counterskills - Alliance Healthcare

Transcription

training
skills
COUNTERSKILLS
training programme
Vitamins, minerals
and supplements
10
workbook
vitamins
minerals
skill builder:
supplements
advising confidently
herbal remedies
using WWHAM
activities & assessment
merchandising aid
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Alphega Pharmacy team continue to offer comprehensive support and training
packages for the whole pharmacy team. For more information please contact:
Member Support on membersupport@alphega-pharmacy.co.uk or speak to your
Alliance Healthcare account manager.
Content developed by:
2 Counterskills
Market overview
3%
5%
2% 2% 1%
VMS Pharmacy Market – Value Sales*
21%
ADULT VITAMINS
7%
SINGLE VITAMINS
DEFINED OTHERS
COD LIVER OIL
MINERALS
JOINT CARE
9%
HERBALS
16%
OMEGA 3
CHILD VITAMINS
COMBINED ADULT AND CHILD VITAMINS
10%
EVENING PRIMROSE OIL & STARFLOWER
GARLIC
10%
16%
The total vitamins, minerals and supplements
(VMS) market is worth £394.3m* annually
across all retail outlets and has grown by 0.6%*
vs the previous year. The Pharmacy channel
represents £38.3m* of the total market and has
declined -4.7%* vs last year.
The pharmacy channel outscores its competitors
in sales of herbal, minerals and children’s
vitamin products, so there is an opportunity to
develop this range and capitalise on sales versus
other market channels.
The VMS range is extensive and contains many
sub segments, which can make it difficult
when deciding the correct range to stock for
your customers. Stocking too much range will
confuse your customers which may result in
them not making a purchase. A simplified core
product range, merchandising and promotions
will help drive sales growth.
The advice and customer service pharmacies
offer is extremely powerful in offering product
*Source: IRI value sales 52 weeks ending
31st December 2011 (Chemists)
solutions for specific conditions and is a key
point of difference to other market channels.
Merchandising guidelines
Your VMS fixture should be spaced in relation
to market performance. Typically adult
vitamins 21%, single vitamins 16%, cod liver
oil 10%, minerals 10%, joint care 9%, herbals
7%, omega 3 5%, children’s vitamins 3%,
combination adult and children’s vitamins 2%,
evening primrose oil and starflower oil 2%,
garlic 1% and others 14%.
Adult and single vitamins are the prime sales
drivers of the VMS market so they should
receive the most prominent space on your
fixture.
To ensure the fixture is easy to shop, it is
recommended to merchandise by brand and
then further sub categorise by ingredient, as this
reflects the consumer purchase decision tree.
Counterskills 3
Section 1: Introduction
Eating a healthy, balanced diet is important
for overall health and wellbeing. This means
getting the right types and amounts of foods
and drinks to supply nutrition and energy
to the body to maintain body cells, tissues,
organs, and for supporting normal growth and
development. Eating a healthy, balanced diet
means having the right amount and type of the
following:
Simple
Simple carbohydrates are the sugars found in
food. They are contained in cakes, sweets and
jams. Examples are sucrose, lactose, fructose
and glucose. Their function is to provide a rapid
release of energy. They are not required as part
of a balanced diet as this energy can be gained
from other foods.
• Carbohydrates
• Proteins
• Fats
• Salt
• Water.
Carbohydrates
There are two types of carbohydrate:
• Simple
• Complex.
Complex
Complex carbohydrates are found in pasta,
bread, rice, potatoes, cereals, fruit and
vegetables. Their function is to provide a
gradual release of energy and these should be
included in a diet.
Proteins
Protein is found in meat, eggs, fish, pulses
(such as lentils and beans), and nuts. It is
needed in the diet as it helps the body to grow
and repair itself. It cannot be stored in the
body and so a regular supply is needed. Some
protein rich sources can be high in fat (such as
cheese, whole milk) and so care is needed to
ensure a variety of protein sources are eaten.
4 Counterskills
Fats
Salt
We need some fat in our diet as it helps the
absorption of fat soluble vitamins and provides
fatty acids which cannot be made in the body.
There are two types of fat:
Salt is essential for the body but too much salt
can lead to high blood pressure and so intake
should be kept to a maximum of 6g a day for
adults. There are many products that come
with added salt such as cereals, cooked meats
and readymade meals and sauces. Processed
foods tend to be high in salt such as canned
vegetables and soups.
• Saturated
• Unsaturated.
Saturated
Saturated fats are found in cheese, whole milk,
butter, meat fat and in processed foods such as
chocolate, crisps and some ready meals. They
provide the richest source of energy. A diet rich
in this type of fat is likely to lead to weight gain
and high cholesterol levels in the blood.
Cholesterol is a fat that can stick to the inside
of blood vessels. This can lead to a blockage
of the blood vessels, increasing the risk of
coronary heart disease (CHD), heart attacks and
strokes.
There are two types of cholesterol; good
cholesterol (or high density lipoprotein HDL)
and bad cholesterol (or low density lipoprotein
LDL). It is the bad cholesterol which blocks
the blood vessels whereas good cholesterol
protects the blood vessels and stops the bad
cholesterol from sticking to the blood vessels.
The easiest way to reduce salt intake is to
add salt to the water during cooking rather
than when the food is served. Adding salt
towards the end of cooking, rather than at the
beginning, will reduce the amount absorbed
into the food.
There are various notification systems in
place that help identify how much salt a food
product contains, such as the traffic light
system. At a glance a customer can see if the
food has a high (red), medium (amber) or low
(green) salt content, along with fat, saturated
fat and sugars. In short, the more green lights,
the healthier the choice.
Saturated fats contain bad cholesterol.
Unsaturated
Unsaturated fats are found in sunflower oil,
olive oil, margarine and oily fish. They again
provide a rich source of energy and help to
increase good cholesterol in the blood. Intake
should still be monitored as unsaturated fat
eaten in excess can lead to weight gain.
Counterskills 5
Section 2: Vitamins
Water
Water is essential for the body and makes up
around 70% of a person’s body weight. Some
water will be absorbed from the food we eat;
the rest will need to come from drinks.
To maintain good hydration the body needs
around eight to ten 250ml glasses of water a
day (around two litres). This can come from
drinks such as tea and coffee but should be
restricted to a maximum of five a day if they
contain caffeine. This is a diuretic, (which
means they make the body lose water).
Sugary drinks should be kept to a minimum
as they will damage teeth and contain simple
carbohydrates.
Vitamins and minerals
Vitamins and minerals are essential nutrients
that the body requires in small amounts to
function properly. Most of these vitamins
6 Counterskills
and minerals can be gained from eating a
varied and balanced diet. However, some
customers may choose to take vitamin and
mineral supplements, either because they
have been recommended to do so by a
healthcare professional because they feel run
down or know they are not eating as well
as they should. Care should always be taken
when recommending vitamin and mineral
supplements to ensure that customers are not
taking too many or taking supplements for too
long as this can cause harmful effects.
There are certain types of customers who will
benefit from taking vitamins and minerals such
as pregnant women and young children. These
are covered later in this workbook, along with
tonics and meal supplements and who may
benefit from them.
There are two types of vitamins; fat soluble and
water soluble vitamins.
Fat soluble vitamins
Fat soluble vitamins dissolve in fat not water
and so need fat to be absorbed by the body.
Fat soluble vitamins are found mainly in fatty
foods including butter and lard, vegetable
oils, dairy foods, liver and oily fish. While the
body needs these vitamins every day to work
properly, foods containing them do not need to
be eaten every day as these vitamins are stored
by the body in the liver or fatty tissues if it does
not need them immediately. These stores can
build up so they are available when needed.
However having too much stored in the body
can be harmful and so care is needed when
recommending supplements.
Fat soluble vitamins are:
• Vitamin A (retinol)
• Vitamin D (calciferol)
• Vitamin E (tocopherol)
• Vitamin K (phytomenadione).
Water soluble vitamins
Water soluble vitamins dissolve in water not fat
and so need water to be absorbed by the body.
Water soluble vitamins are not stored in the
body, so they need to be ingested on a more
frequent basis.
Any water soluble vitamins that are in excess
of the body’s requirements are removed from
the body upon urination. As the body does not
store water soluble vitamins, ingesting more
than needed is not generally harmful.
Water soluble vitamins are found in fruit,
vegetables and grains. Unlike fat soluble
vitamins, they can be destroyed by heat or by
being exposed to the air. This means a lot of
vitamins can be lost from foods during the
cooking process especially if they are being
boiled. The best way to retain water soluble
vitamins is to steam or grill foods.
Water soluble vitamins are:
• Vitamin B1 (thiamine)
• Vitamin B2 (riboflavin)
• Vitamin B3 (niacin)
• Vitamin B6 (pyridoxine)
• Vitamin B9 (folic acid)
• Vitamin B12 (cobalamin)
• Vitamin C (ascorbic acid).
Counterskills 7
Section 2: Vitamins
The table below summarises key information about vitamins.
Vitamin
Sources
Why they are important
Signs of lack of
this vitamin
A
Milk, cheese, butter,
eggs, green vegetables,
carrots, tomatoes and
fish liver oils
Helps maintain healthy eyes,
skin, teeth and bones
Poor teeth and bone
growth, night blindness
and dry skin
B1
Bread, pasta, rice,
pork, nuts, fortified
cereals, lentils and
beans
Essential for the release of
energy from carbohydrates, fats
and proteins. Nerves, tissues and
muscles need it to function.
Heart damage, a sense
of feeling weak
Can stimulate appetite and help
relieve tiredness
B2
Milk, yoghurts, eggs,
green leafy vegetables
and fortified cereals
and proteins.
Contributes to healthy skin and
eyes
B3
Milk, meat, eggs,
fortified cereals and
fish
and proteins.
Skin rashes, cracking
in the corners of the
mouth and eyes and
sensitivity to light
Weakness, dizziness and
loss of appetite
Contributes to healthy skin,
nervous and digestive system
B6
Meat, fish, leafy green
vegetables, poultry,
fortified cereals
and proteins.
Contributes to healthy nervous
system and helps form red blood
cells
B9
Bread, liver, green leafy
vegetables, beans, nuts
and fortified cereals
8 Counterskills
Formation of new cells in the
body
Anaemia (deficiency in
red blood cells causing
skin to be pale and
tired), cracking in the
corners of the mouth
Anaemia, a sense of
feeling weak
Vitamin
B12
C
D
Sources
Meat, poultry, eggs,
milk, cheese and
fortified cereals
Formation of new cells in the
body.
Citrus fruits (such as
oranges), broccoli,
tomatoes, strawberries,
potatoes and fortified
cereals
Helps with wound healing and
supports immune system, aids
the absorption of iron
Leafy green vegetables,
eggs, milk, butter, liver
and oily fish
Needed for strong bones and
teeth and aids absorption of
calcium
Signs of lack of
this vitamin
Anaemia, a sense of
feeling weak
Contributes to a healthy nervous
system
Anaemia, prone to a
range of infections, sore
gums, weak muscles
Acts as an antioxidant and may
help reduce the symptoms of
a cold
Deformation of bones in
children and soft bones
and pain in adults
It is also produced
when sunlight contacts
the skin
E
Leafy green
vegetables, eggs,
vegetable oils, pulses,
nuts and seeds
Antioxidant. May therefore
prevent heart disease, and
some cancers
Anaemia, a sense of
feeling weak
K
Leafy green vegetables
such as spinach
and kale, broccoli,
vegetable oils and
cereals
It is required for the blood to
clot
Prolonged bleeding and
excessive bruising
Counterskills 9
Section 2: Vitamins
ACTIVITY
A man of about 23 comes into your
pharmacy. He says that he is a big meat eater
and is not very keen on vegetables or fruit. His girlfriend
has told him to come into the pharmacy to get some
vitamins to make up for this lack of fruit and vegetables.
Write in the box below what you would advise in this situation.
my r
we
ans
Ask your Pharmacist to review your answer and discuss it with you if required.
10 Counterskills
Product recommendations Vitamins, minerals and supplements
Well range
Key attributes:
Why recommend:
•The Wellkid
range has been formulated by
Vitabiotics’ nutritional experts providing great tasting
comprehensive supplements to safeguard a child’s diet
from the ages of 1 month to 12 years.
•For babies and infants Wellkid® Baby Drops is suitable
from 1 to 12 months, and Baby & Infant liquid is
suitable from 3 months to 5 years. Wellkid® Smart
Chewable is suitable for children aged 4 to 12 years
and includes iodine and iron which contribute to
normal growth and cognitive development of children,
respectively
•Wellman® and Wellwoman are the UK’s No1 leading
supplements for men and women
•Wellman® and Wellwoman Original, 50+ and 70+ have
been designed specifically for men and women who
have different nutritional requirements at different
ages and life stages. Wellman® and Wellwoman Plus
offer additional Omega 3, 6, 9 capsules.
®
•Vitabiotics is the UK’s No.1 supplements for specific
lifestages
•Vitabiotics recognise the need for segmented products
as the RDA for vitamins, minerals and nutrients change
for each lifestage
•The nutritional requirements of young children are
particularly high in order to support health and
rapid physical growth. The UK Department of Health
recommends that all infants aged from six months
onwards should be given a supplement that contains
vitamins A, C and D†. Each Wellkid® formula provides a
carefully balanced range of nutrients.
†Unless they are drinking 500ml (or approx. 1 pint) of infant formula
a day, as infant formula has vitamins added to it.
Immunace® Original & Immunace®
Why recommend:
Extra Protection
•Developed by Vitabiotics’ leading scientists in
nutritional research
No
• need to take an additional multivitamin
•Independently tested in a ground breaking published
international trial.†
Immunace® Original
Key attributes:
•Advanced comprehensive nutritional support for
all-round health
•With vitamin D for the normal function of the immune
system
•Antioxidants vitamins C & E contribute to the
protection of cells from oxidative stress
•Includes vitamin A which contributes to the
maintenance of normal skin and mucous membranes.
Immunace® Extra Protection
•Includes all the benefits of Immunace
®
Original,
plus additional nutrients, such as natural
lycopene, and resveratrol.
†Jiamton S, Pepin J, Suttent R et al.
AIDS 2003; 17: 2461-2469
•Can be taken for as long as required
•Gluten Free
•Suitable for vegetarians.
OTHER
ADVICE
Counterskills 11
Product recommendations
Berocca
Key attributes:
Why recommend:
release your energy
•Free from caffeine, sugar and artificial stimulants.
•Berocca provides a healthy way to stay on top form
•Contains magnesium, zinc and B vitamins, including B1
•Packed with vitamins and minerals
•Contains a high dose of B vitamins to help you to
•Daily energy release drink with a high dose of B and C
vitamins and minerals
and B2, which help you to release your energy.
Berocca can be taken every day and is best taken first thing in the morning to ahead
the most of the day ahead.
Choose from 3 flavours; Orange, Tropical or Mixed Berries.
Place one effervescent tablet in 250ml of water
OTHER
ADVICE
Berocca Boost
Key attributes:
•Packed with vitamins and minerals plus Guarana, a
natural form of caffeine
•Guarana and vitamins B2 and B6 help reduce fatigue
and provide a kick!
OTHER
ADVICE
Why recommend:
•A much healthier alternative to sugary caffeine drinks.
Can be taken any time of the
day, whenever you need a kick.
Add one effervescent tablet to
approx. 250ml water
Berocca Film Coated Tablets
Key attributes:
•Packed with vitamins and minerals
•Contains a high dose of B vitamins to help you to
release your energy
•Free from caffeine, sugar and artificial stimulants.
Why recommend:
•Non effervescent tablet – easy to take
•Daily energy release with a high dose of B and C
•Berocca provides a healthy way to stay on top form
•Contains magnesium, zinc and B vitamins, including B1
and B2, which help you to release your energy.
12 Counterskills
Sanatogen MTB
Key attributes:
•400mcg Folic Acid, 10mcg Vitamin D + 16 other Vitamins & Minerals
•For use before and during pregnancy.
Why recommend:
•Healthy Baby – Specifically designed to support healthy growth of the unborn baby – contains the recommended
amount of Folic Acid & Vitamin D
•Energy Release – Gives nutritional support for your body & includes Vitamins B1 & B12 to help energy release
from food
•Immunity – Contains Vitamin C, Iron & Zinc to help the immune system.
Counterskills 13
Redoxon
Key attributes:
•Redoxon Double Action is a combination of high
strength Vitamin C (1000mg) and Zinc (10mg) to help
support your immune system.
Why recommend:
•Works with the body to help support a healthy
immune system
•Contains Vitamin C which is needed in your diet
everyday as it cannot be stored in the body for any
length of time
•Contains Zinc which is required to maintain healthy
skin – the body’s first line of defence.
14 Counterskills
Ateronon
Key attributes:
•Highly Bioavailable Lycopene
•Patented formulation
•High levels of media coverage
•No side effects
•Ateronon has undergone clinical trials at Cambridge
and Harvard Universities.
Why recommend:
•Scientific data to support product
•Easily absorbed
•Natural product.
If you need any more advice
please contact CamNutra
directly
OTHER
ADVICE
Counterskills 15
Multibionta
More than just an ordinary Multivitamin
Key attributes:
•O nly Multibionta contains a unique blend of Probiotics
combined with vitamins and minerals
•Probiotics are the “friendly” bacteria which colonise
the intestinal tract. They help improve digestive health
and support the immune system helping to keep you
healthy and full of vitality all year round
•The Probiotics are protected through the stomach by
the coating on the 3 layer tablet which is shown to
deliver significantly more of the friendly bacteria to the
gut than uncoated Probiotics on their own
Why recommend:
•Vitality – Complete Multivitamin including CoQ10 to
help energy release
•50+ – Complete Multivitamin including Lutein and
Bilberry for healthy vision and Ginseng for vitality
•Immune Defence – Vitamins and minerals to support
a healthy immune system and provide antioxidant
protection
•Activate – B Vitamins and minerals in a slow release
tablet to help support energy release throughout the
day
NEW Centrum Men and Woman
Key attributes:
Why recommend:
scientifically formulated with specially balanced
nutrient combinations to help support the health and
wellbeing of men and woman1
•Each contains 24 key nutrients
backed by 30 years of nutritional expertise and proven
science2
•Centrum’s range provide a nutritional boost of
vitamins and minerals scientifically tailored to your
age and lifestyle, for children, men, athletes, women,
pregnancy, breast feeding or the over 50
•Complete daily multivitamins with minerals
Centrum Men
•The combination of
to support the nutritional
needs of men, including Zinc to
contribute to normal fertility
Centrum Woman
•The combination of vitamins
and minerals support the
nutritional needs of women,
including Calcium, Iron and
Folic acid
16 Counterskills
•Centrum is the World’s number one multivitamin,
Centrum Men contains Zinc & Selenium to support men’s
reproductive health. Centrum Women contains
iron and Folic Acid to support regular blood
formation
2
Based on worldwide sales of the Centrum
range
1
OTHER
ADVICE
Centrum Men and Women is
free from: Gluten, Azo-dyes
and Wheat.
Women who are pregnant or planning
a pregnancy should consult their
doctor before taking vitamin or mineral
supplements
Bassetts Soft & Chewy Vitamins
Key attributes:
•Early Health – The one containing a selection of
vitamins to help support the health of children aged
3+. Contributes to the normal function of the immune
system, nervous system and collagen formation for the
normal function of skin, bones, gums, teeth and blood
vessels
•Everyday Health – The one to support the nutritional
needs of children and adults alike, containing a
selection of essential multivitamins to help support a
healthy lifestyle
•Vitamin C with Zinc – The one to support the
nutritional needs of children and adults alike,
contributing to the normal function of the immune
system
•Active Health – The one for teenagers and young
adults, containing a selection of multivitamins and
minerals to help support a healthy and active lifestyle
•Early Health Plus – Specifically formulated with
added Omega-3 to support the nutritional needs of
growing children
•Daily Energiser – The one for people with busy and
hectic lives who would like to maintain their energy
levels throughout the day – and night! Contributes
to the reduction of tiredness and fatigue and normal
mental performance
Why recommend:
•Only one pastille per day for 100% RDA
•One for all the family
•Soft and chewy format – easy to take!
•Great fruit taste
Please visit
www.bassettsvitamins.co.uk
for more details on our entire
vitamin range
OTHER
ADVICE
Counterskills 17
Section 3: Minerals
Minerals are essential for good health. There
are many minerals the body needs. Common
ones are:
• Calcium
• Iron
• Zinc
• Sulphur
• Selenium
• Magnesium
• Sodium
• Potassium.
The table below summarises key information about minerals.
Mineral
Sources
Signs of lack of
this mineral
Calcium
Milk, cheese,
yoghurt, seafood,
leafy green
vegetables
Essential for production and
maintenance of teeth and
bones, muscle function and
blood clotting
Can cause bone loss in
adults
Iron
Red meat, green
leafy vegetables,
eggs, beans and
fortified cereals
Helps transport oxygen and
use of oxygen in the body
Anaemia, a sense of
feeling weak, prone to a
range of infections
Zinc
Meat, poultry, eggs,
milk, cheese and
fortified cereals
energy from carbohydrates,
fats and proteins.
Weakened immune
system
Contributes to wound healing
and immune system.
Acts as an antioxidant and may
help reduce the symptoms of a
cold and aid wound healing
Sulphur
Tomatoes, leafy
green vegetables,
eggs, carrots,
cheese, garlic, nuts
and seeds
18 Counterskills
Helps to make tissues such as
cartilage
Acne
Why they are
important
Signs of lack of
this mineral
Mineral
Sources
Selenium
Meat, fish, nuts and
fortified cereals
Antioxidant
No data on deficiency
directly related to
selenium
Magnesium
Leafy green
vegetables, fish,
pulses, nuts, whole
grains and seeds
Keeps our hearts beating
steady, a strong immune
system and strong bones
No data on deficiency
directly related to
magnesium
Sodium
Salt
Assists with fluid balance
in the body.
Muscle cramps, weakness
and loss of appetite
Aids in the transmission of
nerve messages
Potassium
Meat, bananas,
milk, leafy green
vegetables, fish, nuts
and pulses
Assists with fluid balance
in the body.
Muscle cramps, weakness
and confusion
Aids in the transmission of
nerve messages
Counterskills 19
Section 3: Minerals
ACTIVITY
A woman of about 35 comes into your
pharmacy. She explains that she has been feeling
dizzy for the last few weeks and has been feeling
generally run down.
She says that she eats very healthily but never eats meat,
fish or dairy products as she is vegan.
Write in the box below what you would advise in this situation.
my r
we
ans
20 Counterskills
Valupak
Vitamin D3 1000iu
Key attributes:
•Vitamin D3 can be helpful in treating the following
For more
OTHER
information
ADVICE
on Vitamin
D3 or further
products
please visit
www.valupak.co.uk
conditions:
- Osteomalacia in adults, rickets in children
- Diabetes
- Auto-immune disease
- Multiple Sclerosis
- Rheumatoid Arthritis
•
- Colon, breast and prostate cancer.
Possible vitamin function:
- Build bone mass and prevent bone loss
- Protect against muscle weakness
- Promote strong teeth
- Enhance immune system.
Why recommend:
•Each tablet provides 100% EU RDA - 1000iu
•Poor summer weather may cause an epidemic of vitamin
D deficiency through lack of exposure to UV rays in whole
population
•Intervention is needed because of the scarcity of sunlight
in Britain
•A supplement to lack of oily fish in the diet
•Those who need vitamin D most are - infants, pregnant or
breastfeeding women and the elderly.
Osteocare®
(Original, Chewable, Glucosamine &
Chondroitin and Plus)
Key attributes:
•Osteocare
®
Original provides the exact Recommended
Daily Allowance of Calcium and Zinc, with 10µg Vitamin D
and Magnesium which contribute to normal bone health.
Also available in Chewable format
•The Osteocare
®
formula is balanced with magnesium.
The Magnesium to Calcium ratio in the body is vital as
Magnesium contributes to normal muscle function
•Osteocare
®
Plus is a convenient 2-in-1 dual pack providing
soy isoflavones and omega-3 capsules
•Osteocare
®
Glucosamine & Chondroitin provides great
value by combining bone and cartilage health nutrients in
one comprehensive formula.
Why recommend:
•Osteocare
®
is the UK’s no.1 bone health formula providing
a rich source of calcium together with supporting cofactors magnesium, zinc and vitamin D
•Developed by Vitabiotics nutritional experts based on the
very latest scientific studies on bone health.
Osteocare has been specially developed so
that it can be taken with other Vitabiotics
products, allowing you the freedom to
continue taking your daily multivitamin
OTHER
whilst ensuring an additional supplement
ADVICE
of calcium and supporting nutrients for
normal bone health
Counterskills 21
Section 4: Taking supplements
Generally, vitamins and minerals should not be
needed if someone is eating a balanced diet.
However some customers may wish to take a
vitamin or mineral supplement and may ask
your opinion on which supplement(s) would be
the most beneficial for them and what strength
they should take.
The amount of vitamins and minerals needed
varies from person to person. It depends
22 Counterskills
on many things including gender, age and
activity levels. The Department of Health
gives guidance on the levels of nutrients to
have in a diet, although these aren’t exact
recommendations. They are called dietary
reference values and they are usually listed on
food and supplement packets. These values
show how much of a particular nutrient a
group of people of a certain age range (and
sometimes gender) need for good health.
Who should take
supplements?
There are particular groups of customers who
may benefit from taking either a vitamin or
mineral supplement.
People over 50
It is especially important for older people to
have plenty of iron to stay healthy. Taking
an iron supplement will lower the risk of
developing iron deficiency anaemia, which
can cause tiredness and weaken the immune
system.
Caffeine interferes with the body’s ability to
absorb iron and other nutrients. Advise the
customer to try not to have tea or coffee with
or immediately after their breakfast, or any
other meal. Suggest that instead they drink
fruit juice as this will help their body to absorb
iron.
Pregnant women
The Department of Health recommends that
women take Vitamin B9 (folic acid), 400mcg
a day while trying for a baby and during the
first three months of pregnancy. This helps to
reduce the baby’s risk of spina bifida and other
neural tube defects. The Department of Health
also suggests they take a 10 microgram vitamin
D supplement while pregnant and if they are
breastfeeding.
Vitamin A supplements should not be taken
by pregnant women and foods high in this
vitamin should also be avoided. Vitamin A can
cause abnormalities in the unborn baby and
may even cause spontaneous abortion (loss of
the baby).
Large quantities of vitamin B6 can cause nerve
damage and so only lower dose products are
available for over the counter sale.
Osteoporosis is a major health issue for older
people, particularly women, so it’s vital to have
plenty of calcium and vitamin D.
If a customer has age related macular
degeneration then they would benefit from
taking vitamins C, E and zinc.
Counterskills 23
Vegetarians and vegans
Iron, calcium and vitamin B12 are often lacking
from vegetarian/vegan diets. If customers are
vegetarian they need to make sure they get
enough iron and vitamin B12. Good sources
of iron are pulses, dried fruit, leafy green
vegetables such as broccoli and watercress and
fortified cereals. Good sources of vitamin B12
are dairy products and eggs.
Customers who are vegan need to make sure
they get enough iron, vitamin B12 and calcium.
As vegans don’t eat eggs or dairy products a
good source of vitamin B12 is yeast extract
and soya products fortified with vitamin B12.
Calcium can also be found in soya products,
sesame seeds and bread.
24 Counterskills
If their diet is not planned properly, this group
could miss out on essential nutrients and so a
supplement suitable for vegetarians and vegans
containing these nutrients may be of benefit.
If customers choose to take an iron
supplement, they should take it with a vitamin
C supplement as this aids iron absorption. If
they choose to take a calcium supplement, they
should take it with a vitamin D supplement as
this aids calcium absorption.
Children
A supplement containing vitamins A, C and
D should be given to all children aged six
months to four years. This is a precaution
because growing children may not get enough;
especially those not eating a varied diet
particularly if they are fussy eaters.
Not getting enough sun
Long term illness
Some customers may not get enough exposure
to the sun, for example people who cover up
their skin for cultural reasons, or people who
are housebound (stay indoors) for long periods
of time. As a result they may not get sufficient
quantities of vitamin D. Taking up to 25
micrograms of vitamin D a day can ensure they
are receiving sufficient to maintain strong teeth
and bones.
Customers who take warfarin or other
medication for thinning the blood must be
referred to the Pharmacist as supplements
containing Vitamin K can interfere with their
prescribed medication.
Care should be taken with customers who are
taking prescribed medication for conditions
such as high blood pressure or have a history
of kidney stones or other problems with their
kidneys. Check with your Pharmacist before
selling supplements in these cases.
Tonics
Tonics are liquid preparations which contain
vitamins and minerals along with additional
ingredients such as gentian infusions (a bitter
ingredient thought to stimulate the appetite)
and caffeine. They tend to be useful either
after an illness such as a cold or flu, or when
someone is feeling tired or run down.
Counterskills 25
Meal supplements
It is possible that your customer may be
interested in buying a meal supplement. There
are a number of different reasons for this:
As people recover from an illness or
operation, their eating habits may
change. They may find that they don’t
feel like eating three meals a day
•
•
s people age, their eating habits
A
change. They may find that they can’t
face three proper meals a day and adapt
by having a reduced number of meals
each day or by snacking
tress can cause people to stop eating
•Shealthy
food and perhaps to eat less
as they are preoccupied with other
problems. Healthy people can become
undernourished if they don’t take time
to eat a full and well balanced diet on
a regular basis. Busy lifestyles can mean
that meals and food become a low
priority
thletes undergoing training regimes
•Amay
not be receiving sufficient nutrients
in their normal meals to compensate for
the additional physical exercise.
There are a number of issues that can arise
when an individual is not getting enough
nourishment. These include:
Taking longer to recovery from a serious/
major illness
•
•Being tired and lacking concentration
•Having a impaired immune system
•Suffering from depression
•Being weak and having wasted muscles.
Meal supplements are rich in Vitamin C, D
and calcium. They provide a mix of essential
26 Counterskills
protein, fat and carbohydrate to provide energy
as well as an extensive range of vitamins and
minerals.
They can be used between meals as a
supplement or occasionally as a meal
replacement when appetite is poor.
They can also be used to help customers
who wish to lose weight as part of a calorie
controlled diet.
Typically meal supplements come in a powder
format and can be made freshly as required by
the customer. They can be mixed with water or
milk and made hot or cold.
They contain the following:
Vitamins A, C, D, and E
•
•Essential minerals
•Calcium (for healthy teeth and bones)
ron (to help maintain physical stamina,
•Istrength
and mental alertness)
•Protein.
Omega oils
Omega 6
Omega oils are essential fatty acids which are
essential as they cannot be made by the body.
There are two main omega oils:
Omega 3
These are thought to help with premenstrual
tension and breast tenderness, and can
improve skin conditions such as eczema and
psoriasis.
•
•Omega 6.
Omega 3
Omega 6 is found in nuts, seeds and sunflower
and olive oils.
These are thought to be beneficial in
preventing heart disease and improving the
condition of people suffering with depression
and bipolar disorder. Recent studies have
shown that they can play a key role in the
development of the brain in infants and
increase concentration levels in children.
Omega 3 is found in oily fish, flax seed,
pumpkin seeds, walnuts and soya beans.
Counterskills 27
T
MEMBE
R
RE
N
io
at
n TO
W
ho is it for?
Refer to the Pharmacist if:
You will need to know the age of your customer to determine
the relevant product and dose
Pregnant or breastfeeding women asking for vitamin and/or
mineral supplements should be referred to the Pharmacist
W
hat are the symptoms?
Symptoms seem severe
H
ow long have they had the symptoms?
Any symptoms have persisted for a long time or if your customer
has had a bad reaction to any supplements tried before
A
ctions taken so far:
Customer not feeling better after taking a supplement or
tonic for two weeks or longer
A customer requests an iron supplement not recommended
by a healthcare professional
M
edication, if any, taken at the moment?
The answer is yes
28 Counterskills
INform
WWHAM!
•
PORTA
IM
A 78 year old woman comes into the
ACTIVITY
pharmacy. She is a regular customer to your
pharmacy as she has asthma and gets her
prescription from you. You notice that she is
looking thinner than the last time you saw her
(about 4 weeks ago). You ask her how she is doing.
She replies that all is well with her but that her age is
beginning to tell! She goes on to say that she isn’t eating
much these days as she is too down since her husband
passed away.
Write in the box below what you would do in this situation.
my r
we
ans
Counterskills 29
Menopace® range
Key attributes:
•Menopace
®
Original – effective one-a-day micronutrient
supplement scientifically formulated for during and after
the menopause, including vitamin B6 for its contribution
to the regulation of hormonal activity, as well as vitamin
D which contributes to the absorption and utilisation
of calcium from the diet. Vitamins B2, B6 and B12 with
copper and iron contribute to normal energy release
•Menopace
Plus – providing all the benefits of Menopace®
Original plus an active botanical tablet which includes
Green Tea Extract, extra Soya Isoflavones and Sage
®
•Menopace
®
Calcium – combines the Menopace® formula
with additional calcium (700mg) plus magnesium which is
needed for the maintenance of normal bones
•Menopace
Night – an advanced supplement designed
to be taken at night time before going to sleep. Includes
botanical extracts of Chamomile and Hops, as well as
5-Hydroxytryptophan (5-HTP)
®
•Menopace
Red Clover – provides an ideal 40mg
Menoflavon® Red Clover isoflavone extract and can be
taken alongside any product in the Menopace® range.
®
Why recommend:
•Developed by a team of experts including highly qualified
pharmacists and medical consultants, and is based upon
solid scientific research evidence
•Highest quality United States Pharmacopeia standard
•Menopace includes vitamin B6 to contribute to the
®
regulation of hormonal activity.
or during and after the
•Fmenopause
aken alongside or
•Tindependently
of Hormone
OTHER
ADVICE
Replacement Therapy (HRT)
Menopace® is also recommended
for those women who have an early
menopause.
•
Pregnacare®
(Conception, His & Hers, Original, Plus,
Max, New Mum, Breast- feeding)
Key attributes:
•Pregnacare
®
His & Her Conception provides the
opportunity for couples to take a convenient, balanced
daily formula specifically developed with nutrients for male
and female reproductive health as well as overall wellbeing
•Pregnacare Original is the most trusted prenatal
supplement by mums including vitamin B12 and 400mcg
folic acid at exactly the level recommended by the
Department of Health
•Also available is Pregnacare Plus with an additional
Omega-3 capsule providing DHA and EPA to support
normal brain and eye development of the foetus**.
Pregnacare Max also provides an Omega-3 capsule with an
advanced tablet providing the readily bioavailable form of
folic acid L-Methylfolate, together with 500mg Calcium
•Pregnacare Breast-feeding provides the ideal follow-
on product for mums after childbirth and contains the
recommended 10mcg Vitamin D3, the full RNI of 700mg
Calcium and 300mg DHA. Pregnacare New Mum provides
30 Counterskills
Vitamins B6 & B12 to contribute to the reduction of fatigue
plus Biotin which helps to maintain normal hair & skin
health after Pregnancy.
Why recommend:
•Pregnacare is the UK’s No1 Pregnancy supplement brand
and is most recommended by midwives††
•Pregnacare
®
has always contained 400mcg folic acid† and is
supported by unique clinical research with mums-to-be 1,2
•Pregnacare has been carefully developed by experts so that
all ingredient levels are within safe levels for pregnancy
and are moderate rather than excessive.
†Folic acid contributes to maternal tissue growth during pregnancy. Pregnacare®
has always contained 400mcg folic acid, the level recommended for all women
from the start of trying to conceive until the 12th week of pregnancy.
††Based on a survey of 1000 midwives. For more information on this research,
please visit www.pregnacare.com/mostrecommended
1 Agrawal, R. et al. Prospective randomised trial of multiple micronutrients
in women undergoing ovulation induction, Reproductive BioMedicine Online
December 2011.
2 L Brough et al. Effect of multiple-micronutrient supplementation on maternal
nutrient status, infant birth weight and gestational age at birth in a low-income,
multi-ethnic population. British Journal of Nutrition (2010), 104, 437-445.
** The beneficial effect is obtained with a daily intake of 200 mg of DHA in
addition to the recommended daily intake of 250mg DHA/EPA for adults.
Jointace®
(Original, Omega-3, Collagen,
Rose Hip, MAX)
•Copper helps to maintain normal connective tissues and
therefore can be beneficial to cartilage, as cartilage is
made up of connective tissues.
Key attributes:
•Developed by Vitabiotics nutritional experts to provide
nutritional support for an active life
•The Jointace
®
range offers unique combinations of
Glucosamine with trace minerals, vitamins and nutrients
including Omega-3 fish oil, Collagen, Rose Hip and Ginger
Extract
•Jointace
®
Max provides the most comprehensive
support in the range combining collagen, glucosamine &
chondroitin tablets and super strength Omega-3 capsules
in a special triple pack.
Why recommend:
•Cartilage and bone health are important for long term
wellbeing and maintaining an active lifestyle
•Vitamin D, zinc and manganese help to maintain normal
bones
•Vitamin C supports normal collagen formation for the
normal function of bones and cartilage
Seven Seas Fish Oils
(Cod Liver Oil & Health Oils)
Key attributes:
•Seven Seas Cod Liver Oil is enriched with Omega-3
Fish Oil and Vitamins D & E. Available in both one-aday capsule or liquid formats in varying strengths up
to 2800mg of Omega-3 per dose
•Seven Seas Health Oils have been innovatively
designed to help keep you at your best by expertly
blending fish oil, a natural source of Omega-3 with
combinations of vitamins and minerals for tailored
health benefits.
Why recommend:
Seven Seas Cod Liver Oil
•Seven Seas is the original Cod Liver Oil producer, with
more than 75 years experience of sourcing the finest
fish and refining oils of the highest quality
Can be taken for as
long as required
OTHER
ADVICE
•Cod Liver Oil is a rich natural source of Omega-3 that
contains nutrients EPA and DHA which are essential
for good health. Research has shown that eating
250mg daily of EPA and DHA as part of a healthy
lifestyle contributes to normal heart function, normal
brain function and normal vision
•Vitamin D – supports a healthy immune system, helps
maintain healthy bones, muscles and teeth
•Vitamin E – helps protect against free radical oxidative
damage.
Seven Seas Health Oils
•Each Health Oil has been tailored for a different health
benefit so it works with your body where you need
them most eg Immune Defence – helps keep you
fighting fit; Radiant You – for healthy hair, skin and
nails; Sunshine Vitamin D – helps maintain healthy
bones and teeth.
Counterskills 31
Section 5: Herbal remedies
Herbal remedies tend to be viewed as a more
natural remedy compared to over the counter
medicines. This view can be misleading as a
lot of over the counter medicines started out
as plant or herbal remedies. This means that
herbal remedies are not always appropriate
for everyone as they can have side effects
and interact with other over the counter and
prescribed medicines.
Herbal remedies come from plants and can be
from any part of the plant; root, stem, flower,
leaf, or the whole plant. They can sometimes
be confused with homeopathic remedies which
is a system of medicine that uses very small
quantities of a substance that would normally
produce the effects of the condition being
treated.
32 Counterskills
Medicines which have a product licence
have been approved by the Medicines and
Healthcare products Regulatory Agency
(MHRA). This agency ensures medicines given
the licence are safe, of high quality, and meet
with strict manufacturing standards. Some
herbal remedies also have a product licence.
A product licence allows the manufacturers to
clearly state on the packaging what it can be
used for. If it doesn’t have a product licence
then it cannot have any uses or claims on the
packaging.
Herbal remedies take longer than conventional
medicines to have an effect and so you should
advise your customers accordingly.
Herbal remedies are used for a range of common ailments.
Some of the more common ingredients and potential uses are listed in the following table.
Herbal
remedy
Effect
Advice / Cautions
Recommeded
for
Arnica
Helps the healing process
Bruises
Echinacea
Helps support the immune Shouldn’t be taken
Fighting colds, flu and
system
continuously as it will lose its other viral infections
potency
Evening
primrose
Anti-inflammatory and
healing properties
Avoid in pregnancy,
epilepsy
Pre-Menstrual Syndrome
(PMS), mood swings, dry
skin conditions
Feverfew
Many have antiinflammatory properties
Not to be taken in
pregnancy
Headaches and
prevention of migraines
Fucus
Thought to have mild
stimulant effect on the
thyroid gland (which
controls the bodies’
metabolism) and so
boosting metabolism
Refer any customers on
any medication to the
Pharmacist
Weight loss
Garlic
Antioxidant, antiseptic,
antibacterial. Helps keep
blood pressure down and
cholesterol levels low
Fighting colds, flu
Can produce strong garlic
smell from breath. There are including excess mucus
some brands available which and catarrh
are marketed as low odour
if this is a problem your
customer is worried about
Ginseng
Acts as a stimulant
and reduces stress and
tiredness
Not to be taken by
Tiredness and stress
customers who are pregnant
or have heart disease.
Caffeine should be avoided
Gingko
Biloba
Improves circulation and
may improve memory
function
Not to be taken by
Customers who have
customers who are pregnant loss of memory function
or breast feeding
Counterskills 33
Section 5: Herbal remedies
Herbal
remedy
Effect
Advice / Cautions
Recommeded
for
Ginger
Speeds up the digestive
process and can relieve
bloating and wind
Taste is quite strong and
may not be liked by all
customers.
Avoid in pregnancy and
customers with thyroid
disorders
Travel sickness
St John’s
Wort
Helps lift low mood,
depression or
premenstrual symptoms
See “When to refer”
Calming and mood
lifting action
Tea tree oil
Antiseptic and antifungal
properties
Take care if being used
undiluted. Should be
avoided in pregnancy
Acne, athletes’ foot,
other skin conditions
and head lice
34 Counterskills
Section 6: Check your
understanding
Complete the following multiple
choice questions on vitamins, minerals
and supplements. Ask your
pharmacist to check
your answers.
ACTIVITY
Question 1
Protein is found in:
A) Meat
B) Pasta
C) Rice
Question 2
The body is made up of around:
A) 50% water
B) 70% water
C) 40% water
Counterskills 35
understanding
Question 3
An example of a water soluble vitamin is:
A) Vitamin A (retinol)
B) Vitamin B1 (thiamine) C) Vitamin D (calciferol)
Question 4
A good source of vitamin A can be found in:
A) Red meat
B) Rice
C) Cheese
Question 5
An example of a mineral is (tick any that are true):
A) Calcium
B) Sulphur
C) Iron
36 Counterskills
Question 6
A good source of potassium can be found in:
A) Leafy green vegetables
B) White rice
C) White pasta
Question 7
The Department of Health recommends that pregnant women take:
A) Vitamin B9 (folic acid)
B) Vitamin A (retinol)
C) Vitamin D (calciferol)
Question 8
Meal supplements are useful for people who are (tick any that are true):
A) Suffering from stress and not eating properly
B) Recovering from an illness or an operation
C) Athletes undergoing training regimes
Counterskills 37
understanding
Question 9
Ginseng:
A) Relieves bloating and wind
B) Acts as a stimulant and reduces stress and tiredness
C) Improves circulation
Question 10
Herbal remedies:
A) Work more quickly than conventional medicines
B) Work at the same pace as conventional medicines
C) Take longer than conventional medicines to
have an effect
38 Counterskills
Look out for the next Counterskills
workbook from Alliance Healthcare
covering Allergies and Eye Disorders
Workbooks
11 and 12
have been
switched
due to
seasonality
training
skills
COUNTERSKILLS
training programme
Allergies &
eye disorders
11
workbook
hayfever
eye disorders
skill builder:
advising confidently
using WWHAM
activities & assessment
merchandising aid
Supported by:
Queries relating to Counterskills should be directed to
counterskills@alliance-healthcare.co.uk or 0203 044 8062
Content developed by:
©2011 Scientia Skills Limited Copyright in the whole and every part of the workbook
belongs to Scientia Skills Limited (“the Owner”) and may not be used, sold,
transferred, copied, adapted or reproduced in the whole or in part in any manner or
form or in any media to any person without prior written consent of the Owner.
Counterskills 39
Planogram
This planogram has been provided as a guide to help you optimise the sales opportunity on vitamins, minerals and
supplements category. For a full listing see the ‘Star Ratings’ document included with this workbook which contains
essential, additional and supplementary brands within pharmacy.

counterskills - Alliance Healthcare

Transcription

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