VN: Benefits and Risks/ Harms of Implementation (2011)
Benefits and Risks/Harms of Implementing the Recommendations
Safety issues must be reviewed carefully for each individual. General benefits and risks associated with implementation of the guideline are addressed for each recommendation.
Potential Benefits
A primary goal of implementing these recommendations includes improving a person's ability to achieve optimal nutrition through healthful plant-based food choices and a physically active lifestyle.
Although costs of medical nutrition therapy (MNT) sessions and reimbursement vary, MNT is essential for improved outcomes. Medical nutrition therapy education can be considered cost effective when considering the benefits of nutrition interventions on the onset and progression of comorbidities vs. the cost of the intervention.
Risk/Harm Considerations
When using these recommendations:
- Review the patient’s age, socioeconomic status, cultural issues, health history, and other health conditions
- Consider referral to a behavioral specialist if psychosocial issues are a concern
- Consider a referral to social services to assist patients with financial arrangements if economic issues are a concern
- Use clinical judgment in applying the guidelines when evaluating vegetarian patients or clients and pregnant adolescents and adults
- Some individuals who take calcium supplements, particularly calcium carbonate, might experience gastrointestinal side effects including gas, bloating, and constipation. To alleviate these symptoms, consideration for another form of calcium may be warranted, as well as spreading out the calcium dose throughout the day and taking the supplement with meals (Office of Dietary Supplements).
- Since the optimal ratio of EPA and DHA are not known for vegetarians, very high levels of EPA and DHA may be contraindicated; over-supplementation should be avoided. The US Food and Drug Administration advises that consumption of more than three grams of omega-3 fatty acids per day may cause gastrointestinal symptoms.
- Care should be taken that pregnant patient or client micronutrient intake from all sources is not above the tolerable upper intake level (UL). Supplementation is only encouraged after assessment of dietary intake and supplementation intake.
In addition to the above, a variety of barriers may hinder the application of these recommendations.
- A vegetarian dietary pattern encompasses wide variations in foods eaten and complexity regarding dietary practices, beliefs and motivations. The RD should maintain flexibility and acceptance to support the lifestyle choices in working with this population. See the Guideline Oerview for a more detailed explanation of the complexity of vegetarian dietary patterns.
- In some cases, there may be increased cost associated with the selective use of vitamin and mineral supplements
- Accessibility and costs of biochemical parameter testing should be considered.