Can reducing your risk of losing a toe or foot really be as simple as eating a diet rich in oranges, broccoli and strawberries?
It could be, according to researchers at Westmead Hospital in Sydney who found that vitamin C - which is found in citrus fruit, berries and green vegetables - can help heal chronic foot ulcers and prevent the need for amputation.
Ulcers are open wounds that fail to heal. They are caused or exacerbated by poor blood and nerve supply, and in the case of foot ulcers, bad feet architecture.
In severe cases they can lead to amputation and there are an estimated 8000 preventable foot amputations in Australia every year.
Those particularly at risk are people with contributing factors such as vascular disease, which affects bloody supply, and type 2 diabetes as it can result in nerve damage.
The 16-patient study published in the British Journal of Nutrition was led by clinical endocrinologist Professor Jenny Gunton, chair of medicine at Westmead Hospital and head of the Centre for Diabetes, Obesity and Endocrinology Research at the Westmead Institute for Medical Research (WIMR).
The randomised, double-blind study involved giving 500mg of slow-release vitamin C a day - roughly the weekly recommended intake - to people with foot ulcers at Westmead Hospital's foot wound clinic.
"One surprising thing we found in this study is half of the participants had a vitamin C deficiency, including one-quarter who had no detectable levels of the essential vitamin. This is probably due to a lack of fresh fruit and vegetables in their diet," Prof Gunton said.
The study found a significant improvement in ulcer healing by eight weeks with no amputations needed in the vitamin C group. In the control group, 44 per cent of ulcers either didn't heal in 180 days or required toe amputations.
Prof Gunton said the result was good news for people prone to foot ulcers, especially those most at risk due to a combination of vascular disease and nerve damage.
"Chronic foot ulcers are notoriously difficult to treat and have a significant impact on people's quality of life," Prof Gunton said.
"They can lead to very serious bone infections, and in around 40 per cent of cases at our clinic, amputation is necessary - as we saw in our control group."
Vitamin C is not produced by the human body and must be obtained through supplements or foods such as citrus fruits, berries, capsicum, sweet peppers, kale, broccoli and Brussels sprouts.
Vitamin C deficiency, also known as scurvy, can lead to a myriad of health problems including exhaustion, anaemia, pain and swelling in the joints, dry skin, gingivitis (gum inflammation) and tooth loss.
The recommended daily intake of vitamin C for adults is at least 65-90mg, which is more than covered by following the advice of eating five serves of vegetables per day.
These are examples of servings that would meet your daily vitamin C needs:
- One large orange
- One and half kiwifruits (any colour)
- One cup of broccoli (cooked but still slightly crunchy)
- One cup of strawberries
- One cup of Brussels sprouts
For more advice about health eating, see the NSW Health website.