October 16, 2008 Foot Health Week 2008: Obesity Can Damage Your Feet

This item is brought to you by Cameron Kippen: podologist and radio personality.

As we grow older the waistline starts to expand and then we need to wear the flared trousers upside down. According to the Australian Bureau of Statistics’ National Health Survey (2005), 72% of men and 58% of women in the middle years were overweight or obese and in a more recent survey from the Institute of Health and Welfare obesity is on the increase with 1 in 3 Australians overweight.

More frighteningly almost half of all adults were overweight (7.4 million) and 3 in 10 children considered obese. Just when you thought it safe to come out of the cookie jar, women in their early thirties gain on average 12kg as they approach their mid fifties, men upscale 8kg in the same period.

Overweight and obesity are terms used to describe abnormal or excessive fat accumulation that may impair health. An index known as the Body mass index (BMI) is calculated based upon weight in kilograms divided by the square of height in meters (kg/m2) and is used as a guide by health experts to measure obesity. The World Health Organization (WHO) defines "overweight" as a BMI equal to or more than 25, and "obesity" as a BMI equal to or more than 30. (Normal range is 18.5 to 24.9).

A second measure is waist circumference in men abnormal would be above 40 inches and women, a waist circumference of above 35 inches. Research has shown every kg of body weight puts 4 to 8 pounds of stress on the weight bearing joints and obesity also affects every part of the body, including the feet but obese people are more likely to suffer from chronic health problems like: Cardiovascular disease (mainly heart disease and stroke); Diabetes Type II; Orthopaedic complaints e.g. osteoarthritis, overuse syndromes and surgical complications; and some cancers e.g. endometrial, breast, and colon.

Childhood obesity is also associated with a higher chance of premature death and disability in adulthood. The total financial cost of obesity in Australia in 2005 was estimated at nearly $4 billion and rising.

Many factors influence weight but a sustained minor change in energy imbalance between calories (in) consumed and calories (out) expended during exercise can result in weight gain. All I need to do is lie on the couch and look at a piece of bread and butter and the pounds pile on.

Some people are more likely to gain weight than others because of their genetic and biological makeup. A major disadvantage of being obese is the unwanted pressure on weight bearing joints which can in some cases adversely affect the function of feet.

No one is quite sure why this is but very obese people (young and old) do walk with a wider base of gait (shuffling) and in some cases place intolerable stress on the architecture of their feet. Accelerated wear and tear in the joints under these circumstances may cause traumatic arthritis which further impairs mobility as we age.

Research supports a clear relationship between diabetes and obesity and a global shift to diets which contain energy-dense foods (high in fat and sugars but low in vitamins, minerals and other micronutrients) this combined with a sedentary existence where we take less physical activity is most likely to be deadly combination.

High sugar intake places increasing demand on natural supply of insulin in the body and as we age sometimes the insulin balance cannot cope either because we produce less quantity of what is available is ineffectual.

Diabetes and its co moribund partners can lead to damage to blood vessels and nerve supply, reducing the blood flow to the feet and increasing blood pressure. The reduction in the ability of sufferers to feel their feet and increased risk of developing foot ulcers and infection places them at greater risk of ulceration and amputation.

It is still unclear the role obesity has in the onset and progression of osteoarthritis but there is an association and according to a Framingham Knee OA Study reducing body weight by 5Kg reduces the risk of OA by 50%. Other studies have shown obese woman decrease their symptoms of OA in direct proportion to the amount of weight lost.

What to do
The main aim is to achieve energy balance and a healthy weight;

Changing dietary habits to reduce sugar intake and increase the consumption of fibre and vitamins can help reduce weight.

Increase the amount of physical exercises including walking for at least 30 minutes each day can help reduce weight. Losing weight is associated with remission of type 2 diabetes, lower blood pressure, resolution or improvement in sleep apnea, improved fertility, and benefits OA in all locations.

Speak to your doctor if you experience symptoms like tingling, numbness or burning sensation in your feet; or leg pain when you walk.

Contact the Perth Foot & Ankle Clinic if you experience chronic foot ailments like arch pain or foot soreness.