How Can Food Affect Your Foot Health?
What are the best foods for you foot health? There is a big distance between your mouth and feet but a strong relationship between poor diet and adverse foot health. This blog will outline the good and bad foods for foot health. I have written in the past on Diabetes and your diet. In this post, there will be a strong focus on peripheral neuropathy, but what is it? Keep reading to find out.
This post will cover:
- The Impact of Sugar and Carbohydrates on Foot Health
- What is Peripheral Neuropathy?
- Other Nutritional Causes of Peripheral Neuropathy
- The Impact of Salt on Foot Health
- The Impact of Fat on Foot Health
- Good Foods for Osteoarthritic Joints
- Nutrients for Wound Healing
Some of the information has strong evidence behind it, some of it is anecdotal. I will outline the current evidence in each section. In all honesty, there is a lot of waffle (pun intended) out there about nutrition. It’s important to see what sort of evidence is behind the waffle. Let’s see how many food related puns and references I can fit into this post!
The Impact of Sugar and Carbohydrates on Foot Health
Here we go again, someone else is going to explain how sugar is evil. I’m not going to tell you to cut out sugar completely. You need to maintain healthy sugar levels because excessive blood sugar levels can affect nerves. Even complex carbohydrates will be broken down as glucose or sugar in the body. The most vulnerable nerves in our body are the peripheral nerves. The peripheral nerves are found in our toes, feet and hands. The exact process of how excessive glucose affects the nerves is not entirely known. We know there is a strong relationship between years of high blood glucose levels and peripheral neuropathy (nerve disease).
People with uncontrolled diabetes are more likely to have high blood glucose levels. This is because they are not able to transfer the sugar into the body’s cells. Often this is due to a problem with insulin. Just because you eat a bar of chocolate doesn’t mean those sugars are heading to your feet to attack your nerves. If your insulin and it’s receptors are working well, you may be able to transfer the glucose into your cells at a reasonable rate.
It’s a good idea to get your blood glucose levels checked by your general practitioner. This is one way to find out if your sugar levels are within normal range. There is an extremely high relationship between long term (greater than 10 years) high blood glucose levels, diabetes and peripheral neuropathy in the research and developed world.
What is Peripheral Neuropathy?
As mentioned above, excessive glucose levels can affect the nerves. Peripheral neuropathy is a dysfunction of the nerves at our feet. There are more than 100 types of peripheral neuropathy with many different causes. The causes may be genetics, trauma to a nerve, tumors, toxins, autoimmune responses, nutritional deficiencies, alcoholism, medical procedures, and vascular and metabolic disorders.
In the developed world, peripheral sensory neuropathy is the most common sub-type of neuropathy. It is contributed to excessive blood glucose levels. Symptoms of peripheral sensory neuropathy include tingling, burning, sharp, shooting, electric and numbness sensations. Sensory loss may start at the toes and spread to the legs and hands in a “stocking and glove” distribution.
People with sensory neuropathy lack protective sensation. This is what tells your brain if something is wrong with the feet. If you can’t tell if something is wrong, it can go unnoticed and cause damage. For instance, a shard of glass wedged in the skin can cause an ulcer making the limb at risk of amputation.
Other types of neuropathy are motor neuropathy which can cause muscle weaknesses and muscle imbalances and autonomic neuropathy which reduces the production of the skin’s natural emollient leading to dry skin.
Other Nutritional Causes of Peripheral Neuropathy
Vitamin B6: or pyridoxine in one of its forms is unique in that either a deficiency or an excess of vitamin B6 can cause neuropathy1. Good sources of vitamin B6 are organ meats, muscle meats, vegetables and fruits. According to the Nutrient Reference Valves for Australia and New Zealand, clinical deficiency in B6 is rarely seen. B6 deficiency is determined when intake is below 0.5 mg/day. In adults, neuropathy due to B6 deficiency starts with numbness, burning pain in the feet, which then ascend to affect the legs and eventually the hands1. Visiting a nutritionist or dietitian will help you to determine if you are receiving enough or too much vitamin B6.
Vitamin B12: or cobalamin is present in animal and dairy products. Those on a vegan diet need to consider taking vitamin B12 supplements. This is very, very little B12 in a plant based diet. Vitamin B12 deficiency occurs in 5 to 20 percent of older adults and up to 40 percent of older adults have low serum vitamin B12 levels1. In conjunction with sensory nerve symptoms, someone with vitamin B12 deficiency may present with a decline in cognitive function/dementia like symptoms. Read further information on appropriate intake.
How alcohol Affects Your Foot Health
Alcohol: You may not consider alcohol to be a nutrient. The truth is many people in this world digest alcohol and therefore it can have an impact on the body. According to the Australian Government’s Department of Health, for healthy men and women, drinking no more than two standard drinks on any day reduces your risk of harm from alcohol-related disease or injury over a lifetime. Peripheral sensory neuropathy and excessive alcohol consumption are closely linked. This is a great fact sheet for further information.
The Impact of Salt on Foot Health
I know people put their feet in salt baths and rub fatty like creams on their feet but that’s not where I’m going with this topic. I’m talking about ingesting salt and fatty foods and how they can adversely affect the feet.
Salt or sodium chloride, is related to blood pressure. When sodium levels are too high in the body it affects the ability of the kidneys to remove fluid. The additional fluid puts extra strain on the blood vessels resulting in higher blood pressure.
Arteries, which supply your feet with blood, try to cope with this extra strain by thickening their walls. Plaque can also form inside the arteries. This is known as atherosclerosis. This leads to a smaller space inside the artery reducing circulation.
The Impact of Fat on Foot Health
A high intake of bad fats can also increase blood pressure and contribute to atherosclerosis. Processed foods are high in bad fats and salt. The research shows a strong relationship between processed foods and elevated blood pressure and over a long exposure time, peripheral arterial disease.
Peripheral arterial disease means there is a lack of blood getting to the feet. Blood supplies the feet with oxygen and nutrients. When there is a lack of these you may experience the following signs and symptoms.
Signs of reduced circulation:
- Reduced healing times of cuts and grazes
- A change in skin colour, bluish or red
- Reduced skin temperature
- Slower nail growth and less hair growth
- Reduced pulses
- Arterial ulcerations
- Necrosis (dying tissue)
- Swelling in legs and feet if the high blood pressure has led to heart disease.
Symptoms of reduced circulation:
- Cramping in the feet and legs
- Pain in the calf muscle when walking. Your calves require more blood when walking, if the arteries can’t meet the demand the muscles starve of oxygen causing pain.
- Foot pain that wakes you when you are sleeping. During the day, gravity and movement assists with circulation. At night, the feet are starved of oxygen. This is what causes the pain.
Good Foods & Supplements for Osteoarthritis
When you walk into a pharmacy you may feel overwhelmed by the amount of supplementation for joint health. The evidence behind a lot of these supplements isn’t the best. My general advice is to try the supplement for 6 months and if it works continue on, if not, discontinue use. The best evidence around osteoarthritis and food is lowering calorie intake to lose weight. Our joints have significant forces going through them, the higher the body weight the higher the deforming forces and potential pain. Forces in our knee joints are approximately 4-5x our body weight, losing 10kgs will have a dramatic influence on your knee health.
Omega 3 fatty acids, glucosamine and chondroitin are common supplements in pharmacies and health food shops. Omega 3 has anti-inflammatory properties and it can be found in oily fish such as salmon and tuna. Turmeric is a relatively newcomer to the anti-inflammatory market and needs a lot more research. The mechanism of glucosamine and chondroitin is a bit of a mystery.
People with early osteoarthritis of the knee may be more likely to benefit from glucosamine/chondroitin than those with more severe disease2. Not only is the research undecided on whether these supplements work, it’s undecided on what to bind the glucosamine and chondroitin to. It looks like sulfate is the best. The sulfate form of both oral supplements has been used in a recent successful trial. The trail used doses of glucosamine 1500 mg/day and chondroitin 800 mg/day2.
Eating foods high in antioxidants such as fruits and vegetables may help to protect cells from damage. Vitamin C, found in citrus fruits and many other fruits and vegatables assists in collagen and connective tissue production. The idea being to promote the regrowth of the structures surrounding painful arthritic joints.
Nutrients for Wound Healing & Foot Health
Whether your skin wound is from a surgery, a traumatic incident or as a result of a chronic health condition such as diabetes, reviewing your nutrition is an important factor to heal as quickly as possible.
Protein is a major building block of our skin and connective tissue. A lack of protein in our diet can impair blood vessel formation, collagen synthesis, wound remodeling and fibroblasts (helps collagen production) proliferation. A significant protein deficiency can suppress the immune system by reducing white blood cell production and levels, this increases the body’s susceptibility to infection. According to the Dietitians Association Australia, the average adult intake recommendation for protein is 50g.
Vitamin C, A and E have antioxidant and anti-inflammatory actions. Antioxidants help to get rid of bad cells in wounds. A vitamin C deficiency can reduce collagen synthesis, blood vessel formation and capillary (small blood vessel) strength. Vitamin A and E help to keep a wound strong by assisting cell integrity. Research indicates that Vitamin E also has anti-inflammatory properties. It has been suggested that Vitamin E has a role in decreasing excess scar formation in chronic wounds. Important minerals for would healing are Magnesium, zinc and iron.
Over the next few decades in the research world it will be interesting to see which foods help with peripheral vasodilation to increase blood, oxygen and nutrient supply to the feet to help healing. Currently, nitrates have anecdotal evidence for a vasodilatory effect. You can find nitrates in beetroots, watermelon, garlic, spinach and rocket. Preserved and cured meats also contain nitrates and it is likely that this type of nitrate is potentially carcinogenic.
So here are the take home messages for today’s post:
- Good nutrition is often the first line of defense to avoid peripheral neuropathy.
- An unbalanced diet can lead to peripheral neuropathy
- There are opposing results for joint health supplementation in medical research.
- Poor nutrition can lead to delayed healing.
Useful websites and references:
Dietary guidelines: https://www.nrv.gov.au
Alcohol consumption: http://www.alcohol.gov.au/internet/alcohol/publishing.nsf/Content/home
Dietitians Association Australia: http://daa.asn.au/
- Hammond N, Wang Y, Dimachkle M, Barohn R. Nutritional neuropathies.Neurol Clin. 2013; 31(2):477-489.
- Fransen M, Agaliotis M, Nairn L, et al. Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens. Ann Rheum Dis 2014; Jan 6 doi:10.1136/annrheumdis-2013-203954