1. ©2015 MFMER | slide-1 Lifestyle Supplements Talking Points for Patient Counseling Natalie Gentile, MD PGY-2 Family Medicine Noon Conference October 8, 2015

2. ©2015 MFMER | slide-2

3. ©2015 MFMER | slide-3 Do you want to look like this?? Subtitle for Chart

4. ©2015 MFMER | slide-4 Why is this an issue? Dietary supplement industry is a $34.9 billion industry Unregulated products in this industry Are we properly counseling our patients to make educated choices? Unrealistic expectations for long-term wellness

5. ©2015 MFMER | slide-5

6. ©2015 MFMER | slide-6 Buzz Words

7. ©2015 MFMER | slide-7

8. ©2015 MFMER | slide-8 What they are promising… Alkaline and pH balance Cognitive Enhancement Joint Support Inflammation Support Lean Muscle Support Digestive and Immune Support Anti-Aging Probiotics and Natural Enzymes Weight Management How could you not want to buy this stuff?!

9. ©2015 MFMER | slide-9 Types of products

10. ©2015 MFMER | slide-10

11. ©2015 MFMER | slide-11

12. ©2015 MFMER | slide-12

13. ©2015 MFMER | slide-13 62 ingredients!!

14. ©2015 MFMER | slide-14

15. ©2015 MFMER | slide-15

16. ©2015 MFMER | slide-16

17. ©2015 MFMER | slide-17 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

18. ©2015 MFMER | slide-18 What is a normal amount to spend on groceries per month?

19. ©2015 MFMER | slide-19 GoalAdvocareIsagenixThriveItWorks!Grocery Store Increase Intake of Vitamins and Nutrients Meal Replacement Shakes $44.95/14 shakes Cleanse for Life Juice $43/2-4 week supply Lifestyle Pack $100/month IT’S VITAL™ MINERALS $39/60 capsules Sweet potatoes Chickpeas Dark, leafy greens Broccoli Energy, Fat Burning Spark $22.95/14 pouches 30 Day System for fat burning and cleansing $373 Tone Pack $140/month Advanced Formula Fat Fighter $23/60 tabs Coffee (few dollars/day) Green Tea (few dollars/day) Exercise (Free- $100’s/month) Sleep, Relaxing, Stress Management SleepWorks ® $35.95/12 servings Brain and Sleep Support System $65/90 capsules + 2 oz spray bottle Rest Premium Lifestyle Gel $62/30 gel paks Confianza $25/60 tabs Melatonin ($7.49 for 365 tabs) Chamomile Tea Sleep hygiene Exercise Digestive Support Herbal Cleanse System $36.95/10 day supply IsaFlush® $22/60 capsules Thrive Plus Balance $52/60 capsules REGULAR™ $45/60 capsules Metamucil ($29.99 for 228 doses) Whole Grains Vegetables

20. ©2015 MFMER | slide-20 ProsCons Teaching portion control Sense of community Money making opportunity No FDA approval Expensive Not sustainable Chronic disease patients Drug interactions Potential for vitamin toxicity

21. ©2015 MFMER | slide-21 So where can we send them? Nutritionist Weight Watchers MediFast Gyms YouTube Grocery shopping classes Teach our patients to read ingredients labels Work toward self-efficacy

22. ©2015 MFMER | slide-22 Understand the underlying motivations Social pressures Chronic disease Quick fix Path of least resistance Past failures with weight loss, exercise, diet Not a “prescription” drug Easy to get online, quickly Appeal of a “natural” remedy, which is presumably “safe”

23. ©2015 MFMER | slide-23 Final Verdict

24. ©2015 MFMER | slide-24 References 2013 Nutritional Business Journal www.isagenix.com www.advocare.com http://www.healthy-experience.com www.myitworks.com www.costco.com http://www.aafp.org/afp/2004/1101/p1731.h tml http://www.aafp.org/afp/2004/1101/p1731.h tml

25. ©2015 MFMER | slide-25 Questions & Discussion