Ask the doctors: Readers respond

Hello, dear readers, and welcome back to our monthly letters column. We would feel remiss if we didn’t (once again) urge you to please take the time to protect yourselves and your loved ones from the sun, heat and hungry bugs of summer. And now, onward to your letters.

• We heard from a reader who has added an additional level of sun protection to her daily routine. “I have a 15-minute walk between my car and my office, and on sunny days it gets hot and uncomfortable,” she wrote. “I bought a small travel umbrella to use like a parasol. It worked so well to block the sun that now I carry it in my purse and use it all the time.” Thank you for sharing a simple and great idea. For anyone interested in following suit, umbrellas are also available in UV-blocking fabric, which adds an important layer of protection.

• A column about resistant starch continues to generate a lot of interest. Resistant starch is just as it sounds – a carbohydrate that resists digestion and reaches the large intestine intact. That not only reduces the amount of glucose going into the bloodstream, but it also creates a food source for the all-important gut microbiome, which lives in the large intestine. It turns out that when foods like potatoes, beans, legumes and pasta are cooked and then allowed to cool, they develop resistant starch. That led to a question from a reader: “Does reheating the cooled food change the amount of resistant starch it has?” she asked. “If so, do you know by how much?” The good news is that while researchers found reheating the cooled foods does lower the amount of resistant starch, the change is small enough to be negligible.

• A column about foot fat pad atrophy, which is when the pads of fat that cushion the balls of the feet and heels begin to shrink, elicited a question from a reader: “Can this be due to a lack of nerve servicing the lower legs?” he asked. “Is that why you mentioned peripheral neuropathy?” The answer is yes, nerve damage, particularly when associated with diabetes, can contribute to foot fat pad atrophy.

• In every batch of mail, we continue to hear from readers regarding a column about a clinical trial that looked at stem cells to possibly reverse diabetes. The very small study is using stem cells engineered to behave like the insulin-producing cells in the pancreas. The first of the 17 participants to complete the study had such a promising response – his body began to manufacture its own insulin – that the researchers released the preliminary data. However, for everyone asking if this technique has been translated into an available treatment, unfortunately, the answer is no. Or, on a more hopeful note, not yet. Additional study is needed to ensure the treatment is widely effective, safe and long-lasting.

Thank you, as always, for taking the time to write. We read all of your letters and will continue to respond to as many as possible.

Send your questions to askthedoctors@mednet.ucla.edu.