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Tips for Joint Health

Joint is the connection between two bones structure that allows you to bend and being flexible. Part of the structure are also, smooth tissue called cartilage, synovium and synovial. Synovial is fluid that act as lubricator in the joint area (1,2).


Below are few tips for healthy joint:


Maintaining healthy weight


Joint pain usually occurs as a result of the normal wear and tear thus it is no surprise that the heavier the person the more load joint must carry, thus,  in the long run this will develop pain in the joint. Study found out that, just by being obese an individual has four- to five-fold increase in the risk of developing osteoarthritis (1, 2).


So, now go and weigh your body and find out your healthy weight
(psssttttt you may talk to us as well)!





Exercise regularly


We always know that by being physically active it can lower the risk of getting diseases. However, what if one already has the joint problem? How can one exercise and be physically active?


Many do not know that by performing correct exercise and do it with correct technique, it can alleviate joint pain and/or numbness that usually people with osteoarthritis or rheumatoid arthritis have.  Aerobic exercise (Exercise that can increase heart rate) such as swimming can improve joint health (2,3).


If you already experiencing joint pain and would like to alleviate the pain using exercise method in combination with trying to get healthy weight, bear in mind to apply heat, because heat can relax your joint and muscle, you can also try to use warm towel or hot pack. Always go for slow movement and warm up your body with stretching first for about 10minutes to 15 minutes. If you feel pain, take a break or slow down.


Another easy tip is that, do not be a couch potato! By not moving your joint it increases the tendency for your joint to become stiff hence in the long run you will experience joint pain (2, 3).



What about food?


Eat food that is high with Calcium and Vitamin D


Food plays a huge role in our daily life, not only that it nourishes our body with nutrient, vitamins and minerals but it also at the same time prevent us from getting diseases. Deficiency of minerals and vitamin such as Vitamin D and Calcium can lead to many problems such as joint problem (1,4,5).


Calcium is the healthy bone mineral. About 99% of the calcium in the body is stored in bones and teeth. It is mineral that makes them hard strong. Study found out that, adequate amount of calcium intake lead to better bone and joint health.  In older adults, especially in post-menopausal women, bone is broken down at a faster rate than it is built. If calcium intake is too low, this can contribute to osteoporosis. Thus, consumption of food high with calcium content is very crucial since young (1,4,5).


Apart from dairy product, there are various other food that is close to Malaysians but people do not know that is high with calcium such as fish with edible bones (sardines and anchovies), beans and bean products such as yellow dhal, tofu, and tempeh, or locally processed food such as cencaluk, budu, vegetables like spinach, cekur manis, tapioca leaves, kailan and brocolli. In fact the bioavailability of calcium in broccoli is just about the same in milk!



Check this out…




Whilst for Vitamin D, usually we can get it from the exposure to sunlight, however, since nowadays we often stay indoors and use products with SPF when we are outside thus lesser vitamin D is able to absorb by our body. Vitamin D is important for the absorption of calcium, even when there is enough calcium intake, when vitamin D is not enough in the body, calcium will then become a waste (1,4,5).




Thus, it is very important to consume calcium and vitamin D rich foods in order to take care of our bone and joint health. Since in most countries currently the ‘lockdown’ phase is still ongoing, thus if you notice that you may be suffer from not getting enough vitamin D, thus start consume vitamin D rich foods like the above. Read food labels and consume food that is fortified with vitamin D such as breakfast cereals and milk.




  1. Kristin L. Clarke. (2007). Nutritional Consideration in Joint Health. Vol 26. Issue 1 (1010-108). :
  2. WebMd (n.d). Tips for Taking Care of your Joints.
  3. WebMd (n.d). Tips to Keep Joint Healthy.
  4. Healthline (n.d). Is there are connection between Vitamin D and Joint Pain?
  5. Cleveland Clinic (2015). Osteoporosis Prevention with Calcium Treatment

Workout Tips and Tricks!

You’ve been told a hundred times that exercise is good for you, and it’s true, but to maintain or do it everyday is a problem right. Here are five very good tips to rock out during your next workout time.



Tip 1: Make an exercise goals that you can achieve.

Many people find that having a firm goal in mind motivates them to move ahead. Goals are most useful when they are specific, realistic, and important to you. So maybe you can start try to exercise on three weekdays and one weekend day for 30 minutes to start but if you can only do less but slowly increase the duration, that’s okay too. The point is to get moving and keep moving. You can also start with mini workouts for only 5 minute. After you get comfortable then challenge yourself by increase the duration until your exercise get 30 minutes (1).


Tip 2: Get a partner to work out together so both of you can support each other.

There will be someone to help motivate you. Doing with your exercise partner, however, makes it a lot easier. Men and women have different intensity level. People put more effort into their workout routine when they’re exercising with someone else. So you must to realize your partner can not always keep on with you if your partner is different gender . What feels like a good workout to one of you might be too much or too little for the other. The same goes for healthy eating. The identical meal may not be acceptable to both of you. You must meet nutritionist and get advice on tips for healthy eating (2). Fact! Men lose weight faster than women. It is due to the fact that they have more muscle mass and can burn 30 to 40 percent more calories during the same workout. You cannot compare your result with your partner. It’s not realistic to see the same results in the same time period (3).




Tip 3: Don’t stick only one place or one exercise.

Head outside. Do variety of exercise so you don’t get bore. One of the simplest reasons for working out at variety of places and do different exercise is that it will be more fun. Going to the gym day after day can start to feel routine, and the last thing you want is to dread your workouts. Instead, get some fresh air with a walk, run, bike ride or hike (2).


Tip 4: Play Some Music to Keep Your Energy Up.

Music could be just what you really need to motivate you to push further. Research has found that playing music while exercising increases the duration of workouts without a perceived increase in effort. This effect because music boosts mood and encourages rhythmic movement. When a song has a strong, steady beat, for example, you can pedal or run to the beat of that music, which tends to feel satisfying and may inspire you to exercise more. While any type of music is beneficial, some research suggests faster music is more effective than slow music.

Choosing music that you enjoy and that fits your exercise routine can help you get more out of your exercise experience. Since everyone has a different ideal workout pace and intensity (4).



Tip 5: Work Out in the Morning and Get It out of the Way.

Some people find it easy if they do it in the morning, getting it out of the way before an excuse comes up to skip it. By the end of the day, you’re often really tired, random things have come up, and there’s always something else to do instead of exercise.


Morning workouts have been shown to lower night time blood pressure and improve sleep quality and physical activity also improves focus and concentration, regardless of when you do it. But if you have trouble focusing during the day, a morning workout might be just the ticket. The most important thing is to find a routine or schedule and workout routine that you can stick with (5).



  1. WebMD (n.d). Setting Your Goals on Fitness.
  2. Sadie Trombetta. (2016). 12 Reasons To Exercise With A Partner, Because Everyone Should Have A Gym Buddy.
  3. Cari Nierenberg. (2018). Yes, Men Lose Weight Faster Than Women, Here’s Why.
  4. National Center for Health Research (n.d). Can Listening to Music Improve Your Workout?.
  5. Kirsten Nunez (n.d). 13 Benefits of Working Out in the Morning.

Calcium Supplementation, Who Needs it?

Calcium is among very common micronutrient heard by public and milk advertisement is the contributor to this. Through this many people know that calcium is very important for bone and teeth. Calcium can be found in various food products nowadays not only milk. It has becoming partly marketing strategy for food company to incorporate calcium in their food product especially if the target consumer is children or elderly since many people know that calcium is vital for these two groups, children, and elderly.


Function of Calcium?


Body needs calcium for strong bones and teeth. Calcium is also required to carry out important function such as for muscle to move, for nerves system to carry messages between brain and body parts, for blood vessels to move blood throughout the body, and for body to help release hormones and enzyme that affect almost every function in the human body (1,2,3).


How much calcium is needed?


Normal adult need about 1000 mg of calcium daily, however there are certain condition which require to consume up to 1300 mg of calcium daily such as for pregnant lady, lactating mother, post-menopausal women, and man who is above 70 years old of age (1,2,4).



Calcium and diet


Body does not produce calcium, so it needs to be consumed from foods. Luckily, calcium can be found in variety of foods such as dairy products, dark leafy vegetables, fish, and many other fortified food products (1,2,3).   As for our local food products sardine, anchovies, cencaluk, budu, tofu, tempeh, broccoli, kalian, and tapioca leaves are among food that is high with calcium (4).


It is also important to take note that in order to absorb calcium, body needs vitamin D. Only a few foods containing small amount of natural vitamin D, such as egg yolks and salmon with bones. Mostly, we rely on the exposure to sunlight in order to get enough vitamin D, of course in Malaysia the country with sun all year long have no problem with this! However, as currently we are still in the so to say the ‘lockdown’ phase thus it is very important to remind everyone to get the sunlight every day at least 20 minutes for its vitamin D and calcium absorption (1,2,4).

Though all the foods stated above are easily found, but there are conditions which hinder individuals from getting enough calcium from diet thus require it from calcium supplementation.



Condition for calcium supplementation


Before considering calcium supplement, individuals must understand how much calcium needs by the body (stated above). Then individuals must seek help from nutritionist, dietitian, pharmacist, or doctors, where they will assess your calcium consumption from your diet through diet recall. If the calcium intake falls short thus you need to top up calcium from supplement.


Hypertensive individuals and diet with large amounts of sodium.


Several literature reviews on topic of total calcium intake from food and supplements with regards to hypertension suggested that there is possible link to lowering high blood pressure. However, since most of the study design have small number of subjects, and were tested with people from different background, and not to mention possess various kind of biases thus making it difficult for scientist to draw conclusion (1,2).


However, a large study subject (Women’s Health Study), found out that calcium intake was inversely associated with risk of hypertension in middle-aged and older women, in terms of preventing hypertension (1,2).


The consumption of high sodium food lead to more calcium excretion through the urine, which will lead to constriction of blood vessels, which in the end resulting  in high blood pressure. Drinking large water after consuming salty food, is not enough, as it may be making blood pressure return to its slightly normal condition, but it is not helping with the loss of calcium (1,2,5).


Pregnant and lactating mother


Often times, pregnant women is being reminded of how important is folic acid for the baby, even from the trying to conceive period, healthcare providers already advise them to consume folic acid, in order to prevent spina bifida to the baby. However, calcium is as well very important for mothers throughout pregnancy and lactating period especially for mother who is lack of calcium from diet (1).


Several professional organizations recommend calcium supplements during pregnancy for women with low calcium intakes to reduce the risk of preeclampsia (a condition where gestational hypertension always occur). For example, the American College of Obstetrics and Gynaecology (ACOG) states that daily supplementation with 1,500–2,000 mg calcium may reduce the severity of preeclampsia in pregnant women who have calcium intakes less than 600 mg/day. Similarly, the World Health Organization (WHO) recommends 1,500–2,000 mg calcium for pregnant women with low dietary calcium intakes, particularly those at higher risk of gestational hypertension (1).


As for normal healthy mother, the consumption of calcium is especially important during lactating period, mother may notice symptoms such as cramps which indicates lack of calcium during pregnancy and lactation period. Also if a mother is on iron supplementation as well, it is advisable to not consume both at the same time, it is best to gap several prior the consumption of these two since it can interfere with the absorption (1,2).



Post-menopausal women and elderly


Throughout the lifespan, bones are constantly being broken down and built up in a process known as remodelling. Bone cells called osteoblasts build bone, while other bone cells called osteoclasts break down bone if calcium is needed. In healthy individuals who get enough calcium and physical activity, bone production exceeds bone destruction up to about age 30. After that, destruction typically exceeds production. This is sometimes called “negative calcium balance,” which can lead to bone loss. Women tend to experience greater bone loss than men later in life due to menopause, a condition that lowers the amount of hormones that help to build and preserve bone (5).


Getting enough dietary calcium at all ages may help to slow the degree of bone loss, but calcium intakes at any level are not known to completely prevent bone loss. Calcium is less easily absorbed at later ages, and therefore eating a very high amount of calcium will not always resolve the problem (5).


Studies on calcium intake and bone density in postmenopausal women have mixed results that could be due to various reasons. Because the results of some large trials found that higher calcium intakes (usually achieved with a supplement) was associated with improved bone density and slightly lower risk of hip fractures, the RDA for calcium for postmenopausal women is higher than at younger ages. Some studies suggest that frail elderly (80 years and older living in institutions) may benefit from supplementation more than “younger” elderly who live independently in the community (5).




Individuals with lactose intolerance and limit dairy products


Individuals with lactose intolerance usually, is unable to consume food that has high amount of calcium especially if it come from milk and dairy source of food. Thus, lactose intolerance individuals need to consume it form dark leafy vegetables and soy-based product. However, in most cases the consumption is not enough or individuals with lactose intolerance consume not enough vegetable rich with calcium or other food source rich with calcium, thus for this specific population calcium supplementation is needed either from fortified food product such as ready to eat cereals or from calcium supplementation tablet itself.


Individuals receiving treatment on certain medication in the long period


Well, there are certain medication which can influence the absorption of calcium. Medication such as to treat osteoporosis (bisphosphonates), antibiotics (fluroquinolone), medication to treat low thyroid problem (levothyroxine), anticonvulsant (phenytoin), diuretic medication (Lasix and bumex), antacids containing aluminium and magnesium and also glucocorticoids (prednisone). These are all either causing calcium loss in the urine or cause calcium depletion in the bone. Thus, if you are on these medication, it is advisable to take calcium rich foods four hours prior or after the intake of medication, so that it would not interfere with the absorption of calcium, it is also best if you consume calcium supplementation if you do have poor intake of calcium rich food as well (2).



In conclusion, in all these conditions, calcium supplements may help you meet your calcium requirements. Talk with your doctor or dietitian about whether calcium supplements are right for you.




  1. National Institute of Health (NIH). Department of Health and Human Service. Calcium. Fact Sheet for Health Professionals. (Accessed on November 18, 2020).
  2. National Institute of Health (NIH). Department of Health and Human Service. Calcium. Fact Sheet for Consumers. (Accessed on November 18, 2020).
  3. Mayo Clinic. Nutrition and Healthy Eating. Healthy Lifestyle. Calcium and calcium supplements: Achieving the right balance. (Accessed on November 18, 2020).
  4. Ministry of Health (MOH). National Coordinating Committee on Food and Nutrition. Recommended Nutrient Intake (RNI): A Report of the Technical Working Group on Nutritional Guidelines (2017).
  5. Harvard T.H. Chan. School of Public Health. The Nutrition Source. Calcium. (Accessed on November 18, 2020).

Should we consume milk every day?

Milk is the most single food that has almost all the nutrient or can also be recognized as food that has the most nutrients as compared to the other food. Which is why from the ancient times naturally it is the staples food for babies. This also explain why bedridden patient who cannot tolerate food well, usually the first oral nutrition supplement given is milk (1).


However, the issues with milk always is controversial. There are study saying that as adult we do not have to consume milk every day, while there are also study suggesting that milk should be consumed every day (1). Down below we list out reasons why you should consider your consumption of milk, whether to drink it every day or not!



Milk reduced obesity risk


Well, people always equate full fat-dairy products for gaining weight however, finding of the research found somewhat contrary. Full-fat dairy products may actually be better than low-fat variety for keeping off weight! According to Walter Willet, Harvard School of Public Health nutrition expert, the idea that all fats are bad emerged in the 1950s and 1960s, when saturated fat was linked to high cholesterol and increased heart disease risk (2).


What happened was that, when saturated fat is reduced in food products or in people’s diet, it is often replaced with sugar or carbohydrates. The problem with this is that it takes more carbohydrates to make we feel full and unlike fat carbohydrates does not promote satiety (the longer feeling of fullness) thus making us consume more food (2). Another study saying that, the more sugar we consume the more we are craving for its, its like addiction (3).



The kind of milk that we have nowadays


Since the demand of high fat milk is low, most of food manufacturer has lower down their amount of fat, which is replaced with sugars. Which explained why if you looked thoroughly on food label for low fat milk, the chance is it has higher sugar content. Thus, when it comes to milk, it is very tricky. Some more we have various kind of milk nowadays from animal-based milk to plant-based milk.


How to choose?


When it comes to milk, if you want to drink milk as a means to avoid you from eating more food, as it promote satiety, then choose full cream milk, however you need to monitor your calorie intake from other source of food and choose milk with low sugar. However, according to Vasanthi Malik of Harvard School of Public Health, as we often get our fat from other source of food, thus it is best if we consume low fat milk, but still…need to check on the sugar content. Bottom line, when it comes to milk, choose the one that has lowest sugar, saturated fat, and trans-fat. As these are the culprit behind various health complication.


As for plant-based milk, it is not necessarily healthier than cow’s milk, for example it might be that it has higher sugar content as well. However, they are the better choice if your primary concern is environmental impact, since soy milk, almond milk, oat milk, and rice milk produce less carbon and greenhouse gas emission than cow’s milk.


Pro and cons of milk


Again, the decision on whether to impart milk on the daily diet is still debatable though it is in the guideline of food pyramid and even healthy plate. The consumption of milk everyday is still depending on your dietary intake and body weight. Let say if you have normal weight, thus consuming one glass of milk per day is enough, however if you are underweight you may consume more than one. Maybe two glass of milk. But again, as mentioned above, while you are getting your good fat from milk it is very important to reduce other bad fat from your diet such as deep fried food, food that has high trans-fat which is bad for you and also food with high saturated fat.


The actual scenario is in Malaysia many people are overweight and obese thus, perhaps we should look at the suggestion to actually drink milk everyday again. What we are trying to emphasized is if you already get your calcium from other sources of food such as anchovies, sardine, almond, kale and many other foods, then probably you have already got the 1000 mg of calcium that you need daily!



Fact Check (5,6)!


Saturated fat is the kind of fat that is usually high in animal-based food and in some plant-based food such as coconut milk (santan). Excessive intake associates with raised blood cholesterol and increases risk of heart disease. Anddd do you know that coconut milk (santan) does not have cholesterol like what been claimed by almost all coconut milk products? It really is cholesterol free it just that it has high saturated fat!


Trans fat is ‘man made’ fat usually derived from the hydrogenation process. It raises your bad (LDL) cholesterol levels and lower your good (HDL) cholesterol levels. Eating trans fats increases your risk of developing heart disease and stroke. It is also associated with a higher risk of developing type 2 diabetes. Doughnuts, cookies, crackers, muffins, pies, fast foods and cakes are examples of foods that may contain trans-fat.





  1. Ask the Experts: Is Milk is good for you? (Accessed on November 23, 2020).
  2. Harvard T.H. Chan School Public Health. Calcium and Milk. (Accessed on November 24, 2020).
  3. Avena, N. M., Rada, P., & Hoebel, B. G. (2008). Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience and biobehavioral reviews, 32(1), 20–39.
  4. Harvard T.H. Chan School of Public Health. Milk not necessary for adult, should be good option for kids. (Accessed on November 20, 2020)
  5. Ministry of Health (MOH). Fats and cholesterol. (Accessed on November 23, 2020).
  6. American Heart Association (AHA). Trans Fat. (Accessed on November 24, 2020).

Gout: What you need to know?

Gout is one of the most frequently recorded medical illness throughout history. It is caused by a condition known as hyperuricemia, a condition when there is too much uric acid in the body. Body makes uric acid when it breaks down purines. Purines are found in the body and foods that we consume. Example of food containing purine are steak, seafood, organ meat, alcohol drink, and many more.


Normally, uric acid dissolves in the blood and passes through kidneys and excreted in urine.  But when there is too much uric acid in the body, uric acid crystals (monosodium urate) will build up in joints, fluids, and tissues within the body. The build up will become sharp needle like crystal compound in joint or in the surrounding tissue that will cause pain, inflammation and swelling in the affected joint area.


Sometimes hyperuricemia does not cause gout, which also refer to as asymptomatic hyperuricemia. This condition does not need to be treated but efforts should be made to lower the uric acid levels by encourage individuals to make changes in their diet or lifestyle.



What are the sign and symptoms for gout? (1,4)


Sign and symptoms for gout occur when there is appearance of inflammation and swelling in the joint are, this condition usually refers to as acute gout attack. Usually during this condition symptoms below can be seen:


Intense joint pain. Usually it affects the large joint in the big toe area, but it can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists, and fingers. The pain is likely to be most severe within the first 4 to 12 hours after its presence.


Lingering discomfort. After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks.


Inflammation and redness. The affected joint or joints become swollen, tender, warm and red.


Limited range of motion. As gout progresses, individuals may not be able to move joints normally, as it will becoming stiff.


For gout there will be times when symptoms get worse, known as flares, and times when there are no symptoms at all, known as remission. Repeated attack of gout can lead to gouty arthritis, a worsening form of arthritis.


What are the risk factors for gout (5)?


There are factors which makes individuals are more susceptible to gout as compared to others:


  • Male


  • Being Obese



  • Have certain health condition such as hypertension, diabetes, and poor kidney function


  • Using certain medication such as diuretic pills


  • Excessive drinking of alcohol


  • Frequently have diet that is high with purine


How gout is diagnosed? (1,5)


 Doctor usually diagnose gout based a review of your medical history, physical examination, and the symptoms. However, as for gout as people in Malaysia rarely do blood test thus the only time, they found out that they have gout is when their big toe is already at stake. Usually when you meet doctor with presence of tophi or podagra, the doctor usually will manage or treat the condition as gout until proven otherwise. Doctor will usually further confirm this via X-ray to see if there is any stone, or through your blood result where your uric acid level will be measure. Sometimes doctor can also take fluid sample from your joint to confirm whether it contains uric acid (4).


How gout is treated? (1,5)


Gout is usually treated by managing the pain of flare. Treatment of flare consists of non-steroidal anti-inflammatory (NSAID), like ibuprofen, steroids, and the anti – inflammatory drug colchicine.



However as to prevent from the future flare, changes in lifestyles is a must. Losing weight, eat less purine-rich food (like red meat or organ meat), limit alcohol consumption, and drinking plenty of water will help to prevent future attack.


 In order to prevent gout from happening, it is none other than to live a healthy lifestyle, eat diet in balance, variety, and moderation manner. Exercise frequently. Always make sure your weight is in the healthy range of weight for your height and frequently conduct medical check up to see if there is any changes in your blood result as our age increases.




  1. Centre of Disease Control (CDC). Gout. (Accessed on November 26, 2020).
  2. What is gout? (Accessed on November 26, 2020).
  3. American Family Physician Foundation (AAFP). Gout and Hyperuricemia.,changes%20in%20diet%20or%20lifestyle. (Accessed on November 26, 2020).
  4. Mayo Clinic. Gout. (Accessed on November 26, 2020).
  5. Clinical Practice Guideline (CPG). Gout. Ministry of Health Malaysia (MOH).

Low Purine Diet 101

Have you heard of low purine diet? Low purine diet is diet that is prescribed to individuals who have gout, or have symptoms of gout, or have high or borderline uric acid in their blood results. Low purine diet is not a first line mechanism in treating gout or hyperuricemia (a condition of high uric acid level). Usually in the condition of gout attack, or when individual have swollen joint (usually in the big toe area), doctor or pharmacist will prescribe medication to ease the inflammation and diuretic medication to help with the retention of uric acid crystal.

These two prescription usually will be accompanied with pain killer to ease the pain. Depending on severity, condition, and individuals’ level of uric acid, the acute attack will slowly resolve in few days or week. However, if individuals fail to be cautious on food that they consume, gout may attack again (1,5). So here in this article, we are going to explain on diet that is suitable for individual with gout. Some said that it can be used for people who have kidney stone as well, but it is best to seek medical advise on what kind of stone itself, such as sometimes it can be calcium stone, oxalate stone, and many more thus avoidance of food must be made according to what kind of stone in the individuals body. Again, in this article we focus on gout.


Purine is found on many types of food, the only different is the amount of purine in a particular food. Certain food has high amount of purine while the other have low amount of purine. Food that is high in purine is the kind of food that has to be avoided by individuals with gout since it will be broken down into uric acid which for individual with gout it will be a huge problem (1,5,3).





Most carbohydrate does not have high amount of purine; thus, it is okay for individual to consume carbohydrate within recommended intake. However, as for people who have gout and diabetic, it is very tricky since wholegrain product has high amount of purine but has low glycemic index and high fiber, which is meant for individuals with diabetes but not gout, thus for individual with both problems, they need to balance in the amount of carbohydrates taken from these two source, meaning to say, let’s take rice as an example, certain days individual has to consume white rice while other days it can be brown rice. The same thing works for bread and pasta etc (carbohydrate-based food) (2,3,6).




Most of gout individuals must be cautious when it comes to protein-based food. Fish such as anchovies, sardines, scallops, tuna, codfish, herring, and haddock has high level of purine thus need to be avoided. Meat such as from goose and duck and organ meat such as brain, heart, liver, and kidney also have high amount of purine thus must be avoided or limit it intake. Gravies that is made from meat, like red meat broth or soup or stocks also has high purine (2,4,6).


For individual with gout, protein rich food can be consumed from source such as chicken, lean meat, and prawn. However, the consumption of meat also must be limited to 2-3 ounces only per day. For individuals with gout it is best to consume protein from legumes and eggs since most of it does not has high purine, but for individuals with gout and high cholesterol level consumption of eggs need to be limit  as well. If for normal and gout individual consumption of egg is up to two eggs per day while for gout and high cholesterol need to limit to one only or better do not consume egg yolk for it can elevate your cholesterol level. You sure don’t want your cholesterol level rising while managing your uric acid level, don’t you ?



Vegetables and fruits



Most of the vegetables and fruits has low amount of purine except for asparagus, cauliflower, spinach, and mushroom. Thus, individuals with gout may consume vegetable without concern that it may elevate level of uric acid in the blood. As for individuals who has diabetes and gout, consuming a lot of vegetables also will help in the management of blood glucose level as well, but you need to consume fruits that has low glycemic index such as apple, strawberry, kiwi, and peach (2,3,7).



Milk and dairy products


Milk and dairy products are mostly low in purine. However, in consuming milk and dairy products, individuals need to be aware on the amount of fat they are ingesting. It is also not suitable for individual who has high cholesterol. Thus, always choose milk and dairy product that is low trans-fat, low saturated fat, and low sugar (2,3,7).



In conclusion,


Other than category of food mentioned above or in the picture above, alcohol consumption also must be taking in cautious, for gout individuals, wine is better than beer. And, if you are considering supplementation consumption, it is best to avoid supplement that contained yeast. Consumption of low purine diet also must be together with drinking plenty of water and exercise which can help you to maintain or lose weight, which is one of the risks for gout (2,3,6). You may follow the low purine diet table below to understand diet for gout individuals better!





  1. 7 Tips following a low-purine diet. (Accessed on December 1, 2020).
  2. com. Low Purine Diet. (Accessed on December 1, 2020).
  3. Mayo Clinic. Gout: What’s allowed what’s not. (Accessed on December 1, 2020).
  4. sg. Gout Diet: Top Carbohydrate, Dairy, Fruits, and Vegetables to eat. (Accessed on December 1, 2020).
  5. My Health Portal. Ministry of Health Malaysia (MOH). Gout. (Accessed on December 1, 2020).
  6. My Health Portal. Ministry of Health Malaysia (MOH). Diet Management for Gout. (Accessed on December 1, 2020).
  7. Clinical Practice Guideline (CPG). Ministry of Health Malaysia (MOH). Gout.

Arthritis, what you need to know?

Arthritis is not a single disease; it is referring to joint pain or joint diseases. There are more than hundred types of arthritis and related condition. It can be due to various reasons and require different kind of treatment. Arthritis is more common among women, and it can affect just anyone but more frequently older and overweight/ obese individual. Two most common types of arthritis are osteoarthritis and rheumatoid arthritis (1,2).


Osteoarthritis cause cartilage (the tissue that cover the bone end) to break down. While rheumatoid arthritis attacks the join beginning with lining the joint. Another condition which often occur but to individual with younger age unlike osteoarthritis and rheumatoid arthritis are, gout, the condition is when the uric acid crystals form from too much uric acid in the blood (1,2).


Symptoms of arthritis?


The symptoms of arthritis usually develop over time, but they may also appear suddenly. Common arthritis joint symptoms include swelling, pain, stiffness, redness, and decreased range of motion. Symptoms may come and go. They can be mild, moderate, or severe but most often it is reported to be severe in the morning. The pain may stay about the same for years but can progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs (2,3).


Arthritis can also cause permanent joint change. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. Some types of arthritis also affect the heart, eyes, lungs, kidneys, and skin as well as the joints (2,3).




What cause arthritis?


There are many causes to arthritis and different type of arthritis has different causes, as an example osteoarthritis (OA) occurs due to normal wear and tear, but an infection or injury to the joints can exacerbate this natural breakdown of cartilage tissue. Also, if you have family history of OA the risk of developing OA is higher for you (2,3).



While for rheumatoid arthritis (RA) it occurs when your body’s immune system attacks the tissues of the body. These attacks affect the synovium (a soft tissue in joints that function to nourishes cartilage and lubricates joint). RA is the kind of disease that will invade and destroy joint. It can eventually lead to the destruction of both bone and cartilage inside the joint. The exact cause of the immune system’s attacks is unknown. But scientists have discovered genetic markers that increase your risk of developing RA nowadays (2,3).



What to do?


When it comes to pain, if you notice some changes in your body, it is important for you to seek help so that you will get the accurate diagnosis on it, the earlier the better. So, talk to your doctor about your symptoms. You may be referred to a rheumatologist or orthopedic, or doctors who specialize in arthritis and related condition. There are many things that can be done to preserve joint function, improve its mobility, and quality of life. Learning about the options available for treatment will make you have higher chance to find the best solution fits you (3,4).



However, apart from learning the best solution for your joint pain, it is also best if you try to reduce your weight if you are obese or overweight. Try to maintain weight since weight has some impact on joint, regardless of where the joint is, by maintaining weight, you will start putting nutritious foods in your body that can reduce inflammation on your joint. The main goals when you have arthritis is to reduce symptoms and improve the quality of life (3,4).






  1. Mayo Clinic. Arthritis.,are%20osteoarthritis%20and%20rheumatoid%20arthritis. (Accessed on December 4, 2020).
  2. Arthritis. (Accessed on December 4, 2020).
  3. Arthritis Foundation. What is arthritis? (Accessed on December 4, 2020).
  4. Arthritis. (Accessed on December 4, 2020).


Collagen, what you need to know?

The word collagen comes from Greek word “kola” which means glue, and that basically function of collagen which is to hold protein and/ or non -protein substance together. As an example, in skin, collagen function is to hold all the skin structure together.  Collagen is a protein that provides structure to many parts of the body, including bones, skin, tendons, and ligaments. It accounts for about one-third of body protein composition. It is one of the major building blocks of bones, skin, muscles, tendons, and ligaments. Collagen is also found in many other body parts, including blood vessels, corneas, and teeth.

Types of collagen


There is various type of collagen, but the main type of collagen is type I, type II, type III, and type IV.


Type I: Most of your body’s collagen is made of type I. It is densely packed fibres which provides structure to skin, bones, tendons, fibrous cartilage, connective tissue, and teeth.

Type II: This type is made of more loosely packed fibres and found in elastic cartilage, which cushions the joints.

Type III: This type supports the structure of muscles, organs, and arteries.

Type IV: This type helps with filtration and is found in the layers of your skin.


Collagen in skin, do we need it?


Our body can produce its own collagen, however the production of collagen gradually declined as we aged, which explains among the sign of aging is wrinkles, that is coming from skin that is less elastic, supple, and firm.



Researchers also revealed that women lose collagen faster than men causing women’s skin aging faster than men. Apart from gender, nutrition and recreational drugs,  environmental stress such as sun exposure and exposure to toxins such as pollutants, and cigarette smoke can also affect collagen in the body.


Where can we get collagen from?


Good news is, collagen can be gotten from food, there are foods which can stimulate production of collagen and break down collagen. Body makes collagen from combining proline and glycine (types of protein).Thus consuming food high with proline and glycine will help with restoring collagen level in the body.


According to Dr. Bradley from Cleveland Clinic, your body cannot make them if they don’t have them, which means all the nutrients such as glycine and proline are essential to produce collagen, but if we do not acquire it from diet then our body might not be able to produce collagen. Foods that are high with collagen are mostly diet from protein-rich foods such as bone broth, pork, chicken, beef, eggs, and fish. Plant based food also have added benefits to collagen rich food consumption since vegetables and fruits contain high level of antioxidants which can protect oxidative stress from reducing collagen. Whilst, food that can break down collagen are sugary foods and refined carbs.



As for supplement containing collagen, it is usually in the form of hydrolysed collagen. The source of hydrolysed collagen can be from fish, marine seaweed, pork skin and food source that has high collagen contents. It is also said that hydrolysed collagen is much easier to be absorbed by body as compared to food.


 To date studies that report whether consumption of collagen has benefits to skin, joint health, muscle mass, bone and many more is inconsistent. It is depending on various factors such as the source of collagen, the bioavailability of collagen, the frequency of consuming it, the severity of skin condition or joint condition previously and many more. Thus, it is advisable for individual to check on the supplement ingredients  prior consuming any kind of supplement.


Since consuming collagen supplement can also be harmful such as to individual with cyst problem and cancer problem. Again, which is why it is best to seek professionals helps before consuming any supplement. Certain supplement is contraindicated with medicine that you currently taking and many more.



  1. Top 6 Benefits of Taking Collagen Supplement. (Accessed on December 29, 2020)
  2. Collagen, what is it and what it is good for? (n.d) (Accessed on December 29, 2020).
  3. Atikah Khalim (2015). Ministry of Health Malaysia (MOH). My Health Portal. Collagen.
  4. Fadzilah kahar (2015). Ministry of Health Malaysia (MOH). My Health Portal Collagen and its source.
  5. Cleveland Clinic. The best way you can get more collagen. (Accessed on December 29, 2020).
  6. What is collagen.,in%20the%20body%20by%20mass. (Accessed on December 29, 2020).

Fish Oil Supplement: Who Needs It?

Consumption of fish is really important as it is a good source of protein. It is recommended to consume one fish per day according to Malaysia food pyramid. This is because the consumption of fish in Malaysia is rarely equated to having risk of contamination of mercury etc unlike in western countries. This might be due to types of fish and size or fish that we are consuming here as compared to in the other part of the world. It is said that the bigger fish the more contamination that it has hence there is recommendation for pregnant mother to consume small fish rather than big fish to avoid the risk of contamination.


Research on the benefits of fish oil supplement also vary greatly, which is why in this article we are going to list out who might need fish oil supplement in their daily life!


Benefits of fish oil consumption vary greatly from one study to another, there is study link between mental health and disorder with omega, as it said that EPA and DHA can improve brain development ability, even in young children, there are also study noted that it can help with cardiovascular diseases, joint pain, and skin problem such as eczema. The question is, is true that fish oil consumption can help with these all? ?(1)



Individual with mental health problem/disorder


Researchers examined link between suicide and consumption of fatty acids intake among more than 205, 000 participants in three long term studies from 1988 to 2008 found out that there is no evidence that intake of fatty acids or fish lowered the risk of suicide. “The vast majority of previous literature on whether there is a mental health benefit from fatty acid intake has been based on depression screening data. Our study represents one of the few times—and it is certainly the largest of its kind—that this relationship has been studied with hard data on suicide mortality.” (2)


Whilst for brain health,  study noted that it is better to eat nutritious diet and be physically active than to take omega 3 fatty acids supplements or fish oil, Study showed little benefit of omega 3 supplements on memory of a 3073 elderly people at risk of macular degeneration (an age related cause of vision loss). The participants of the study were randomly assigned to take omega 3 pills or placebo for five years.  The researcher concluded that supplement cannot replace a healthy dietary pattern, if you eat a healthy diet with high amounts of fruits, vegetables, and marine fish, you probably don’t need to take fish oil supplement. The overall dietary pattern is more important than a single nutrient (2).


Individual with cardiovascular disease


Recently there are many studies suggesting that Omega 3 will not lower the risk of heart problem. To answer this Dariush Mozaffarian, cardiologist from Harvard Medical School said that, he gathered 20  previous studies involving more than 68, 000 patient since 1989, overall, fish oil supplement neither harm nor good, since they found that the supplements did not significantly reduce people’s risk of mortality, cardiac death, heart attack, and stroke. But according to him, the research and link between the fish oil supplementation and heart problem is rather complex, since it does not only take fish oil to shield heart from various problems and diseases, it also take weight status, exercise frequency, cigarettes’ or substance use and many more (3,4,5).



Which is why interpreting the study, we would still recommend customers and patients to consume fish more as a first line measure. But, if you do not like fish, or you feel like your consumption of fish is not enough or you simply want to be sure that your body is getting omega 3, there is no harm in taking fish oil, it will certainly help with the nutrient essential nutrient, since omega 3 is a nutrient that your body cannot produce can only get form diet (3,4,5).


Individual with skin problem


A systematic review for the treatment of atopic dermatitis or eczema using fish oil supplementation is very scarce, the studies available are all only small sample size studies. Not only these three studies are small, it is also described as poor methodological studies from reviewer, as it has many confounding factors, but the outcomes of these studies shows positive outcome from eczema condition and overall daily living as compared to placebo (6,7).


Another convinced relationship between consumption of fish oil and skin health is that in a study where pregnant lady were given fish oil during pregnancy and follow up to 6 years found out that, consumption of fish oil during pregnancy lead to positive skin health outcome on babies skin health. The study also concluded that maternal supplementation with fish oil might have prophylactic potential for long-term prevention of asthma in offspring (6,7).




In conclusion, consumption of fish oil has mixing result in studies depending on what kind of problem that we are looking at to solve with fish oil. Since there are various factors influencing a particular health problem. There is no magic pill in this world honey! You need to however eat healthily, consume a lot of vegetables and fruits, and exercise, but if you think that you do not get enough omega 3 from diet, as you dislike fish, or you are afraid to consume fish regularly due to contamination etc, or you simply would like to make sure that your body has enough omega 3, then there is no harm in taking fish oil supplementation. It just that in order to make sure you get the right omega 3 for your body, buy it from pharmacy, make sure the product has Ministry of Health (MOH) notification number, and simply ask healthcare professional on which omega 3 supplementation suits you, simply for the dosage and perhaps current medication that you are on and you are good to go!




  1. Harvard T.H Chan. School of Public Health. Fish: Friend or Foe?
  2. Harvard T.H. Chan. School of Public Health. No mental health benefit from fish oil.
  3. Harvard T.H. Chan. School of Public Health.
  4. Harvard T.H Chan. School of Public Health. Major Meta Analysis in Clinical Trial Omega 3 Supplemeny link with lower risk of CVD.
  5. Harvard T.H. Chan. School of Public Health. Fish Oil Supplementation and Heart Health.
  6. Schlichte, M. J., Vandersall, A., & Katta, R. (2016). Diet and eczema: a review of dietary supplements for the treatment of atopic dermatitis. Dermatology practical & conceptual6(3), 23–29.
  7. Huang, T. H., Wang, P. W., Yang, S. C., Chou, W. L., & Fang, J. Y. (2018). Cosmetic and Therapeutic Applications of Fish Oil’s Fatty Acids on the Skin. Marine drugs16(8), 256.

Should you consider collagen supplementation ?

Collagen is a fiber-like structure that is used to make connective tissue, which connects other tissue together. It is a major component of bone, skin, muscles, tendons, and cartilage. Collagen is a component that help to make tissue strong, resilient, and able to withstand stretching (1).



Although the saying that our bodies make less collagen as we age is true, but the production of collagen drops most not only because of this but also due to excessive exposure to sun, smoking including second hand smoke, excessive consumption of alcohol, lack of sleep and lack of exercise. As the collagen level in our skin diminish, the deep skin layers change from a tightly organized network of fibers to an unorganized maze. Environmental exposure to skin such as harsh weather can also damage collagen fibers by reducing their thickness and strength which can lead to wrinkles on the skin surface (1).




Research on collagen supplementation are mostly on joint and skin health. Although studies pertaining to this using human subjects are still lacking, but some randomized controlled trials have found that collagen supplementation improve skin elasticity. In one study, women who took a supplement containing 2.5 – 5 grams of collagen for 8 weeks experienced less skin dryness and a significant increase in skin elasticity as compared to those who did not. Another study found out that women who consume it for 12 weeks experienced increased skin hydration and a significant reduction in wrinkle depth as compared with a control group (1,2, 3,4). 


Trials on collagen supplement and  joint health also found that it can improve joint mobility and decrease joint pain for people with osteoarthritis or in athletes (5). Collagen comprises about 60% of cartilage, a very firm tissue that surrounds bones and cushions them from the shock of high-impact movements; so a breakdown in collagen could lead to a loss of cartilage and joint problems.



Other than consumption of collagen based supplement, there are also foods that is rich with collagen, or that encourage collagen production other than lifestyles modification mentioned above. Food such as  tough cuts of meat full of connective tissue like pot roast, brisket, and chuck steak. However, a high intake of red meat is not recommended as part of a long-term healthy diet. Collagen is also found in the bones and skin of fresh and saltwater fish. Bone broth which require animal bones to simmer in water with small amount of vinegar for 4 – 24hours also is said to have high collagen properties. However, the amount of amino acids will vary among batches, depending on types of bones used, cooking period, and many more. Other foods that can help to with production of collagen are foods that is rich with zinc such as legumes, nuts, seeds, whole grains, and vitamin c rich food such as citrus fruits, bell peppers and tomatoes.




Although studies on the effectiveness of collagen to health is still  not in the solid, but many available research has not shown negative side effects in individuals given collagen supplements (6). Thus, it is worth to try for its said benefits especially if the benefits is your health concerns! But be sure to talk to your healthcare professionals on this based on your medication intake and your health issues before consuming any health supplement.



  1. Harvard T.H. Chan. School of Public Health. Collagen.
  2. Healthline. Top 6 Benefits of Taking Collagen Supplements.
  3. Proksch E, Segger D, Degwert J, Schunck M, Zague V, Oesser S. Oral supplementation of specific collagen peptides has beneficial effects on human skin physiology: a double-blind, placebo-controlled study. Skin Pharmacol Physiol. 2014;27(1):47-55. doi: 10.1159/000351376. Epub 2013 Aug 14. PMID: 23949208.
  4. Borumand, M., & Sibilla, S. (2015). Effects of a nutritional supplement containing collagen peptides on skin elasticity, hydration and wrinkles. Journal of Medical Nutrition and Nutraceuticals4(1), 47.
  5. Bello AE, Oesser S. Collagen hydrolysate for the treatment of osteoarthritis and other joint disorders: a review of the literature. Current medical research and opinion. 2006 Nov 1;22(11):2221-32.
  6. Kim DU, Chung HC, Choi J, Sakai Y, Lee BY. Oral intake of low-molecular-weight collagen peptide improves hydration, elasticity, and wrinkling in human skin: a randomized, double-blind, placebo-controlled study. Nutrients. 2018 Jul;10(7):826.

How to improve your blood circulation ?

Individuals with poor blood circulation typically experience numbness and coldness in their extremities, particularly their hands and feet. It is often the result of an underlying condition to a more serious condition, such as uncontrolled diabetes or low blood pressure, but it can also be the result of poor posture, among other things.


Here are some tips on how to improve your blood circulation:


1. Go on regular walks 


Walking can improve blood circulation. Contraction of the calf muscle causes venous blood to be pushed back up to the heart. The arteries dilate when patients walk and improve blood flow throughout the body. Aim for a minimum of 30 minutes of walking three times per week.


2. Reduce your weight


Being obese or overweight poses a greater health risk to your circulatory system because it increases your risk of hypertension, high cholesterol, and diabetes, all of which lead to blood circulatory problems.


Consumption of food in moderation, balance and exercise regularly can help to prevent being obese and overweight.


3. Take more breaks at work


Taking more work breaks allows you to develop the habit of alternately sitting, standing, and walking. This reduces the demand on the circulatory system because sitting causes blood flow to slow and pool in your legs, resulting in muscle pain and fatigue. Thus, taking more breaks while working in an office is beneficial for improving blood flow and keeping your stress level in check.

Try to stretch every 15 to 20 minutes and get up and move every hour—even if it's just a power walk around your house.


4. Stay hydrated 

When your body is dehydrated, it affects the amount of blood that circulates through it. It also causes your blood to retain more sodium, causing it to thicken and making it much more difficult for your circulatory system to function properly.

Checking your pee is the simplest way to ensure that you are getting enough fluid. A yellow light or clear urine indicates that you are drinking enough water; anything darker indicates that you need to up your water intake game!


5. Manage your blood pressure

High blood pressure causes your blood circulation to go haywire, putting more strain on your heart and blood vessels. If you do not manage your blood pressure properly, the heart and circulatory system will have to work harder to supply blood flow throughout the body.

High blood sugar levels can harm the lining of small blood vessels, causing blood circulation issues. This condition will also encourage the formation of plaque in your blood vessels, further complicating matters.

Exercise, limiting sodium intake, reducing stress, getting enough sleep, and making changes to your lifestyle can all help to lower your blood pressure and improve your circulation. Ideally, your blood pressure should be less than 120/80 mmHg.


6. Elevate your legs

Elevating your legs relieves pressure on your veins because the blood does not have to work against gravity to return to the heart.

When you are watching TV or taking a nap, the most convenient time to elevate your legs is when you are lying down and prop your legs above your heart level for 15 minutes or more at a time. This will greatly improve overall blood circulation.


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