Episode 6: Do Picky Eaters Need Multivitamins? What Parents Should Know About Kids’ Supplements

Picky eaters don’t automatically need multivitamins—and in this episode of The Lunchbox Reformation, pediatrician and dietitian Dr. Liz Daniels explains how to tell the difference between real nutrient gaps and normal toddler eating patterns. Learn which nutrients actually matter for kids’ growth, what multivitamins typically miss, and how everyday foods can support nutrition without added stress or guilt.

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Transcript

Liz 0:16
Welcome to the Lunchbox Reformation with Dr. Liz. This podcast is for folks who are creating better nutrition for their kids, better tired of the whiplash of nutrition claims and diet culture influence. You're reading labels, paying attention to ingredients, but you still doubt yourself. And for good reason, food goes deep. And often we fear making costly mistakes that as parents we hope to prevent. If you're ready to explore the ins and outs of your child's actual nutrition needs and nourish the whole child from the inside out, hang with me, Dr. Liz Daniels. I'm a board-certified pediatrician plus registered dietitian. And we're going to dig deep into real-deal nutrition science, honest talk about barriers to health, and real stories that I help address. So let's dig in. Hey guys, what's up? Thanks for joining me today on the Lunchbox Reformation. Today we're going to talk about the multivitamin versus the Piggy Eater. I'm going to give you my take on what the best multivitamin is and you might want to stick around to the end because my answer might surprise you. Have you ever found yourself wandering down the grocery aisle and stopping in the multivitamin aisle just thinking, oh yeah, I probably ought to. my kid is such a piggy eater or and all my friends like this one. Maybe I should give it a Well, I've been there I've even fallen for it. And you know what, What if I told you that in the overwhelming majority of toddlers and kids? Yes, even the picky ones. Most multivitamins really aren't worth it. Today, I want to break that down in greater detail on what multivitamins actually have inside them, what they don't and how to confidently peruse the aisle without having second thoughts. as we get into the it's good to feel uncomfortable to most parents. And you know, even for you, if you listen to the whole podcast, it's possible that you could feel resistant to what I have to say and still keep giving your kids multivitamins in the end. And you know what, if you do, I won't judge you. But I want to offer you a strong alternative and I want to empower you to look a little deeper into what is in your and think about some simple ways that maybe you're already doing a great job. know, it's just, it's something that requires, I think, a little bit more explanation than me simply saying to somebody in the office, yeah, I don't think your kid needs it. Well, what's your natural response? You haven't seen my kid eat. You know, and to that end, that's what I want to do today. Today, I'm going to talk through what's commonly in multivitamins, ingredient by ingredient, how much you need, where to get that in how does that and how much is actually in the multivitamins. We're going to compare that also with a sample menu of a real toddler. And I'm going to break that down and show you kind of how much they're actually getting from a nutrition standpoint when we look at it and think that might be just junk, okay? without further ado, let's talk about it. You know, and here's the other thing. If you have a toddler, remember that the first year of life, you knew exactly what they consumed. You actually, you know, through looking back on it probably spent hours figuring out what formula you were going to use if you used any and analyzing all of the different prenatal vitamins that you would be taking even while you're breastfeeding, if that was your choice, and even longer planning what their first solids were. You could have even taken a course on that. I mean, like, there's so much out there now, there's so many more options than there were in the years past. And so, I think that while that's beneficial, I think sometimes it actually,you know, reinforces to parents that they should worry. I heard once a psychologist who I really adore child psychologist say, hmm, I said, you know, okay, you have a toddler who's like suddenly afraid of monsters in the closet and you turn the flashlight on to go show you're just reinforcing that there's actually something to be afraid of. What would it look like if you just well, you want to make a joke? You want to learn a knock-knock joke for the monster? Maybe they'll be your friend. And the kid obviously knows your teasing, right? a similar kind of concept, I think, that marketing companies multi-vitamin companies, well, I do think there can be a role for them. The overwhelming majority is that they're actually not that necessary. And so I think what they do is reinforce parents feeling like they're not doing enough or their kids not doing a good enough job and therefore they have to rescue them. just go down that rapid hole. Because you have a toddler now and you can no longer, analyze every little thing they're doing or eating. You know, you used to be totally in control of their nutrition, and now, you know, you're lucky if you get any at all, you can cut the peanut butter sandwich that they've had 42 times the wrong way, even though it's the same way you always do it, and you're to get a tantrum. The opposition and the moving target of their preferences these days as a toddler is really erratic, and it's And so it feels really stressful as a parent and there's a little, like, sort of warm security blanket when you think of, well, if they don't eat, you know, fill in the blank today, it's fine they're going to get a vitamin. And I'm going to call the loony sandwich on that. Okay. So what do our kids actually need for growth? If you listen to podcast for a while, you already know that they probably are going to benefit from milk. And that they, they need protein, but not too much. Well, what about the micronutrients? The little things, right? Well, they do need calcium. So calcium is important for bone health. As most people understand, it's also really important for electrolytes. And it serves a lot of different rules in enzymatic functions. So anyway, we need about 700 milligrams. 1 cup of milk offers about 300, so once again, here claiming that kids need 2 cups of milk. Okay. In those 2 cups, they're gonna get roughly all their calcium needs. How much does a multivitamin have you asked? Well, most of them have none. Or if they do, little. It's very bulky, and it doesn't really go well in most vitamins, especially if it's a gummy. loses. So calcium, food multivitamin 0. Okay. Let's go to iron. Iron in a toddler, they're gonna need about 7 milligrams. Remember the PB&J, well, that's about 3 milligrams if they eat the thing. A half a cup of beans, and this is pretty close with most beans. Whether you compare it to navy or black or refray or any of those, you're going to see that about 3 more grams of iron in it. of ground beef, 2.5 milligrams. Okay. So in our food, we're we're doing okay. What about our supplements? Well, most of them have none. Unless you specifically look for it. Again, the gummy vitamins? Nada. Okay. Well, so, back to the scoreboard here. 1, multivitamin 0. All right. Let's look at vitamin D. In a toddler, they need about 600 IU. 2 of milk, offers you about 225 IU. 3 ounces of salmon, you say? 500 IU. Outside of that, it's kind of hard to get vitamin D. There are some select foods like sun-dried mushrooms and some other fish sources as well as vitamin D fortified items. But at the end of the day, that one is actually kind of tricky to get. So, a multivitamin, 600 IU. And on this one,

going to go with a And multivitamin? 1. Okay. So multivitamin got a score there. Let's go on to one of the other things that I think kids really need in the toddler years. Omega 3 fatty acids. They need about 0.7 grams or 700 milligrams depending on how you like to think about it. Hemp seeds, chia seeds, flax seeds. Most of those seeds have about 500 milligrams per tablespoon. If you happen to get grass fed beef or grass chicken, grass fed egg, like they egg from free range chickens. They're going to be a little higher in their omegas as well. So, check the box. If you get a multivitamin, none. Most multivitamin don't contain omega 3 fatty acids. If you specifically look for an omega 3, then but you can certainly do, the only downside here is that they're about a dollar a dose. So, they add up especially when you've got multiple kids. So, once again, scoreboard, food, one, multivitamin, zero. Okay. So, so far, not find many great reasons for multivitamin. Well, let's move on to fiber. Okay. I the traditional American diet, especially for toddlers, that's an area we really struggle. The recommendation is to get about 19 grams of fiber. So, according to most studies, right now, some of the more recent studies, about 7 to 11.5 grams of fiber daily is pretty common for most toddlers. That's actually pretty reflective American diets as well. And so, I'm just going to camp out here for a minute that when your toddler's asking for crackers or once the grains and the fruit, those are pretty good. Now, the best source is a fiber that we often overlook are actually going to be in beans or legumes. So, I really love those and highly recommend them. But, you know, in a lot toddlers in general, that's going to be something that actually we sometimes struggle to get enough of. Now, that said, thinking about a multivitamin, there's no fiber in multivitamin. So, spoiler alert. On this one, I'm going to say American diet probably is zero and multivitamin zero. So, in total, I bring it up because I think that we benefit from having a little attention on getting that in our diet rather than some of the other ingredients that are already present. So, overall, the things that we need to have for our kids for growth are overwhelming, not in the multivitamin. So let's think a little bit more about some of the other ingredients that the multivitamin does have. Okay, let's look at that. On the back of the multivitamin, you're typically going to see vitamins A, C, D, K. vitamins plus a lot of B vitamins. And some minerals such as zinc, colline, iodine, pantythinic acid, selenium. They're all going to be present on the multivitamin label. the so while that's really exciting to see, I just want to remind you that in America, at least, fortified grains, right now currently deemed processed grains, are actually fortified with B vitamins, iron, and zinc. So, two slices of bread have pretty much the same amount of the B vitamins that you're going to be looking for in a multivitamin. Pretty impressive. Most others, I know, are getting about two slices of bread a day, if not more. Or they're getting it in the form of other fortified grains, like cereals, crackers, pretzels, tortillas. Any of those processed grains are going to be having that added back in. So, I think that's pretty nice to know that it's in the multivitamin, but it's honestly not something that we really need to be supplementing with, because naturally to others diets are going to have that in them already. So, what about some of the other ones? Let's look at vitamin A. for growth for a toddler, we need about 300 micrograms of vitamin A. And in most foods, you're going to be seeing this in terms of a toddler diet in the dairy sources, because in America, milk has vitamin A fortified into it. So, that's pretty awesome. The other thing you'll see that in is in animal sources. S, cheeses, as well as eggs, and some beef, you'll be able to see, like, a good amount of vitamin A, you'll beta carotene, which is a precursor to vitamin A in your yellow, green, and orange fruits and veggies. And so, get--they usually get plenty. Now, let's look at C and E. Those are going to be found in-- C is going to be found pretty readily in almost all the fruits. Vitamin E actually is much richer in seeds, which sometimes isn't always present in a toddler diet. And so, you know, that said you're going to get plenty in a multivitamin. So, you'll note about vitamin E, as well, in an analysis of toddler diets. It's pretty common to see kids not quite meet that if they're eating a lot of packaged foods. However, vitamin E, like a true vitamin E deficiency, is so incredibly rare, like so, so incredibly rare. I mean, I've personally never seen it. I've got a lot of exposure to--I've been doing this so while. So, you know, I would argue, not missing much here. So, just getting even deeper into some of the minerals, zi, choline, iodine, panathetic acids, linium, actually, those are going to be met again with any of the other foods that we're already talking about in eating.

And, in my opinion, the micronutrients that kids really need and really benefit from are actually often not in the multivitamins. And the things that are in the multivitamins are often in great abundance in the things that they're already eating really well. So, for me, don't offer these to my kids. I never did when they were little. I feel pretty confident that we're doing okay as long as my kids are regularly getting variety in their diet. In our household, my kids do still proudly drink milk, and we do eat fish in our diet. So, those are things that I tend to recommend. And the other heroes here that I just--I reference, but I want to remind you, are beans and seeds. Really, really valuable things to add to your diet. Okay, our eye ductulas. So, I hear you. You think multivitamins are worthless? Yes, got it. Okay, but, like, is there any harm in offering the multivitamins? I mean, what if it just makes me feel better? Like, okay, so fine. And you might be Especially if you don't remember them every day. But, you know what? They're actually can be a little bit of risk in doing that, especially if your kid's diet is actually really diverse. And for this, while it's pretty uncommon to see any toxicities, I would just mention that they actually can overdo it with some multivitamins on board. Interestingly, um, vitamin A can actually be pretty easy to obtain. And so, there is a chance that we'll reach the upper limit. And in the sample menu, I'm going to go over in just a minute. That happened. So, I tend to not recommend them simply because it's actually more than what my kid would need. Okay. The multivitamins would put me in a place where now they're getting more vitamin A than they actually need for growth. Um, additionally, they would also get extra zinc. Is that super problematic? Not really. But one caveat is that zinc interferes with iron absorption. And actually, my kid really does need to absorb the iron in their diet. So, while you're not going to have a problem by having extra zinc once in a while, if it's regularly a part of your diet, it really can interfere with the other nutrients that you need to be able to absorb from your diet that are also, by the way, not in your multivitamins. So, in this situation, it actually is doing you more harm than good. Okay. And then, last but not least, selenium. So, selenium is super... Selenium has a value. But in the tolerate diet, I'm going to go through with you. That diet actually already met the selenium needs. And then we got an extra 20 mica rins from the multivitamins, which actually put us pretty close to the upper limit for that day. So, again, in my take, I would say that in the typical tawther diet that I'm going to offer you, in this kiddo, in this diet for this day, really was getting more harm from the multivitamins than good. All right. So, what was I feeding that kid? And what did I recommend? so, in a sample menu from a from a tawther, I know, they got in the morning a slice of french toast, which was made with whole grain bread an egg. They ate the whole thing. Hooray! They also had about three ounces of Greek yogurt and about a quarter cup of blueberries for breakfast. They were pretty hungry, and breakfast tends to be their best meal. So, that was a good one. For daycare that day, they got a gogo squeeze, yogurt pouch, and a bag of teddy grams for their snack. They ate some of those. Then, later that day for lunch, they were offered meatballs and macaroni and cheese. They ate one meatball and had, in total, about a quarter cup of macaroni and cheese. They also had a snack later that day, where they ate a whole mandarin orange. Then, at night time, they just weren't as hungry, so they ended up having a couple bites of, once again, some mac and cheese, because it had been prepared, a single chicken nugget and two strawberries. To round out the whole day, what had been offered during daycare, and they ate at dinner, totaled about 16 ounces of whole milk. And they really consumed a little under that, so closer to like the 10-ish to 12-ounce mark. That day, that actually offered this kiddo. All their calorie needs, their protein needs were actually double. What they actually needed for growth. And they got plenty of calcium, B12, riboflavin, and the only thing that really came out under the RDA for that kid that day, was you guessed it. What did I already elude to earlier? Fiber. And, a little bit of item in D. So, in this toddler diet, what would have made it a little bit healthier, you wonder? And I would actually go back and say, "Hold grains, beans." The things that I actually suggest, I think they're really, really great and they're often underrated. They can be really helpful, even in the form of your kid really likes crunchy stuff. So, for example, you know, edamame, like the crunchy edamame is really good, and they can be in the form of other bean-based chips or snacks these days. So, there's offering as well. So, I just put it out there. One other thing that I would say, if a family really wanted to do they really could even consider something like a tofu or soy products. Some families like to do that instead of meat, for example, and that can be a nice little way to get a little bit of subtle fiber in there. You just have to be conscientious that you're doing complimentary proteins when you are on a plant-based diet. So, for what it's worth, that's my hot take. Bottom line, I don't think you need the multivitamin. Even if you have a picky eater. I also think that most kids do really, really well even if you just give them the space to get hungry enough to try some different Now, if that's not true for you, it's time to have a conversation. If you still are listening to this and you're like, "Oh, I still think my keep really needs it"

that's okay. Again, I'm not gonna judge you. I just like to you to understand that there actually are sometimes more risk with the multivitamin than the benefit. Okay. Okay Dr. Liz, I hear you. So if you're not going to do a moldy item and do you do anything else? What are your like wins or how do you know what to help your your toddler with when they won't eat anything? And for that, I love to encourage you that time and observation are really, really key because there's probably something that they will eat. And then we can optimize that. there really are kind of three things that I do think that in an American diet, we tend to not get enough of. And that is fiber, vitamin D and omega-3 fatty acids plus or minus iron depending on what else is going on in the diet. So I really really love to encourage, as I already mentioned milk and I kept the milk going in my house when they were young and I encouraged it. And there were seasons where they weren't huge on it. But sometimes we would do things to make the milk taste a little better. Sometimes it was with cereal. And then the cereal sat there and they would drink the milk. Sometimes we made chocolate milk. Sometimes I just made smoothies and they got the milk in there. That's how I was really focusing on their vitamin D. I also really happened to love fish but my kids had to learn how to like it. when they got a little older, they really started to like sushi because my husband loved sushi. And so that was one way that we would get fish in their For the omegas, I found that when my kids were little and even still to this day, I make protein balls pretty regularly in those and if you're curious, I happen have a recipe on my but you know, I'm sure you have one you've already used before or confined one. It's essentially oatmeal, peanut butter, honey, chocolate chips, sometimes coconut and I often like one of my staples that I'm always putting in there is ground flaxseed and hemp seed. And when I make that, my kids love them and I change it up. Sometimes I put sprinkles in, sometimes I So when I want to make sure that my kids are, you know, if I feel like we're not getting enough nutrition or they're lacking or they're eating a bunch of processed foods and I worry about the quality of it, I go to that recipe and I make my protein balls, I think about getting fish in their diet, I think about making sure milk and then for the best for fiber, I like to add beans. We make tacos often and beans are usually regularly our household I don't tend to think that my kids need multivitamins nor do I stop by supplements for them. I just make sure that the foods that I'm offering have enough diversity in them and I can consistently provide diversity with my again, once again my protein balls some fish and my milk and For those of you who out there who are like "oh that's bougie", I just want to remind you that when my kids were little

were a really tough place financially. were on WIC and food stamps. most of the foods that my kids benefited from were like the fish that we would buy was often canned. And back. I still go back and do that now. So I just want to mention that it is intentional and it does come from not modeling. But if you're interested and curious as a parent, then it may be worth trying. would love to hear if there's any recipes like that that have worked well for you and your household. I would love to know what it is that you really like. Maybe it's the summertime and you guys like to plant a little garden and you like to grow some things. Wonderful, amazing. I mean, there's so much out there. There's so many ways to go about diversifying our foods. And I just want to encourage you all to think of one way that you might be able to get one of those ingredients in your diet this week. Whether that's fiber, vitamin D, whether it's omega-3 fatty acids, try it and see. Let me know what you think.

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