A patient follows a plant-based diet low in saturated fat and high in fruits and vegetables but reports fatigue and pale conjunctiva. As a nutritionist applying the course definition, what is the most appropriate next step?

• A. Suggest only psychological counseling and ignore dietary assessment because fatigue and pale conjunctiva are always due to emotional factors and not nutritional status.
• B. Recommend immediate cessation of the plant-based diet and replacement with a high-saturated-fat omnivorous diet because the plant-based diet cannot support health under any circumstances.
• C. Conclude the diet is universally nutritious because it emphasizes plants, so no further assessment is needed and fatigue is unrelated to nutrition.
• D. Investigate potential micronutrient deficiencies (e.g., iron, B12), assess dietary intake and consider targeted supplementation or food-based changes to improve both nutrient status and overall health outcomes.

Answer: (D)