QHow Do You Approach the Topic of Supplementation With Clients?

As a plant-based gut health dietitian, I often recommend supplements to patients who may be struggling to meet all of their nutritional needs through food alone. A properly planned plant-based diet should provide a majority of macro- and micronutrients needed to thrive, but certain illnesses, diets, or medications may cause some of your key nutrients to be lacking.

This can especially be the case in those suffering from gut issues, which may be causing nutrient malabsorption. In these cases, supplementation can help to support your gut and overall health and help you to 'Heal with Each Meal™.' It is important to remember that supplements should not be replacing foods in the diet, but complementing them.

Most often, I see the need to remove dietary supplements rather than add them. Typically, after running labs, I find that clients are taking supplements that are unnecessary or that are causing elevated levels of nutrients. Recently, someone was taking an iron supplement, but their labs showed that they were approaching a very high level. We removed that iron pill and ensured they selected iron-rich foods in their nutrition pattern. I also educate on choosing third-party-tested supplements for quality and safety.

The topic of supplementation can be tricky because some clients are amenable to them, and others are not. I ask clients about their experience with supplements, which provides relevant insight. There is often a benefit to supplements such as vitamins, minerals, herbs, probiotics, or others. The standard American diet (SAD) is deficient in many nutrients. Therefore, explaining and educating the client about the benefits (and risks) enhances understanding and opens new possibilities. A client had trouble with constipation, and per my suggestion, she added magnesium citrate. The supplement relieved the issue, and the client was happy and relieved.

I approach the topic of supplementation with a client by first assessing their dietary intake via a food diary, discussing health history, lifestyle factors, and any other specific health conditions or concerns (e.g., allergies, intolerances) that are involved.

Furthermore, the potential benefits and risks are discussed, as well as any potential interactions they may have with medications that they are presently taking. I prioritize meeting nutritional needs via whole foods first whenever possible.

Examples of where supplementation was beneficial with clients include exploring the need for vitamin B12 and zinc supplementation for those clients who follow a vegetarian or vegan diet, and calcium and vitamin D supplementation for those who may eliminate dairy due to lactose intolerance. Older adults who are eating less may benefit from supplementation in order to meet their macro- and micronutritional needs.

First, we would review lists of foods that would help meet their RDA (Recommended Daily Amount). If the client is not able to meet those needs via food, then supplementation is a recommended intervention.