by Heidi Green
February 08, 2009

Just a couple of weeks after the American Academy of Pediatrics (AAP) doubled the recommended amount of daily vitamin D supplementation for all infants, children and adolescents, results from a new study suggest that the recommendation may not matter. According to Dr. Ulfat Shaikh and colleagues, the youth who receive vitamin and mineral supplements may not need them, and those who do need them are least likely to receive them.

Research
Dr. Shaikh and his colleagues looked at data from 1999-2004 National Health and Nutrition Examination Survey (NHANES). This U.S. survey includes a questionnaire, a household interview, and a medical examination. The study population included 10,828 children and adolescents between the ages of 2 and 17 years.

In this analysis, researchers used the data to test several hypotheses about vitamin and mineral use. They expected to find more vitamin and mineral use among children with unhealthy nutrition habits, lower food security (assured access to food), lower levels of physical activity, less access to health care, and underweight bodies. In sum, they thought that children with the most barriers to healthy nutrition would fill the gap with vitamin and mineral supplements. In reality, this was not the case.

Results
Here’s what the researchers found:

• Many youths use supplements. Over one-third (34.2 percent) reported taking a supplement in the previous 30 days.

• Those who use supplements tend to engage in other healthy behaviors as well. Supplement use is more likely among youth who eat healthy and exercise. In large part, it seems to be a habitual part of an overall approach to health.

• Youth who are at highest risk of nutritional deficiencies use supplements the least. Those with less healthy nutrition, lower food security, poorer health and less access to health care use supplements the least. Why? The researchers don’t know, but suggest that it could be lack of perceived ability to afford the supplements. It could also be due to a lack of confidence in the health benefits that could be expected.

Just because the youth who take supplements seem to be the healthiest does not mean they should forgo their daily vitamin. The study design makes it impossible to prove causality, more importantly, the study did not look at the health impact of a vitamin-mineral supplement.

How can the researchers conclude that “almost half” took supplements “daily” while also stating that just over one-third of youth had taken a supplement in the month preceding the survey? I can’t think of how anyone who hadn’t taken a vitamin-mineral in the past 30 days could be classified as a “daily” user.

In addition, it appears that the researchers did not use available data on actual dietary intake in their assessment of vitamin-mineral need. Since their study is based on the assumption that vitamin-mineral supplements might “fill the gap,” it seems that it would have been helpful to look at data pertaining to those gaps.

Recommendations
Parents, here’s what we know: A balanced diet is important. If there are gaps in your child’s overall nutrition, a vitamin-mineral supplement could help to fill those gaps. (Full disclosure: As the mother of, now, three picky eaters, I do give my own children vitamin-mineral supplements.) If you decide to go this route, choose carefully. (A new report by ConsumerLab found that supplements’ contents vary widely from what is declared on their labels and recommended sticking with well-known name brands.)

It’s a good idea to discuss supplement use with your child’s health care provider. Recent research suggests that vitamin D is much more important to overall health than was previously thought. Yet, it’s still as difficult as ever for largely-indoors, sunblock-wearing children to get enough. Which explains why the AAP recently doubled (to 400 IU per day) the amount of recommended vitamin D supplement.  This is definitely one vitamin you’ll want to give close scrutiny to when considering supplements for your children.