Over-the-Counter Doesn’t Mean One Size Fits All

By Sharon Price, MS, CNS, LN

Sharon Price, MS, CNS, LN

While many practitioners fear the risks of over-the-counter healing options, the perspective in the nutrition field can be quite the opposite. I mean, food is often literally served over the counter. And the purpose of OTC supplements is just that—to supplement the nutrients from food, to correct an insufficiency, or simply to help support the body better in times of increased need. So as a nutritionist, I work primarily with over-the-counter options to help people achieve their wellness and nutrition goals.

But just because something is OTC or has loads of slick, compelling success stories on the Internet doesn’t make it universally useful. How I use or combine those options—or don’t!—can make a world of difference in terms of results.

And that is the key point: Decisions about if, when, and how to use OTC remedies and supplements must be made in context; and the “context” is the individual person. Many clients will come to me with a laundry list of supplements they’ve heard about from someone. Are they good supplements? Maybe, depending on the brand and quality—which, by the way, can be iffy in the more loosely regulated world of dietary supplements. But the vitamins and minerals you might need depend on so many factors—your health, health problems, metabolism, medications, etc., etc., etc. Just because minerals are good, for instance, doesn’t mean you should take them within two hours of your thyroid medicine—at least not if you want that thyroid medicine to work!

Further, I’ll often find duplicative or conflicting items on that list my client brings me. Or maybe there’s something that I don’t think adds much benefit. And while people can be devoted to adding on the newest, coolest supplements, they rarely take the time to pare down and rationalize that list, or even think about the right way to take things. But I do!

BEYOND “COMMON KNOWLEDGE”

Knowledge and accessibility can be wonderful things. More people now understand that taking antibiotics can carpet bomb both the good and bad elements in your gut, and have better ideas on how to limit the damage. But research disagrees about whether probiotics are helpful to take during antibiotic therapy, or which ones, and at what timing from the medication itself. So, common knowledge may not reflect the latest professional research or best practice.

And even food can get tricky. Many so-called “health foods” aren’t healthy for everyone. For example, cruciferous vegetables contain fiber and phytonutrients, including one particular compound that helps keep estrogen in its “healthy” state. But excess consumption of broccoli or cabbage or cauliflower can also be goitrogenic, which could lead to a major energy crash for someone with an underactive thyroid.

There can be layers of complexity to the “right” personalized eating approach. Some people have trouble with histamines, or salicylates, or oxalates, or yeast. Knowing what foods to avoid and what foods are actually helpful can feel like a super complicated equation to the average person. But figuring out the right approach may be as simple as finding the right nutritionist.

MAKING YOUR WAY THROUGH THE WEIGHT-LOSS LABYRINTH

The same goes double for weight loss. Even today, I see too much emphasis on calorie counting, or counting “macros” or other, overly simplistic approaches. And I understand the appeal! I’ve had several clients who’ve tried a so-called keto diet for several months with literally no results; but they persist because they find it “simpler” to know what time of day to eat and what types of foods to eat or to avoid. They like the rules, and it worked for their neighbor, so . . . ?!

As for me, I have a bias towards results. Can keto be helpful? Sure, particularly in the case of someone with seizures or with certain types of brain cancer. Can it help people lose weight? Yes, in the short-term. But in the long-term, a diet devoid of healthy fiber and carbohydrates does not typically benefit brain, mood, or overall health. And if you haven’t even lost weight after months of trying, it’s most certainly not worth the long-term downsides.

Instead, I take the parts of keto I like—healthy fats, clean protein, and lower starch vegetables, along with the benefits of intermittent fasting for some—and customize it for a given individual.

Another red flag? I am skeptical of any diet with such passionate acolytes that they believe every other person must be “converted” to the same approach. Recognizing individual needs and nuances is the hallmark of personalized nutrition and often, the critical difference between success and years of yo-yo dieting.

That’s not to say I can’t work with people holding different principles. I work with people who eat meat or animal products and those who don’t. With vegans, I focus on ensuring they consume or supplement with the vitamins and minerals that tend to be less available in a vegan diet. And that’s important. I have met vegans and vegetarians who eat the most bland, white-food-centric, processed diet of all—a potent reminder that every diet can be executed in either a healthy or blatantly unhealthy way. The trick isn’t the name or the label, it’s how you approach it.

My personal starting point tends to be more Mediterranean diet style: ample healthy, anti-inflammatory fats and plant foods, moderate lean proteins and fruits, and perhaps equally important, a healthy approach to eating as a social experience. From there, I layer on the specific needs for each individual, taking into account food allergies, other sensitivities, religious or cultural dietary norms, and other factors like medical conditions or even genetic background.

And sometimes the challenge isn’t what to remove, but how to add back color and flavor and joy to what has become an overly limiting set of options. Individuals suffering from gut health conditions like SIBO (small intestinal bacterial overgrowth) may have become overwhelmed by restrictions and by the often-painful consequences of eating the “wrong” thing. The challenge then is to find ways to introduce more variety and balance, gradually and safely.

My process may seem wonky or even boring, especially compared to the buzz and flash of the newest diet du jour—but the end result is as individualized as each person. And unlike that latest trendy diet, my personalized roadmaps deliver results that last without sucking all the joy out of the journey.