Tiny Tummies: The Supplement Debate

While reading my scientific journals, I came across some interesting findings published in the MMWR by physician Bryan Stierman and colleagues at Boston Children’s Hospital who used data from the National Health and Nutrition Examination Survey for patients aged 19 years and younger. Their review of the data found that approximately 1/3 of children and teens are taking dietary supplements. The study sample was quite large, with 3,683 participants. So it gives us a good idea that what they found is quite typical. And in that sample the researchers noticed that 34% of the participants had taken supplements in the past 30 days with girls using supplements slightly more than boys. 

And whey they compared their results with the results of previous studies, it appears that dietary supplements may help to mitigate, or lessen, nutrient shortfalls from a unbalanced diet but may also lead to nutrient intake above recommended upper limits for some nutrients. So this tells us that supplements can be a good thing in certain situations but need to be used with caution. A review of literature by pharmacist Edward A. Bell notes that data supporting the use if supplements in otherwise healthy individuals is weak. 

So, based on this data, the question that jumps to mind is: Are nutritional supplements safe for kids? 

Transcript

Hello and welcome to another episode of Proactive Parenting. Remember, this is a judgement-free space to learn how to raise value-driven kids in a way that is right for your family, using the most current scientific research out there. 

I’m your host, Dr. Deanna Marie Mason. I’m a certified pediatric nurse practitioner, published author, and a professional who has devoted my career to studying and using child development to help parents manage childhood issues. 

So, grab a cup of coffee or tea and settle in to learn something new about your child because when we know better, we do better. 

While reading my scientific journals, I came across some interesting findings published in the MMWR by physician Bryan Stierman and colleagues at Boston Children’s Hospital who used data from the National Health and Nutrition Examination Survey for patients aged 19 years and younger. Their review of the data found that approximately 1/3 of children and teens are taking dietary supplements. The study sample was quite large, with 3,683 participants. So it gives us a good idea that what they found is quite typical. And in that sample the researchers noticed that 34% of the participants had taken supplements in the past 30 days with girls using supplements slightly more than boys. 

And whey they compared their results with the results of previous studies, it appears that dietary supplements may help to mitigate, or lessen, nutrient shortfalls from a unbalanced diet but may also lead to nutrient intake above recommended upper limits for some nutrients. So this tells us that supplements can be a good thing in certain situations but need to be used with caution. A review of literature by pharmacist Edward A. Bell notes that data supporting the use if supplements in otherwise healthy individuals is weak. 

If this is the case, it’s a good idea to understand which age groups are using supplements the most. The data shows that 43% of young children, ages two to five, were most likely to take supplements. Followed closely by 38% of children ages 6-11 taking supplements. Nearly 30% of 12-19 year olds also take supplements. And findings showed that 22% of children younger than 2 years also take supplements regularly. When we compare this current data to data from 10 years ago, we see a significant increase in usage, but not only in the number of children taking supplements but also how many supplements are being taken. According to the data collected, the most common supplements being taken are multivitamin-mineral and single ingredient vitamins, like vitamin D. The next most common supplements were probiotics, melatonin, omega-3 and botanicals, such as echinacea. 

So, based on this data, the question that jumps to mind is: Are nutritional supplements safe for kids? 

The truth is that sales of nutritional supplements continue to rise and many families include nutritional supplements in their dietary routines. However, there is a clear lack of quality research regarding the recommended dosages and the toxicity levels of nutritional supplementation for children in the scientific literature. So it can be hard to know if nutritional supplements are safe for kids? 

When speaking with parents, the most common reason parents report giving their children nutritional supplements or vitamins is to make up for poor eating habits. However, when kiddos have poor eating habits and are resistant to eating a balanced diet that includes a variety of fruits, vegetables, whole grains, and lean protein sources, it is still the gold-standard recommendation that parents reinforce a healthy, balanced diet before adding nutritional supplements. 

It’s good to say that when we say a “balanced diet,” what we mean is an overall diet that contains quality protein sources, healthy fats, and complex carbohydrates. These are frequently referred to as “macros” in popular culture. Within those protein sources, fats and carbohydrates, it’s also important that kiddos get those from a variety of sources so assure they are getting all the vitamins and minerales that are essential for healthy growth and development. The vitamins and minerals are often referred to as “micro” nutrients. So, in a nutshell, a balance diets will give children all the macro and micro nutrients needed for optimal growth and development. That is the reason a balanced diet is so important during childhood and adolescence. 

Often, nutritional supplements don’t include the full range of nutrients necessary for complete nutrition. And, as I said before, there are no well-researched levels stipulated for children. Which means that some nutritional supplements may be missing some important nutrients while providing too much of others. 

Another concerning issue with nutritional supplements is that they are not manufactured and regulated under the same strict conditions as medications. Especially in countries like the United States, supplements are treated similarly to food which means companies that manufacture nutritional supplements are at their own discretion in choosing the ingredients, testing the levels of active ingredients they include in their products, how they label their products, and are responsible for ensuring quality. This lack of oversight can lead to the product having less of the active ingredient than the label states, or a completely different ingredient than what should be in the labeled product, a dirty product, mislabeled bottles, and a myriad of other issues. Making sure products are purchased from honest manufacturing facilities is vital for product safety and purity. 

And the last complication of supplements, especially for children’s supplements, is the packaging. Many products do not have child-resistant safety mechanisms on their bottles to prevent children getting into the bottles on their own which may lead to accidental ingestion and toxicity. The packaging for children’s nutritional supplements often have bright colors, are made in candy form, such as animal shaped gummies, and have colorful drawings on the packaging. They can look a lot like candy which means it can be enticing to our little ones to want to eat the supplements outside of parental supervision. Without a child-resistant cap, kiddos can get into the bottle and ingest or eat a toxic amount. So keeping supplements well out of the reach of children and assuring they cannot access the contents independently is very important for their safety. 

It’s understandable that parents who feel that their children have poor dietary habits would consider using supplements to improve their little one’s diet. But all the major pediatric health organizations recommend going back to the basics and focusing on a balanced diet before introducing supplements. 

Providing a wide variety of food choices throughout the week, encouraging family meal times to model good dietary habits, limit snacking between meals to support a good appetite at meal time, and allowing your child to choose how much they eat while you, as the parent, chooses what is served and when food is offered is the key to getting a picky eater to be more open to trying new foods and beginning their journey to enjoying a balanced diet. The truth is, the consequences of poor eating habits goes beyond just nutrition and can have an impact on many areas of your child’s life. 

If you want to learn how to introduce a healthy relationship with food and a balanced diet, take a look at my audiocourse, The Proven Method for Getting Your Kid to Sleep, Eat & Play Happily. This course is also available as an e-book and print book. You can find out where to purchase this resource on my webpage: proactiveparenting.com. Or, you may be interested in listening to my other podcasts on this topic including Mealtime Magic - Secrets to Feeding Your Little Ones or Food Trends Unwrapped-A Parent’s Guide to Smart Choices. 

If you feel that supplements are needed or preferred, that’s okay too. Seeking the assistance of a clinical nutritionist is recommended when providing supplements to children to assure they are getting enough of what they need and avoiding too much of what they don’t. And, when it comes time to purchase supplements, there are a few reputable websites to help families know which manufactures have good practices. Two frequently cited resources are: 

consumerlab.com

naturalmedicines.therapeuticresearch.com

As previously shared, eating a balanced diet full of whole foods is the best option for children to get complete nutrition. However every family is different and some families feel strongly about nutritional supplements. If that is the case for your family, it’s a great idea to seek assistance from trained licensed professionals, to remember to keep supplements out of the reach of children and purchase high quality supplements to help reduce the risks and maximize the benefits of these items. 

Nutrition can be a sensitive topic for some families and today’s topic was meant to be informative so parents have more information to make choices that are right for their family because when we know more, we can start to consider other things we may have not thought about before. 

Obviously, this topic can been delved into much deeper, but I’ll stop here for today. Too much information can be as confusing as too little. That said, if you want to know more about this topic please don’t hesitate to reach out and let me know at deanna@proactiveparenting.com. And if you want to find out more about who I am and what I do, please take a look at my webpage, proactiveparenting.com. 

You can also go to Facebook and Instagram to connect with other parents just like you. Find me by searching for my name - Deanna Marie Mason. Finally, if you would like to purchase any of my books on how to understand and connect with your adolescent, online courses to make the first days of parenthood easier, such as Newborn Care or Breastfeeding Bootcamp, or audio courses on sleep, eating, play, autonomy, or toilet training you can find all those resources on my webpage, again that is proactiveparenting.com 

Thanks so much for taking time out of your day to listen. I hope you found this episode useful and interesting. If you did, please leave a comment and tell a friend so they can become a Proactive Parent too! 

Well, that’s all from me for right now. This is Dr. Deanna Marie Mason signing off. I look forward to connecting with you again soon. Until then, take care and be well. Bye!