Dietary supplements and Mental Wellness

dietary supplements and mental wellness

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Eating a balanced diet, if fundamentally important for mental wellness. However, our diet sometimes lacks nutrients that are key to mental wellness which leaves room for supplementation. if you know your diet is lacking key nutrients, dietary supplements may be the key to symptom relief.

Dietary supplements are not a replacement of a healthy diet itself or by any means meant to cure any diseases. However, they help supplement the diet until the diet gets back in track

What about herbs?

1. Vitamin A

People with anxiety may lack vitamin A. Vitamin A is an antioxidant that may help with anxiety [2]

2. B-complex

Vitamin B complex includes all the water-soluble B- vitamins that are our body use and excrete any excess amounts. Many are vital to a healthy nervous system. They may help improve symptoms of anxiety and depression [2]

3. Vitamin C

Vitamin C is an antioxidant that can help prevent oxidative damage in your nervous system. Oxidative damage can increase anxiety [2]

4. Vitamin D

Vitamin D is an important nutrient that helps the body absorb other vitamins and minerals. Vitamin D deficiency may lead to other vitamin & mineral deficiencies, which may compound anxiety and make it worse [2]

5. Vitamin E

Vitamin E is another antioxidant. Your body uses this nutrient up quickly in times of stress and anxiety. Supplemental vitamin E may help restore this balance and reduce your symptoms [1]

6. Omega 3 fatty acid 

Omega 3 essential fatty acids are antioxidants. Omega-3 supplements like EPA and DHA have been studied and they show to help reduce anxiety.

7. Magnesium

Magnesium is a necessary mineral for human health. Your body doesn’t need too much of it. But if you aren’t getting enough, magnesium deficiency may lead to anxiety symptoms. 

Certain herbs contain phytochemicals (plant chemicals) = that may help ease symptoms associated with anxiety

  1. Ashwangandha (Withania somnifera) is an adaptogen and Ayurvedic remedy. Some research suggests that it may be just as effective as certain medications in reducing anxiety [3] 
  2. Chamomile comes from the Matricaria chamomilla or Chamaemelum nobile species. It’s widely accepted as a natural remedy for anxiety symptoms.
  3. St. John’s wort – the classic herb used for depression, St Johns Wart (Hypericum perforatum), is also used for anxiety. Current research that it’s better suited for depression-related anxiety. How St. John’s wort may help other forms of anxiety requires more research [5]

Consult with your healthcare provide before the use of any dietary supplements. 

Take-Away message: 

Although the research on supplements for anxiety is promising, it is very important to note that mental wellness is not only about popping pills. It is a far more complex area of medicine or health than that.  Before taking any dietary supplements, it is important to consult with your healthcare provider and or before adding anything new to your treatment regimen. The healthcare provider will discuss any potential risks or side effects, as well as adjust any medications that may cause an interaction. 

There is also a recommendation to adopt healthy lifestyle changes to help manage your symptoms. Most supplements aren’t recommended for: 

  • adults over age 65
  • women who are pregnant
  • children

If you do try a new supplement, carefully monitor the effects it has on your overall health. If you begin experiencing any unusual symptoms, such as heightened anxiety or stomach pains, discontinue use until you can talk with your doctor.


  1. Lewis JE, et al. (2013). The effect of methylated vitamin B complex on depressive and anxiety symptoms and quality of life in adults with depression. DOI: 
  2. Gautam M, et al. (2012). Role of antioxidants in generalized anxiety disorder and depression. DOI: 
  3. Pratte MA, et al. (2014). An alternative treatment for anxiety: A systematic review of human trial results reported for the Ayurvedic herb Ashwagandha (Withania somnifera). DOI: 
  4. Pyndt Jorgensen B, et al. (2015). Dietary magnesium deficiency affects gut microbiota and anxiety-like behaviour in C57BL/6N mice. DOI: 
  5. Apaydin EA, et al. (2016). A systematic review of St. John’s wort for major depressive disorder. DOI: 10.1186/2Fs13643-016-0325-2

Yours In Health

Mbali Mapholi


Glucosamine – Heart health

glucosamine - Heart health

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New Promising research on Glucosamine and cardiovascular health

Glucosamine may help lower risk of cardiovascular disease, according to a new study.

A popular and successfully widely used dietary supplement for joint pain, arthritis could also be beneficial for your heart [1]

A recent study has found that a habitual use of the supplement glucosamine was associated with a significantly lower risk of cardiovascular disease (CVD) and its more severe consequences like stroke [1]

What is glucosamine? How does it work as cardio protective?

Glucosamine is a naturally occurring substance found within the body that’s recognized for its role in maintaining the cartilage between joints[2].

Still, there remains a large unknown: If glucosamine is in fact protective for the heart (and that’s still a big if), how does it work?

There is still more clinical research and future studies to study the glucosamine action as a cardioprotective. What is known is that inflammation is common among heart disease and stroke patients, and it’s believed to play a role in cardiovascular disease. Glucosamine appears to have anti-inflammatory properties which could therefore be preventive[2] 

New research that included nearly a half-million participants found that habitually taking glucosamine was associated with 15 percent lower overall risk of CVD events, compared to nonusers [2]

It was further associated with a 9 to 22 percent lower risk of CVD death, coronary heart disease, and stroke, compared to nonusers [2]

It’s generally safe for most people at a dosage of 1,500 milligrams per day. However, it can cause some adverse reactions, including nausea, vomiting, diarrhoea, and abdominal pain if taken over the recommended dosage.


Individuals with shellfish allergies and those who are pregnant, or breastfeeding shouldn’t take glucosamine. There are reported cases of glucosamine and warfarin interactions and people on warfarin (blood thinners) should take extra precaution. It is important for everyone to speak to their doctor before taking any dietary supplement [3]. 
Despite its popularity for the treatment of osteoarthritis, glucosamine remain somewhat controversial, as evidence of its effectiveness is mixed.

Consult with your healthcare provide before the use of any dietary supplements. 


Glucosamine remains a good product for arthritis with new emerging science that is promising to support it’s use for cardiovascular disease. The new study suggests a potential new beneficial effect of glucosamine on cardiovascular health. The practical implication would still need to be established upon further evidence from future studies, such as clinical trials, that verify such effects as causal. 


  1. lad SC, LaValley MP, McAlindon TE, Felson DT (2007) Glucosamine for pain in osteoarthritis: why do trial results differ? Arthritis and Rheumatism 56: 2267–2277. [PubMed] [Google Scholar
  2. use with risk of cardiovascular disease: prospective study in UK Bioban trials. DOI:
  3. Myers SP (2002) Interactions between complementary medicines and warfarin. Australian Prescriber 25: 54–56. [Google Scholar]

Yours In Health

Mbali Mapholi


Omega 3 fatty acids supplements

Omega 3 fatty acids supplements

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Omega 3 essential fatty acids

These are a family of essential fatty acids that play important roles in your body and may provide several health benefits. They are called essential fatty acids because the body cannot produce them on its own, they are sourced externally from the diet or supplementation

What are omega 3 essential fatty acids

These are a family of essential fatty acids that play important roles in your body and may provide several health benefits. They are called essential fatty acids because the body cannot produce them on its own, they are sourced externally from the diet or supplementation. 

There are three most important types are ALA (alpha-linolenic acid), DHA (docosahexaenoic acid), and EPA (eicosapentaenoic acid). ALA is mainly found in plants, while DHA and EPA occur mostly in animal foods and algae [1]

  • ALA (alpha-linolenic acid),

This is the most common type of omega 3 which is mainly used by the body it for energy. It can also be converted into the biologically active forms of omega-3, EPA and DHA.  However, this conversion process is inefficient. Only a small percentage of ALA is converted into the active forms [1]

Common food sources:  flax seeds, flaxseed oil, canola oil, chia seeds, walnuts, hemp seeds, and soybeans.

  • DHA (Docosahexaenoic acid) 

This is the most important omega-3 fatty acid in the body. It’s a key structural component of the brain, the retina of the eyes, and numerous other body parts.  

Common food sources:  fatty fish and fish oil. Meat, eggs, and dairy from grass-fed animals also tend to contain significant amounts. Vegans and vegetarians get DHA from microalgae [1]

  • EPA (eicosapentaenoic acid)

Eicosapentaenoic acid (EPA) is mostly found in animal products, such as fatty fish and fish oil and microlalgae, part of EPA is converted into DHA [1]


Omega 3 fatty acids dosage: 

To date, there is no official recommended daily allowance for omega-3 fatty acids. However, most health guidelines from various health associations agree that 250–500 mg of combined EPA and DHA is enough for adults to maintain overall health. However, these may differ per individual depending on health status and need.  The therapeutic dose for heart health is 1000mg EPA and DHA combined which is equivalent as eating 3 servings of oily fish a week e.g. Salmon, pilchards, trout amongst others [1]

Verdict on Omega 3 fatty acids & heart health: 

Heart and heart related diseases are the world’s leading causes of death

Researchers observed that fish-eating communities had very low rates of these diseases which was later linked to omega 3 fatty acids. 

These benefits address:

  • Triglycerides: Omega-3 fatty acids may reduce triglycerides, usually in the range of 15–30% [3]
  • Blood pressure: Omega-3 fatty acids may reduce blood pressure levels in people with high blood pressure 
  • “Good” HDL cholesterol: Omega-3 fatty acids may raise “good” HDL cholesterol levels [2] There is mixed evidence when it comes to “LDL” cholesterol, some studies have shown an increase in “LDL” cholesterol.
  • Blood clots: Omega-3 fatty acids may keep blood platelets from clumping together. This helps prevent the formation of harmful blood clots [1]
  • Plaque: By keeping your arteries smooth and free from damage, omega-3 fatty acids may help prevent the plaque that can restrict and harden your arteries [3]
  • Inflammation: Omega-3 fatty acids reduce the production of some substances There is mixed evidence when it comes to “LDL” cholesterol, some studies have shown an increase in “LDL” cholesterol released during your body’s inflammatory response [1]

Research shows that there is a link between omega 3 fatty acids and heart health. At least, markers that if left unattended such as high cholesterol, plaque, triglyceride were reduced by omega 3 supplementation. All the benefits stated above are linked to improving heart health, however there is no evidence at this point that really shows that omega 3 fatty acids help reduce actual heart attacks and stroke. More data and research is needed in that area of medicine. 

Omega 3 fatty acids supplements: 

1. Omega-3 fatty acids Capsules

Omega-3 oils are commonly found in capsules or soft gels, these are the preferred form as they are easy to swallow.  The capsules are usually made from a soft layer of gelatine, and many manufacturers also use enteric coating. If you take omega-3 capsules, it may be a good idea to open one from time to time and smell it in order to make sure it hasn’t gone rancid.

2. Omega-3 supplement doses

The American Heart Association (AHA), among other organizations, recommends that people with coronary heart disease take 1,000 mg of combined EPA and DHA daily, while those with high triglycerides take 2,000–4,000 mg daily [1]  The maximum dose is 3000 mg EPA and DHA combined. 

Ascendis Direct has supplements that contain omega 3 fatty acids (EPA/DHA) in the sportron & swissgarde range. Kindly follow the recommended dosage on the label or product insert provided. Consult with your healthcare provide before the use of dietary supplements. 


The recommended omega 3 intake differs as per individual need, the dose increases significantly from maintenance to therapeutic dose. People with high cholesterol and triglycerides already existing may need a much higher dosage. Always make sure the supplement contains what it says it does and pay special attention to the EPA and DHA content.  EPA and DHA are best found in animal-based omega-3 products. Vegetarian options are available, but they usually only contain ALA with an exception of algal oil. It is best to take omega 3 fatty acids supplements with a meal that contains fat, as fat increases the absorption of omega-3 fatty acids. Finally, keep in mind that omega-3s are perishable, just like fish, so buying in bulk is a bad idea and it 

Always consult with your healthcare provider before taking a supplement. 


  • Thusgaard M, et al (2009). Effect of fish oil (n-3 polyunsaturated fatty acids) on plasma lipids, lipoproteins and inflammatory markers in HIV-infected patients treated with antiretroviral therapy: a randomized, double-blind, placebo-controlled study.

Yours In Health

Mbali Mapholi


Hypertension an Dietary Supplements

Hypertension & Dietary Supplements

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High Blood pressure is a common condition in which the pressure of your blood against your blood vessel walls poses a risk to your health. Over time, high blood pressure increases risk of stroke and heart disease.

What is hypertension (high blood pressure)?

High Blood pressure is a common condition in which the pressure of your blood against your blood vessel walls poses a risk to your health. Over time, high blood pressure increases risk of stroke and heart disease. 

High blood pressure is a condition that often carries no symptoms and can go undetected for years, hence it is called a “silent killer”.  Two measurements are used to diagnose high blood pressure: diastolic and systolic pressure. Diastolic is the pressure on your arteries in between heartbeats. A diastolic blood pressure measurement above 80 is considered high. Systolic blood pressure is the pressure against your artery walls during a contraction of your heart (a heartbeat). A systolic blood pressure measurement of 120 or above is considered elevated while above 130 is considered high. 

Both the systolic and diastolic blood pressure measurements are used in medicine to determine if you have high blood pressure, and if treatment may be necessary.

Many people are interested in using natural supplements to help improve their blood pressure, especially in combination with their medication. 

It is important to always check with the doctor before starting any supplement while on blood pressure medication and to note that supplements alone may not be enough to resolve high blood pressure.

What is science around supplements use for people with high blood pressure: 

1. Vitamin D

Low levels of vitamin have been linked to high blood pressure. However, there are concerns that vitamin D supplements had a very minor effect on diastolic blood pressure, and no effect on systolic in people with high blood pressure [1]

It is important to get enough Vitamin but its effects on high blood pressure may be minor. The major source of vitamin D is through sun exposure, and food sources.  Vitamin D supplements are also available should you not be able to get enough sunlight exposure or even Vitamin D rich foods.

2. CoQ10

Coenzyme Q10 (also known as ubiquinone) is an antioxidant that helps your cells produce energy. Research shows positive results that CoQ10 is beneficial in bringing down diastolic blood pressure by up to 10 millimetres of mercury (mm Hg) and systolic blood pressure by 17 mm Hg [2]

3. Garlic

Garlic has been used as a diuretic and circulation treatment since the time of ancient Greece.

Garlic may improve the way your body circulates blood through your system. Research has shown that garlic may help reduce both diastolic and systolic blood pressure in randomized clinical trials [3]

Garlic supplements or garlic as an active ingredient in supplements and raw garlic can both be used to help with high blood pressure. [4]

4. Omega-3s through fish oil or flaxseed supplements

Omega 3 fatty acids may help improve cardiovascular tone.  There is growing and promising evidence that omega 3 may help lower blood pressure.  Omega 3 fatty acids are found in food especially oily fish, seeds to name a few. Fish oil supplements as well as flaxseed supplements (capsule and liquid) [5]

5. Folic acid

Pregnant women are more at risk of high blood pressure due to increased to increase blood volume seen in pregnancy.  Folic acid is a B-Vitamin which is an important supplement for a baby’s development during pregnancy. Folic acid may have the additional benefit of reducing the risk of hypertension during pregnancy and there have been studies proving folic acid to be beneficial for non-pregnant women and men too. Folic acid can be found in food and supplements as part of prenatal vitamins, multivitamin & mineral supplements and / or stand-alone supplement [6]

Consult with your healthcare provide before the use of any dietary supplements.


Natural supplements are a promising way to treat high blood pressure. But some supplements can interact with blood pressure medications, such as ACE inhibitors and Beta Blockers.  It is important to seek professional advice before starting any supplement to help lower high blood pressure or any supplement for that matter if living with hypertension.  Supplement are not meant to replace blood pressure medication but as means to support the action of blood pressure medication.


  1. Witham MD. (2009). Effect of vitamin D on blood pressure: A systematic review and meta-analysis.
  2. Rosenfeldt FL, et al. (2007). Coenzyme Q10 in the treatment of hypertension: A meta-analysis of the clinical trials. DOI: 
  3. Xiong XJ, et al. (2015). Garlic for hypertension: A systematic review and meta-analysis of randomized controlled trials. DOI: 
  4. Ried K, et al. (2014). Potential of garlic (Allium sativum) in lowering high blood pressure: Mechanisms of action and clinical relevance.
  5. Cicero AF, et al. (2009). Omega-3 polyunsaturated fatty acids: Their potential role in blood pressure prevention and management. DOI: 
  6. De Ocampo MPG, et al. (2018). Folic acid supplement use and the risk of gestational hypertension and preeclampsia. DOI: 

Yours In Health

Mbali Mapholi


Vitamins for Skin Health

Vitamins essential for skin health

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Many nutrients (vitamins and minerals), herbs and other phytonutrients help support good skin health. Adopting healthy lifestyle and improving your water intake amongst other wellness goals help improve skin health.

Vitamins are essential for our health and body functions, vitamin deficiencies can cause adverse effects on the skin. Vitamin C and vitamin E play such important roles in protecting your skin from the sun, deficiencies in either vitamin can increase the risk of skin damage, including skin cancer.

Vitamins essential for Skin Health

  1. Vitamin K

Vitamin K is essential in aiding the body’s process of blood clotting, which helps the body heal wounds, bruises, and areas affected by surgery. The basic functions of vitamin K are also thought to help certain skin conditions.

Vitamin K can be found in many different topical creams for the skin, and it can help treat a variety of skin conditions. Doctors frequently use creams that contain vitamin K on patients who have just undergone surgery to help reduce swelling and bruising. This may help speed up skin healing. However, research on vitamin K’s effects on the skin is more limited than that for vitamins E and C.

Main food sources of Vitamin K are kale, spinach, lettuce, cabbage, green beans. 

2. Vitamin E

Vitamin E is an antioxidant. Its main function in skin care is to protect against sun damage. Vitamin E absorbs the harmful UV light from the sun when applied to the skin. The body has an ability to protect itself from damage cause photo protection which is the body’s ability to minimize the damage caused by UV rays this helps prevent dark spots and wrinkles. The body produces vitamin E through sebum, an oily substance discharged though the skin’s pores. In the right balance, sebum helps keep the skin conditioned and prevents dryness. If you have particularly dry skin, vitamin E can possibly help counteract a lack of sebum. Vitamin E also helps in the treatment of skin inflammation.

3. Vitamin D

Getting enough vitamin E in your diet is important. Most adults need about 15 mg of vitamin E per day. Main food sources of Vitamin E:  nuts and seeds, such as almonds, hazelnuts, and sunflower seeds

The main source of vitamin D is the sunlight and it is absorbed by the skin. Cholesterol converts to vitamin D when this happens. Vitamin D is then taken up by your liver and kidneys and transported throughout the body to help create healthy cells. This includes the skin, where vitamin D plays an important role in skin tone. It may even help treat psoriasis.

Getting 10 minutes of sun exposure a day (check with your doctor first, especially if you have a history of skin cancer), eating fortified foods, such as breakfast cereals, orange juice, and yogurt and eating foods that have vitamin D naturally, such as salmon, tuna, and cod. 

    1. Vitamin C

Vitamin C is found at high levels in the epidermis (outer layer of skin) as well as the dermis (inner layer of skin).  Vitamin C is an antioxidant and its role in collagen production help keep your skin healthy. This is why vitamin C is one of the key ingredients found in many antiaging skin care products.

Taking vitamin C orally in a form of supplement can enhance the effectiveness of sunscreens applied to your skin for protection from the sun’s harmful UV rays. It does this by decreasing cell damage and helping the healing process of bodily wounds. Vitamin C can also help fend off the signs of aging because of its vital role in the body’s natural collagen synthesis. It helps to heal damaged skin and, in some cases, reduces the appearance of wrinkles. Adequate vitamin C intake can also help repair and prevent dry skin.

Vitamin C food sources: citrus foods such as oranges, strawberries, broccoli, and spinach


Vitamins are essential for skin health, you might already be getting enough of these vitamins through your daily diet. Eating a balance healthy diet could be sufficient to meet the vitamin requirements such as Vitamin C, vitamin E and Vitamin K.  Ascendis Direct has nutritional supplements that may help, should you not be able to meet your vitamin requirements that are important for good health. However, it is important to consult with a healthcare professional before taking any dietary supplement.


  1. Michaels, A. J. (2011, September). Vitamin C and skin health
  2. Michaels, A. J. (2012, February). Vitamin E and skin health

Yours In Health

Mbali Mapholi


Premenstrual Syndrome (PMS)

Premenstrual Syndrome (PMS)

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What is premenstrual syndrome (PMS)?

Premenstrual syndrome (PMS) is something a lot of menstruating women experience — as many as 3 out of 4 women experience PMS [1]. PMS is a series of physical symptoms (e.g. weight gain, breast pain, headache, nasal obstruction, and pins and needles) and psychological complaints (e.g., irritability, anxiety, and depression) experienced by most women during the luteal phase of the menstrual cycle (7–14 days before the menstrual period) [2,3]. The symptoms of PMS can vary from person to person and, since physical, emotional, and behavioural symptoms may have different causes, the biological factors and symptoms of PMS should be separately evaluated [4]. However, the prevalence of PMS has been estimated to be 30–40% among women of reproductive age and 20–32% among premenopausal women.

The main cause of PMS is still unknown, and the syndrome is most likely multifactorial. Some researchers argue that hormonal agents and some micronutrients might be involved in the development of PMS [6]. These micronutrient deficiencies such as Vitamin D6, Calcium, Folic Acid, and magnesium of-which supplementing has been linked with improving symptoms associated with PMS.


Dietitiab Tips:

1. Magnesium:

There are studies that have found that supplementing with magnesium helped participant’s ease their PMS symptoms, including depression, anxiety, insomnia, water retention, and breast tenderness [5]

Some foods high in magnesium:

• almonds

• green leafy vegetables e.g. spinach, kale

• peanuts

Recommendation: Take 200 to 250 mg per day, keeping in mind that the average daily recommendation for adults should be around 300-400 mg, depending on age and sex.  It is important to stick to the dosage recommendation by supplement manufacture [5]. 

Caution: Dietary supplements may have interactions with medications you’re taking. Talk to your doctor or dietitian if you have any questions or concerns. It is important to enquire about product information for any precautions or and read the leaflet insert on the product.

2. Calcium

Women with PMS symptoms often don’t get enough calcium from their diet. Calcium levels may also change throughout your menstrual cycle.

There are studies that found that calcium supplements helped to reduce some symptoms of PMS, like bloating and fatigue. More so, they concluded that calcium supplementation was effective for reducing psychological symptoms, including sadness, mood swings, and anxiety.

Paying attention to taking high calcium foods, adding foods that are high calcium foods to your diet.

Some foods high in Calcium:

• Dairy Products (Milk, yoghurt

• green leafy vegetables e.g. spinach, kale

• seeds 

• Sardines & canned salmon 

If you can’t get enough from your diet, supplement with 50 to 100 mg per day. Always follow the manufacturer’s dosage guidelines. If that isn’t doing it, calcium supplements are available [6]

Recommendation: Start by taking 500 milligrams (mg) per day. It’s good to keep in mind that the daily recommended allowance for calcium in adults ranges from 1,000 to 1,300 mg, depending on your age and sex.

Caution: Dietary supplements may have interactions with medications you’re taking. Talk to your doctor or dietitian if you have any questions or concerns. It is important to enquire about product information for any precautions or and read the leaflet insert on the product.

3. Vitamin B-6

Vitamin B6 is a water-soluble vitamin which is also known as pyridoxine which is involved in the production of neurotransmitters, which play a big role in your moods [5]

Some foods high in Vitamin B6:

• chickpeas

• tuna, salmon, and other fish

• potatoes and other starchy veggies

• beef liver and organ meats

• Many breakfast cereals are also fortified with this essential vitamin.

Several small studies have found that taking a daily vitamin B-6 supplement may help with many of the psychological symptoms of PMS, including moodiness, irritability, and anxiety. However, conclusions are still limited due to poor quality of the current research 

Daily intake of water-soluble vitamins is needed because the body doesn’t store Vitamin B-6.

 4. Ginkgo biloba

Gingko biloba is best known as an herbal remedy for improving memory, but it can also help with PMS symptoms.

There is limited scientific research, but some researchers have found that taking 40 mg tablets, 3 times per day reduced the severity of both physical and psychological symptoms in the students studied [8;9]

Recommendation:  it important to start with the lowest recommended dose and take for about 10 to 14 days from mid-cycle until a day or two after your period.

Caution: Herbs may interactions with medications you’re taking. Talk to your doctor if you have any questions or concerns. It is important to enquire about product information for any precautions or and read the leaflet insert on the product.

Recommendation:  it important to start with the lowest recommended dose and take for about 10 to 14 days from mid-cycle until a day or two after your period.

Caution: Herbs may interactions with medications you’re taking. Talk to your doctor if you have any questions or concerns. It is important to enquire about product information for any precautions or and read the leaflet insert on the product.


5. St. John’s wort

Many consider st.John’s wort  to be an herbal alternative to prescription antidepressants. It affects both serotonin and norepinephrine, two neurotransmitters that affect your mood and that are typically targeted in traditional antidepressants [10]

There are studies on medicinal herbs, with several studies pointing to its effectiveness in treating PMS symptoms.  The st. John’s Wort seemed to improve both physical and emotional symptoms, particularly depression and anxiety [11]

Recommendation: Dosage recommendations vary significantly depending on the manufacturer.

Caution: Herbs may interactions with medications you’re taking. Talk to your doctor if you have any questions or concerns. It is important to enquire about product information for any precautions or and read the leaflet insert on the product.


For many people, PMS is a frustrating monthly ordeal. However, there are supplements that may help with both your physical and emotional symptoms.

Many supplements become more effective over time, so don’t be disappointed if you don’t notice immediate results. Some may take 3 to 6 months to work.

Ascendis health direct offers a range of dietary supplements and herbal remedies that can help with these symptoms, a range of products/supplements that contain nutrients such as magnesium, vitamin B6, Calcium among others. 


1. Abdnezhad R, Simbar M, Sheikhan Z, Mojab F, Nasiri M. The effect of Salvia (Sage) extract on the emotional symptoms of premenstrual syndrome. Iran J Obstet Gynecol Infertil. 2017; 20:84–94. [Google Scholar]

2. Brahmbhatt S, Sattigeri BM, Shah H, Kumar A, Parikh D. A prospective survey study on premenstrual syndrome in young and middle-aged women with an emphasis on its management. Int J Res Med Sci. 2013; 1:69–72. [Google Scholar]

3. Raval CM, Panchal BN, Tiwari DS, Vala AU, Bhatt RB. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder among college students of Bhavnagar, Gujarat. Indian J Psychiatry. 2016; 58:164–170. [PMC free article] [PubMed] [Google Scholar]

4. Halbreich U, O’Brien PM, Eriksson E, Bäckström T, Yonkers KA, Freeman EW. Are there differential symptom profiles that improve in response to different pharmacological treatments of premenstrual syndrome/premenstrual dysphoric disorder? CNS Drugs. 2006; 20:523–547. [PubMed] [Google Scholar]

5. Kahyaoglu Sut H, Mestogullari E. Effect of premenstrual syndrome on work-related quality of life in Turkish nurses. Saf Health Work. 2016; 7:78–82. [PMC free article] [PubMed] [Google Scholar]

5. Fathizadeh N, et al. (2010). Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. 


7. Vitamin B6. [Fact sheet]. (2018).

8. Ginkgo. (2018).

9. Ozgoli G, et al. (2009). A randomized, placebo-controlled trial of ginkgo biloba L. in treatment of premenstrual syndrome.

10. St. John’s wort. (2014).

11. St. John’s wort. (n.d.).–johns-wort

Yours In Health

Mbali Mapholi


Calcium Supplements for Menopausal Woman

Calcium Supplements for Menopausal Women

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Why Do postmenopausal women need Calcium?

Everyone’s body needs calcium to build and maintain bone health. Over 99% of the calcium in the body is stored in your bones and teeth (1)

Calcium is also used to send nerve signals, help blood vessels and muscles contract and dilate, and help release hormones like insulin (1). Low Calcium intake results in the withdrawal of calcium from your skeleton and teeth to use elsewhere, weakening your bones. Since a lack of oestrogen enhances the rate of bone loss, a postmenopausal woman must take more calcium to development & protection of bones. 

Although a balanced diet aids calcium absorption, high levels of protein and sodium (salt) in the diet are thought to increase calcium excretion through the kidneys. Excessive amounts of these substances should be avoided, especially in those with low calcium intake.

Lactose intolerance also can lead to inadequate calcium intake. Those who are lactose intolerant have insufficient amounts of the enzyme lactase, which is needed to break down the lactose found in dairy products. To include dairy products in the diet, dairy foods can be taken in small quantities or treated with lactase drops, or lactase can be taken as a pill. Some milk products on the market already have been treated with lactase

General Recommendations of Calcium for women

Below are the current recommendations from the Institute of Medicine, by age (2):

  • Women 50 and younger:1,000 mg per day
  • Women over 50:1,200 mg per day

Some of Calcium -rich foods(2)

  • Milk
  • Yoghurt
  • Cheese
  • Sardines & canned salmon 
  • Bean & lentils 
  • Almonds
  • Edemame beans & tofu >
  • Seeds (e.g. poppy seeds, chia seeds) 

Calcium dietary supplements: 

It is possible for one to meet their calcium daily recommendation through food however, due to increased needs there can be a need to add a calcium supplement.

There are also recommended upper limits for calcium intake. The cap is 2,500 mg per day for adults up to age 50 and 2,000 mg per day for adults over 50 

It’s possible to get enough amounts through your diet. However, people who don’t eat enough calcium-rich foods might consider taking supplements especially postmenopausal women who have higher calcium requirements (3)

Who Should Take Calcium Supplements & what are their Benefits?

When your calcium intake is insufficient, your body will remove calcium from your bones, making them weak and brittle. This can result in osteoporosis.

Since women are at a higher risk of osteoporosis, many doctors recommend that they take calcium supplements, especially after reaching menopause.

Because of this, older women are much more likely to take calcium supplements (4). Studies of bone histomorphometry and markers of bone remodelling indicate that bone remodelling is accelerated in the perimenopausal and postmenopausal periods. The span of 5 to 10 years surrounding menopause is characterized by a decrease in oestrogen production and an increase in resorption of calcium from bone, resulting in a marked decrease in bone density (4). These changes during the postmenopausal period increases the need for calcium supplement. 

If you don’t get the recommended amount through your diet, supplements can help fill the gap.

You might also consider calcium supplements if you:

  • Follow a vegan diet.
  • Have a high-protein or high-sodium diet, which may cause your body to excrete more calcium.
  • Have a health condition that limits your body’s ability to absorb calcium, such as Crohn’s disease or inflammatory bowel disease.
  • Are being treated with corticosteroids over a long period of time.
  • Have osteoporosis.

Studies have linked taking calcium supplements with a lower risk of colon cancer and blood pressure, as well as fat loss and increases in bone density. Several studies have suggested that giving postmenopausal women calcium supplements — usually around 1,000 mg per day — may reduce bone loss by 1–2% (4)


excessive intake of Calcium supplements may increase the risk of heart disease and prostate cancer, although the link is unclear. Extremely high levels of calcium from any source may have negative health effects. It is important to take calcium supplement with or after a meal to help increase its absorption which some studies have estimated to be an increase by 20 – 30% (5)

Overview on Vitamin D

Vitamin D, a fat-soluble vitamin, occurs naturally in very few foods, with fatty fish like salmon or tuna, fish liver oil, beef liver and egg yolks serving as the best food sources. To decrease the occurrence of vitamin D deficiency syndromes such as rickets, food manufacturers fortify foods including milk, cheese, orange juice and breakfast cereals with vitamin D. Your body can also produce vitamin D when the ultraviolet rays of the sun stimulate the conversion of pre-vitamin D-3 in the skin cells into vitamin D. As women age, their skin loses the ability to produce vitamin D, making postmenopausal women a high-risk group for vitamin D deficiency (5)

Link of Vitamin D to Calcium 

The body needs vitamin D to absorb calcium.Without enough vitamin D, one can’t form enough of the hormone calcitriol (known as the “active vitamin D”). This in turn leads to insufficient calcium absorption from the diet. In this situation, the body must take calcium from its stores in the skeleton, which weakens existing bone and prevents the formation of strong, new bone. Vitamin D plays a very crucial role in the absorption of Calcium in the body (5)

Vitamin D Sources: 

You can get vitamin D in three ways: through the skin from sunlight (main source of Vitamin D)from the diet, and from supplements. Experts recommend a daily intake of 600 IU (International Units) of vitamin D up to age 70. Men and women over age 70 should increase their uptake to 800 IU daily (5)

vitamin D-rich foods (6)

  • Egg yolks
  • Saltwater fish
  • Liver
  • Fortified milk 


Calcium supplements can help people who are at risk of osteoporosis, as well as those who don’t get enough calcium in their diets. Menopausal women are the most vulnerable group with higher calcium requirements.  Vitamin D is a crucial fat soluble vitamin that is needed for the absorption of calcium 

While some research suggests a link between calcium supplements and heart disease, the link is not clear.

However, it is known that getting more than the recommended amount of calcium from any source may raise your risk of kidney stones.

Calcium supplements are fine in small doses, but the best way to get calcium is from food. Strive to incorporate a variety of calcium-rich foods in your diet, including non-dairy sources.  


  4. Vitamin D fact sheet for health professionals [fact sheet]. (2016, February 11)
  5. Vitamin D: Safety. (2013, November 1)

Yours In Health

Mbali Mapholi


The Salt Talk

The Salt Talk

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What is Salt? 

Salt is mainly composed of two minerals, sodium and chloride, which have various functions in the body. It is found naturally in most foods and is widely used to improve flavour.

The essential minerals in salt act as important electrolytes in the body. They help with fluid balance, nerve transmission and muscle function.

Some amount of salt is naturally found in most foods. It’s also frequently added to foods in order to improve flavour.

Salt and sodium are words used interchangeable in the food industry as the by product of salt is sodium and Chloride.

Salt/Sodium intake Recommendation: 

The world health Organization (WHO), recommends an intake of less than 2g Sodium / day (2000mg Sodium) which is equivalent to 5g/day salt (1 teaspoon of salt = 4-5 g salt)

Scientific evidence shows that reducing intake to less than 2g/day is more beneficial for high blood pressure as compared to reducing salt intake but still consuming more than 2g/day 

“WHO recommends a reduction in sodium intake to reduce blood pressure and risk of cardiovascular disease, stroke and coronary heart disease in adults (strong recommendation1). WHO recommends a reduction to <2 g/day sodium (5 g/day salt) in adults (strong recommendation). WHO recommends a reduction in sodium intake to control2 blood pressure in children (strong recommendation). The recommended maximum level of intake of 2 g/day sodium in adults should be adjusted downward based on the energy requirements of children relative to those of adults.

These recommendations apply to all individuals, with or without hypertension (including pregnant and lactating women), except for individuals with illnesses or taking drug therapy that may lead to hyponatraemia or acute build-up of body water, or require dietitian-supervised diets (e.g. patients with heart failure and those with type 1 diabetes).

Health Dangers of high Salt Intake; 

High sodium intake has been associated with several Non-Communicable Diseases:

  • Hypertension
  • Cardiovascular disease 
  • Stroke

Hypertension is (high blood pressure) which is considered a major risk for cardiovascular disease, especially heart attack and stroke. Suboptimal systolic blood pressure (>115 mmHg) is estimated to contribute to 49% of all coronary heart disease and 62% of all stroke. In Africa and South Africa included the prevalence of hypertension has dramatically increased over the years where 1 in 3 adults have hypertension.  Africa is has very hypertension rate globally.  More than half of the countries in Africa are affected by hypertension and it affects more men than women.

Risk factors of Hypertension: 

  • High salt intake 
  • Age 
  • Genetic make-up 
  • High Alcohol consumption 
  • Sedentary lifestyle 
  • Being overweight / obesity – In Africa, obesity is seen more in women compared to men

5 Practical household to reduce salt intake: 

  • Once food is cooked, do not add table salt. Add minimal salt to your cooking (Just a pinch, literally) 
  • Avoid the use of stock cubes, packet soups, meat spices in your food 
  • Choose a variety of herbs and spices to provide flavour and taste to your food 
  • Be ware of “lite” food products they may be lower calories and lower sugar but higher sodium 
  • Read your food labels: choose foods with 120mg or less Sodium per 100g 


1.WHO. Global health risks: Mortality and burden of disease attributable to selected major risks. Geneva, World Health Organization (WHO), 2009

( ).

2. WHO. Preventing chronic disease: a vital investment. Geneva, World Health Organization (WHO), 2005


3. Murray CJ, Lauer JA, Hutubessy RC et al. Effectiveness and costs of interventions to lower systolic blood pressure and cholesterol: a global and regional analysis on reduction of cardiovascular-disease risk. Lancet, 2003, 361(9359):717–725 (

4. WHO. Prevention of recurrent heart attacks and strokes in low and middle income populations: Evidence-based recommendations for policy makers and health professionals. Geneva, World Health Organization (WHO), 2003 (

Yours In Health

Mbali Mapholi


Probiotics 101

Probiotics 101

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What are probiotics? 

Probiotics are living microorganisms that, when ingested, provide numerous health benefits. They’re usually bacteria, but certain types of yeasts can also function as probiotics.

Probiotics should not be confused with prebiotics, which are dietary fibres that are food to the probiotics.

You can get probiotics from supplements, as well as from foods prepared by bacterial fermentation or that have naturally occurring probiotics.  

Probiotics explained:

Probiotics food examples:

  • Yoghurt (particularly plain yoghurt or Greek yoghurt 
  • Kefir
  • Sauerkraut
  • tempeh 
  • kimchi
  • Sour milk (Maas) and buttermilk 
  • Other fermented or pickled vegetables 
  • Fermented drinks e.g. Kombucha 

Different Probiotics

Dozens of different probiotic bacteria offer health benefits. The most common group of probiotics s include Lactobacillus and Bifidobacterium groups. Each group comprises of different species, and each species has many strains.

Interestingly, different probiotics address different health conditions. Therefore, choosing the right type — or types — of probiotic is essential.

Benefits of Probiotics: 

There is strong scientific research that provides benefits of probiotics such as: 

    • Our gut flora consists of hundreds of different types of microorganisms. Probiotics help your gut flora perform optimally
    • Probiotics are effective against various digestive problems, including antibiotic-associated diarrhoea, constipation and IBS
    • Though more research is necessary, some evidence suggests that certain probiotic strains can help people lose weight
    • Probiotics may also improve heart health, skin health, immune function and symptoms of depression and anxiety
    • More research is needed to support the use of probiotics for the purpose of restoring gut flora during the antibiotic cause

Side note: Antibiotics help kill harmful bacteria in our bodies, unfortunately they also erode good bacteria. There has been a practice of doctors recommending probiotics with antibiotic cause to help restore good gut flora.

Probiotics Supplements: 

Taking the right type of probiotics may help you target specific health issues and improve your overall health and quality of life. They are several types of different probiotics strains that are used in probiotics supplement, you need to understand what you need probiotic for so you can choose a right supplement.

Supplements also differ in how they combine probiotics – Some supplements — known as broad-spectrum probiotics or multi-probiotics — combine different species in the same product. 


Maintaining a healthy gut is important, this can be achieved through healthy Day-to-day diet and exercise as important aspects of many lifestyle factors impact your gut bacteria. Taking Probiotic Supplement is also recommended for those who do not consume enough probiotic foods.  Probiotic supplements offer a wide range of benefits with few side effects — so if you’re interested in improving your gut health, they could be worth a shot.

Yours In Health

Mbali Mapholi


Healthy treat recipe: Oat Date balls

Healthy treat recipe: Oat Date balls

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Makes 12

  • 1 cup dates
  • 2 cups rolled oats
  • 3/4 cup desiccated coconut
  • 1 tbsp cacao powder
  • 1 tbsp natural peanut butter


Dietitian tipss:

  • Place dates in a pot of water and bring to the boil. 
  • Drain the dates and put the liquid into a container and set aside. 
  • Place drained dates, coconut, peanut butter, oats and cacao in a food processor.
  • Add roughly 1/4 of the date liquid to the mix and process (you may need a little more liquid than this, add it slowly until the mix holds its shape.

-If you accidentally add too much liquid add a little more of the other dry ingredients to balance) 

  1. Roll mixture into 12 balls and store in the fridge or freezer. 
  2. Roll in extra coconut if desired 

Dietitian comment: 

Healthy, delicious & done right

Yours In Health

Mbali Mapholi