2007-10-02 19:00:00
Bradly Jacobs M.D. M.P.H.

Picciano and colleagues recently published a report on the use of dietary supplements (vitamins, minerals, herbs etc.) in the Archives of Pediatrics and Adolescent Medicine.

They found that one-third of children take dietary supplements, and 18% take multi-vitamins. Use peaked among 5-year olds with 50% and 25% taking supplements and multi-vitamins, respectively.  Less than 1% of  children take herbal medicines.  The most commonly used supplements include multi-vitamins/minerals, Calcium, Vitamin D, Vitamin C, Retinol, Iron, and Flouride.  Mirroring the patterns of adult use, children with higher income, non-smoking families, minimal television/video time, not eligible for WIC services (low income) were more likely to take these supplements.  Unfortunately, the very children who may be at greatest risk for nutritional deficiencies due to poor access to high quality food are least likely to be taking multi-vitamin/minerals.

These findings suggest that while use of supplements by ADULTS continues to rise, among children it hasn't changed much and if anything may have declined.  The survey was performed on over 10,000 children (and family members) across the United States as part of the 1999-2002 National Health and Nutritional Examination Survey (NHANES). 

Other studies have also found athletic performance enhancing aids to be commonly used, particularly among adolescents. In contrast to the low use of herbal medicine in this study (which included children from infancy to 18 years), a national online survey by Wilson published in 2003, 40% of adolescents reported using herbal or green tea, zinc, echinacea, ginseng, ginger, ginkgo, soy supplements, omega 3 fatty acids/fish oil, creatine, weight loss supplements, St John's wort, valerian, ephedra, or feverfew.

What are the professional organizations saying about using Dietary Supplements?

The American Academy of Pediatrics and other health professionals emphasize using food as the primary source for good nutrition.  Some physicians suggest supplementation for children at risk for deficiencies. For example, 200 IU of Vitamin D is recommended for breast-fed infants or infants who drink less than 16oz of Vitamin D-fortified formula/milk per day, and for kids who aren't in the sun regularly and drink less than 16oz of milk per day. Iron is also a concern for certain groups. 

Buyer Beware: 

As you may already know, there is no regulation on the quality of dietary supplements sold in the United States. There have been dozens of reports of contamined, adulterated, and misidentified supplements that have been recalled by the FDA. Consequently, if you are going to purchase dietary supplements for your child, please be sure to verify that the product has been tested by USP or Consumer Lab.  Please see my previous blog post on "Dietary Supplements- Buyer Be Informed" for more information.