Are kids just the lat­est tar­get in the lu­cra­tive vi­ta­min mar­ket­place, or is there a gen­uine need for sup­ple­ments for them?

Singapore Women's Weekly (Singapore) - - STYLE SETTER -

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

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

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