The colorful pills and capsules of dietary supplements seem to have taken over people’s daily plates filled with food. Globally, more than 40% people take some supplement or the other for either bone health, overall well being or to fill their nutrition gaps like athletes for muscle building or vegans to compensate for Vitamin B12 that is lacking in their food sources.
A survey of 300 Registered Dietitians (RD) conducted in 2009 showed that a whopping 97% of dietitians agreed when asked if they “ever recommend dietary supplements to clients”. The primary reasons to recommend supplements were bone health (70%), to fill nutrient gaps (67%), and overall health and wellness (49%) and 74% dietitians use regular supplements in their daily life.
Code of Ethics for Dietitians
The Code of Ethics for Dietitians by the Academy of Nutrition and Dietetics (formerly the American Dietetic Association) states that “The dietetics practitioner does not invite, accept, or offer gifts, monetary incentives, or other considerations that affect or reasonably give an appearance of affecting his/her professional judgment.”
This means that dietitians should not be endorsing a particular brand of supplements, products, food, etc. in exchange for gifts of any kind that will affect their judgement. Let’s say a brand ABC approached a dietitian asking her/him to endorse and suggest their brand ONS (Oral Nutrition Support) in exchange for commission but the dietitian knows that the product is not apt for her clients or there are other ONS in the market that will suit the client better, then it is the duty of the dietitian to refrain from such endorsements.
Dietitians must recommend supplements to their clients based on the needs of their clients. They should analyze the individual’s dietary intake, exercise, lifestyle, biochemical parameters, goals, etc. and then only prescribe supplements.
Need for Supplements
Even if one is consuming a balanced diet, he/she may need supplements for overall well being. Supplements aren’t meant to replace nutritious eating and balanced diets but rather they help ensure that you are meeting your optimal nutrient needs to look and feel your best. Some of the reasons why supplements may be needed are –
- Mineral Losses – The soil is depleted of its minerals and the processing of ingredients from farm to form leads to loss of nutrients. Shelf life of foods and the nutrient content in them are closely related and hence even if one is eating a balanced diet to some extent minerals may have been lost.
- Lifestyle – The fast-paced lifestyle has led to many people adapting to ready to eat foods or make food that requires minimum effort. It is rather easy to pop an iron supplement than to eat green leafy vegetables along with vitamin C rich foods.
- Individual Health – Everybody’s body assimilates nutrients differently. Stress, certain medications, genetics, hormones, underlying conditions, etc. all can affect the way nutrients are absorbed and used in the body.
Dietitians And Supplements
Dietitians vouch for the words of Hippocrates “Let Food be thy Medicine and Medicine be thy Food”. They believe in consuming a balanced diet and educating others on the importance of a balanced diet and physical activity. The fact “Food before Supplements” always comes first for dietitians, but they also believe in the fact that supplements may help people bridge the gap to optimal health and wellbeing.
Dietitians know for a fact that the majority of the population is unable to meet the Recommended Dietary Allowances (RDA) for nutrients and supplements can be one way of getting the RDA of vitamins and minerals.
Dietitians also recommend supplements based on the phase of life of individuals. Women after the age of 30 need more calcium and hence he/she would recommend the client calcium tablets, pregnancy is a crucial period and therefore dietitians would prescribe folic acid and iron supplements. After the age of 50, men and women need more protein and hence dietitians would ask clients to take the help of protein powders to meet the requirements.
Coming to answer the question in the title “Should Dietitians recommend Supplements?” my take would be Yes. Ofcourse! Dietitians would obviously first recommend the balanced diet and the holistic approach to health, but to get the overall optimum health they can recommend supplements.
A study showed that even when an individual exercises, consumes a balanced diet and copes with stress in a holistic way, they still can have deficiencies. And when they included supplements, their quality of life increased.
Supplements can be both a disaster and a miracle for individuals. When individuals take supplements by themselves over the counter, which may not be approved or have harmful ingredients or supplements which are not clinically tested it can lead to complications and unnecessary burden on the body. But when they consult a dietitian and take supplements that are required for them and not just because everyone is doing so, individuals can improve their quality of life and have better overall health.
Dietitians go through 3-5 years of education about physiology, nutrient interactions, metabolism, food science, etc. and extensive research studies and reviews and therefore know what individuals’ needs are. So, if your dietitian thinks you need that B12 or iron or calcium supplement, go ahead and trust him/her and take them. Never take supplements over the counter or self-prescribe because it is trending to pop pills!
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References –
- Dickinson, A., Bonci, L., Boyon, N., & Franco, J. C. (2012). Dietitians use and recommend dietary supplements: Report of a survey. Nutrition Journal, 11(1), 14. https://doi.org/10.1186/1475-2891-11-14
- American Dietetic Association/Commission on Dietetic Registration Code of Ethics for the Profession of Dietetics and Process for Consideration of Ethics Issues. (2009). Journal of the American Dietetic Association, 109(8), 1461–1467. https://doi.org/10.1016/j.jada.2009.06.002
- Steyn, N. P., Labadarios, D., Nel, J. H., & Heidi-Lee, R. (2005). Development and validation of a questionnaire to test knowledge and practices of dietitians regarding dietary supplements. Nutrition, 21(1), 51–58. https://doi.org/10.1016/j.nut.2004.09.008
- Liljeberg, E., Andersson, A., Malmberg, K. B., & Nydahl, M. (2019). High Adherence to Oral Nutrition Supplements Prescribed by Dietitians: A Cross-Sectional Study on Hospital Outpatients. Nutrition in Clinical Practice, 34(6), 887–898. https://doi.org/10.1002/ncp.10243