Supplementation Support of Dietitian and Nutritionist

A registered dietitian and nutritionist can provide guidance around the use of supplements in the following ways:

• Help assess one’s diet and determine areas where certain nutrients may be lacking.
• Take a food-first approach and provide education on ways to increase macro and micronutrient intake via diet–depending on the individual, supplementation can certainly come into play here as well.
• When working with clients who may have one or more dietary restrictions, whether it be for personal, ethical, or medical reasons, supplementation is a tool used by dietitians to ensure that all nutritional requirements are being met.
• Vitamin D is a great example of a micronutrient that dietitians often advise supplementing here in North America, due to winter taking up at least half the year and limiting sun exposure. Although we have access to vitamin D fortified foods (i.e. milk), if an individual is perhaps not eating very many of these foods due to dietary restrictions (i.e. a dairy allergy), and are also not spending much time in direct sunlight, a dietitian can make an educated decision around how much vitamin D this individual may need to supplement in order to meet their daily requirement.
• That said, supplements are not exclusively recommended by registered dietitians in the context of meeting basic nutritional needs. They are often also suggested to play a therapeutic role in supporting health and wellness goals.
• Digestive health is a large area of nutritional counselling where this type of supplementation comes into play. A dietitian may recommend supplements to assist with chronic constipation or diarrhea, for example. They may also provide guidance on supplements that assist with the management of gas and/or bloating, the promotion of overall gut health (i.e. probiotics), or the breakdown of specific nutrients (i.e. digestive enzymes).
• Certain gastrointestinal conditions can involve dietary restrictions as well, so a dietitian and nutritionist can advise supplementation that helps ‘fill the gaps’.
• Supplementation comes into play when supporting overall wellness too. A dietitian can provide guidance on supplements that may support stress management, or improve sleep. The world of sports nutrition supplements can come into play here as well.
• Dietitians and nutritionists who have expertise in sports nutrition can provide education on supplements that help clients meet their macronutrient requirements, in addition to supplements that can support progress at the gym and assist with recovery.
• Chronic disease management is another topic of potential supplementation. Dietitians can provide direction around supplements that may assist with blood sugar control as it pertains to diabetes, or optimize blood lipid levels re: dyslipidemia.
• And more.

Although supplements certainly have a time and place, and the recommendation of numerous supplements is well within the scope of practice for dietitians, there are some limitations worth mentioning.

• Generally, the recommendation of supplements by dietitians is very much secondary to dietary recommendations. As much as possible, dietitians advocate for meeting nutritional needs and support of health and wellness goals via dietary adjustments.
• Part of the reason for this is sustainability–if you are able to get what you need through what you are eating and spare the need for supplements, then why not do so? This can also increase motivation to make mindful food choices versus relying on supplements to meet certain requirements.
• Cost can come into play here as well. With the cost of food already inflated, adding supplements to the mix can become quite pricey and potentially out of budget for many.
• With supplementation, also comes the risk of potentially overconsuming certain nutrients. Although supplements are mostly regulated by sources like the FDA and Health Canada, some do not have these certifications and may contain higher dosages than recommended, or have other additives that have not been well researched or approved by regulatory bodies for frequent consumption.
• Some nutrients are stored by the body, whereas others may get filtered out by our kidneys and digestive systems if they are not being utilized right away. Therefore, supplementing certain nutrients unnecessarily may also contribute to build-up of too much or even toxicity. Dosage becomes very important here.
• Some supplements have simply not been well researched for regular or long-term intake, which is an additional factor that registered dietitians and nutritionists can provide direction on, and another potential limitation.
• In the constantly evolving world of social media and marketing tactics, it is also very important to pay heed to potential false claims regarding supplement benefits. Many companies may claim that their products have a much greater impact on health and wellness goals than actually true. They may also lack strong research to support their claims.
• Additionally, because taking care of one’s health has become increasingly relevant and almost even trendy in recent years, many people may have a misconceived notion that using supplements, especially several of them, indicates that they are ‘being healthy’ or ‘health-conscious’, when this is not necessarily the case.
• Overall, the way that dietitians encourage viewing supplements is right in their name. They are products used to supplement or enhance what someone may not be able to get through their diet. They are used supplementary to diet and lifestyle changes.