How Vital are Multivitamins?

Despite the nutritional demands of childhood, kids are typically not the epitome of healthy eating. Given the dwindling health of our fast food nation and the critical role that vitamins and minerals play in a developing child, what part should multivitamins play in a child’s diet?

By Jenni Frankenberg Veal

Our bodies require vitamins and minerals to function and grow. When it comes to growing kids, a few stand out as particularly critical:

• Vitamin A promotes growth and development; tissue and bone repair; and healthy skin, eyes and immune responses. Sources: milk, cheese, eggs, and yellow-to-orange vegetables like carrots, yams and squash

• B Vitamins (B2, B3, B6 and B12) aid metabolism, energy production and healthy circulatory and nervous systems. Sources: meat, chicken, fish, nuts, eggs, milk, cheese, beans and soybeans

• Vitamin C promotes healthy muscles, connective tissue and skin. Sources: citrus fruit, strawberries, kiwi, tomatoes and green vegetables

• Vitamin D promotes bone and tooth formation and helps the body absorb calcium. Sources: milk, cheese, yogurt (especially fortified dairy products), egg yolks and fish oil

• Calcium helps build strong bones. Sources: milk, cheese, yogurt, tofu and calcium-fortified orange juice

• Iron builds muscle and is essential to healthy red blood cells. Sources: beef and other red meats, turkey, pork, spinach, beans, prunes and raisins

According to the American Academy of Pediatrics (AAP), healthy children who eat a well-balanced diet should not require vitamin supplementation over and above the recommended dietary allowances.

“With a healthy and well-balanced diet, most children should get the essential vitamins and minerals their bodies need for normal growth and development, metabolism, immunity, and cognitive function,” says Dr. Elaine Hatch, a pediatrician with Signal Mountain Pediatrics, a division of Beacon Health Alliance. “Vitamins are needed when a child isn’t eating well or if a child has a specific need.”

The Hard Facts

In today’s fast-paced world, a healthy and well-balanced meal can be hard to come by.

According to the 2010 Dietary Guidelines for Americans, the majority of U.S. children and adolescents consume more calories per day than they expend in physical activity or need for metabolism and growth – and the calories they do consume are often not worth their weight in nutrition.

In fact, according to the guidelines, nearly 40 percent of total calories consumed by 2 to 18 year-olds in the U.S. are in the form of empty calories, primarily from six specific foods and beverages: soda, fruit drinks, dairy desserts, grain desserts, pizza and whole milk.

To add insult to injury, the report finds that kids today do not consume the daily recommended servings of fruits and vegetables or the recommended variety.

“The bottom line is that we have to learn to stay out of fast food restaurants or choose restaurants that offer choices such as salads, fruit cups and milk,” says Dr. Hatch. “Nothing beats the nutrition provided by healthy food. Parents need to teach kids at an early age to eat a variety of foods – and then expect them to eat it.”

Healthy Choices

Armed with a little determination and information, a healthy diet isn’t as difficult to achieve as it might seem, and it is never too late to start on a new path to health.

First of all, it doesn’t take much of any one food to provide the vitamins and minerals a child needs each day. A good reference is the USDA’s Food Guide Pyramid, which can be found at www.mypyramid.gov. The pyramid outlines the types and amounts of food children and adults should have each day as part of a healthy diet. It is divided into six food groups: grains, vegetables, fruits, milk, meat and beans, and oil. The amounts and portion servings are based on age.

Also, it is important to remember that vitamins can come from a variety of sources. For instance, if a child cannot or will not drink milk, calcium is also found in salmon, baked beans, tofu, spinach and almonds.

Comedian Jerry Seinfeld’s wife Jessica took another approach to healthful eating with her bestselling cookbook Deceptively Delicious. Her family-friendly recipes contain hidden vegetables so kids don’t even know that they are eating them!

There is no need to panic if a child doesn’t eat the same amount every day or doesn’t eat exactly according to the food pyramid – every child is different. However, any concerns or issues should be addressed with a pediatrician.

In the end, the best approach to teaching children good eating habits is for parents to model good eating habits themselves.

Deficiencies Defined

Although severe nutritional deficiencies are not common in the United States, pediatricians do recognize some problems.

Recent studies show that most American children are not getting enough vitamin D, which is important for bone growth and many other facets of health. Researchers at the Centers for Disease Control found that as few as one in five formula-fed babies and one in 20 breastfed babies are getting as much vitamin D in their diets as recommended. The American Academy of Pediatrics recently doubled the amount of vitamin D it recommends for babies and children to 400 International Units (IU) per day.

“Breastfed and partially breastfed infants should be supplemented with vitamin D beginning in the first few days of life,” says Dr. Jon Boroughs, a pediatrician with Galen North Pediatrics. “And vitamin D should be supplemented if an infant is consuming less than 32 ounces a day of vitamin D-fortified formula or milk.”

Additionally, as a child grows, so does the need for iron. Children absorb only 10 percent of the iron they eat. If a child doesn’t eat iron-rich foods, an iron supplement may be recommended. Interestingly, iron is absorbed three times better when it is in breast milk, so breastfed infants may not need a supplement.

Iron deficiency can be caused by an iron-poor diet, a child’s body not being able to absorb iron well, long-term blood loss, or rapid growth (in the first year of life and in adolescence).

According to Dr. Boroughs, it’s a good idea to consult a pediatrician if there are concerns about whether a child is getting the recommended level of vitamins and minerals. A multivitamin might be appropriate if a child:

• Has an eating disorder

• Has been diagnosed with failure to thrive

• Doesn’t eat regular or well-balanced meals

• Has a chronic disease or food allergies

• Has a restrictive diet, such as a vegetarian or vegan diet

Vitamins and minerals are critical building blocks in a child’s growth; however, multivitamins should not replace proper nutrition. The best way to build on a lifetime of health is by teaching your child to make healthy food choices.

Visit www.mypyramid.gov to learn more about the USDA Food Pyramid Guide and healthy food choices.

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