12/10/2013    Robert Kornfeld, DPM

RE: NY Podiatrist Discusses Nutrition and its Effect on Foot Health (Ron Raducanu, DPM)

Dr. Raducanu, I am not coming from an "extreme"
opinion. Quite the contrary. The movement in
medicine is toward patient-specific diagnosis and
treatment. The fastest growing sub-specialty among
MDs and DOs is integrative medicine. The
literature on anti-inflammatory diets is easy to
find.

Empirically, you need to know that omega-6 fatty
acids in excess will promote default into chronic
inflammation, while omega 3 fatty acids build the
pathway of detoxification and repair. The average
American consumes 1 Omega 3:15 Omega 6 fatty
acids. The optimal ratio is 1 Omega 3:2 Omega 6.

This alone speaks directly to an anti-inflammatory
diet. It is well documented that free radicals are
at the root of inflammation. It is also well
documented that a whole food anti-oxidant rich
diet controls free radicals far better than
inorganic diets and chemical anti-oxidants. This
speaks directly to an anti-inflammatory diet.

It is also well documented that patients with a
diet high in refined carbohydrates and saturated
fatty acids are 50 times more likely to present
with chronic inflammatory problems than those who
consume a balanced whole foods, organic diet. High
consumption of refined sugars also promotes the
proliferation of parasites in the gut, such as
yeasts, molds and pathogenic bacteria. This speaks
directly to an anti-inflammatory diet.

It is well documented that patients who do not
drink enough water will have higher levels of free
radicals. This speaks to an anti-inflammatory
diet. The biggest antigenic challenge faced by
humans is food consumption. A diet that promotes
inflammation will misdirect the immune system (as
I'm sure you know about 3/4 of your immune system
is in your gut). A misdirected immune system
leaves the patient vulnerable to repair problems
therefore, repetitive stress syndromes are much
more likely to occur in these patients. These are
just a few of the issues. There are many, many
more.

Do you believe that the foot is independent of the
patient’s diet? Do you believe that the body has
fences and the foot is an entity unto itself?
Hence, when a patient presents to your office,
your job is to make a diagnosis and then ask why.
Why did this patient cross the morbidity
threshold? They didn’t wind up in your office
because of a shortage of cortisone in their foot.
They didn’t wind up in your office because their
blood levels of NSAIDs were too low. And it is a
gross over-simplification to blame any chronic
pain syndrome on biomechanics alone.

My practice is a chronic pain practice. I have
patients coming to me who have had numerous
cortisone shots, PRP, multiple rounds of PT, a bag
full of orthotics, failed surgeries and have been
given prescriptions for nsaids and analgesics for
years. And yet they still suffer. The conventional
wisdom is to take these patients to the OR and do
an endoscopic plantar fasciotomy. Unfortunately, I
have treated hundreds of patients who were worse
off after the procedure. Why? Simply because their
ability to repair the surgical injury was
inefficient.

I could go on and on but I will stop here. I
really do not care what you think of my paradigm.
I only care about being the best doctor of foot
and ankle problems that I can be. After being
immersed in this paradigm and studying and
mentoring with some of the most amazing MDs and
DOs for over 25 years, and applying it all to the
practice of podiatric medicine, I know it works
and I will continue to practice this way until I
retire.

I simply offer the profession “food for thought”.
Do with it what you will.

Oh yes, one last thing. The reason I believe that
this profession will die a slow and painful death
is because of its fear of embracing all
possibilities.

Robert Kornfeld, DPM, Manhasset, NY,
Holfoot153@aol.com

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