Practice Blog

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Call to Action: Dietitians need to help guide effective nutritional supplementation

Two dietitians discuss why they think RDs should play a stronger role in the booming supplement industry and meet consumer demands for reliable information. 


LK-HS.jpgLaura Kalina, RD, MAdEd is a registered dietitian, author, professional speaker, and award-winner for excellence in health promotion, nutrition communication, and food security. She specializes in low-glycemic eating and weight management, nutritional supplementation, and is a co-author of the national best seller, “Low Glycemic Meals in Minutes.” She has a passion for sharing the importance of healthy eating and cellular nutrition to prevent chronic disease. You can contact Laura by email at laurakalina@telus.net or visit her website lowgimeals.com.

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Kim Arrey, RD has a thriving dietetics practice based in Montreal where she has been able to help her clients achieve their health goals, lose weight, and find lasting relief from pain, while encouraging them to choose delicious healthy food. She is the author of “The Complete Arthritis Health, Diet Guide and Cookbook,” with Dr. Michael Starr. Kim speaks and lectures on healthy eating choice and transforming complex scientific information into easy to understand terms. She is often asked to comment on nutrition issues by local and national journalists. Contact Kim at kimarrey@gmail.com or visit her website kimarreynutrition.com.  
 

  

Consumers are looking for reliable information on supplements. In the quest for better health, sport performance gains, or simply relief when living with chronic or terminal conditions, consumers are willing to invest in supplements – in addition to adopting a healthy diet. In the past, most dietitians have been hesitant to promote supplements – instead, emphasizing investment in good foods and healthy eating patterns. There is now a growing body of dietitians who have honed their expertise in this area and are calling on others to do the same.

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Laura Kalina’s personal experience using supplements highlights the benefit of more dietitians seeking training in this area. She tells her story below:

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Over 10 years ago, I was diagnosed with an autoimmune condition. My physiotherapist suggested I start on some good quality antioxidants and fish oil to combat the oxidative stress and inflammation in my joints as a result of this inherited condition. At the time, I was skeptical about the benefits of nutritional supplements and decided to research the field.
 
To make a long story short, about three months after taking a combination of antioxidant and chelated minerals, omega-3s, grape seed extract, and a glucosamine/turmeric supplement, my inflammation lessened remarkably and I just kept feeling better.
 
It has been over 10 years and I have not missed a day of taking my nutritional supplements. Since that time, I have attended conferences and undergone extensive training in the field. I now feel I have more expertise in the area of nutritional supplements and can assist consumers in determining which products are the best for them.

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Because of our passion for promoting food first, the dietetic profession has in some ways been cautious to embrace the benefits of nutritional supplementation for the general population and the public is often turning to unregulated nutrition practitioners to get advice in this area. I think it is incumbent on our profession to become more educated and expand our scope of practice into the area of nutritional supplementation.

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Laura has a compelling personal story, and no doubt many of you can think of clients whom you have encountered during your career with similar stories. Clients come to see us and are clearly misinformed about the amount and type of supplement(s) to be taking, if indicated.
 
Clients in these situations need the help of registered dietitians to learn what supplements to take, how much to take, and when to take them. Registered dietitians are the only members of the health care team who have the educational background to evaluate the dietary needs of an individual. As dietitians, we are well positioned to determine if clients have the ability and the willingness to make the necessary changes to their diets to improve their nutrition status, or if an alternate route to meeting nutrition needs should be considered. 

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Of course, we need to be well versed in how to encourage clients to consume nutrient dense diets. But, when this is not attainable for some clients, dietitians also need to be aware of the most effective supplements available to help clients reach their goal of optimal health, especially considering the marketing of supplements can be misleading. And, not all supplements contain what is indicated on the label. The makers of supplements do not have to follow the same rules as the makers of pharmaceutical products. So, for the same type of product you could have differences in formulations, manufacturing practices, and quality control procedures that can affect everything from potency and absorption to effectiveness and safety. 
 
Not only do dietitians need to know what nutrients may be necessary to obtain a specific therapeutic effect, they also need to know which supplements are the most absorbable, and what possible interactions there can be with medications or even between two supplements.
 
Dietitians should know not only about food but also about supplements. As the scientific research moves forward, it is possible – maybe even likely – that nutrition supplements will play a more important role in achieving and maintaining optimal health. Our profession needs to be better prepared to address this shift.  
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Editor’s note: If Laura and Kim’s call to action have inspired you to learn more about supplements, Dietitians of Canada has some great resources on Learning on Demand and under Nutrition A-Z here.  
 
  1. We definitely need to learn more about dietary and herbal supplements as we encounter lots of questions about them from clients.
    Thanks for interesting points!
  2. Great post. I would like to see a PEN professional summary resource listing out supplements and what the most current evidence says, not just what Health Canada might say (for example Health Canada is considered way behind on vitamin D supplements). Currently I have to look them up one by one in PEN, and many aren't in there yet.
  3. Thank you Kim and Laura, you make excellent points in this discussion. We do need to align ourselves more closely with naturopathic medicine, as we cannot begin to learn everything that there is to learn about supplementation.
    If we partner our professional practice with their professional practice, we can promote the food perspective and they can share their expertise from their formal education. I have finally come to realize that I cannot "do it all," anymore or be "all things to all people."
  4. I agree with the comments above. I think that we need to be better informed about nutritional supplements, their benefits and contraindications. I have also taken the DC course, which helped some, but would like more information. I think an accredited course would be very helpful.
  5. Congratulations Laura and Kim! We are so behind the '8 ball' on supplementation as far as being RDs; in part because of our regulatory bodies being somewhat confusing... can we or can't we?
    I would like to see a specialized accredited course to help rds be more credible in this segment of our practice and for our Colleges to support this initiative in very precise terms to lead to less confusion.
  6. I have heard conflicting information that taking calcium supplements with Fosamax (for osteoporosis) can increase heart disease over a long period of time. This blog tells me I need to know more. Interesting article.
  7. Great article! Are there any practical continuing education courses on this topic. I've taken the DC courses, but found them very theoretical and not overly helpful?

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