Scurvy is making a surprise comeback, according to the Westmead Institute, due to poor dietary choices
Professor Jenny Gunton, who heads the Centre for Diabetes, Obesity and Endocrinology research at The Westmead Institute, said several of her patients at Westmead Hospital with long-running unhealed wounds were cured by a simple course of vitamin C.
A research paper by Prof Gunton, just published in the international journal Diabetic Medicine, concludes that some diabetes patients should be tested for vitamin C deficiency.
“While diabetes is not traditionally a risk factor for vitamin C deficiency, the research suggests that clinicians should have a high index of suspicion,” says Prof Gunton, “particularly if their patients present with unhealed ulcers, easy bruising or gum bleeding without obvious cause.”
Her paper reported that there was no predominant social pattern to the incidence of scurvy and that patients with poor diets were observed to be from a range of socio-economic backgrounds.
“This result suggests that despite the plethora of dietary advice readily available to consumers, there are still plenty of people – from all walks of life – who are not getting the messages.”
Former pharmacist of the year Karalyn Huxhagen told the AJP that when some people with diabetes cut sugary foods from their diets, they go too far and eliminate vitamin C-containing fruits.
Other consumers are also cutting fruit out of their diet, particularly if they are following popular diets which advise them to avoid fructose.
Supplementation has its place, she says, but investigating lifestyle choices and advising on simple strategies such as not overboiling vegetables is a better first-line strategy.
“From an HMR pharmacist’s point of view, nutrition is one of the things we certainly ask them about, and of course the criteria for even prescribing medicines is that you should have tried diet and exercise and everything else first before you go to medicines for diabetes management.
“So they’ve normally been down this road of visiting a dietitian or a diabetes educator and discussing food. One of the jobs that I have working for Diabetes Australia, with Know Your Score, is about talking about dietary balance and what you should have in minor proportions.
“You see it with other things too, like sodium, where the doctor says ‘don’t use too much salt’ and so they don’t use any at all and come back with really low sodium counts. We find that a lot of these patients are told to minimise their fruit intake because fruit is high in sugar, and so they cut it out entirely.
“Diets are supposed to be balanced, and it’s a really big problem: people unbalance their diet.”
Huxhagen recommends having Australian Dietary Guidelines information on hand to share with patients who are concerned about Vitamin C deficiency or modifying their diet to reduce or eliminate sugar.
“And if there’s a good reason why they can’t have fruit for a period of time, you do have to back it up with a supplement.”
Carl Gibson, CEO of Complementary Medicines Australia, says that nutritional supplements act to fill in the gaps in a diet that is lacking in sufficient vitamins and minerals.
“Too many Australians today are relying on a diet of tea, toast and takeaways,” he says.
“Getting a healthy diet filled with all the essential vitamins and minerals is at the cornerstone of good health; however, in reality no one eats perfectly all the time.”
He cited latest ABS data which shows that the typical Australian is eating plenty of food but is still starving of quality nutrients.
Based on self-reporting, 6.8% of the population met the recommended usual intake of vegetables and just over half, at 54%, met the recommendations for serves of fruit.”