Multidisciplinary Public Health : The Foot And Ankle Specialist

So what is the connection between a foot and ankle specialist and the management of diabetes and pre-diabetes metabolic syndrome and the risk factors associated with these diseases?  These diseases and their individual risk factors negatively impact the feet in many significant ways.

The Nutrientology team uses the science of supplementation, nutrition and exercise to help you reduce or control the major risk factors for prediabetes metabolic syndrome, and therefore diabetes – abdominal fat, dyslipidemia, insulin resistance, high blood pressure, cardiovascular disease, and inflammation. These risk factors produce numerous negative health effects throughout the body that are often most readily evident in the lower extremities in particular.

The Nutrientology resource blog discusses the influence of nutrition, exercise, and diet supplementation on these risk factors. The products available at the Nutrientology Store are also geared toward countering these unwanted risk factors and their resultant impact on your health.

The nutrition and diet information is probably the most critical for assisting you in the management of prediabetes metabolic syndrome.  The Nutrientology resource blog looks at the scientific literature to try to cut through the maze of dietary information to assist you in consistently eating well toward preventing and stopping prediabetes, and therefore diabetes. Podiatrist foot and ankle specialists should provide intelligent fundamental diet and nutrition counsel.

The exercise component of the resource blog is also important. Exercise can have a profound effect on your systemic metabolic health. Healthy functioning feet and legs are most important to productive and successful exercise, and exercise encourages healthy functional feet and legs.

The advice at not only directly reduces the negative consequences of metabolic syndrome and prediabetes, but by maintaining lower extremity function and strength, it also impacts your mobility, your risk of falling, and your risk of fracture or other injury. This promotes a healthy independent lifestyle into your senior years. Falls can be especially devastating, and are responsible for at least 90% of all hip fractures. Exercise is successful in reducing fall risk and preventing falls in elderly people. The risk of sustaining a fall fracture in elderly women goes down as their level of physical activity goes up. Studies show that strength and balance training for healthy elderly people can reduce the risk of falls by up to 50%.

Muscular weakness plays a major role in the functional impairment that occurs with aging. As we age, strength and muscle mass do not decrease at the same rate. The large muscles of the legs and thighs lose size and strength faster than the muscles of the upper body as we age. It is therefore imperative that as we age our exercise activities become more focused on improving the strength and neuromuscular coordination of the lower extremities. This will help preserve your ability to functionally move about and perform the daily activities, prevent disability, and maintain independence as you age. If you want to maintain independence and health into later life, work exercise-movement of your legs into your life now. At least do something.

The supplements and other products available at the Nutrientology Store help manage the unwanted risk factors associated with prediabetes metabolic syndrome— abdominal fat, dyslipidemia, insulin resistance, high blood pressure, cardiovascular disease, oxidative stress, and inflammation.

The categories of supplements available at the Nutrientology Store are as follows:

1. Anti-inflammatory/Antioxidants

Diabetes mellitus and prediabetes metabolic syndrome are inflammatory conditions. This is largely instigated by the excess visceral abdominal fat that tends to occur with these conditions. The deep fatty tissue of the abdomen actually acts like an endocrine organ causing the release of inflammatory cytokines and adipokines that promote metabolic derangement of which insulin resistance or insulin insensitivity plays a large role. This silent inflammatory stress and insulin resistance can have a significant effect on your health in general, and your feet in particular. For example, even so-called “borderline diabetics” with early insulin resistance can develop the diabetic nerve damage known as peripheral neuropathy that can lead to potentially devastating foot injury.

2. Cardiovascular Support

The heart is a pump that operates your blood circulation. Having a healthy heart is important for proper blood circulation to the lower extremities all the way to the toes.  And having healthy muscular legs is important for pumping the blood back to the heart to be re-circulated. Elevated blood glucose, obesity, high blood pressure, elevated triglycerides and low HDL-cholesterol are well accepted risk factors in the development of cardiovascular disease.

Poor heart function and immobility prevents the movement of sufficient blood down to the feet and toes and may also cause a backup of blood flow creating swelling in the feet and legs. The circulatory system is a closed system and if there is bad blood flow to the legs, there is also likely bad blood flow to the heart and/or brain.

The pathology that leads to circulation blockage is complex and the damage that occurs to the cells that line the blood vessels—known as endothelial cells—creates endothelial dysfunction leading to blockage of blood flow. This pathologic process involves many factors including cholesterol-lipids as well as the adipokines and inflammatory cytokines that I mentioned above. A healthy cardiovascular system is achieved through proper nutrition, diet and exercise and that is why they are included as an integral part of the Nutrientology mission. In many ways, the heart is to the circulation system what the brain is to the nervous system.

3. Cholesterol-Lipid Support

Cholesterol and blood fat levels have shown a correlation and are an independent risk factor for the development of poor blood circulation to the feet known as peripheral arterial disease (PAD) as well as poor blood flow to the heart known as coronary artery disease (CAD). Those with PAD are likely to also have arterial vascular disease in other parts of the body. Increased cholesterol, particularly small LDL-cholesterol, is associated with endothelial dysfunction and blood vessel occlusion. This can result in significant alterations to the circulation to the feet and toes not only through physical blockage, but also by negatively impacting the vascular endothelium causing reduced nitric oxide (NO) availabilty. NO is an endothelium-derived relaxing factor. In addition to its circulation-relaxing effects, NO is now recognized as a key determinant of vascular health, exerting antiplatelet, antithrombotic, and anti-inflammatory properties throughout your circulation. Proper diet and physical activity can decrease PAD risk factors that are the same risk factors for diabetes and prediabetes metabolic syndrome: obesity, stress, poor blood sugar control and increased blood pressure. It will also have a tendency to increase healthy HDL-cholesterol levels. Managing your cholesterol and blood fat levels is important in managing the chronic low-grade inflammation, oxidative stress and endothelial dysfunction that all work against healthy circulation.

4. Prediabetes: Blood Sugar Support

This site deals at length regarding the detrimental impact of poor blood sugar levels on the body. To summarize here, prediabetes and its multiple associated medical problems, create a number of negative consequences essentially affecting every tissue of the body. This is often most notable in the feet and legs because of the obvious circulation blockage, nerve damage, skin, bone and joint problems that can be seen or measured.

5. Weight Management

Increased body weight can lead to increased visceral-abdominal fat creating an inflammatory and oxidative stress on your body. Proper weight management assists with the management of the above categories (cardiovascular support, cholesterol-lipid support, blood sugar support, anti-inflammation/antioxidation), but weight management is also important with regard to the feet and legs due to the direct biomechanical weight bearing stress that is placed on the foot and ankle due to increased body weight. This physical stress can be a major factor in one’s health because if you are not able to move freely due to foot pain, you will start to develop the problems above. When one has problems with metabolism because of an inflammatory state, cholesterol-lipid imbalance and elevated blood sugar levels, and then you add the increased biomechanical stress of obesity on top of this, it is a recipe for foot and ankle problems and pain.  Increased weight leads to increased visceral-abdominal fat creating an inflammatory stress on your body that we are just now starting to gain some understanding of. This can have a silent but profound effect on your health in a number of ways.

6. Vitamins

The vitamins in the Nutrientology Store are geared to supporting health in pre-diabetes metabolic syndrome and have shown some benefit in mitigating one or more of the risk factors of metabolic syndrome noted above– abdominal fat, dyslipidemia, insulin resistance, high blood pressure, cardiovascular disease, oxidative stress and inflammation.

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