Food and Foot Part 2 – Effects of Festive Feasting
Ramadan is a time of spiritual reflection, generosity and developing one’s self-control. However, in recent years, there are more reports of people overeating at iftar (breaking of fast) or during Hari Raya as the mind’s natural reaction is to take in as much food as possible to compensate for the whole day of fasting as the body is starving. While compensating to get the body’s energy up again, you must ensure that your body able to process the food that you have eaten.
What are some of the consequences of overeating?
Most traditional foods we enjoy during Hari Raya such as Dodol, Ketupat and Kueh Lapis are high on sugar content, this also greatly contributes to the chances of developing diabetes. In fact, many of us may already have or know someone who has diabetes. Diabetes has many complications, and the three main parts of your body that are most commonly impacted are your eyes, feet, and kidneys.
As blood sugar rises, glycation, the process wherein sugars bond to proteins, increases. Glycation damages blood vessels, and the foot is one of the most commonly affected part of your body because it is the furthest part of the body and most structures in the foot are very small and delicate. Once the blood vessels and nerves are damaged, the risk of the individual to develop unnoticed wounds greatly increases. This leads to complications such as infection and non-healing diabetic foot, eventually leading to amputation.
For people who have been previously diagnosed with diabetes, here are a number of foot-related conditions you should keep an eye out for.
This occurs when the nerves in the body’s extremities are damaged, and most commonly occur in the legs and feet. This particular condition is dangerous as it symptoms include loss of or reduced sensation in the areas affected, muscle weakness, and a loss of balance and coordination. The last two points combine to make the first dangerous as any injuries to the lower limb caused by falling or trauma may wind up unnoticed till it is a neuropathic wound. These injuries lie undetected due to the patient’s lack of sensation, and can create a large painless wound in the bottom or other areas of the foot.
- Cold feet
- Pins and Needles or Ants crawling sensation
- Reduced sensitivity to pain and temperature changes
- Non-healing wound
- Does not hurt and surrounded by calluses
These are injuries that fail to heal due to the reduced blood flow to your legs caused by diabetes. The lack of blood and nutrients reduces the body’s ability to heal, causing any damaged tissue to heal at much slower rates, while healthy tissue is damaged by the reduced availability of nutrients.
- Painful wound
- No or limited bleeding
- Skin on lower limb appears shiny, tight or hairless
Venous Disease or Ulcers
These types of ulcers differ in that they are caused by increased blood pressure. Due to the weakening of blood vessels due to diabetes, blood may leak out or burst out of the fine blood vessels under the skin, causing blood to pool in areas under the skin. Over time, this develops into an ulcer that may itch or swell, as well as discoloured skin and a foul-smelling discharge.
- Discoloured skin around the wound
- Aching or swelling legs
- Hardened skin around the ulcer
- Chronic wound
- Open painful sore
- Frequently found just above the ankle
While a growing endemic, Diabetes is not the only thing to watch out for.
Diabetes is a frightening concern to many people, but making the wrong food choices can also lead to other lifestyle diseases such as gout. Festive foods during Ramadan and Hari Raya are usually rich in protein, purine, sugar and salt. These foods frequently overload the body by making the important organs such as the kidneys, heart and liver work harder than usual.
Excessive purine intake in the form of meat, seafood, nuts and even some vegetables may increase the accumulation of uric acid in the blood. When consumed excessively, high accumulation of uric acid in the body will eventually lead to joint pains. These pains are commonly known as gout.
Gout is a form of inflammatory arthritis that affects the joints. The most commonly affected locations are the big toe, knees and elbows. However, gouty arthritis can occur at any joint and can easily be mistaken as muscle pain, especially during the early stages.
Some of the common symptoms of Gout include:
- Intense joint pain that most commonly occurs at your big toe, but can occur at any joint
- Red swollen joints that are warm to touch
- Lingering discomfort even after pain has subsided
- Painful to touch, even from something as delicate as a blanket
You may consult a podiatrist if you are experiencing any of the symptoms above, or suspect you have gout. For more information on gout, check out Part 1 of our Food and Foot series and this link.
What are some ways to avoid overeating this Ramadan or the coming festivities of Hari Raya?
1. Eating Suhur is important.
Drink lots of water, start with grains and protein. Start your suhur with dates as it is a great source of energy, sugar, and fibre. Dates are also chockfull of essential minerals such as calcium, iron, phosphorus, sodium, potassium, magnesium, and zinc and are also a valuable source of vitamins such as thiamin, riboflavin, niacin, folate, vitamin A, and vitamin K.
2. Iftar – breaking fast.
Start with easily digestible foods such as sweet potatoes, rice, yoghurt or nuts. You should also include at least two servings of vegetables and minimise your intake of fried and oily foods.
3. Indulge, but only in small amounts.
Pick out small portions of your favourites. Festive foods are frequently rich, sweet and delicious. Unfortunately, they are also typically very bad for you when eaten in large quantities. Choose small servings of your festive favourites and give your body time to digest.
4. Hydrate more.
Before visiting during Hari Raya, consider drinking more water to help curb your appetite and prevent overeating. Water aids digestion by improving absorption of the food as well as filling your stomach.
5. Pace Yourself.
You will visit many homes during Hari Raya, filling yourself up at the first stop will only encourage you to overeat. Pacing yourself has the additional advantage of allowing you to try more dishes at different homes.
6. Choose your food carefully.
Festive favourites like Rendang Daging or Kueh Raya can be extremely high in fat, sugar, purines and should not be consumed excessively.
7. Don’t be afraid to say no.
It is often difficult for us to refuse a host, particularly if it is the festive season. However, your own good health is more important than doing something to please your host. Be honest and open about your condition. Use it as an opportunity to educate others to help them avoid the same issues that you face.
8. Be a healthy host.
This year, make healthy substitutions for the dishes you prepare for your guests by using substitutes that are lower in fat or oil for your dishes. Your guests will surely appreciate your consideration for their health. Make a change to your habits and work towards a happier healthier holiday, Selamat Hari Raya!
Ari Tria Dzulkifle (Senior Podiatrist)
Ari is a Bruneian Podiatrist currently based full-time at East Coast Podiatry’s Kembangan branch. She received her specialised training in podiatric medicine from Cardiff Metropolitan University in the UK and currently serves as a Senior Podiatrist at the practice. Ari has over 13 years of experience in paediatric, geriatric, and diabetic foot management after serving as the deputy head of department at Brunei’s Main Hospital, where she was one of the four pioneer podiatrists. During that time, she helped advance the profession and practice of podiatry in Brunei.