There are tons of children’s vitamins and supplements these days. But does your kid really need them?
Angela Sayers remembers sneaking down to the basement with her brother when they were kids and eating handfuls of yummy Flintstone’s vitamins. If their mom had known about this, she would have freaked.
“I ate jars of them as a kid. I loved them,” Sayers recalls. Now a mom herself, she gives her seven-year-old daughter, Zoe, supplements, including vitamin D3 to boost her immune system, omega-3s for brain development and a probiotic to aid digestion. And she is extra careful to keep the tasty liquids out of Zoe’s reach.
“I look at vitamins as an insurance policy to round out what we’re doing in our diet,” says Sayers, a holistic nutritionist in Calgary. “We eat a healthy diet and the supplements are a backup. Zoe has never had anything more than a cold, knock on wood.”
So many parents today give their children something — whether a Dora-the-Explorer-shaped multivitamin or a gummy calcium supplement, it’s hard to know which came first: parental demand for kids’ pills, or vitamin manufacturers pushing everything from chewable fibre supplements to vitamin D drops. It’s also difficult for moms and dads to decide which, if any, vitamins and supplements their kids actually need. Should children be gobbling down a daily gummy cocktail?
Based on the findings of the 2004 Canadian Community Health Survey, a new Health Canada report, published in 2012, found that the diets of Canadian children do contain adequate amounts of most vitamins and minerals, with the notable exception of vitamin D and calcium. The report also found that nearly one-quarter of kids ages four to eight had inadequate intakes of calcium, while more than one-third of boys ages nine to 18 and more than two-thirds of girls of the same age weren’t getting enough of the bone-building mineral. Additionally, the report expressed concern that children might not be meeting their needs for fibre, and that toddlers weren’t getting enough fat in their diets.
While most paediatricians agree that a parent’s first line of defence should be diet, they acknowledge that our busy schedules make it hard for us to get healthy meals — instead of processed snacks and energy drinks — into our kids. At the same time, health research has taken off, and doctors and the general public have learned a lot more about the importance of nutrients.
“If you eat healthy foods like fish, fruit and vegetables, you don’t need a supplement, except for vitamin D,” says Peter Nieman, a paediatrician in Calgary and the founder of healthykids.ca.
Still, only 10 percent of his patients are eating in what he terms the “ideal world” of 10 servings of fruit and vegetables a day, two to four cups of milk or other dairy, and two servings of fish a week. He says 30 percent are trying to eat better diets, but the reality is, “they cannot sustain it. They’re tired, they travel or they’re sick of wars with picky eaters. They fall back on what I call a ‘security blanket.’ The default setting for a lot of people, more than 50 percent, is a multivitamin,” says Nieman. “You can do better than a multivitamin.”
Registered dietitian Jackie McKenzie agrees. Multivitamins contain low doses of vitamins A, B, C, D and E, as well as some minerals, but most children are meeting those requirements (except for D) through diet. The Barrie, Ont., nutrition consultant, who has worked with Life Science Nutritionals (the company that makes the IronKids line of supplements for children), says parents need to look at what many children aren’t getting enough of — vitamin D, calcium, omega-3s and fibre. They should then appraise the family’s weekly meal plan and decide which of those their kids might be lacking.
“Take a good look at your child’s diet and see a health professional if you are concerned,” says McKenzie. “Even most vitamin companies would say, ‘We want you to eat good food… and the vitamins would supplement that if necessary.’’
Touted as a preventative miracle vitamin for everything from cancer and diabetes to heart disease and multiple sclerosis, vitamin D is made naturally by the body through sun exposure. The problem in Canada is that we live so far north that we don’t get enough sun for eight months of the year, and in the summer, we cover our children in sunscreen. “Because of this sun phobia, people overdo it and kids don’t get their vitamin D,” says Nieman.
Dana Landry, from Alymer, Que., is aware of this problem. She gives her one-year-old son, Sigmond, vitamin D through a multivitamin, and her four-year-old daughter, Guya, takes a vitamin D supplement on top of her multivitamin because it contains a low dose. They both take a probiotic and fluoride, since their town’s water doesn’t contain any. “My father died of cancer, so I want to make sure that if there’s anything I can give my kids to safeguard against it, I do,” says Landry, whose family doctor put her on to the benefits of extra vitamin D when she lived in the Yukon.
Many foods are fortified with vitamin D, such as milk, orange juice and soy products, but unless you are super consistent, these foods aren’t enough on their own. Nieman says just 10 to 20 minutes of unfiltered sunshine is all kids need to make enough vitamin D between June and September. In the winter, all Canadians need a supplement.
Nieman’s daily recommendations: Kids ages zero to one need 400 International Units (IU) a day; ages two to 12 need 800 IU a day; and teens need 1,000 IU a day. Example: 75 g of canned pink salmon = 435 IU
Children begin life with a calcium-rich, milk-only diet, but as they get bigger, their original drink of choice can get bumped by juice, soda or energy drinks. “It’s a concern in terms of kids’ health and bone status,” says McKenzie. “You want to maximize their bone building and they need calcium and vitamin D for that.”
Parents should serve more milk, yogurt and cheese. If you have a daughter between the ages of 10 to 13, know that these are the critical years for calcium intake, which could determine whether she develops osteoporosis later in life, says Nieman. “If a child avoids all dairy products for what- ever reason — intolerance or allergies — if she’s not getting enough dairy, then a supplement is important,” he says. Both of Sarah McIntosh’s daughters are lactose intolerant, and the Oakland, Ont., mother of two worries about their calcium intake. “I rely on a multivitamin and foods forti- fied with calcium,” she says. Two-year-old Erica drinks enriched rice milk, while Julia, four, drinks calcium-fortified almond milk. Both girls also like broccoli, which contains 178 milligrams of calcium per cup.
Nieman’s daily recommendations: Kids ages one to three need 700 mg a day; ages four to eight need 1,000 mg a day; and children ages nine to 18 need 1,300 mg a day. Example: 2 cups of milk = 600mg
Omega-3 fatty acids
Touted as brain boosters, omega-3 fatty acids are found in fish oils, fortified eggs, dairy products, canola oil, flaxseed and walnuts.
“I think omega-3s are super important for kids,” says Sayers, who gives Zoe a daily supplement in addition to cooking salmon at least once a week. “It’s hard to get enough omega-3s from diet alone.”
Nieman agrees. “If you don’t eat two servings of fish a week, you’re not getting as many omega-3s as you should.”
Nieman’s daily recommendations: Kids up to one year need 0.5 g (grams) a day; ages one to three need 0.7 g a day; and kids ages four to eight need 0.9 g a day. Boys ages nine to 13 should eat 1.2 g a day, while girls in this age group need at least 1 g a day. Example: 1 cup of kidney beans = 0.3 g
“As much as 50 percent of children don’t receive enough fibre,” says McKenzie. Fruit and vegetables are the best sources of dietary fibre, but many kids aren’t eating enough fresh produce, says Nieman. “Much of the grab-and-go food today is refined, and processed food takes the fibre out,” he says. “Or, I see picky eaters who don’t eat their fruit and vegetables, and we see a lot of constipation as a result.” Still, Nieman doesn’t recommend a fibre supplement unless a child is extremely constipated. “Have them drink more water and eat more fruit and high-fibre cereals first.”
Nieman’s daily recommendations: Kids ages one to three need 19 g a day; ages four to eight need 25 g a day, girls ages nine to 18 should eat 26 g a day, while boys nine to 13 need 31 g a day and boys 14 to 18 need 38 g a day. Example: 1 cup of blueberries = 4 g
A version of this article appeared in our January 2013 issue with the headline “A vitamin a day?,” p. 30.