Vitamin Supplements Unnecessary for Most Healthy Children

Children and teens go through many physical changes, during which time their bodies need a variety of vitamins and minerals in order to stay healthy and grow properly. Most healthy, active kids get all the nutrients they need by eating a varied diet including whole grains, fresh fruits and vegetables, dairy products, lean meats, fish and poultry, but it’s very common for parents to also give them vitamin and mineral supplements “just to make sure.” This practice is not only medically unnecessary, but may cause problems in children if they do not need them.

In order to find out which children in the United States were taking vitamins or mineral supplements on a regular basis, researchers at University of California Davis analyzed data from 10,828 children between 2 and 17 years old who took part in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. The researchers also looked at other factors, including how much exercise the children got, the types of food they ate and whether or not they were covered by health insurance. “We were curious about why certain parents may choose to use over-the-counter multivitamin supplements for children, and some might not,” said study author Dr. Ulfat Shaikh, an assistant professor of pediatrics at the University of California Davis School of Medicine and pediatrician at UC Davis Children’s Hospital. “We hypothesized that supplements might be used to reduce adverse effects if parents thought their child wasn’t eating right or were wondering where their next meal was coming from.”

Approximately 34 percent of the children and teens had taken a vitamin and/or mineral supplement in the previous month, with underweight children having greater intakes. But surprisingly, these supplements were more likely to be used by children and adolescents who needed them least, such as those with better nutrition, more active lifestyles, greater food security and greater access to health care. Among children who were in excellent health, 37 percent took vitamin supplements, compared to about 28 percent of children in less privileged situations.

“One of the things that we thought was responsible for this was the possibility that income and parental education status might override other factors,” Shaikh said. Indeed, the data showed that among households not considered poor, 43 percent of the children used vitamins, while only 22 percent of children living in households considered below the poverty level used them. Among households not enrolled in the federal Food Stamp Program, 38 percent of children used vitamins, but in households using food stamps, vitamin use was around 18 percent. And children in 36 percent of households where there was no hunger used vitamins, compared to only 15 percent in households where there was “food insecurity and hunger.” Supplements may not seem expensive to a middle-class family, but the cost may be onerous for a low-income family, she said. “Parents who were poor were perhaps unable to afford supplements.”
 
Shaikh said the next step will be to find out why parents chose to give their children vitamins in cases where a medical reason for vitamin and mineral supplement use may not be present. “Multivitamin preparations for older children and adolescents are not regulated by the Food and Drug Administration and may result in adverse effects,” the authors write. In addition, 2- to 4-year-old children may associate taking vitamins with eating candy, making overdose more likely, Shaikh said. Taken in large doses, vitamin and mineral supplements can cause adverse effects including nausea, vomiting, abdominal pain, liver abnormalities and nerve problems.

The researchers recommend that health care providers screen children and make recommendations about whether or not vitamins are needed on an individual basis. The American Academy of Pediatrics (AAP) does not recommend vitamin use in healthy children over 1 year old. Supplemental vitamins are recommended for certain groups of children, including those with chronic diseases, eating disorders, liver disease, problems absorbing nutrients or obese children in weight-loss programs.

The study was published in the February issue of the Archives of Pediatric and Adolescent Medicine.