IN March of this year, a contentious decision was made by the Pakistan Medical and Dental Council (PMDC), which endorsed a directive from the Ministry of Health, prohibiting healthcare professionals from prescribing nutraceuticals such as multivitamins, minerals, and food supplements. This decision, despite significant opposition from the medical community, was aimed at curbing the overuse of such supplements in patient care.
According to the PMDC’s notification, issued following a meeting on February 23, 2024, all concerned authorities were instructed to enforce the cabinet’s decision. Physicians, however, continue to prescribe nutraceuticals, arguing that in many cases, these products are essential for patient treatment and recovery. This ongoing debate highlights several important areas that need to be addressed, particularly concerning the medical curriculum and regulatory practices in Pakistan.
A critical issue is the training of doctors in the field of nutrition. The current MBBS curriculum in Pakistan provides very little practical guidance on how to incorporate nutrition into patient care. Most medical students are exposed to basic biochemistry and community medicine, but the information they receive is often highly technical and not adequately aligned with clinical medicine. Nutrition, which should be a cornerstone of patient care, is relegated to peripheral subjects rather than being integrated into the core clinical training. As a result, many doctors are ill-equipped to handle the complex nutritional needs of their patients. This gap in education becomes particularly problematic when these same doctors are expected to prescribe nutraceuticals—supplements that are designed to enhance health but require an understanding of nutrition and its impact on disease and wellness.
The nutraceutical market in Pakistan is vast and rapidly growing, driven by both local and international companies. These businesses not only promote multivitamin and mineral supplements but also a wide range of herbal medicines and other alternative therapies. Without proper training in pharmacognosy (the study of medicinal plants) or naturopathic therapies, many doctors are prescribing these products without a solid understanding of their benefits or potential risks. This lack of knowledge raises serious concerns about the efficacy and safety of nutraceutical prescriptions in Pakistan.
Moreover, the absence of education in lifestyle medicine compounds the problem. Doctors are not just tasked with treating diseases but also with guiding patients on how to lead healthier lives. Lifestyle medicine focuses on preventive care through diet, exercise, and behavioral changes, which should be a fundamental part of any medical practice. Yet, these concepts are often overlooked in Pakistan’s medical education system. If doctors are not trained to advise patients on nutrition and healthy lifestyles, they are more likely to rely on supplements and nutraceuticals as quick fixes, further entrenching a culture of over-prescription.
The regulatory environment in Pakistan also plays a significant role in this debate. Despite the directives issued by the Ministry of Health, nutraceutical prescriptions remain widespread. Local companies capitalize on the lack of regulation, selling overpriced products wrapped in attractive packaging that often misleads consumers. These products, marketed as essential for health and well-being, are not always backed by scientific evidence. Yet, they are routinely prescribed by doctors, adding to the financial burden on patients. The unchecked marketing of these supplements highlights the weaknesses in Pakistan’s regulatory framework, which has failed to ensure that only evidence-based nutraceuticals are available and prescribed responsibly.
The reality is that supplementation should not replace proper nutrition, but rather complement it when necessary. As Hippocrates famously said, “Let food be your medicine, and medicine be your food.” This timeless principle underscores the importance of whole foods in maintaining health and preventing disease. Unfortunately, the current medical practices in Pakistan often overlook this, prioritizing supplements over diet-based interventions. Instead of focusing on prescribing pills, doctors should be trained to educate their patients on the importance of balanced diets, rich in natural vitamins and minerals, which can provide the same, if not better, health benefits than synthetic supplements.
—The writer is Associate Professor, Health Services Academy, Islamabad.
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