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Vitamins for children A balanced diet may be better for them

THE BALTIMORE EVENING SUN

THE COMPETITION WAS TOUGH. Fred Flintstone vs. Bugs Bunny. Circus shapes vs. smiling fruit. My 8-year-old daughter, Lia, carefully weighed her selection.

"I'll take these," she finally announced, picking the package decorated with grinning oranges. I asked her why. "Because I like fruit," she replied, "and these are great-tasting. No kid wants a yucky-tasting vitamin." Indeed, the words "great-tasting" blared from the box.

The experience reminded me of nothing so much as watching my daughter choose a treat from the candy rack -- except that Lia had made her first foray past the drugstore candy counter and into the realm of "drugs."

I had taken Lia to the drugstore because, like millions of other parents, I'm never quite certain whether she and her brother get all the nutrients they need. Is pizza really a balanced meal, as they contend? Do corn chips and salsa, ice cream bars and pepperoni truly represent the four basic food groups? Should I worry about riboflavin, especially since I can never remember exactly what it is?

Children's vitamin makers appeal to such parental concerns. "Vitamin Insurance for Your Children -- Reassurance for You," reads the blurb on one brand of children's chewables. It does sound reassuring and parents have been buying into this "insurance" since 1960, when Miles Inc., introduced Chocks, the first children's vitamin.

Current estimates put children's vitamin sales at $200 million annually, a healthy chunk of the $1 billion-plus U.S. vitamin industry.

Parents can start their babies out on vitamin drops, often fortified with iron. Children aged 2 and up can graduate to cartoon character-shaped chewables. Colored in a rainbow assortment of pastels, the tablets usually feature a choice of sugar or artificial sweeteners to enhance the "great-tasting" natural or artificial flavors. (It's easy to tell which vitamins contain which sweetener. If it's sugar the package trumpets, "No artificial sweeteners!" If it's an artificial sweetener, the package cries, "No sugar!")

Almost lost amid the packaging hoopla and hype, however, is the presumed reason you're buying the product: the nutritional content of the pills inside. Supplements for youngsters typically provide from 8 to 12 vitamins -- A, C, D, E, folic acid, thiamine, riboflavin, niacin, B6 and B12 are most common -- often with added iron, calcium and other minerals.

Each ingredient generally comes in an amount equal or close to the children's U.S. Recommended Daily Allowance, although for jTC children under 4, quantities may exceed the RDAs by as much as 50 per cent.

Do such supplements really provide "vitamin insurance" for your youngsters? And do the kids need such insurance in the first place? Some medical and nutrition experts had this to say.

John Udall, a pediatrician in Tucson, Ariz., and a member of the American Academy of Pediatrics Committee on Nutrition, said, "No good data suggest that supplements are necessary for a child who is steadily gaining height and weight."

Felicia Busch, a St. Paul, Minn.-based registered dietitian and spokesperson for the American Dietetic Association, was even more negative toward kiddie vitamins.

"Giving healthy, normal children vitamin supplements may make you feel better, but it's not doing anything for your kids," Busch said. "Many parents view them as replacements for eating well -- "Well, I don't have to worry about what Susie eats" -- but they aren't."

While supplements may provide up to 18 nutrients, they're hardly nutritionally complete, Busch said. "There are actually at least 40 that everyone needs, plus things like fiber and carbohydrates that you can't get from a pill."

As for the nutrients that are contained in supplements, most healthy American children get them from their diet anyway, said Frank Oski, professor of pediatrics at the Johns Hopkins School of Medicine.

"Non-breast-fed babies need iron supplements in the first year of life," Oski said. "But vitamin supplements are totally unnecessary for the average child."

The key, said Busch, is to make a wide variety of nutritious foods available to your children. "If they don't like vegetables, they may get the nutrients they need from fuits and juices. They'll probably end of selecting a balanced diet, as long as you're not giving them just chips and fast foods."

And if your kids get fixated on peanut butter for a few days, it doesn't mean they're on the road to rickets. No one needs to meet the U.S. RDAs every day.

Since most vitamins are water-soluble, Oski explained, once the body has enough to meet its needs and supply a small safety margin, the excess is flushed out as urine or perspiration.

A few vitamins, however -- A, B, E and K -- are fat-soluble, and the excess is stored in the body. Taking too much A or D (10 times or more the RDA), by accident or design, can prove toxic to the liver and other organs, as can excessive iron.

Vitamin poisonings, in fact, are alarmingly common. In 1988, 30,000 children under age 6 suffered a non-fatal overdose of vitamins, no doubt having confused them with candy.

The problems range from stomach upsets to lasting liver damage. (According to a 1985 report in "American Disease of Children," half of the 3-year-olds surveyed said it was okay to eat an entire bottle of chewables.)

Overzealous parents are another problem.

"Many think that if a little is good, more must be better," Busch said. "But when given in megadoses, vitamins don't act like vitamins any more -- they act like drugs."

She noted that megadoses of vitamin C -- available in colorful packs of chewables -- can behave like an antihistamine, masking cold symptoms by drying up nasal passages. Excesses of vitamin C can also results in kidney stones and urinary infections. (For kids 4 to 10 years old, a megadose of vitamin C is anything over 450 milligrams, or 10 times the RDA for children.)

"I don't want to scare parents into thinking they can't give their children vitamins once in a while," Busch said. "It's the day-in and day-out megadoses that pose the danger."

If you do opt for vitamin supplements, look for products designed to give children no more than 100 percent of the U.S. RDA for their age group, caution the experts. If taken in recommended amounts, these don't present a danger of toxicity, and are far safer than individual supplements of vitamins or minerals, which can come in huge doses and should be given only with a doctor's guidance.

And with any kind of vitamins, pediatricians warn, parents should be the ones to dole them out. Don't let kids get into the habit of reaching for their own pills. No matter how cute the packaging, vitamins should be treated as drugs.

Which brings us back to the drugstore when I read over the print on the bright package of children's vitamins that had caught Lia's eyes.

"Imagine squeezing the natural juices from great-tasting citrus fruits into nutritious multivitamins," it gushed. Then I imagined myself squeezing the natural juices from great-tasting fresh citrus fruits directly into a glass and handing it to my daughter. I put the package back on the store shelf, and Lia and I headed across the street to the produce market.

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