Food and Nutrition
Diabetic Feet and What You Eat
By
Aug 10, 2008 - 4:41:36 PM

(HealthNewsDigest.com) - It may sound strange, but what you eat can directly affect your feet. Many health concerns that can be prevented or treated by diet also have a significant impact on a person’s feet. Why, you ask?

The human foot is a very complicated structure with 28 bones and multiple soft tissue and skin structures. Each step you take has complex interactions – bone on bone, soft tissue on bone, foot surface to shoe, and foot surface to floor. There are many opportunities for problems to occur.

Individuals with diabetes are always counseled to adjust their diet and their carb intake to match the insulin they are injecting or the medicine they are taking. Careful blood sugar control through diet, exercise and medication helps maintain a healthy weight and forestall secondary complications. A troublesome secondary complication is peripheral neuropathy, which may cause damage to nerves and decreased sensation in the hands and feet.

This nerve damage causes burning pain, interferes with balance, changes how a person walks, creates skin breakdown, and causes pressure sores which heal very slowly and may become infected. Once walking becomes too difficult, a person has no option but to use a wheelchair. In the time it takes to read this article, at least one person around the world will have lost a foot or leg due to diabetic foot complications. Up to 85% of amputations are preceded by foot ulcers. Careful blood sugar control can slow down the progression of neuropathy and help to correct the symptoms.

A person at risk for heart disease is told to reduce their salt and fat intake and to maintain a healthy weight. Being overweight and eating too much salt (sodium) increases the risk for high blood pressure. High intakes of fat, especially saturated fat and trans fat, increases the risk for blockage in the arteries. All of these risks increase the chance of a heart attack or a stroke.

Currently there are more than 4 million stroke survivors in the US. Over 50% of them have hemiplegia, reduced mobility on one side of the body. This directly affects a person’s ability to balance, walk normally, and control the movement of their foot during the walking cycle. Weakness on one side makes it difficult to push off and allow the foot to clear the floor while swinging ahead to the next step.

Thirty percent of stroke survivors are unable to walk without assistance. Many use a brace which can be unattractive, heavy, and create sores on the foot from constant friction against the skin. First the stroke itself changes the normal movement of the foot. Then the brace prescribed to aid walking modifies a person’s walking pattern and may irritate the skin creating more foot discomfort. Sadly, lifestyle changes such as exercise, weight management, and diet modifications might have prevented the stroke altogether.

Being overweight, by itself, is a risk for foot problems. Clinical gait analysis of overweight subjects shows more pressure is exerted on the feet during walking and even while standing still. The feet become flatter and fatter as the ligaments in the arch weakened. This persistent loading over time results in soreness and discomfort in the legs and feet and prevents participation in simple physical activities such as walking.

During pregnancy, the necessary release of hormones makes ligaments more flexible causing the feet to flatten. This change in foot structure traditionally reverses itself once the pregnancy is over. Overweight women, however, enter pregnancy with flatter feet. Researchers are currently trying to find out if the feet of overweight pregnant women, which are already flatter than normal, will rebound after pregnancy. If not, during subsequent pregnancies and as a woman ages, she may have more mobility problems. The long term effect of carrying too many extra pounds negatively affects the structure of our feet, making standing and walking more difficult.

The foot problems seen in overweight adults are appearing in very young children, too. Typically the arch develops between the ages of 2 and 5, but the feet of overweight elementary school children are typically flatter and fatter than those of their leaner classmates.

Researchers in Australia are trying to find out if encouraging overweight children to exercise will result in the development of a more normal foot structure. In an exercise programs, after 6 months, overweight kids were moving more but the shape of their feet had not changed. The program is being extended for 2 years with the hope that over time, as the children exercise and get slimmer, their foot structure will normalize as well.

Unless they hurt, we rarely give our feet a second thought. Next time you grocery shop, cook, or order a meal in a restaurant, take a moment to think about how your food choices affect your feet. If you eat well to reduce your risk for obesity, heart disease, and diabetes you are also being kind to your feet. That’s important because you want them in good working order for many years to come.

© NRH Nutrition Consultants, Inc.

Jo-Ann Heslin, MA, RD, CDN is a registered dietitian and the author of the nutrition counter series for Pocket Books with 12 current titles and sales in excess of 6 million books. The books are widely available at your local or on-line bookseller.
Current titles include:
The Healthy Wholefoods Counter, 2008
The Cholesterol Counter, 7th Ed., 2008
The Diabetes Carbohydrate and Calorie Counter, 3rd Ed., 2007
The Calorie Counter, 4th Ed., 2007
The Compete Food Counter, 2nd Ed., 2006
For more information on Jo-Ann and her books, go to www.TheNutritionExperts.com.

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