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Bacteria are to blame for stinky feet

- Keith Roach, M.D. Readers may email questions to: ToYourGood­Health@med .cornell.edu or mail questions to 628 Virginia Dr., Orlando, FL 32803.

Dear Dr. Roach: My nephew has foot odor. Even after showering, his feet have a bad odor. His shoes smell bad and have to be replaced often. What is the remedy for this problem?

B.C.

Answer: Foot odor is caused mostly by bacteria living on your feet. Bacteria thrive in warm and moist environmen­ts, so people who sweat a lot from their feet are at high risk. Some people are also colonized with particular­ly bad bacteria, such as Kytococcus (formerly Micrococcu­s), Corynebact­erium or Dermatophi­lus. These bacteria do not cause disease, but they break down dead skin cells into unpleasant­ly smelly chemicals. A careful look at the skin on his feet may reveal small pits in the skin, especially around the heel, after a long day in socks and shoes.

Treatment may include disinfecti­ng skin solutions, antibiotic­s, and keeping the feet as dry as possible. This may require applicatio­n of antiperspi­rants to the feet, either regular overthe-counter or prescripti­on varieties. He also should wear lighter, more breathable footwear. Washing the feet several times daily and putting on new socks each time may also help. Dear Dr. Roach: At 75, I had my first ever kidney stone in December. The urologist told me to stop drinking so much milk. But he never asked if my diet had changed. I had been eating almonds by the handful every day. I felt certain this was the cause of the stone.

I drink skim milk, which is practicall­y tasteless. I started adding a slight bit of almond milk to the skim to give it a more pleasant taste. Should I not be doing this?

P.T. Answer: I am not certain why the urologist told you to stop drinking cow’s milk. We used to believe that the calcium in milk increased risk for kidney stones, especially calcium oxalate stones, which are the most common type; however, dietary calcium paradoxica­lly decreases risk of kidney stones, whereas calcium supplement­s increase risk of stones. What makes the biggest difference in diet is the oxalate content. Almonds, as well as almond milk, are very high in oxalate.

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