Making the Case for Vitamin Supplements

By Alan Greene, MD, FAAP

No matter how well intentioned people are about making sure they get the right balance of vitamins and minerals, they face tough obstacles. With breastfed newborns, the scale is tipped in the right direction (except for vitamin D). After infancy we are biologically designed to thrive on a balanced variety of whole foods, such as fruits, veggies, whole grains, beans, nuts, and lean sources of protein and calcium. But natural instincts to eat the right amount of healthful, balanced foods can be tricked by sugar- and fat-laden empty calories that make up a good portion of the American diet.

Even if people learn to choose fresh, sweet corn over processed corn chips, they face another challenge: today’s natural foods do not contain the same level of micronutrients they used to. The typical American consumes too many calories, but the extra calories do not translate to adequate nutrition. We often get suboptimal levels of many key nutrients and phytonutrients that scientists are just beginning to understand.

Missing the mark on vitamins and minerals is especially worrisome for our kids and expectant mothers. As a pediatrician, I worry most about “the Greene 13”: calcium, fiber, folic acid, iron, magnesium, omega-3 fatty acids (especially DHA), phosphorus (except for kids who drink carbonated beverages and get too much phosphorus), potassium, vitamin A, vitamin C, vitamin D, vitamin E, and zinc. These micronutrients can affect children’s growth, behavior, and/or immune systems – and typical American children do not get enough.

Over the years I’ve learned to appreciate vitamins and the role they play in our health, especially the healthy development of our children. I’ve seen firsthand how a mother’s vitamin intake can help a growing infant, even before she conceives. I’ve monitored the decrease in the value of the nutrients that our children digest, even when we think we’re feeding our families all the fruits and vegetables they need to stay healthy.

Take vitamin D, for example – one of the critical Greene 13. A recent study found that children with low levels of vitamin D have a higher chance of respiratory concerns, and related research looked at how vitamin D might help respiratory health. Earlier studies suggest that adequate vitamin D might support many other systems in the body.

Earlier this year the American Academy of Pediatrics doubled the amount of vitamin D they recommended for our kids. But parents are going to have to work a little harder to meet these new levels, as it has become more difficult to get enough vitamin D in recent years. Kids are consuming less vitamin D-rich foods such as tuna and vitamin D-fortified milk (in favor of sweetened drinks with less nutrition). They spend less time outdoors during the middle of the day, and when they do, they need to wear sunscreen. A study released this year showed that forty percent of healthy babies and toddlers were not getting enough vitamin D – and an earlier report said the same about American teens.

Another Greene 13 nutrient that’s tough to get naturally is the omega-3 fatty acid DHA, an important nutrient that studies have shown helps support healthy joint function, cardiovascular health, and helps to enhance mood and support a healthy state of mind.

Although everyone can benefit from taking a balanced multivitamin, women of childbearing age and children have special needs. One of the most critical times for good nutrition may be the trimester before the pregnancy test turns positive. Thus, I recommend a prenatal vitamin for women who may become pregnant. Babies or toddlers can start on liquid vitamin drops when they slow down on breastfeeding or formula. Breastfed babies should get at least 400 IU of vitamin D starting soon after birth. When kids can start chewing pills, I look for palatable supplements that do not mimic candy or contain sweeteners or artificial coloring.

Of course, in the developing world, adding supplements to a diet isn’t as easy as going to the vitamin aisle in a drugstore. More than 30 percent of the world’s population suffers from micronutrient deficiencies. One non-profit organization has dedicated itself to decreasing the problems caused by malnutrition by providing supplements to children and expecting mothers in developing countries and communities in need. Vitamin Angels (www.vitaminangels.org) is focusing on distributing vitamin A to at-risk children. The program is privately funded with donations from vitamin manufacturers, companies and individual donations. I give to Vitamin Angels each year because this charity does so much with every dollar that I give. I've travelled with Vitamin Angels to the Dominican Republic to see the program at work. I've never seen such a big improvement in people's lives achieved so inexpensively and so quickly.

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