Should Your Children Be Taking Vitamin Supplements?
Posted Nov 09 2010 11:46am
A blanket recommendation that all children would benefit from vitamin/mineral supplements is not justified provided their nutritional intake reflects the recommended servings for carbohydrates, protein and fat. In reality, too few do.
A look at the typical diet indicates that many children fall short of the recommended servings for fruit, vegetables, whole grains, and low-fat/skim diary products based on national consumption data. In fact, only 12.7% of children, ages 6-11, consume two or more servings of whole grains daily out of the six needed. Likewise, a minimum of 3 vegetables is recommended, but 1.5 vegetables is more typical. There is concern that children are consuming too little vitamin D and calcium since milk has been displaced by soda and sugar-laden drinks.
Then there’s the problem of too much dietary fat, which has a role in determining the acceptability of a child’s overall diet. Data from the Child and Adolescent Study for Cardiovascular Health (CATCH) indicates that the nutrient density of foods increases with less fat eaten. This means that the vitamin and mineral status of children who consume more than 30% of calories from fat, particularly saturated fats and trans fatty acids, will fall below desired levels.
Interestingly, children who need vitamin and mineral supplements the least—because they are healthy, active and have access to good food and regular health care—tend to get supplements. It is the children who are underweight, have restricted food choices, or have illnesses that put them at risk for a vitamin and mineral deficiency (low level), who should receive supplemental vitamins and minerals, but usually don’t.
Better safe then sorry? Many professional organizations, including the American Academy of Pediatrics and the American Dietetic Association, stress that healthy children should be encouraged to eat a variety of unprocessed foods as the best way to get the necessary requisite of vitamins and minerals, naturally. Lest you believe that more is better, remember that a multivitamin is only intended to supplement an inadequate diet, not to replace the foods needed as part of a healthy diet. And, supplements do not provide fiber, essential to reduce disease risk and promote lifelong health. That said, there are situations when a multivitamin may be beneficial, such as for children who follow a strict vegetarian diet, especially Vegan, may need supplemental vitamin B12 or those with a medical condition that may challenge their nutritional status.
Let’s look at nutrients that particularly needed by growing children:
Vitamin D and Calcium
These nutrients are essential for healthy bones and teeth. It is recommended that all infants, get 400 IU of vitamin D daily. Children who drink low-fat or fat-free milk and/or eat dairy products, such as yogurt, ice cream and cheese, usually get enough vitamin D and calcium. A milk intolerance can be managed with lactose-free dairy products, and for others who just don’t like milk, there are fortified non-dairy foods, such as soy products and orange juice. Since multivitamins generally contain only 200mg, or 20% of the daily calcium needed ( 800 mg for children ages 4-8 (3 servings) and 1300 mg from age 9 on(4 servings) , even a basic supplement can’t be relied on to meet the levels needed.
Most children get enough fluoride to protect teeth enamel if they are drinking fluoridated water. For children over 6 months who live in areas that do not add fluoride to tap water, pediatricians and dentists may prescribe a fluoride supplement.
Children, particular adolescent girls, need sufficient iron to prevent anemia and may lead to impaired brain function and intellectual performance. Good foods sources of this mineral include meats, fish, legumes (beans, lentils, Edamame, peas) and fortified breads and cereals.
While there is compelling data linking antioxidant nutrients such as vitamins A, E and C as well as beta carotene to reduced risks of chronic diseases, including cancer, cardiovascular disease and diabetes. The benefits, however, have been shown in diets high in fruits and vegetables, and not from isolated supplements, which may even be harmful, according to a recent study published in Cancer Causes and Control
How Do You Manage With A Finicky Eater?
For children who prefer chips and sweets to vegetables and whole grains, and those who typically reject vegetables, the goal should be to promote good food choices, rather than trying to solve this dilemma with a pill. After all, most children are otherwise healthy, active, and have plenty of food available to them so they do not need supplements. In recognizing that vitamins are just that, nutrients that are provided above and beyond a good diet, it makes sense not to substitute a pill for good eating habits. It is far better to put your energies into offering the right food s, keeping in mind that it takes repeated introduction—anywhere from 6 to 15–to a new food before it is typically accepted.
“We want families to provide their child with an environment in which they not only learn how to eat healthy, but have the opportunity to practice what they learn,” says Debra Haire-Joshu, Ph.D., a professor at the George Warren Brown School of Social Work. The answer isn’t a vitamin pill, it is sitting down to eat with your kids so they see you demonstrating the behaviors you want them to develop. And, meals shouldn’t become a battleground. Knowing that kids tastes change and evolve, just like ours, concentrate on modeling good eating habits and your children
will pick up on it. That means, serve everyone the same food, and let your children eat what they want; if they’re hungry, they will eat enough. Of course, if you have any concerns about your child’s health status, it is best to consult with your physician and/or a registered dietitian to make certain the diet is sufficient to promote growth and maintain health. According to the experts, providing a diet that reflects the recommended servings for carbohydrates, protein and fat as presented in the U.S. Department of Agriculture’s MyPyramid for Kids is the best way to establish lifelong healthy eating habits.
That said, do not be tempted to offer your children individual supplements cautions Peter Gann, MD, ScD, professor of preventive medicine at the University of Illinois at Chicago in a recent JAMA editorial. If anything, choose a high-quality multivitamin and mineral supplement that provides the dietary reference intakes for essential nutrients, but contains no additives or fillers, and is manufactured by a reputable company to ensure that its label claims meet the levels declared for nutrient content.