Hemorrhoids

"More than half of men and women aged 50 years and older will develop hemorrhoid symptoms in their lifetime. In certain populations, up to 85% of pregnancies are affected by hemorrhoids in the third trimester. Individuals typically develop hemorrhoids after the age of 30. Over 80% of Canadians will experience hemorrhoids at some point in their lives. Men and women are equally affected. Women tend to be affected earlier due to pregnancy."  mentioned in Canadian Digestive Health Foundation.

Hemorrhoids is also known as "piles". They are swollen tissues located in the smooth muscles of the walls of the rectum and anus. They occur inside and outside of the anal area. They are annoy because they cause pain, itching, discomfort, burning and bleeding when you have constipation daily. The treatment of hemorrhoids are coagulation, sclerotherapy, band ligation and surgery.

Researchers are not certain what causes hemorrhoids. It's likely that extreme abdominal pressure causes the veins to swell by blocking the flow of blood through them. They then become susceptible to irritation. The increased pressure can be caused by obesity, pregnancy, standing or sitting for long periods, straining on the toilet, coughing, sneezing, vomiting, and holding your breath while straining to do physical labor.

hemorrhoidectomy

Hemorrhoid surgery is very common and is considered safe. However, every surgery has some risks including:

• Bleeding
• Infection
• Reaction to anesthesia

In addition, patients might have some trouble urinating because the pain following surgery makes it difficult to relax and allow urine to flow. Further, the anal sphincter might be damaged during surgery, which can lead to pain and/or accidental bowel leakage. In most cases, recovery takes about two weeks following hemorrhoidectomy. In some cases, it can take as long as three to six weeks to make a full recovery. However, it's important to eat a high-fiber diet, maintain good hygiene, and avoid becoming constipated, which can cause new hemorrhoids to form again.

One of hemorrhoid operation is called "Rubber band ligation of hemorrhoid". To remove a hemorrhoid using rubber band ligation, your doctor inserts a small tool called a ligator through a lighted tube (scope) in the anal canal and grasps the hemorrhoid with forceps. Sliding the ligator's cylinder upward releases rubber bands around the base of the hemorrhoid. Rubber bands cut off the hemorrhoid's blood supply, causing it to wither and drop off.

How Can I Prevent Hemorrhoids From Reoccurring?

The best way to prevent hemorrhoids is to keep stools soft so they are easy to pass and don't require straining. Eating a high-fiber diet and drinking plenty of fluids (six to eight glasses each day) can help you stay regular and keep stools soft, and may reduce constipation and the need to strain on the toilet, lowering the risk of developing new hemorrhoids.

To prevent hemorrhoids, you’ll need to avoid straining during bowel movements. Some tips include:

• Drink a lot of fluids.  Unless your medical condition prohibits it, you should consume seven or eight glasses of water each day.
• Add 15 grams of fiber to your diet (two tablespoons of natural oat or wheat bran, Metamucil, Benefiber, flax or other soluble fiber).
• Do not sit longer than two minutes on the toilet. If you can’t have a bowel movement in that time, come back later. This “two-minute” rule can help keep you from straining during bowel movements without realizing it.
• During air travel, be sure to stay hydrated, avoid alcohol, eat fiber and walk around when you can.

Relieve Hemorrhoids Naturally

1. Apply vitamin E capsule on anus area. Make sure the anus is clean and dry.  Place the opened end of the vitamin E capsule right up against the anus, and squeeze the capsule. Spread the slightly oily vitamin E around.
2. Eat more fiber. Fiber can help soften stool and reduce the pain associated with hemorrhoids. Increasing fiber intake to 30 grams per day can help prevent constipation and the development of hemorrhoids.
3. Drink more water. You need water for fiber to work.
4. Eat less meat. Meat contains no fiber. eat grains, beans, vegetables and fruit, which are loaded with fiber.
5. Exercise and Lose Weight. Overweight cause health decline. Without exercise, organs and internal system as a whole becomes sluggish and works at low levels. It will keep your digestive track active.
6. Take Probiotics and Consume Probiotic-Rich Foods. Probiotics are essential for balancing the bacteria in your gut, which can prevent constipation and absolutely promotes overall health. Either take a high-quality probiotic supplement, or consume more probiotic-rich foods such as fermented foods like fermented cheese, yogurt, sauerkraut, Korean kimchi.
7. Avoid surgery.

Home Remedy for Hemorrhoids

1. Apple Cider Vinegar: It is one of the most popular natural treatments for hemorrhoids.
2. Rutin : A health-promoting compound found in numerous plants such as buckwheat, oranges, grapefruit, lemon, cranberries, and asparagus.  Rutin is another home remedy often used for hemorrhoids. Buying it in supplement form may be the best option.
3. Witch Hazel: An astringent and healing tree, witch hazel is one of the oldest known natural remedies for hemorrhoids. Just soak a pad or cotton ball with witch hazel and apply it to the area.
4. Aloe Vera:  simply apply aloe vera to the affected area to relieve symptoms.

Conclusion

Surgery is safe and effective to get rid of hemorrhoids. However, without personal eating and life style change, they will reoccur again. You have got them before but you don't want them back to annoy your life day to day. Following the preventative method mentioned above, Hemorrhoids won't come back to you.

Supplements (Suggestion)

Fiber

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12 Keys to Protect your Body Filter Organ - Kidneys

The latest statistics show about 2.4 million Canadians suffer from chronic renal failure, and nearly 95 per cent have never been told by a health care professional that they have kidney disease or dysfunction. "One of the issues that we see is that people are just not diagnosed quickly enough in terms of knowing that they are at risk for kidney disease," Terry Young, president of the Ontario branch of the Kidney Foundation of Canada, told CTV News[5].

He said one in 10 Canadians have kidney disease and millions more are at risk, adding that kidney failure is "one of the big health challenges" Canada is facing[5].

Kidney Functions

Your kidneys are two bean-shaped organs, each about the size of a fist. They are located just below your rib cage, one on each side of your spine. Every day, two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine. Urine flows from your kidneys to your bladder through tubes called ureters. Your bladder stores urine until releasing it through urination. 

There are three kidney functions[6].

·         removing waste products from the body, keeping toxins from building up in the bloodstream

·         producing hormones that control other body functions, such as regulating blood pressure and producing red blood cells

·         regulating the levels of minerals or electrolytes (e.g., sodium, calcium, and potassium) and fluid in the body

Signs of kidney failure

Kidney disease usually progresses silently, often destroying most of the kidney function before causing any symptoms. Therefore, people at risk of developing kidney failure should be evaluated regularly by urine and blood test[4].

Cause of Kidney Failure

The most common causes of chronic renal failure in North America are diabetes mellitus (type 1 or type 2 diabetes) and high blood pressure[6].

Treatment of Kidney Failure

When kidneys can't function at all, kidney dialysis or a transplant is the only way to remove the body's waste products.

Kidney Transplant

In American, there are 122,000 people waiting for kidney transplanted. Most of them cannot wait till death. There are at least 22 people dying due to kidney failure every day. There are 15,000 people got kidney transplanted from those dying or accidental people. There are 5,000 people got their kidney transplanted from living people who donate their kidney. Protecting you kidney is essential to your health life.

Dialysis

Kidney dialysis uses a special machine to filter harmful wastes, salt, and excess fluid from your blood. it restores the blood to a normal, balanced state.

You cannot live without at least one functioning kidney. Dialysis is the only way to replace your kidney function currently. Without a kidney transplant, you will need dialysis for the rest of your life. Maintaining and protecting your kidneys is most important for your healthy life.

There are ways to protect your kidney[1][2][3].

1   Eat healthier foods. high in sodium and phosphorus additives can have negative effects to your kidneys. Eating more fruits and vegetables, whole grains, legume, low GI foods.

2  Limiting salt and caffeine. Limiting salt and caffeine intake is especially important if you have high blood pressure, which is the second leading cause of kidney disease and also increases your risk for heart attack and stroke.

3  Set aside time to relax. Find something you feel relax. Taking vacation, window shopping etc.

4  Exercise regularly. When you exercise, your body releases endorphins – chemicals that have been shown to boost mood and reduce feelings of pain. Regular exercise can also help lower high blood pressure and even small amounts of physical activity have been proven to lower stress levels.

5  Maintain a positive attitude and outlook. How you think impacts how you feel, so maintaining a positive outlook and reducing stress can play an important role in staying healthy.

6  Get plenty of sleep.

7 Do not take over-the-counter pills on a regular basis. Common drugs such non-steroidal anti-inflammatory drugs like ibuprofen are known to cause kidney failure if taken regularly.

8 Do not smoke. Smoking slows the flow of blood to the kidneys. When less blood reaches the kidneys, it impairs their ability to function properly. Smoking also increases the risk of kidney cancer by about 50 percent.

9 Drink 1.5 to 2 litres (3 to 4 pints) of water per day. According to researchers in Australia and Canada, drinking plenty of fluid helps the kidneys clear sodium, urea and toxins from the body which, in turn, results in a “significantly lower risk” of developing chronic kidney disease.

10  Monitor blood pressure and blood glucose if you are diabetes. Although many people may be aware that high blood pressure can lead to a stroke or heart attack, few know that it is also the most common cause of kidney damage.

11  Limit alcohol intake.

12  Lose weight if you are overweight.

Supplements

B vitamins, especially vitamin B12, are important for proper kidney function because they help keep dangerous homocysteine levels from building up in the blood. Homocysteine damages blood vessels and is associated with many diseases of aging, including chronic renal failure. 

For optimum kidney health and overall good health, I recommend taking a high-quality vitamin B complex that contains at least the following dosages: : 50 mg each of thiamine, riboflavin (B2), niacin/niacinamide, B6, and pantothenic acid, plus 400 micrograms of folic acid/folate, 12 mcg of B12, and 100 mcg of biotin.[7]

Essential (well balanced nutrition contains B complex daily) , Biomega

Note: do NOT take B complex only supplements because balanced nutrition is the key. Taking only one supplement may cause other nutrition shortage, causing in-balanced in your body system.

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Reference

[1]National kidney foundation. http://www.kidney.org/content/stressed-10-ways-protect-your-kidneys.

[2]The World Kidney Day. http://www.worldkidneyday.org/faqs/take-care-of-your-kidneys/8-golden-rules

[3]National Institute of Diabetes, Digestive and Kidney Diseases. http://www.niddk.nih.gov/health-information/health-topics/Diabetes/prevent-diabetes-problems/Pages/keep-your-kidneys-healthy.aspx

[4]Kidney foundation of Canada. http://www.kidney.ca/warning-signs

[5] http://www.ctvnews.ca/health/2-2m-canadians-unaware-they-re-suffering-kidney-damage-kidney-foundation-1.1728212.

[6]http://bodyandhealth.canada.com/channel_condition_info_details.asp?channel_id=2049&disease_id=258&relation_id=37908

[7]http://www.drmicozzi.com/the-deadly-disease-often-ignored-by-modern-medicine

Healthy Life without Diabetes

Diabetes is a common metabolic disorder. It is associated with too much glucose in the blood. Naturally, as we digest foods, our body will maintain sugar balance in the blood by releasing insulin, a polypeptide hormone, produced by the beta cells of the islets of Langerhans of the pancreas. The hormone will turn on cells to store sugar inside. As you constantly eat high GI diets, insulin released always pop up from the pancreas to lower spike sugar level in the blood. Besides, oxidation stress or aging occur on cells and pancreas. Therefore, insulin resistance starts to build up on cells. More insulin is required to low your blood sugar but your body pancreas cannot produce extra insulin to regulate. As a result, nerve, blood vessels and organs will damage due to too much sugar in the blood. Lots of people with diabetes are not aware of till symptom, such as sugar in urine, extreme fatigue, blurry vision, tingling or numbness in the hands/feet etc. happen in some days.

Statistic Fact

The total population with diabetes in Canada is estimated to be 2.7 million people (7.6%) in 2010, and is projected to rise to 4.2 million people (10.8%) by 2020. While the number of Canadians diagnosed with diabetes is already high, an additional almost one million are estimated to have the disease but do not know it. Currently, one in four Canadians lives with diabetes, undiagnosed diabetes, or prediabetes; this will rise to one in three by 2020 if current trends continue. 

Impact of diabetes:

• Diabetes complications are associated with premature death. It is estimated that one of ten deaths in Canadian adults was attributable to diabetes in 2008/09.[2]

• People with diabetes are over three times more likely to be hospitalized with cardiovascular disease, 12 times more likely to be hospitalized with end-stage renal disease and over 20 times more likely to be hospitalized for a non-traumatic lower limb amputation compared to the general population.[3]

• Thirty per cent of people with diabetes have clinically relevant depressive symptoms; individuals with depression have an approximately 60% increased risk of developing type 2 diabetes.[3]

• Foot ulceration affects an estimated 15-25% of people with diabetes. One-third of amputations in 2011- 2012 were performed on people reporting a diabetic foot wound.[4]

• Some populations are at higher risk of type 2 diabetes, such as those of South Asian, Asian, African, Hispanic or Aboriginal descent, those who are overweight, older or have low income. Diabetes rates are 3-5 times higher in First Nations, a situation compounded by barriers to care for Aboriginal people.[3]

 • Fifty-seven percent of Canadians with diabetes reported they cannot adhere to prescribed treatment due to the high out-of-pocket cost of needed medications, devices and supplies. The average cost for these supports is >3% of income or >$1,500.[5]

• As a result of stigma or fear of stigma, 37% of Canadians with type 2 diabetes surveyed by the Canadian Diabetes Association reported they do not feel comfortable disclosing their diabetes.

Cause of Diabetes

Obesity is a leading cause of insulin resistance – at least 80% of people with type 2 diabetes are overweight.
Over 60 % of Canadian adults are overweight or obese.[11] Close to one third(31.5%) of children and adolescents are overweight or obese.[12].

Preventing Diabetes [7]

Type 2 diabetes can be reduced by healthy lifestyle choices. Factors to consider include:

Weight Loss – The Body Mass Index(BMI) is a simple, widely accepted way of assessing body weight in relation to health for most people aged 20 to 65. BMI is calculated by dividing the individual's body weight by the square of their height (Kg/m2).

Eating Healthy - By eating foods that are rich in fibre, reducing the amount of fat in food selections and adding more fruits and vegetables, a person can help control their diet and maintain or lose weight.Body fat stored around the abdomen (rather than the hips and thighs) is also a risk factor for   developing type 2 diabetes.

Regular Exercise – it is a key element in controlling weight and reducing the likelihood of developing type 2 diabetes.

Managing High Blood Pressure, Cholesterol and Glucose - Diabetes and high blood pressure are often found together. Up to three-quarters of people with undiagnosed diabetes have high blood pressure.

Nature Way to Treat Diabetes

Clinical research studies show that a low-fat, plant-based diet improves insulin sensitivity, helps with weight loss and reduces blood sugar and cholesterol. The Physicians Committee recommends five easy steps to end diabetes:[13]

1. Avoid animal products, daily products.

2. Avoid added vegetable oils.

3. Low glycemic index foods.

4. Go high fiber.

5. Focus on four food groups: grains, legumes, fruits and vegetable.

Supplement with Vitamins and Minerals

Nobel Prize Winner Dr. Linus Pauling declared:"Nearly all disease can be traced to a nutritional deficiency". A balanced and high quality supplements are also important to our daily body cell metabolism and antioxidants to avoid oxidation stress from our environments. Aging is one of symptom happening on very one of us. How beautiful you were when you were young. Now, A few wrinkles appear on your face. I believe everyone can live over 90 years old. Therefore, Protecting your body and avoiding from chronic illness are your responsibility to achieve your healthy life. Without health, it is all nothing to fulfill your passion and dream. 

No one is perfect to pick foods with all essential nutritional value every day. We are human with emotion and feeling not a robot, so adding vitamins and minerals to your daily diet can help provide your body with the proper nutrients that you may not be getting from your food. You make sure to find the best high quality product.

Alpha Lipoic Acid(ALA): the antioxidant can smash insulin resistance and autoimmune disease[10]. Alpha lipoic acid (ALA) has many functions, but it’s one of the most effective free radical scavengers, and the only one known to easily get into your brain. It also has the ability to regenerate other antioxidants such as vitamins C, E, and glutathione.  So, when your body has used up these antioxidants, if there’s ALA around, it helps regenerate them. 

Reset your body - Eat true nutrition meal to lose your weight and change your eating habit 
Alpha lipoic acid and balanced formula nutrition

Avoid Inflammation - all chronic diseases


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Reference: 

[1] Estimated diabetes statistics in Canada are generated by the Canadian Diabetes Cost Model.

[2] Public Health Agency of Canada. (2011). Diabetes in Canada: Facts and figures from a public health perspective. Ottawa, Ont.: Public Health Agency of Canada. Retrieved from http://www.phac-aspc.gc.ca/cd-mc/publications/diabetes-diabete/facts-figures-faits-chiffres-2011/index-eng.php

[3] Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. (2013). Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes, 37 (suppl 1).

[4] Canadian Institute for Health Information. (2013). Compromised wounds in Canada. Ottawa, Ont.: Canadian Institute for Health Information. Retrieved from https://secure.cihi.ca/free_products/AiB_Compromised_Wounds_EN.pdf

[5] Canadian Diabetes Association. (2011). The burden of out-of-pocket costs for Canadians with diabetes. Toronto, Ont.: Canadian Diabetes Association. Available at http://www.diabetes.ca/CDA/media/documents/publications-and-newsletters/advocacy-reports/burden-of-out-of-pocket-costs-for-canadians-with-diabetes.pdf

[6] Canadian Diabetes Association. (March 2011). Diabetes: Canada at the tipping point. The public perspective: a national survey. Available at http://www.diabetes.ca/CDA/media/documents/publications-and-newsletters/advocacy-reports/environics-opinion-poll-report-english.pdf

[7] Public Health Agency of Canada http://www.phac-aspc.gc.ca/cd-mc/diabetes-diabete/index-eng.php

[8] Alpha-lipoic acid: molecular mechanisms and therapeutic potential in diabetes Rochette L, Ghibu S, Muresan A, Vergely C.  Can Journal Physiol Pharmacol 2015 Dec.

[9] Nutrition Review 2008 Nov Alpha-lipoic acid supplementation and diabetes.

[10] http://articles.mercola.com/sites/articles/archive/2009/05/16/this-antioxidant-can-smash-insulin-resistance-and-autoimmune-disease.aspx

[11] Statistics Canada.(2012). Body composition of Canadian adults, 2009-2011. Retrieved from http://www.statcan.gc.ca/pub/82-625-x/2012001/article/11708-eng.htm

[12] Statistics Canada. (2012). Overweight and obesity in children and adolescents: results from the 2009 to 2011. Canadian Health Measures Survey. Retrieved from http://www.statcan.gc.ca/pub/82-003-x/2012003/article/11706-eng.htm

[13] http://www.pcrm.org/health/diets/eat-plants-end-diabetes. Dr. Neal Barnard’s Program for Reversing Diabetes.

Nature Food to Fight Gout

I ran across toe swelling once. It was very painful experience.It lasted for two to three days. I couldn’t walk during that time. I googled it. It was too much uric acid in the blood without going out from your kidney. The uric acid is metabolized from what we eat protein, sugar and high purines enriched foods. Those foods of high purines are red meat, organ meat and oily fish (such as salmon, sardines, herring), as well as lentils, peas and beans. Is there something wrong with my body at that time while I had no such toe swelling early in my life? Those foods are nothing but your body needs your attention at least when it was not behavior right?

Did You Know?
According to the National Health and Nutrition Examination Survey carried out during the year 2007 - 2008, 8.3 million Americans were reported to have suffered from gout at least once, out of which 6.1 million were men and 2.2 million were women.

Cause of Gout

Our bodies all have a breakdown product called urate (or uric acid). Most urate is produced by the body. It breaks down substances known as purines and usually passes out in our urine.

If urate does not pass out of the body, or if your body produces too much, it can build up and form crystals. Gout is caused when these crystals build up and form around the body’s joints, causing inflammation and pain.

Purines are found naturally in the body and also in some foods, such as shellfish, red meat and offal, and certain alcohols, such as beer and stout. Drinking a lot of alcohol can also cause dehydration, which makes gout more likely to occur. Dietary purines account for only 5-10% of total purines in the body.

Not everyone with high urate levels will develop gout. We do not know why some people develop it. However, obesity is a risk factor. A healthy diet and weight loss will reduce your chances of developing gout.

Low GI Diet

Low-GL diet is the most rapid way to stabilise blood sugar levels and will, naturally, reduce the amount of both fructose and uric acid in your system. Eating a low-GL diet also improves your resistance to insulin – which is the hormone you produce to process sugar – and this helps to support healthy kidney function. The reason this is important is because it is the kidneys that need to excrete uric acid. I have had many people with gout who have reported instant relief when switching to a low-GL diet, even when eating previous high-purine trigger foods. If you follow low-GL diet you will almost certainly find that your gout goes away, along with unwanted fat.

Alcoho

Some alcoholic drinks are rich in purines, notably beer which contains guanosine. Alcohol is thought to increase the risk of gout because the metabolism of ethanol to acetyl CoA leads to adenine nucleotide degradation, resulting in increased formation of adenosine monophosphate, a precursor of uric acid. Alcohol also raises the lactic acid level in blood, which inhibits uric acid excretion. In the Health Professionals Follow-up Study (HPFS), overall the higher the daily alcohol intake, the higher the risk of gout [37]. However, differences in risk were observed with different alcoholic drinks. Beer had the greatest effect, probably because of its high purine content, then spirits, whereas wine had no increased risk [37].

Some Nature Food Remedy 

Vitamin C has a modest uricosuric effect and in the HPFS, there was an inverse relationship between vitamin C intake and serum uric acid  (SUA) [31]. In a randomized placebo-controlled trial, vitamin C supplementation (500 mg/day) for 2 months resulted in a significant reduction in SUA of 0.5 mg/dl (∼20% of the starting values) [32]. There are anecdotal reports that consumption of cherries has a beneficial effect on gout and this is supported by a recent study showing a decrease in urate levels after consumption of cherries but not other fruits [33]. The mechanism for this, and whether it relates to differential vitamin C content, is not clear. Consumption of coffee, but not green tea (both contain high levels of caffeine), has been reported to be associated with lower SUA levels in Japanese men [34], and recent data from the HPFS have confirmed an inverse relationship between coffee consumption and the risk of incident gout [35]. Again, this effect appeared independent of caffeine intake, suggesting that other, as yet unidentified components of coffee are causal in this respect. Long-term coffee consumption is associated with a lower risk of incident gout. Green tea extract may modestly lower SUA level and decreases uric acid clearance. Green tea extract also significantly elevated serum antioxidant capacity with a positive dosage effect.

Regular Exercise, Drinking more Water

In a 7-year prospective study of almost 29 000 healthy male runners, the risk of self-reported incident gout was lower in men who were more physically active, with a low BMI, with diets including more fruit and less meat and alcohol [36], supporting the benefit of lifestyle changes in reducing the risk of gout.

Supplements for Gout

HealthPak, Biomega (Omega 3,6) or Essential, Active Calcium Plus, Proflanoval C 100, Biomega.
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Conclusion

Health elements are eating low-GI diet, regular exercise, taking high quality supplements, drinking more water and sleeping well.  Simple lifestyle change can say goodbye to gout without medication. Once I have changed my lifestyle and followed the health elements. Gout does not come back to me ever since. Would you like to own a healthy life? It is not difficult but you must take an action to work on them. If you would like to own your health, let’s join team together because “Health Life is Awesome”.  Contact Me for Detail

Gout Diet Menu

Dr. Oze show talked about Gout

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Reference

1.       [31]Gao X, Curhan G, Forman JP, Ascherio A, Choi HK. Vitamin C intake and serum uric acid concentration in men. J Rheumatol 2008;35:1853-8.Abstract/FREE Full Text

 [32]Huang HY, Appel LJ, Choi MJ, et al. The effects of vitamin C supplementation on serum concentrations of uric acid: results of a randomized controlled trial.Arthritis Rheum 2005;52:1843-7.CrossRefMedlineWeb of ScienceGoogle Scholar

[33]Jacob RA, Spinozzi GM, Simon VA, et al. Consumption of cherries lowers plasma urate in healthy women. J Nutr 2003;133:1826-9.Abstract/FREE Full Text

[34]Kiyohara C, Kono S, Honjo S, et al. Inverse association between coffee drinking and serum uric acid concentrations in middle-aged Japanese males. Br J Nutr 1999;82:125-30.MedlineWeb of ScienceGoogle Scholar

1.       [35]Choi HK, Willett W, Curhan G. Coffee consumption and risk of incident gout in men: a prospective study. Arthritis Rheum 2007;56:2049-55CrossRefMedlineWeb of ScienceGoogle Scholar

[36]Williams PT. Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men. Am J Clin Nutr 2008;87:1480-7.

[37]Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Alcohol intake and risk of incident gout in men: a prospective study. Lancet 2004;363:1277-81.CrossRefMedlineWeb of ScienceGoogle Scholar