Are kids just the latest target in the lucrative vitamin marketplace, or is there a genuine need for supplements for them?
Doctors dish on whether supplements for kids are a good idea
Doctors are often asked if children need dietary supplements. The answer is that some children need supplements in certain circumstances. “Generally speaking, healthy children do not need dietary supplements if they are taking a wide range of food items every day,” says Professor Quak Seng Hock, Head & Senior Consultant of Paediatric Gastroenterology, Nutrition and Hepatology at National University Hospital.
“These should include adequate intake of good quality protein, unrefined carbohydrates and an adequate supply of long chain polyunsaturated fats, fresh vegetables and fruits. Kids with a limited intake of these nutrients, such as picky eaters or those who have a restricted intake in certain food groups, dietary supplement would be necessary. For example, vitamin B12 and iron are recommended among children who are strict vegetarians.”
As a parent, it is important to know what supplements to give your child, in which combinations and when, says Professor Kerryn Phelps, who is also a GP. “Supplements will never replace a healthy, balanced diet of fresh whole foods in a child with no problems with their digestion. That presumes that children are eating healthy diets with all the essential nutrients they need and they are able to digest and absorb those nutrients. Of course, that is not always the case.”
There are many medical conditions where specific dietary supplements are recommended, and should be guided by patients’ doctors, adds Prof Quak. “Some children do have problems with digestion because of diseases of their gut. Others have food allergies or intolerances (such as gluten or lactose) and their diets may need to exclude a lot of nutrients,” says Prof Phelps. “Children with chronic medical conditions will have higher nutrient needs than their diets can
provide. Some pharmaceuticals will reduce the absorption of essential nutrients.”
Prof Quak says that the most important consideration is that the supplement should not cause harm. “An overdose of fat-soluble vitamins can be harmful to the body. When a child is not consuming a certain food item, it is always better to consider alternative food sources, rather than use supplements. To give an example, a child with lactose intolerance would not be taking milk, and thus he may have inadequate calcium intake. Instead of rushing to give him a calcium supplement, do consider letting the child consume other calcium-rich source foods, including low-lactose milk.”
Many parents give their children food supplements, which may not be necessary. “It’s more important to inculcate the correct eating habits when they are young: Avoiding processed foods as far as possible, having an adequate intake of fruits and fibre daily, and eating a wide variety of foods daily,” says Prof Quak.
“Natural foods have different colours, and it is advisable to consume as many coloured foods as possible every day, and not be confined to eating green and white foods alone. Kids should eat foods in a rainbow of colours if possible.”
Children on a vegetarian diet are at risk of a number of deficiencies, particularly protein, vitamins B12 and D, iron and zinc. Thus, parents need to be very well informed about the nutritional content of foods.
The decision about whether a supplement will benefit a child is not just about making up for a presumed dietary deficiency.
Supplements are also prescribed in the same way as pharmaceutical medicine for the treatment of specific conditions, such as attention deficit hypersensitivity disorder, where supplements may be used in preference to consuming medication.
COMMON SUPPLEMENTS Multivitamin
If your child refuses many different types of food, if their diet consists of a lot of fast food, if they have had recurrent illnesses or take medications, or they are at risk of multiple nutritional deficiencies (for example, vegans), then they may benefit from taking a multivitamin supplement.
Fish Oil (Omega-3)
Omega-3 essential fatty acids are mostly found in seafood. They are essential “healthy fats”, particularly for your child’s brain development. Some children refuse to eat fish or other sources of Omega-3, such as flaxseed oil.
Vitamin D is essential for the development of bones and teeth, and all the sun-safe messages to parents over the years have worsened this deficiency. Vitamin D deficiency is particularly a problem in children who are breast-fed for a longer period of time. Children with dark complexions will also be at higher risk.
Iron deficiency is remarkably common in children and adolescents. Signs include tiredness, behavioural problems, repeated infections, loss of appetite and slow growth. It may be a sign of undiagnosed coeliac disease. Please do not assume that your child has iron deficiency if he or she appears pale and tired. Include a food source of iron and supplement only with medical advice. A blood test is needed to confirm iron deficiency before supplementing a child’s diet.
Probiotics (acidophilus, bifidobacteria) should be given whenever a child is prescribed an antibiotic. They are also useful in helping gut recovery after a bout of diarrhoea.
A word of caution about “gummy” vitamins and chocolate-coated supplements. They can easily be mistaken for sweets and while most contain relatively low doses of vitamins and minerals, it would be easy to overdose if your child eats more than the recommended dose. Fat-soluble vitamins (A,D, E and K) and iron are particular concerns because they can be toxic in excess.
Supplements will never replace a healthy, balanced diet of fresh whole foods. – Prof Kerryn Phelps