Bacteria to blame for stinky feet

Dear Dr. Roach: My nephew has foot odor. Even after showering. His shoes smell bad and have to be replaced often. What is the remedy? — B.C.

Foot odor is caused mostly by bacteria living on your feet. Bacteria thrive in warm and moist environments, so people who sweat a lot are at high risk. Some people are also colonized with particularly bad bacteria. These bacteria do not cause disease, but they break down dead skin cells into smelly chemicals. A careful look at the skin on his feet may reveal small pits in the skin after a long day in socks and shoes.

Treatment may include disinfecting skin solutions, antibiotics and keeping the feet dry. This may require application of antiperspirants. 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: I had my first ever kidney stone. 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.

I drink skim milk. I started adding a slight bit of almond milk to the skim to give it a more pleasant taste. Should I not? — P.T.

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; however, dietary calcium paradoxically decreases risk of kidney stones. What makes the biggest difference in diet is the oxalate content. Almonds are very high in oxalate; cow’s milk is not. I would find another way to flavor the milk. I know a few people who add a drop of vanilla.

Everybody with kidney stones should drink plenty of water, and nearly everyone should be very careful not to have too much sodium.