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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 every day is a problem, right? Here are five very good tips to rock out during your next workout.


Tip 1: Make 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 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 minutes. After you get comfortable, challenge yourself by increasing the duration until your exercise lasts 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 it with your exercise partner, however, makes it a lot easier. Men and women have different intensity levels. People put more effort into their workout routine when they’re exercising with someone else. So you must realise your partner cannot always keep up with you if your partner is of a 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 may get advice on tips for healthy eating from a nutritionist (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 results with those of your partner. It’s not realistic to expect the same results in the same time period (3).




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


Head outside. Do a variety of exercises so you don’t get bored. One of the simplest reasons for working out in a variety of places and doing different exercises 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 occurs 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 nighttime 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, 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).

Milk: A Nutrient Powerhouse with Controversial Health Implications

Milk is renowned as a nutritional powerhouse, often considered the food with the highest nutrient density, making it a natural dietary staple for infants from ancient times. This association continues to hold true, as milk is the preferred oral nutrition supplement for bedridden patients (1).

Nonetheless, the role of milk in adult diets remains a topic of debate. Some studies argue that daily milk consumption is unnecessary, while others advocate for its regular inclusion (1). Here, we present a breakdown of the considerations to help you decide whether daily milk intake is right for you.


Milk and Obesity

Despite the common perception that full-fat dairy products contribute to weight gain, research has revealed a contrary perspective. In fact, full-fat dairy products might be more effective in weight management than their low-fat counterparts. Walter Willet, a nutrition expert from Harvard School of Public Health, clarifies that the demonization of all fats emerged in the 1950s and 1960s when saturated fats were linked to high cholesterol and increased heart disease risk (2).

However, reducing saturated fat in food products or diets often leads to their replacement with sugars or carbohydrates. The downside to this substitution is that carbohydrates do not provide the same feeling of fullness as fats, causing increased food consumption (2). Some studies even suggest that the more sugar we consume, the stronger our cravings become, akin to an addiction (3).


Modern Milk Dilemma

Modern milk options have evolved to cater to various preferences and dietary needs, from animal-based milk to plant-based alternatives. The variety of choices makes selecting the right milk a bit tricky, especially given the differing nutritional profiles.


Choosing the Right Milk

If your goal is to use milk to promote a sense of fullness and avoid excessive food intake, full cream milk is a suitable choice. However, be mindful of monitoring your overall calorie intake and opt for milk with lower sugar content. On the other hand, if you tend to obtain fats from other food sources, opting for low-fat milk is advisable while remaining vigilant about sugar content. In essence, prioritize milk with minimal sugar, saturated fat, and trans-fat content, as these components have been associated with various health complications.

Plant-based milk alternatives may not necessarily be healthier than cow's milk, as they could contain higher sugar levels. However, they are an environmentally friendly choice, with soy milk, almond milk, oat milk, and rice milk producing fewer carbon emissions and greenhouse gases compared to cow's milk.

Pros and Cons of Milk

The decision of whether to incorporate milk into your daily diet remains a subject of debate. Factors such as your dietary intake and body weight play a pivotal role in determining the daily milk consumption that suits you. For individuals with normal weight, one glass of milk per day may suffice, while those who are underweight might consider upping their intake to two glasses. Yet, it is essential to balance the intake of beneficial fats from milk with the reduction of harmful fats from sources such as deep-fried foods, foods high in trans-fats, and those with high saturated fat content.

In Malaysia, where a significant portion of the population is overweight or obese, reconsidering daily milk consumption may be prudent. The key is to ensure you meet your daily calcium requirements, which can also be obtained from alternative sources like anchovies, sardines, almonds, kale, and various other foods (5,6).



Fact Check (5,6)

  • Saturated fat is often high in animal-based and certain plant-based foods, such as coconut milk (santan). Excessive intake is linked to elevated blood cholesterol levels and an increased risk of heart disease. Notably, many coconut milk products claim to be cholesterol-free, despite containing high levels of saturated fat.

  • Trans fat is a man-made fat produced through hydrogenation, which raises bad (LDL) cholesterol and lowers good (HDL) cholesterol levels. Consuming trans fats increases the risk of heart disease, stroke, and type 2 diabetes. Examples of foods that may contain trans fats include doughnuts, cookies, crackers, muffins, pies, fast food, and cakes.





  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 do you need to know?

Arthritis is not a single disease; it refers to joint pain or joint diseases. There are more than 100 types of arthritis and related conditions. It can be due to various reasons and require different kinds of treatment. Arthritis is more common among women, and it can affect just anyone, but more frequently older and overweight or obese individuals. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis (1, 2).


Osteoarthritis causes cartilage (the tissue that covers the bone end) to break down. While rheumatoid arthritis attacks the joint, beginning with the joint lining. Another condition that often occurs in individuals of younger age, unlike osteoarthritis and rheumatoid arthritis, is gout. The condition occurs when 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 they are 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, an inability to do daily activities, and the inability to walk or climb stairs (2, 3).


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



What causes arthritis?


There are many causes of arthritis, and different types of arthritis have 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 a family history of OA, your risk of developing it is higher (2, 3).


While rheumatoid arthritis (RA) occurs when your body’s immune system attacks the tissues of the body, These attacks affect the synovium (a soft tissue in joints that functions to nourish cartilage and lubricate joints). RA is the kind of disease that invades and destroys joints. 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 can get an accurate diagnosis. The earlier you seek help, the better. So talk to your doctor about your symptoms. You may be referred to a rheumatologist, orthopaedic surgeon, or other doctor who specialises in arthritis and related conditions. There are many things that can be done to preserve joint function, improve mobility, and improve quality of life. Learning about the options available for treatment will give you a higher chance of finding the best solution that 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 joints, regardless of where the joint is. By maintaining weight, you will start putting nutritious foods in your body that can reduce inflammation in your joints. The main goals when you have arthritis are to reduce symptoms and improve your 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 the Greek word "kola,” which means glue, and that is basically the function of collagen, which is to hold protein and/or non-protein substances together. As an example, in the skin, the function of collagen is to hold all the skin structure together. Collagen is one of the major building blocks for many parts of the body, including bones, skin, tendons, and ligaments. It accounts for about one-third of the body's protein composition. It is also found in many other body parts, including blood vessels, corneas, and teeth.

Types of collagen

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

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

Type II: This type is made of more loosely packed fibres and is 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 that among the signs of ageing are wrinkles, which come from skin that is less elastic, less supple, and unfirm.

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

Where can we get collagen from?

The good news is that collagen can be gotten from food. There are foods that can stimulate the production of collagen and break down collagen. The body makes collagen by combining proline and glycine (types of proteins). Thus, consuming foods high in proline and glycine will help restore collagen levels in the body.

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

As for supplements containing collagen, they are usually in the form of hydrolyzed collagen. The source of hydrolyzed collagen can be fish, marine seaweed, pork skin, or other food sources that have high collagen contents. It is also said that hydrolyzed collagen is much easier to absorb by the body as compared to collagen from food.

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

Individuals with cyst problems and cancer problems must be careful with their consumption of collagen supplements, as they can be harmful. Hence, it is best to seek professional help before consuming any supplement. Certain supplements are contraindicated with the medicine that you are consuming, etc.


  1. Top 6 Benefits of Taking Collagen Supplement. (Accessed on December 29, 2020)
  2. (n.d). Collagen, what is it and what it is good for? (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 Supplementation

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


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


The benefits of ingesting fish oil can differ significantly between studies. A study found a connection between these omega-3 fatty acids and mental health disorders and that EPA and DHA can speed up brain development even in young children. Additionally, studies have demonstrated that it can help treat cardiovascular diseases, joint pain, and eczema. The question is, is it true that all of these effects can be obtained from fish oil consumption? (1)

Individual with mental health problems/disorders


In three lengthy studies spanning the years 1988 to 2008, researchers looked at the relationship between fatty acid intake and suicide risk among more than 205 000 participants. They discovered no proof that eating fish or fatty acids reduced the risk of suicide. "The vast majority of earlier research on whether fatty acid intake has any positive effects on mental health has been based on results from depression screening. The only time this relationship has been studied with concrete data on suicide mortality is in our study, which is also the largest of its kind.” (2)


While a study found that eating a balanced diet and exercising regularly are better for brain health than taking fish oil or omega-3 fatty acid supplements, A study of 3073 elderly people at risk of macular degeneration, an age-related cause of vision loss, found little benefit from omega-3 supplements on memory. Omega 3 supplements or a placebo were given to study participants at random for a five-year period.  According to the researcher, a healthy diet cannot be replaced by a supplement; therefore, if you eat a healthy diet rich in fruits, vegetables, and marine fish, you probably don't need to take a fish oil supplement. According to this study, the overall dietary pattern is more important than a single nutrient (2).


Individuals with cardiovascular disease


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



Which is why, interpreting the study, we would still recommend customers and patients consume more fish 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 essential nutrient, since omega 3 is a nutrient that your body cannot produce and can only get from diet (3,4,5).


Individuals 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 small-sample studies. Not only are these three studies small, but they are also described as poor methodological studies by the reviewer, as they have many confounding factors. However, the outcomes of these studies show positive outcomes for eczema and overall daily living as compared to placebo (6, 7).


Another convincing relationship between consumption of fish oil and skin health is that in a study where pregnant women were given fish oil during pregnancy and followed up for 6 years, it was found that consumption of fish oil during pregnancy led to a positive skin health outcome for babies skin. 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 mixed results in studies depending on what kind of problem we are looking 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 your diet because you dislike fish, are afraid to consume fish regularly due to contamination, etc., or simply would like to make sure that your body has enough omega 3, then there is no harm in taking fish oil supplementation. It's just that in order to make sure you get the right omega 3 for your body, buy it from a pharmacy, make sure the product has a Ministry of Health (MOH) notification number, and simply ask a healthcare professional 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 & conceptual, 6(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 drugs, 16(8), 256.


Should you consider collagen supplementation?

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


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


Research on collagen supplementation focuses mostly on joint and skin health. Although studies pertaining to this using human subjects are still lacking, some randomized controlled trials have found that collagen supplementation improves skin elasticity. In one study, women who took a supplement containing 2.5–5 grammes 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 that women who consumed 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 supplements and joint health also found that they can improve joint mobility and decrease joint pain in 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 the consumption of collagen-based supplements, there are also foods that are rich in collagen or that encourage collagen production other than the lifestyle modifications mentioned above. foods 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 freshwater and saltwater fish. Bone broth, which requires animal bones to simmer in water with a small amount of vinegar for 4–24 hours, is also said to have high collagen properties. However, the amount of amino acids will vary among batches depending on the types of bones used, the cooking period, and many other factors. Other foods that can help with the production of collagen are foods that are rich in zinc, such as legumes, nuts, seeds, whole grains, and vitamin C-rich foods, such as citrus fruits, bell peppers, and tomatoes.


Although studies on the effectiveness of collagen for health are still lacking,  many available studies have not shown negative side effects in individuals given collagen supplements (6). Thus, it is worth trying for its said benefits, especially if the benefits are your health concerns! But be sure to talk to your healthcare professionals about 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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