Healthy eating and use of dietary supplements in children

Implications

The best way for children to obtain the nutrients they need to be healthy is by eating a balanced diet that features a "rainbow" of fruits and vegetables, an appropriate amount of proteins, fiber and carbohydrates, and a limited amount of processed sugar. A balanced diet optimizes a child's growth and development, while an unhealthy diet can negatively affect short and long-term health outcomes as well as school performance.

The reality for many parents is that it is often difficult to get children to eat a healthy diet. Half of the parents in this Mott Poll reported at least one problem with their child's diet, from picky eating to not getting enough fruits and vegetables. Almost half of parents indicated that it is expensive to provide their child with a healthy diet, which can lead to frustration when children waste or refuse to eat healthy foods.

Dietary supplements are products intended to enhance the quantity of vitamins and minerals consumed through regular diet. Some supplements contain a single vitamin or mineral, while others are multivitamins. Other popular supplements include probiotics which are live bacteria and yeast taken to help digestion by enhancing the quantity of good microbes in the gut, and Omega 3 supplements which are fatty acids that support cell growth and brain development.

A particular challenge for parents is estimating whether their child is getting the recommended amounts of vitamins and minerals through regular diet, or whether their child would benefit from taking a dietary supplement.

In this Mott Poll, roughly half of parents reported their child regularly takes a dietary supplement, and another third have tried giving their child a supplement. However, less than half of parents recalled discussing this important health decision with their child's health care provider. It is unclear if this lack of consultation is the result of providers not asking about the child's nutrition, parents viewing supplement use as not warranting guidance from providers, or some other reason.

Parents considering a dietary supplement for their child are faced with a wide array of products and formulations, many claiming specific health benefits. Parents in this Mott Poll indicated that factors important to their decision were whether the supplements worked well, caused few side effects, and were made for children. Since supplements are classified by the FDA as food, they do not receive the same premarketing evaluation and review as medications; thus there is limited information to assess the safety and efficacy of supplements, or to know the side effects they may cause. It is unclear if parents recognize that supplements do not undergo rigorous FDA testing and approval.

This lack of information makes consultation with a pediatrician or other health care provider particularly important. To minimize the risks of supplement use, parents should share with the provider the concerns that are prompting them to consider giving their child a dietary supplement. Providers can help parents choose appropriate products and ensure accurate dosing of dietary supplements. In addition, providers can work with families to identify other strategies to improve the nutritional quality of their child's diet.

A concerning trend in this Mott Poll is that parents in lower-income households were less likely to talk about supplement use with their child's health care provider, compared to higher-income parents. Providers should be diligent about discussing nutrition with all parents, to ensure parents have adequate knowledge about what a healthy diet should include and are using supplements appropriately. In situations where families cannot afford to provide a healthy diet, providers may direct parents to social service programs that assist in this area.