Question 1
Would you recommend the use of dietary supplements for adolescent clients or patients? Why or why not?
posted by lcflier @ 5:39 PM
14 comments
ISU Dietetic Internship Journal Club
Objective: To become familiar with current scientific literature on a variety of nutrition topics and to gain experience in gathering, organizing, critically evaluating, presenting and facilitating group discussion of the literature and the implications to practice.
14 Comments:
I am a strong advocate of the "Food First" mentality that we should encourage people to get their nutrients from food sources. I do understand that in some cases dietary supplements may be necessary, but they should be reserved for special cases and it should be understood that supplements are used on a temporary basis until the problem can be fixed. I would explain that supplements are not the answer to a making someone "healthy" this is because vitamin/mineral supplements do not provide dietary fiber that fruits, vegetables and whole grains provide. Also to date antioxidants/phytochemicls have not been able to be replicateed in the pill form which is why it is so important to recommend Food First. So vitamin/mineral supplements should not be used to correct an unhealthy diet, they are a SUPPLEMENT that if taken should be used to supplement a healthy diet. Also as we talked about in November's topic the bioavailability is a huge issue and even though some vitamin/mineral supplements may provide "100%" of the RDA that amount is truly not available to the person taking them. And as the second article points out even supplement users had less than the RDA for Zn, Ca, Vitamins A, B-6, C, and E so in my opinion supplements are not the answer.
Mary Ellen,
I think you made a good point that nutrients should come from food first. Can you give some examples of cases in which dietary supplements may be necessary? How comfortable would you feel recommending them in these cases?
I actually did my thesis on supplement use of early adolescents so I am excited you picked this article!!! I believe we should encourage adolescents to get thier nutrients from food first, especially since the diets of adolescents appear to be very poor. If I had an adolescent as a patient or client, I would feel that it is my responsibility as a dietitian to counsel them on their diet, and not just recommend they take a pill to solve their health problems, unless they have a condition that requires supplementation, such as some instestinal/digestive disorders, or congenital disorders that result in malabsorption of nutrients. I also would question whether an adolescent would even take the supplement on a regular basis, remembering to take it once daily. As I reviewed research while writing my thesis, I discovered that adolescents don't generally participate in things that would promote good health unless it seems to have an immediate benefit to them. So, unless there were studies that suggested a MVI could help you lose weight or build muscle mass, I don't think many adolescents would be interested in taking them. I would never discourage a client from taking a supplement if they were already taking one, or interested in taking one, I would just explain that nutrients are best absorbed from foods, and that there are some nutrients/phytochemicals/antioxidants in food that cannot be found in a supplement form. I believe the best way to improve overall health and nutrition of adolescents is to help them build healthy eating habits that they can apply for the rest of their lives, and help steer them away from the idea that all the nutrients they need can be found in the form of a pill.
Andrea said...
I also agree about the 'food first' attitude. I wouldn't recommend the use of supplements nor disuade a client from using them. I wouldn't recommend supplements for a few reasons: 1) they can be expensive; 2) the vit/min bioavailability has been shown to be less than that of foods; and 3) we must be cautious of all supplements due to the fact that they are not regulated by the FDA. I would not disuade anyone from taking supplements because that is their choice. I would, however, professionally inform them about the pros and cons of supplement use.
I also agree with everyone on encouraging patients to get their nutrients from food first. In fact, if a person is eating the recommended calories and a variety of foods, they should be receiving the necessary nutrients and they do not require a supplement. However in some cases where supplements would be necessary I would still encourage a proper diet and (like Mary Ellen said) use a supplement only to supplement ones' diet.
Lisa,
Some cases that I would offer supplements as a part of a solution would include any situation that involves malabsorption, and anyone at high risk for osteoporosis (especially eating disorder patients).
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I also agree that food should be everyones first choice for vitamins and minerals. But at the same time if an adolescent is not going to be eating healthy, a MVI is better than nothing. So I guess I would maybe not come right out and suggest a MVI but if it came down to it and the adolescent was not going to eat healthy then I would suggest one. I would of course explain everything that has been said about absorption. Also many people do take vitamins their whole live, starting out with flinstone vitamins as a child and then something like one a day. So taking an MVI as an adolescent would not be bad because some have added calcium, which is important for bone health. Overall, I am not opposed to suggesting a MVI but am not all for it either.
I agree with everyone that adolescents should receive their nutrients from whole foods instead of supplements, unless additional or supplemental nutrients have been deemed necessary from a nutrition or medical professional. Too often people think of a pill as a cure all, when unfortunately that is not the case. I wonder if supplements are touched on in health classes to educate adolescents on the cautions of usage. Does anyone remember learning about supplements in high school? Overall, when discussing supplement use with a patient, it is important to look at the cost/benefit of consuming them.
Andrea said...
Breine, I vaguely remember learning about supplements in health class when I was in either 7th or 8th grade. I don't remember anything specific about supplements, but the main message I remember was, "If it sounds too good to be true, it is". This can be an important message for impressionable teenagers who, like Kalee mentioned, might take supplements expecting great things to happen--like, for example, the boys taking protein supplements to bulk up and the girls taking weight loss supplements.
It seems that we all agree that food should come first and that supplements should only be used in special cases. I'm just curious, does any one feel that our food first mentality has left us lacking in our education on nutritional supplements. I think I would have liked to learn more about supplements in classes. Not necessarily for the purpose of recommending them, but to know more about the supplements clients are already taking.
Lisa, you have a great point. Hopefully, the ‘consumer information on the internet’ assignment opened all of our eyes to vast information that is our there for our clients. It is important for us as nutrition educators to be aware of the popular supplements on the market and more importantly ‘why’ adolescents are consuming them. Finding out the reasoning behind the usage can help direct our education with them. I agree with all of you that food should be the first choice to getting nutrients into adolescents, so proper nutrition education is important with this age group. Kalee, you have a great point about this age group searching for immediate gratification, and it is our job to intervene and educate them.
Personally, I would try to stay away from recommending suppliments for all the reason listed above. Of course, there are some exceptions to this rule.
I agree with Kalee that unless adolescents are getting instant gratification with foods, they will continue consume suppliements. The reality of the situation is that most americans, including adolescents, are lazy. They want something they don't have to think twice about; besides, we all know that you don't get instant gratification from suppliements either! Marketing foods to this age groups will be the key to success!
No I do not remember learning about supplements in high school. One reason we may have not learned is because it seems like supplements have become more popular and a cure all medicine to some people. I also agree with Lisa and wish that we could have learned more about supplements. But I also understand that there are so many supplements out there and everyday new ones are put on the market, which makes it hard to keep track of all of them. Our society definiately likes to take the easy way out instead of just eating healthy.
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