Navigating the Complexities of Dietary Supplements: How RDNs Can Provide Evidence-Based Guidance

The use of dietary supplements in the United States has continued to rise despite concerns regarding their safety and effectiveness. A study featured in the Journal of the Academy of Nutrition and Dietetics  found that adults were "two and a half times more likely" to use dietary supplements while taking prescription medication compared to adults without a diagnosed medical condition.

While the use of supplements may be warranted when nutrient intake is lacking from dietary sources or for certain health conditions, there is a lack of evidence supporting micronutrient supplementation for chronic disease prevention, according to the Position of the Academy of Nutrition and Dietetics: Micronutrient Supplementation. The expertise of the registered dietitian nutritionist is needed to help educate consumers on the safe and appropriate use of dietary supplements, and the Academy's updated Position Paper addresses How to Discuss Use of Supplements with Clients and Patients. It also identifies the roles and responsibilities of the RDN and the nutrition and dietetics technician, registered under the supervision of the RDN and their application based on a practitioner's individual scope of practice.

The U.S. Department of Health and Human Services provides additional resources relating to dietary supplements, including the National Institutes of Health's "Dietary Supplement Label Database (DSLD)" and its Office of Dietary Supplements, both of which are available to health care professionals and the public. In addition, the U.S. Food and Drug Administration (FDA), which is charged with the oversight of dietary supplements as a result of the Dietary Supplement Health and Education Act (DSHEA) has recently proposed modernizing their regulation and initiated a "Dietary Supplement Ingredient Advisory List" in order to quickly inform the public of ingredients that are not approved for use in supplements. In order to make this information more accessible for consumers, educators and health professionals, the FDA has recently launched, Supplement Your Knowledge: Dietary Supplement Education Initiative, which houses a variety of resources. In addition to staying informed of research and regulations relating to dietary supplements, the "Guidance Regarding the Recommendation and Sale of Dietary Supplements" should also be considered.

As the nutrition experts, RDNs must be prepared to address consumer inquiries regarding supplementation and can help their patients or clients sort out any conflicting and confusing information concerning dietary supplement use.

References

• Farina EK, Austin KG, Lieberman HR. Concomitant Dietary Supplement and Prescription Medication Use Is Prevalent among US Adults with Doctor-Informed Medical Conditions. J Acad Nutr Diet. Published Online: April 04, 2014. Accessed August 18, 2014.
• Marra, MV, Bailey RL. Position of the Academy of Nutrition and Dietetics: Micronutrient Supplementation. J Acad Nutr Diet. 2018;118(11):2162–2173.
• Dwyer JT, Saldanha LG, Bailen RA, et al. A Free New Dietary Supplement Label Database for Registered Dietitian Nutritionists. J Acad Nutr Diet. 2014;114(10):1512, 1514-1515, 1517. June 11, 2014.
• U.S. Food and Drug Administration. FDA STATEMENT: Statement from FDA Commissioner Scott Gottlieb, M.D., on the agency's new efforts to strengthen regulation of dietary supplements by modernizing and reforming FDA's oversight. February 11, 2019. Accessed June 17, 2019.
• U.S. Food and Drug Administration. Dietary Supplement Ingredient Advisory List. May 8, 2019. Accessed June 17, 2019.