The Role of Micronutrients, Vitamins, and Supplements in Transforming Patient Health
Malnutrition is a serious global problem that is present in every worldwide community. Malnutrition can manifest either as undernutrition, shortfalls of essential nutrients, that in poorer communities result in stunting, wasting, and anemia; or as overweight and obesity due to excess intake of macronutrients, sources of energy that when consumed in excess are stored as fat. Malnutrition of macronutrients including carbohydrates and proteins can be detected more obviously by practicing clinicians. Shortfalls or deficiencies in intake of vitamins and trace elements, or micronutrients, can be more difficult for a clinician to detect; very often overt clinical manifestations are absent unless the deficiency is chronic or severe. The impact on physiologic and metabolic function can be significant, however, even with milder shortfalls.
Existing clinical recommendations and healthcare professional training emphasizes the role of a balanced diet with a diverse range of nutrient-rich foods to maximize micronutrient intake. Worldwide there is substantial evidence to suggest that many people do not or cannot obtain recommended daily levels of micronutrients, and thereby place themselves at risk of disease.
This activity combines data presented at the recent 21st International Congress of Nutrition with clinical practice guidelines, published evidence, and expert faculty insights to provide practical approaches for learners to the assessment of micronutrient deficiencies in patients, how micronutrient intake requirements change in different populations, and the use of supplementation as an effective means to address shortfalls and improve patient health.
Learners must review the five chapters and complete the posttest for this activity to claim credit.
Chapter 1: Introduction to malnutrition and undernutrition globally
Chapter 2: Micronutrients in the diet
Chapter 3: Assessing micronutrient status in clinical practice
Chapter 4: Supplementation in sick patients
Chapter 5: Supplements in general practice
This activity is intended for physicians, nurses, and other healthcare professionals who are interested in increasing their knowledge and competence at assessing and managing micronutrient shortfalls in their patients.
Learning Outcome Statements:
At the conclusion of this activity:
KNOWLEDGE: Participants will self-report knowledge gained based on current best practices regarding the assessment of micronutrient deficiencies in patients, how micronutrient intake requirements change in different populations, and the use of supplementation as an effective means to address shortfalls and improve patient health.
COMPETENCE/SKILL: Participants will self-report intent to change practice by applying knowledge gained based on best available evidence regarding the management of patients with micronutrient deficiencies.
Upon completion of this activity, participants will be better able to:
- Identify patients with micronutrient shortfalls or deficiencies using tools such as validated screening instruments or a nutrition-focused physical assessment.
- Increase the number of individuals with nutritional deficiencies who are assessed, and referred or receive nutrition counseling on the role of a balanced dietary intake that meets identified nutritional requirements.
- Educate patients on the importance of meeting daily micronutrient needs through their food intake, and the role of supplementation, including multivitamin and mineral supplements (MVMS), in addressing shortfalls.
- Discuss the importance of good nutrition with patients across their lifespan, especially those patients whose micronutrient intake requirements may change due to chronic disease, use of pharmacologic agents that affect micronutrient metabolism, advancing age, or pregnancy.
- Utilize strategies such as motivational interviewing, shared decision-making, simulation, or role-playing to encourage supplementation as a means of meeting recommended micronutrient intake levels.
- Compare the formulations of available MVMS products, and recommend individual supplementation or MVMS based on patient characteristics and needs
Disclosure of Conflicts of Interest
It is the policy of the Elsevier Office of Continuing Medical Education (EOCME) and Elsevier that all faculty, instructors, and planners disclose any real or apparent conflicts of interest relating to the topics of this educational activity.
The faculty reported the following financial relationships or relationships to products or devices they or their life partners have with commercial interests related to the content of this CME activity:
|Faculty||Relationship Identified With:|
|Jeffrey Blumberg, PhD, FASN, FACN, CNS-S||Consultant/Advisor: AdvoCare, Pharmavite, Pfizer Consumer Healthcare, Science Based Health (SBH), Smarty Pants, and Church and Dwight|
|Nancy Collins, PhD, RD, LD/N, NWCC, FAND||Consultant and Speakers’ Bureau: Abbott Nutrition|
|Nicolaas E Deutz, MD, PhD||Speakers’ Bureau and Grant/Research: Abbott Nutrition|
Sherlyn Celone-Arnold, David J. DePalma, PhD, Christopher Blagden, PhD, Phyllis Zimmer, FNP, FAAN, Marilu Kelly, MSN, RN, CNE; Bernard M. Abrams, MD;Marilu Kelly, MSN, RN, CNE; Sandy Breslow and Alison Kemp hereby state that neither they nor their life partners have had any financial relationships with products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.
This activity has been supported by an independent educational grant from Pfizer, Inc.
Jointly provided by the Elsevier Office of Medical Education, Elsevier and Integrated Learning Partners, LLC with support from Consultants in Medical Education.
CME Credit (Physicians)
The Elsevier Office of Continuing Medical Education (EOCME) is accredited by the ACCME to provide continuing medical education for physicians.
The EOCME designates this enduring activity for a maximum of 2.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credits commensurate with the extent of their participation in the activity.
CNE Credit (Nurses)
This continuing nursing education activity, provided by Elsevier, awards 2.5 contact hours for nurses. Elsevier is accredited with distinction as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. Elsevier is provider approved by the Florida Board of Nursing, Provider #50-4681. Provider approved and by the California Board of Registered Nursing, Provider #CEP 3257 for 2.5 contact hours.
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of EOCME, Elsevier, and Integrated Learning Partners, LLC.
CME/CNE Inquiries/Special Needs
For all CME inquiries or special needs, please contact elsevierCME@elsevier.com.
For all CNE inquiries or special needs, please contact firstname.lastname@example.org.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration (FDA). The EOCME, Elsevier, Integrated Learning Partners, LLC, and Pfizer, Inc., do not recommend the use of any agent outside the labeled indications.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Method of Participation
In order to claim credit, participants must:
- Read the educational objectives, accreditation information, and faculty disclosures at the start of this activity.
- Complete the pre-activity questions.
- Read or review the activity content.
- Complete the post-activity test questions and evaluation.
- Physicians who attain a grade of 70% or higher on the post-activity test questions and who complete the evaluation will receive a CME Certificate.
- Nurses who attain a grade of 70% or higher on the post-activity test questions and who complete the evaluation before the expiration date will receive a certificate of completion for 2.5 contact hours. There is no partial credit awarded for this activity.
- All other participants who attain a grade of 70% or higher on the post-activity test questions and who complete the evaluation will receive a Certificate of Participation.
Release date: August 20, 2018
Expiration date: August 19, 2019