Re: Sixty seconds on . . . bad diets
I have read the article “ Sixty seconds on--Bad Diets” By Dr Susan Mayor in the recent issue of your journal (BMJ 2019;365:l1649, 8th April 2019). Bad diets are more deadly than smoking.Quality of food should be given importance in assessing the effect of diet on health (1).In India majority of the people consume far less than the daily recommended level of fruit and vegetable and milk. (1).Nearly 2–4% of healthcare expenditure across Europe is taken up by wound care and the financial cost of caring for wounds is similar to that of obesity.(2,3). With increasing population sizes, and aging ones at that, the number of chronic wounds in need of treatment is likely to increase.(4) Vitamin D is well known as a regulator of epidermal and hair follicle differentiation. Vitamin D is helpful in wound healing (5) Tian and colleagues have observed that topical 1,25(OH)2D enhances wound healing(6).
The factors such as female, obesity, metabolic syndrome, current smoker, and skipping breakfast were positively associated with vitamin D deficiency (7). Dr Bertoia and colleagues observed an inverse association between fruit and vegetable intake and long-term weight change (8). Dr Nour and colleagues have noted vegetables intakes >4 servings/day reduced the risk of weight gain (9). A good hydration (water intake) is also needed for wound healing(10).
1. Hemalatha R, Toteja GS, Bhargava B. It's time we turn our attention to quality of food as well.
Indian J Med Res. 2018 Nov;148(5):469-471 2. Wound Care Costs - A Brief Overview of Health Economics in Wound https://woulgan.com/wound-care-costs/ Aug 21, 2017 3. Guest JF, Ayoub N, McIlwraith T. Health economic burden that wounds impose on the National Health Service in the UK. BMJ Open 2015;5(12):e009283. 4. Posnett J, Franks PJ. The burden of chronic wounds in the UK. Nurs Times 2008;104(3):44–5. 5 Yuan Y, Das SK, Li M. Vitamin D ameliorates impaired wound healing in streptozotocin-induced diabetic mice by suppressing NF-κB-mediated inflammatory genes. Biosci Rep. 2018;38(2):BSR20171294
6. Tian, X.Q., Chen, T.C. and Holick, M.F. (1995) 1, 25-Dihydroxyvitamin D3: a novel agent for enhancing wound healing. J. Cell Biochem 59, 53–56, https://doi.org/10.1002/jcb.240590107 7. Kim SH, Oh JE, Song DW, et al. The factors associated with Vitamin D deficiency in community dwelling elderly in Korea. Nutr Res Pract. 2018;12(5):387–395. doi:10.4162/nrp.2018.12.5.387. 8. Bertoia ML, Mukamal KJ, Cahill LE, et al. Changes in Intake of Fruits and Vegetables and Weight Change in United States Men and Women Followed for Up to 24 Years: Analysis from Three Prospective Cohort Studies [published correction appears in PLoS Med. 2016 Jan;13(1):e1001956]. PLoS Med. 2015;12(9):e1001878. Published 2015 Sep 22. doi:10.1371/journal.pmed.1001878 9. Nour M, Lutze SA, Grech A, Allman-Farinelli M. The Relationship between Vegetable Intake and Weight Outcomes: A Systematic Review of Cohort Studies. Nutrients. 2018;10(11):1626. Published 2018 Nov 2. doi:10.3390/nu10111626. 10. Ousey K, Cutting KF, Rogers AA, Rippon MG.
The importance of hydration in wound healing: reinvigorating the clinical perspective. J Wound Care. 2016 Mar;25(3):122, 124-30.
Dr Suraj M Math, Senior Resident In Surgery
Competing interests: No competing interests