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    Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.

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  • April 11, 2009

    Vitamins and kids' health

    By Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.

2 comments posted

According to a report in the February 2009 issue of the "Archives of Pediatric and Adolescent Medicine," 34% of U.S. kids ages 2 to 17 take multivitamin supplements.  Interestingly, most of these children and adolescents are generally healthy — they have access to food and health care and have healthy lifestyle habits. In contrast, the report found that children and adolescents at greatest risks of vitamin and mineral deficiencies — such as those with less healthy nutrition and activity patterns and less access to health care — use supplements the least.

Reflecting on this report, these thoughts came to mind:

  • Fortunately — and unfortunately — our understanding of the benefits of supplementing children's diets comes from research in developing countries. It begs the question: Do children in developed countries where food is plentiful need multivitamins or supplements of any kind?
  • The American Academy of Pediatrics does not generally recommend multivitamins for children with a healthy, varied diet.
  • Programs such as WIC and food stamps are designed to help families acquire healthy foods for their children. The sad reality, however, is that many still lack food security — access to sufficient, safe and nutritious food — despite such programs. What do we do about this? Do we recommend multivitamins for kids in this situation when we know food is the better option? Might we be changing our view of the "need" for vitamin supplementation as we learn more about vitamin D requirements and deficiency in children?

Will we be putting more emphasis on individualized approaches to supplement use? Tailoring recommendations by age, region, season and socioeconomics?

What are your thoughts?

In closing, I think of my mother-in-law, a former teacher, who lobbied for school breakfast at her school. She saw children coming to school hungry, not having had a meal since the school lunch the day before. We all know the benefits of breakfast and performance at school. It seems obvious that feeding kids healthy foods keeps kids healthy. I'm not a mathematician, but I think if we did that we'd see tremendous savings in short- and long-term health care spending.

2 comments posted

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  • April 13, 2009 10:02 a.m.

    It should come as no surprise that those who use vitamin and mineral supplements also engage in other healthy behaviors, such as trying to eat a well-balanced diet and being physically active. Vitamin supplements are one component of a total health package and cannot be teased out of the overall wellness equation. The researchers in the APAM study rely on data from the NHANES, but fail to point out that other data from the same survey show that many Americans, including children and adolescents, fail to consume recommended amounts of vitamins E, C and A, as well as calcium and magnesium. A daily multivitamin affordably and safely helps fill these nutrient gaps. Many kids who are more affluent and who are exposed to healthier behaviors do not always follow through and have diets just as deplorable as lower income kids. For two decades, I have counseled children in every economic demographic and one thing is for sure: nutrient deficiencies are not partial to any group. Most agree that the underserved population could benefit from a multivitamin. The dietary supplement industry has long lobbied for legislation to include multivitamins in the Food Stamp Provision of the Farm Bill, as well as passage of bills that allow purchase of supplements through flexible spending accounts or health spending accounts, to ensure that all consumers have access to vitamins that can positively impact their overall health and wellness.

    - Bonnie Minsky MA, MPH, LDN, CNS

  • April 11, 2009 11:21 p.m.

    I have been interested in this topic ever since I started writing my blog on Toddler Nutrition. Although, we are not giving any multivitamin supplements to our 3 year old twins, I can understand why 50% of the respondents in a recent survey on my blog said they were using these supplements. I have also written about situations when parents might consider them. I have also done reviews of several multivitamins on the market. On one hand there are alarming headlines about vitamin D deficiency in children, and on the other, there is no reliable advice for parents. Nutritional supplements industry is big, yet there are no standards for quality and efficacy. The end result is that parents are confused and often wonder if they are getting their money's worth out of the popular OTC supplements. I would love to see you tackle this topic in more detail and offer some definitive advice for parents based on sound research and your expertise. Check out my blog at http://www.littlestomaks.com

    - TwinToddlersDad

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