Are multivitamins necessary?

Is your child a picky eater, vegetarian or only eats white foods? Then you’ve wondered what their diet is missing.

Children have a natural instinct to eat just the right amount of calories to grow. Unfortunately, they don’t automatically choose a well-balanced diet. It seems natural to try to fill the gaps in a picky toddler’s diet. Although multivitamins provide B vitamins, vitamin C, zinc and many other nutrients, all of these are easily consumed in even the worst kid diets. So multivitamins really are completely unnecessary. However, there are a few supplements kids do need.

If we don’t eat enough of some nutrients our body can actually make them from a combination of other substances. So we don’t have to stress too much about eating a huge variety of foods. However, there are a few “essential” nutrients that we are obligated to eat because our body can’t make them. Some “essential” nutrients are needed in such tiny quantities that you really don’t need to make an effort to eat them. Vitamin C is an example of an essential nutrient, but unless you are on a boat eating only dried meat and grains for months, you can’t help but take in an adequate amount of vitamin C and avoid scurvy. Arggh! But other substances are not so easy to come by.

Several good studies have shown that kids don’t benefit at all from adding multivitamin supplements. These same studies found that children on supplements got too much vitamin A, zinc, copper, selenium and folic acid. The effect of vitamin overload is unknown but is potentially toxic.

How does your child’s nutrition rate?

  • 1/4 of toddlers 12 to 24 months of age consumed no servings of fruit on any given day
  • 1/3 of toddlers and preschool children consumed no vegetables on any given day
  • After 12 months of age, french fries and other fried potatoes were the most common vegetable consumed by toddlers and preschool children
  • 1/3 of preschoolers were still consuming whole milk (too much fat!)
  • 60-80% of toddlers and 85% of preschoolers consumed some type of sweetened beverage, dessert, sweet, or salty snack on any given day

 

However, these studies showed that kids who take multivitamins were still just as deficient in vitamin D as those who don’t take supplements at all. What that means is that kids often need vitamin D supplements, but multivitamins don’t provide a sufficient amount.

Vitamin D

While I haven’t seen a case of scurvy, I have seen rickets – several times! Rickets is a disease of poor bone mineralization, most commonly caused by a lack of vitamin D. Why is this lacking more than any other vitamin? Vitamin D is the only substance we get through exposure to ultraviolet radiation from the sun. We can get vitamin D in foods, but not in adequate amounts. Humans evolved to depend on sunlight to produce vitamin D in our skin. And vitamin D, along with calcium, is needed to build strong bone. In fact, Caucasians probably evolved to have lighter skin to allow vitamin D-producing solar radiation to more easily enter the skin.

Now that we avoid sun and use sunscreens, we all have lower vitamin D levels. New research has shown a critical role for vitamin D in many diseases. This is one vitamin that you do want to make sure your child is getting enough of. The best way is through “sensible sun exposure”, but nobody knows how much that is. I encourage my kids to get outside everyday and let them play for 5-10 minutes before applying sunscreen. You can also provide vitamin D fortified milk or orange juice or consider a vitamin supplement during darker winter months. And all breast-fed infants should be on a vitamin D supplement.

Where did vitamin D come from?

Screen Shot 2015-03-25 at 9.32.15 AMRickets first appeared in the 1600s during the Industrial Revolution in Northern Europe. Closely built buildings and air pollution limited children’s sun exposure and began an epidemic of children with bone deforming disease. Once the association with sun exposure was discovered, scientists discovered that foods exposed to UVB radiation had anti-rickets activity.

Ergosterol, a substance in mushroom cell membranes, is a precursor of vitamin D. A chemical reaction converts ergosterol when it is exposed to ultraviolet radiation. Many mushrooms are irradiated after harvest to increase their vitamin D content. And this is also how vitamin D is created and extracted to make food additives and dietary supplements.

Early scientists added ergosterol to milk and then exposed it to UVB irradiation. Eventually they added vitamin D to milk. The practice became so popular that by the 1930s, vitamin D was added to soda, beer, hot dogs, and even soap and shaving creams. 

Omega-3 Fatty Acids

There is one other nutrient that evolution has made us dependent on and parents should consider supplementing…. omega-3 fatty acids. Humans don’t make omega-3s so they are “essential” nutrients in our diet.

Omega-3s are primarily found in fish and are important for brain growth and development. They are required to build cells and help with communication between our body’s cells. Relatively small portions (the size of a business card) of fish like salmon or albacore tuna provide enough omega-3s for 3 days in a growing child. But children often don’t eat this much. So you can encourage other omega-3 rich foods (or hide them in stuff they like): soybeans, avocado, ground flax seed, walnuts and almonds.

A typical child’s diet generally provides a good balance of most of the nutrients they need for growth. But kids really don’t make the best food choices. So parents need to offer a variety of nutritious foods to ensure they are getting those nutrients we evolved to depend on.

 

Child with food choices

Choosing a well-balanced diet

 

Make your kid a picky eater in 3 easy steps : What mistakes are you making?

TODAY.com Parenting Team Contributor

Author: Wendy Hunter, MD

Associate Clinical Professor of Pediatrics, UC San Diego and pediatrician at Rady Children's Hospital, Department of Emergency Medicine.

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