-opioid treatment options to manage pain symptoms safely and effectively. We were very pleased to do this webinar. I think it’s had a good impact and I’m hoping that we can get the policy changes made at the legislative and regulatory level.

Sue Peschin:

Terrific. Great. Now I’m going to switch gears and we have a question we ask all of our guests, which is when you were a kid, what did you imagine growing older would be like?

Bob Blancato:

Well, first of all, it’s been a long time since I was a kid so it’s kind of forced me to think about that. And I think the first thing I remember or imagined about growing up is that I’d have to grow up. As you get older, you have to grow up and you have to take the word responsibility, ended up having a greater meaning as you were growing older and the responsibility that comes with it. Growing older meant a whole different approach to how relationships were conducted of all kinds—friendships, relationships. And I think it’s something that you look forward to for different reasons. I love my parents, unfortunately, they’re both deceased at this point. I loved them dearly, but I couldn’t wait to get the hell out of my house when I went to college.

Bob Blancato:

I lived in New York, it was great, but I got accepted to Georgetown. Man, I was out that door before you could count to three. And I saw that as part of growing up, having the ability to see about being on your own. And did I enjoy the parents’ weekends and all the visits? Sure. But did I enjoy it when they left? Absolutely. And things of that nature, and then looking for work. I was lucky enough in my young life when I was at Georgetown to be able to get what turned out to be a 16-year job when I was a junior and I had a professor who said to me, “Well, you can get your three credits one of two ways, come hear my boring lecture or get yourself a job on Capitol Hill.” And out the door I went and lo and behold, it led to a very enjoyable career up there. There are a lot of different things that went into it, but I just knew that it was going to be different than when I was a kid.

Sue Peschin:

What do you enjoy most about growing older now?

Bob Blancato:

Well, I’ll start by saying I’m happy to be in good health. I’m happy to have a wonderful family. I’m happy that I’m staying active. In fact, earlier this week, I decided to celebrate the first warm day by playing a little hooky in the afternoon and going up and taking a run in West Potomac Park, which is a beautiful place this time a year before the tourists come for the cherry blossoms. I enjoy the different nature of friendships that I have now. I enjoy the fact by growing older, I can say no to more things, including using my age as an excuse not to do every honey-do that I’m asked to do by my wife.

Bob Blancato:

I love the fact that mentoring is more meaningful now, as I get older. I will tell you something else that I’ve discovered, I love sunsets now more than I did when I was younger. I look to go to places where I can see a good sunset and I happen to live in Arlington Virginia, where this time of year, we get beautiful sunsets late in the day. Growing older, I enjoy watching Tom Brady more than I ever did before, because look at him. He’s a great model for aging. I enjoy being younger than Joe Biden, and finally, I think I understand that in growing older, the value of experience and experience is valued. And this comes with growing older and growing older well.

Sue Peschin:

Hear, hear. I love it. The only thing I have to say though is if your wife listens to this podcast, she’s going to know what you’re up to.

Bob Blancato:

That’s true.

Sue Peschin:

Bob, I just want to thank you so much for being on our show today. It was really a treasure and just always a delight.

Bob Blancato:

Well, thank you very much, Sue. Have a great day and a great weekend.

Sue Peschin:

Thank you. Before we wrap up this week’s episode, I wanted to let you know that you can now sign up to receive emails letting you know when a new podcast episode has dropped. Visit the link in the show notes or go to agingresearch.org/thisisgrowingold, to sign up for updates from the Alliance for Aging Research, including information on the podcast. Thank you for listening to This is Growing Old and have a great day.