SEOUL NATIONAL UNIVERSITY HOSPITAL

A freezing winter is everybody’s enemy. Sub-zero temperatures force you inside, where you shovel an excessive intake of high-calorie, sodium-rich processed foods down your throat. But sadly, the below zero temperature “conspiracy” runs deeper than that. A lack of exercise allows the residue of the inadvertent excessive intake of high sodium foods and meals to accumulate in the body slowly, leading to a gradual deterioration of the body’s normal blood circulation and fluid balance, which can cause edema or swelling.

Edema is an excessive fluid accumulation within body tissues that are outside blood vessels. Peripheral edema, characterized by swelling of the legs and feet, is the most common form, and has a variety of causes from the mundane to the serious. Edema is a symptom rather than a disease or disorder. It is mainly caused by poor kidney function from chronic disease, congestive heart disease; or liver dysfunction. Other causal factors include hormonal changes during pregnancy, a lack of exercise, obesity, standing or sitting for long periods of time, and external pressure from tight clothing.

Today we see more and more men and women looking to defy their age by trying to appear younger. Wearing tight jeans, stockings, leggings and leg warmers have become a notable fashion trend regardless of gender and age. But do you know that this could play a detrimental role in curtailing and inhibiting normal circulation? Peripheral edema often manifests itself in the feet and legs due to the effect of gravity. However, other body parts can also swell or bloat, which may be accompanied by pain, redness, and heat. So avoid tight clothing and wear loose, comfortable clothes that can be removed easily.

Clinically there are two types of edema. When you press on the swollen area for a few seconds and if you notice an indentation that persists for some time, you are looking at “pitting edema.” This swelling is the result of excessive fluid in tissues, often caused by congestive heart failure or chronic kidney disease. In “non-pitting edema,” which usually affects the legs and feet, pressure that is applied to the skin does not result in an indentation. Non-pitting edema occurs in certain disorders of the lymphatic system such as lymphedema, which is a restriction of lymphatic circulation, or hypothyroidism. Non-pitting edema is usually more difficult to treat.

In some cases, however, edema may be a sign of a more serious underlying medical condition. The kidneys have the capacity to control sodium levels in the body by changing the amount of salt execrated in urine; they serves as a signal as to whether retention or removal of salt is necessary for maintaining a healthy balance. But for people who have kidney disease, their kidneys may not be able to eliminate enough fluid and sodium from their body. This extra fluid and sodium may increase pressure in their blood vessels, causing edema. Furthermore, people who have damage to the blood vessels in their kidneys may not filter waste and excess water from their blood which can result in nephritic syndrome. One result of this is low levels of protein in the blood, which can also lead to fluid accumulation and edema.

We understand that life most days is fast for all of us. We are all busy with work, school, kids, projects, meetings, sports, and all the other things that keep us running every day. And for the most part, there have not been many great options when it comes to eating and getting our hands on good, nutritionally balanced food. It is nevertheless awfully sad to accept that food on-the-go is the answer to a rushed life schedule. Fast foods are high in sodium, preservatives, and other additives that can cause not only weight gain, but also water retention which is equally deleterious to the body. Therefore, eating a healthy diet and avoiding processed foods that contain high amounts of sodium may help decrease edema.

As a final reminder to readers, exercise remains the best solution to treat and prevent edema by pumping the excess fluid from the legs back toward the heart. Any form of regular exercise, including elevating the legs or stretching can decrease edema by improved blood flow.

In addition to helping cardiovascular conditioning, it can burn calories, make people lose weight and prevent swelling. Exercise can improve your overall health by helping you prevent and manage your general health condition. If not, do not hesitate to ask your doctor, as they can provide solutions.

The author is a medical doctor and professor of the Department of Internal Medicine at Seoul National University College of Medicine.