“Most health professionals are inadequately trained to identify those who might be at risk for deficiency, use appropriate testing to assess micronutrient levels, and make recommendations for vitamins/minerals/fatty acids to correct the deficiency,”​ explained Dr Low Dog, who will give a presentation entitled “A clinician’s perspective on nutritional supplements” at the upcoming Natural Health Product Research Society (NHPRS) of Canada Annual Conference, May 14-17, in Guelph, Ontario​​.

“I think there is a trend for the medical community to be more integrative and include more lifestyle recommendations. However, I do not believe nutrient testing is a key part of the training or practice of Western-trained medical professionals,” ​she told NutraIngredients-USA.

“Micronutrient laboratory panels that measure key nutrients at a reasonable price could advance micronutrient testing in clinical practice. But both clinicians and the public get confused with all the media messages that “everyone gets everything they need by eating a healthy diet. This clearly is not true.”​

A clinician’s perspective on nutritional supplements​

Many Americans and Canadians are falling short of meeting nutritional recommendations, she noted, with NHANES data showing that 50% of Americans are not making the Institute of Medicine’s recommendations for vitamin A, 40% for vitamin C, and over 90% for vitamins D and E. For potassium, 98% are not meeting the requirements. For calcium and magnesium it is 50% and 60%, respectively.

And while frank nutrient deficiency states like rickets, scurvy, and pellagra are well-known, Dr Low Dog notes that there is a growing body of evidence showing that less than optimal biochemical levels are associated with a range of conditions, from impaired cognitive function to cardiovascular disease, cancer, type-2 diabetes, poor bone health, eye disease, and depression.

“While most mainstream clinicians are familiar with vitamin B12, folic acid, iron, calcium and vitamin D - other than iron during pregnancy and vitamin B12 testing in those with cognitive changes, testing for micronutrient deficiencies/status in primary care is very limited,” ​Dr Low Dog told us. “We know that metformin and long-term use of proton pump inhibitors (PPI), particularly in those over the age of 50 can lead to a decline in vitamin B12 but it is not routinely monitored. I personally believe it should be tested annually to ensure that the patient does not have marginal or deficient B12. ​

“Magnesium is crucially important for blood pressure, heart rhythm, maintaining insulin sensitivity, etc. We know that many people do not meet the recommended daily intake and yet it seldom is considered in routine clinical practice. Long-term PPI use can also cause magnesium levels to plummet to dangerously low levels. Who is monitoring? ​

“Choline is essential during pregnancy and lactation and yet is not in most prenatal supplements. Choline also plays a role in protecting against nonalcoholic fatty liver disease, something we are seeing even in the pediatric population but very few clinicians recommend it. There are many more examples,” ​added Dr Low Dog.

NHPRS​

Dr Low Dog’s presentation at the upcoming Natural Health Product Research Society (NHPRS) of Canada’s annual conference will discuss a clinician’s perspective on nutritional supplements.

The annual conference’s main theme is "Innovation at the NHP/Food Interface​”. The full conference program​​ will feature sessions on the following themes: