a third of American kids
By Lindsey Tanner
About a third of U.S. children and teens take vitamins, even though most of those taking the pills are healthy, active kids who probably don't need them, a new study suggests.
Youngsters who could benefit the most from vitamins — kids in fair or poor health with the worst eating habits — were the least likely to take them, researchers reported.
The survey of parents of children aged 2 to 17 was done from 1999-2004. The results show a decline in vitamin use from the 1970s when roughly half of all American children took vitamins, the study's lead author said.
The study highlights a question doctors often get from parents: Should I give my kids vitamins?
Stacy Fournier, of Gainesville, Fla., says it's often on her mind even though her daughter is a great eater.
"I probably bring it up every other time we visit the pediatrician because it is looming on my mind and I want to make sure that she's healthy," said Fournier, whose daughter is almost 3.
For now, Fournier has heeded her doctor's advice against it, but she still wonders, "Why not? It can't hurt."
The study's lead author, Dr. Ulfat Shaikh, a pediatrician at the University of California-Davis Children's Hospital in Sacramento, says taking daily multivitamins in the dose recommended on the label probably is harmless. However, they often aren't needed for healthy children with a varied diet, she said.
Shaikh said kids in the study "who had the ideal profile — higher dietary fiber intake, higher milk intake, lower total fat and cholesterol intake, lower computer use, greater physical activity, lower obesity, kids that had insurance coverage, had good health care access, whose parents said that they were in good health — these kinds of kids were the highest users."
She noted that vitamin and mineral supplements aren't cheap. A bottle of 100 multivitamin-mineral tablets for kids can cost around $10, depending on the brand. Almost $2 billion is spent on them annually.
Also, some parents and teens may mistakenly think taking a daily pill will make up for a lousy diet, Shaikh said. Pediatricians generally agree that the best source for vitamins and minerals is a varied diet that includes fresh fruit, vegetables and fiber — not pills.
Still, there's mounting evidence about important potential benefits from a vitamin that can be hard to get enough of from food, particularly for kids who don't drink much milk. That's vitamin D.
The American Academy of Pediatrics last year doubled the amount of vitamin D it recommends for all children, from newborns to teens. It now advises 400 international units daily of vitamin D, which kids can get by drinking four cups a day of fortified milk. But many don't drink that much, and eat little of the few foods containing the vitamin, including tuna and other oily fish. So the academy recommends 400 IU supplements for kids lacking adequate vitamin D in their diets.
The vitamin can keep bones strong, but also has been linked to other possible health benefits, including preventing some cancers and heart disease.
Some physicians think kids and adults should be getting even more vitamin D, and an Institute of Medicine panel begins a series of meetings in March to discuss whether to revise recommendations for both vitamin D and calcium, which work together to keep bones healthy.
The new study, released Monday in the February issue of Archives of Pediatrics & Adolescent Medicine, asked about use of vitamin and mineral supplements in general, not about specific ones including vitamin D. It found supplement use was most common among frequent milk drinkers and those with varied diets — children who likely are meeting the academy's latest recommendations.
The study is based on data from 10,828 kids whose parents took part in a national health survey that included interviews about diet and supplement use. Overall, 34 percent of the children had recently taken vitamin/mineral supplements and almost half of users took them daily.
Vitamin/mineral use was highest among 2- to 4-year-olds — 43 percent; it was lowest in 12- to 17-year-olds — 27 percent.
Among children in excellent health, 37 percent used the supplements, versus 28 percent of those in fair or poor health. The breakdown was similar when comparing frequent milk drinkers to those who generally avoided dairy products.
Lower-income children were less likely to take vitamins and minerals than those from wealthier families.
Shaikh said it's possible the healthy kids were healthy at least partly because of vitamin/mineral use. But she said it's also possible vitamin-using kids simply have more health-conscious parents.
Dr. Ronald Kleinman, editor of the pediatrics academy's nutrition handbook, said the study bolsters previous evidence that children who may need vitamins the most don't take them.
"Most of us would do that by recommending a better meal plan" rather than vitamin supplements, he said.
Breast-fed babies: 400 international units of vitamin D drops daily, until they start drinking at least four cups a day of vitamin D-fortified formula or milk.
Children who don"t drink at least four cups of fortified milk, juice or other vitamin D-fortified foods: 400 IU vitamin D supplements daily.
Children with iron-deficiency anemia: iron supplements.
Children with eating disorders, obese kids in weight-loss programs and those with certain chronic illnesses including cystic fibrosis, inflammatory bowel disease and liver disease: various vitamin and/or mineral supplements.
Doctors should always be consulted before starting children on vitamins.