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Think Feet With Diabetes

About 2 million Canadians are currently living with diabetes. It can be a "silent" disease, as patients may have few symptoms. Once diagnosed with diabetes it is of great importance to be vigilant of lifestyle and nutrition to keep the condition under control. A common problem for about 15% of diabetics is the development of a diabetic foot ulcer. Of those afflicted 14-24% will require an amputation of a lower extremity as a result. In addition to this the mortality rate of patients with below knee amputation due to the complications of a diabetic foot ulcer is 19-55% after three years.
Even though these statistics sound ominous, a lot can be done in the way of prevention. According to the Canadian Diabetes Association guidelines, a diabetic patient should have a foot exam performed at least annually. Diabetic peripheral neuropathy is the leading cause of diabetic foot ulcers. The physician can examine the feet for loss of sensation. He will check for foot calluses and will debride those, which are pre-ulcer state. The physician also checks for poor circulation in the foot at that time.
If there is no loss of protective sensation, an annual exam will suffice, but if there is loss of sensation, several exams per year may be needed. A vascular surgeon may have to assess the patient to see if the foot circulation is sufficient. Infection is a warning sign and has to be treated promptly. Finally, any source of pressure to the foot needs to be removed or offloaded.
A proactive approach to keep the feet healthy starts at home.

The following points are important especially to the patient with diabetes:
-Inspect your feet on a daily basis. Check for sores, blisters or cracks that don't heal.
-Check your footwear. If there is debris (sand, pebbles) remove promptly.
-Wash your feet daily with warm, not hot water and dry them well, especially between your toes.
-Trim your toenails. If you have difficulties doing that, seek out the help of a podiatrist. Also don't use the homemade approach cutting corns and calluses.
-Keep the circulation to your feet going: put up your feet when you sit. Wiggle your toes, move your ankles, don't cross your legs for long stretches of time.
-Shop for suitable footwear! Ask the sales clerk to measure both of your feet in order to determine the proper size. Shop in the afternoon, as your feet can swell during the day.
-Don't break in a tight fitting new show! This may injure your feet. A new shoe should be comfortable right away.
-Don't delay looking after problems. If a cut, sore, bruise or blister does not start to heal after a day, see a physician.

Parkhurst Exchange, October 2006 Edition, page 26

Houseplants Responsible For Allergic Reactions

Generally house dust and dust mites, pet dander, feathers, moulds and ragweed are meantioned, when it comes to the topic of allergies. Nuts and peanuts have also been associated with violent allergic reactions.
With skin prick tests (SPT) the allergists can very clearly determine what substances the allergy sufferer is sensitive to.

A small study, which appeared in the September edition of Allergy has shown that allergic rhinitis in a patient, can have its origin in exposure to houseplants. Allergic rhinitis with a runny nose and sneezing is often neglected, as-opposed to asthma or an urticarial rash. It is perceived as more of a nuisance than a threat. Allergic rhinitis sufferers were subjected to SPT's along with a healthy control group. 78 % of allergic rhinitis patient had a positive STP to at least one plant, while none of the control group developed significant reactions to any of the tested plants.
The plants that produced the most frequent sensitization were Ficus benjamina, yucca, ivy and palm tree.

The Medical Post, October 10, 2006, page 2

Diverticulitis Associated With Obesity

Medical textbooks used to describe acute diverticulitis as a disease that was mostly seen in adults over 50 years of age. Researchers at the University of Maryland Medical Center have assessed the medical records of 104 patients ages 22 to 88 years with the condition of diverticulitis diagnosed between 1999 and 2003. 56 patients (54%) were age 50 or younger, and the remaining 48 (46%) were over 50. The researchers found that a significantly higher proportion of patients (88 %) with abdominal obesity were present in the younger age group with diverticulitis.
Acute diverticulitis is a condition characterized by the chronic inflammation of sacs in the intestinal tract. The condition causes constipation and severe abdominal pain. It is usually related to a low fiber diet containing refined carbohydrates or processed foods.
Dr. Barry who was leading the study observed that the younger the patients with diverticulitis are, the more obese they are likely to be. Also, he found the younger they are when they get the disease, the more likely they will get recurrent attacks, and he sees the most important point in diverticulitis prevention is a change to healthy eating habits without overprocessed food from fast food outlets.

The Medical Post, October 10, 2006, page 1 and 60.

Body Can Fight Weight Loss

Embarking on a weight loss program needs long-term commitment and persistence. Many dieters have experienced the yo-yo effect of good initial results in losing weight, after which the weight loss stopped, and gradually the weight was gained back. Often dieters blame themselves for their lack of success or are criticized for a lack of self-control.
The "plateau effect" has been discussed and documented before, and now an Australian study has found that "it is not just you". After initial success and weight loss the human body is designed to strongly resist attempts to lose weight. Dr. Neil King from Queensland University of Technology does research on appetite regulation and energy balance. He conducted studies on groups of people who were overweight and obese people. He found that weight loss from exercise and calorie restriction stops at a certain point, and this plateau remains firmly in place for a prolonged time, despite continuing dieting and exercise.

In the first study 30 obese men and women from Britain took part in a 12-week, laboratory based exercise program in which they exercised five times a week. The second study observed the weight loss in 200 Australian men who were enrolled in a commercial weight loss program, which involved both an exercise program and dietary advice. Although both groups followed different plans, their weight loss still plateaued. The first group averaged a loss of 3 kg during the first 8 weeks, and weight loss in the next 4 weeks was markedly reduced (0.7 kg). The second group had a variable pattern of weight loss, but it, too, showed a plateau.

Researchers believe that the human body is designed to cope with famine. As a result there is a built-in mechanism responsible for weight loss resistance. It may be a source of frustration to people on a weight loss program in a society where there are no food shortages, but it is meant to be a lifesaver in times when there was a shortage of food.
For the person who wants to lose weight it involves taking a closer look at the caloric output. Longer exercise times, higher intensity or cross training can combat the plateau effect, but patience is also needed along with the determination to carry on with the program.

The Medical Post, October 10, 2006, page 19

Eat Your Salad Greens, But No Spinach

Spinach has traditionally been regarded as a healthy, green leafy vegetable and a valuable source of vitamins and minerals, in particular iron. The tedious chore of cleaning the tender greens and removing soil and sand traces has been taken care of by packinghouses. As a result, the consumer could purchase ready to eat spinach in plastic bags. These greens were a welcome ingredient for spinach salads or other dishes.
Lately all spinach has been recalled from the world's largest producer of organic produce. Natural Selection Food has recalled a total of 34 brands that were distributed nationwide, and some of which were available also in Canada. Consumers are still being warned not to eat fresh spinach from the U.S., even though there have been no reported cases of ill effects or diseases in Canada itself. Problems have surfaced in September in form of food borne illness in the U.S. The culprit seems to be contamination with E. coli 0157:H7. Food borne illness can be serious. So far there have been 109 cases of illness in the U.S. and possibly two deaths. The worst affected area so far is Wisconsin, where 29 illnesses were reported and one person died of the disease.
As a result of this alert, salad mixes that contained a variety of greens including spinach leaves have also been pulled from the shelf. It should be mentioned that washing the spinach leaves does not make it safe to consume, as the E.coli bacteria stick to the leaves.
While it seems good-bye to spinach leaves for now, it remains important to eat your greens. Researchers at University of California in Los Angeles and colleagues at Louisiana State University analyzed the salad consumption based on the intake of salad, raw vegetables and salad dressing on 9,406 women and 8,282 men. The researchers also found from their studies that daily consumption of salad and raw vegetables is not the norm in any population group and even less prevalent among African Americans.
There were data from lab tests on serum nutrient levels, and it showed that consumption of salads was positively associated with above-median serum micronutrient levels of folic acid, vitamin C and E, lycopene, and alpha carotene and beta carotene. All of these nutrients are important for healthy daily functioning. They are weapons that help fight infection, heart disease and cancers. The consumption of salad and raw vegetables remains the most effective strategy for increasing the intake of important nutrients.

The Medical Post, October 3, 2006, page 21

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