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Prescription 2016: Supplement Planning for Success

December 17, 2016 Written by JP    [Font too small?]

Dietary supplements fall into a somewhat murky part of the current healthcare pond. They’re not really food, but they generally contain elements found in food. They’re not really medications, but they often have medicinal effects. Because nutritional supplements straddle the world between traditional and modern medicine, they are frequently not used in an optimal manner.

My defining philosophy about supplementation is as follows: 1) Ideally, supplements should be used to complement a nutrient-dense diet. Supplements should not give license to eating unhealthfully in the hope that they’ll “balance things out”. 2) In most instances, food-based supplements (essential fats, minerals, multivitamins, probiotics, etc.) are meant to be taken on a daily basis and, frequently, more than once daily because of the limited amount of time that they remain active in the body. For all intents and purposes, skipping supplements is akin to eating unhealthfully for a meal or a day or passing on a dose of prescribed medication. 3) Supplements should be tailored to your personal needs as best as possible, taking into consideration diet, genetics, health-related goals and medical history. 4) Unless specifically directed otherwise, most nutritional supplements are best taken with food that contains some healthy fat. Fat soluble nutrients and phytochemicals are absorbed better when consumed in this manner.

Item number two on my list deals with the importance of consistency. By far, the best way I know to encourage consistency in myself and my clients is to prepare supplements in advance. Once a week, I set up my assembly line of supplements and put daily doses in small, individual zip lock baggies marked “AM” + “PM”. The entire process typically takes me about a half hour. Once the tiny zip lock bags are filled and labeled, I store them in a dark, dry container. Light and moisture tend to degrade and/or lead to spoilage and supplement instability. But, portioning in advance allows me to have my supplements ready in one small packet to take at home or grab and go and take to work or on the road as needed.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Study 1 – Lifestyle and Other Factors Explain One-Half of the Variability (link)

Study 2 – Long-Term Adherence and Effects on Grip Strength and Upper Leg (link)

Study 3 – Patient-Reported Adherence to Empiric Vitamin/Mineral … (link)

Study 4 – Micronutrient Supplementation Adherence and Influence on the (link)

Study 5 – Pre-Pregnancy Obesity and Non-Adherence to Multivitamin Use (link)

Example of 2″ x 3″ Morning & Evening Supplement Packets

Source: Team HealthyFellow Headquarters 🙂

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Posted in Alternative Therapies, Nutrition, Nutritional Supplements

4 Comments & Updates to “Prescription 2016: Supplement Planning for Success”

  1. JP Says:

    Updated 12/17/16:


    Obes Surg. 2016 Jul 22.

    Predictors of Vitamin Adherence After Bariatric Surgery.

    BACKGROUND: Vitamin supplementation in bariatric aftercare is essential to prevent nutrient deficiencies; however, rates of vitamin adherence have been as low as 30 % 6 months post-surgery. Preliminary literature suggests non-adherence to prescribed treatments can be linked to demographic and psychological factors. We aimed to determine the relationship between these factors to vitamin adherence in post-bariatric surgery patients.

    METHODS: A total of 92 bariatric patients were assessed 6 months post-surgery. Patients were administered a questionnaire collecting demographic information, psychological scores, and self-reported adherence. Nutrient deficiencies were analyzed through serum vitamin levels measured 3 and 6 months after surgery. Wilcoxon rank-sum and chi-square tests were used for analysis.

    RESULTS: Non-adherence was associated with male sex and full-time employment (p = 0.027, p = 0.015). There were no differences with respect to living situation, education level, or relationship type. Non-adherent patients did not have significantly higher scores for generalized anxiety, depressive symptoms, or avoidant behaviors. However, non-adherent patients displayed greater attachment anxiety than their adherent counterparts (p = 0.0186). Non-adherence was also associated with lower vitamin B12 levels 6 months post-surgery (p = 0.001).

    CONCLUSIONS: Male gender and full-time work have previously been shown to be associated with non-adherence. This is the first study to demonstrate that attachment anxiety is associated with poor multivitamin adherence in the post-surgical bariatric population. This result is concordant with recent literature that has demonstrated attachment anxiety is associated with poor adherence to dietary recommendations in bariatric patients 6 months postoperatively. Presurgical screening for attachment anxiety could facilitate early interventions to promote better bariatric aftercare in this group.

    Be well!


  2. JP Says:

    Updated 12/17/16:


    Artif Intell Med. 2016 May;69:43-52.

    A wearable sensor system for medication adherence prediction.

    OBJECTIVE: Studies have revealed that non-adherence to prescribed medication can lead to hospital readmissions, clinical complications, and other negative patient outcomes. Though many techniques have been proposed to improve patient adherence rates, they suffer from low accuracy. Our objective is to develop and test a novel system for assessment of medication adherence.

    METHODS: Recently, several smart pill bottle technologies have been proposed, which can detect when the bottle has been opened, and even when a pill has been retrieved. However, very few systems can determine if the pill is subsequently ingested or discarded. We propose a system for detecting user adherence to medication using a smart necklace, capable of determining if the medication has been ingested based on the skin movement in the lower part of the neck during a swallow. This, coupled with existing medication adherence systems that detect when medicine is removed from the bottle, can detect a broader range of use-cases with respect to medication adherence.

    RESULTS: Using Bayesian networks, we were able to correctly classify between chewable vitamins, saliva swallows, medication capsules, speaking, and drinking water, with average precision and recall of 90.17% and 88.9%, respectively. A total of 135 instances were classified from a total of 20 subjects.

    CONCLUSION: Our experimental evaluations confirm the accuracy of the piezoelectric necklace for detecting medicine swallows and disambiguating them from related actions. Further studies in real-world conditions are necessary to evaluate the efficacy of the proposed scheme.

    Be well!


  3. JP Says:

    Updated 12/17/16:


    Patient Prefer Adherence. 2015 Dec 16;9:1771-9.

    Drug holidays: the most frequent type of noncompliance with calcium plus vitamin D supplementation in persistent patients with osteoporosis.

    PURPOSE: All current recommendations include calcium and vitamin D (Ca-D) as an integrated part of osteoporosis treatment. The purpose of this pilot study was to analyze compliance with a fixed combination of Ca-D in women persistent with the treatment.

    PATIENTS AND METHODS: An observational study was carried out in three osteocenters in the Czech Republic. Women with osteoporosis ≥55 years of age concurrently treated with oral ibandronate were eligible. Compliance was evaluated in a period of 3 months by Medication Event Monitoring System (MEMS), tablet count, and self-report. Nonpersistence was defined as a MEMS-based gap in the use of Ca-D to be 30 days or more.

    RESULTS: A total of 73 patients were monitored, of which 49 patients were analyzed (target population). Based on MEMS, mean overall compliance was 71%; good compliance (≥80%) was observed in 59% of the patients. As many as 71% of the patients took drug holidays (≥3 consecutive days without intake); overall compliance of these patients was 59% and was slightly lower on Fridays and weekends. Patients without drug holidays were fully compliant (did not omit individual doses). Compliance differed according to daily time at which the patients mostly used the Ca-D. Afternoon/evening takers showed a mean overall compliance of 82% while morning/night takers only 51% (P=0.049). Based on MEMS, tablet count, and self-report, compliance ≥75% was observed in 59%, 100%, and 87% of the patients, respectively. Outcomes obtained by the three methods were not associated with each other. Undesirable concurrent ingestion of Ca-D and ibandronate was present only twice.

    CONCLUSION: Despite almost perfect self-reported and tablet count-based compliance, MEMS-based compliance was relatively poor. Consecutive supplementation-free days were common; more than two-thirds of the patients took at least one drug holiday. This pilot study showed drug holiday to be the most important type of noncompliance with Ca-D in those who are persistent with the treatment.

    Be well!


  4. JP Says:

    Updated 12/18/18:


    Nutr Hosp. 2018 Apr 3;35(Spec no2):44-51.

    [What can be done to achieve therapeutic adherence to nutritional supplements?]

    Oral dietary supplements, are part of the medical treatment, the success of oral supplements depends on the Adherence of the patient to meet the prescribed therapeutic indications in the hospital and once the patient is discharged, if this was necessary. The World Health Organization (WHO) defines Treatment Adherence and Compliance as “the degree to which the behavior of a patient, in relation to taking medicine, following a diet or modifying the habits of life, corresponds whit the recommendations agreed on, whit the health personnel”. The Therapeutic Adherence, is a complex process that is influenced by multiple factors, which are related to the patients, the professionals, the health system, the illness and whit the treatment, it is a problem of great importance for clinical practice and must be approached both from points, the preventive and interventive, once it is detected.

    Be well!


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