health
to overdose on as they are water-
soluble, so they are excreted easily,
but fat-soluble vitamins (like vitamins
A, D, E and K) are stored in the fat and
may build up in the body. This is why it
is important to see a professional, so
you don’t overdose your child.” Most
dangerous of all is overdosing on iron
– about a third of the poisoning deaths
amongst children in the US between
1983 and 1991 were caused by iron
supplements, leading to changes in
packaging and warning labels.
Violet suggests that parents start by
thinking of “food before supplements.
Don’t think a pill can be a substitute
for nutrition, a pill can’t replace all
the nutrients available in vegetables
and fruit. Children will absorb enough
vitamins and minerals from a well
balanced diet.” Getting the balance
right can be hard though. Katie says
“From what I see, many children do not
eat enough vegetables, fruit or good
quality protein today. Many children
eat far too many processed foods
that are devoid of nutrients – such as
cookies, crackers, cakes and sweets.”
Unfortunately for parents, working to
improve a child’s diet is a far more
beneficial strategy than popping a
self-prescribed multi-vitamin into
their mouth.
Aside from multi-vitamins, there
are a couple of other supplements
commonly used by parents. Lets start
with vitamin D. Many experts (and
governments) advocate giving vitamin
D supplements to children, particularly
during the Northern Hemisphere
winter. However the research here
does continue to evolve, with some
of the original proponents now stating
that vitamin D levels vary naturally in
the population, so ‘normal’ levels are
very person specific and supplements
may be unnecessary. So should you
give your child a vitamin D tablet just
in case? “Absorption differs person
to person, so without testing levels in
each child it is not a yes or no answer.
Many children don’t play outside much
and when they do they are wearing
sunblock, which blocks the absorption
of vitamin D,” Katie says. Violet agrees
that “its hard to obtain enough vitamin
D from food alone. Due to heavy
school work loads, children may not be
getting enough vitamin D from sunlight,
especially in winter time. They need
5-15 minutes of sun exposure two
to three times a week, and longer in
winter.” If you are concerned your child
is not getting enough Vitamin D, and
cannot increase their sun exposure,
you should obtain a blood test before
providing supplements. As previously
mentioned, vitamin D is a fat-soluble
vitamin (less easily excreted), so dosing
advice should be sought.
Vitamin C supplements are another
popular choice. “The scientific studies
have shown that vitamin C does
not reduce incidence of colds in the
general population, but may reduce
the duration of colds,” says Katie.
Violet agrees that having adequate
amounts of vitamin C (as well as zinc
and probiotics) in your system can help
with fighting colds but “more research
needs to be done for supplementation.
People should try to obtain enough
vitamin C from fruit like guava, orange,
kiwi and strawberries. Zinc from
oysters, fish, seafood, beef, pumpkin
seeds and baked beans. Probiotics
like kefir, sauerkraut, natto and kimchi.”
Violet also highlights that the ubiquitous
chewable vitamin tablet can cause
dental erosion if used regularly, due to
the acidic nature of vitamin C.
There are times when supplemental
vitamins and minerals are necessary.
Violet states that “if a child is ill or has
had an operation and been unable to
eat well, extra vitamins and minerals
can help for a short term until they get
back to a balanced diet. Children on
any type of restricted diet can require
nutritional help. Children who refuse
to eat a whole food group like meat
or vegetables; those with particular
allergies; and those on elimination
diets or gluten free diets, may
need supplements.”
Whether a child should be given
vitamin supplements isn’t a simple
question to answer. Like most things to
do with our health – there isn’t a ‘one-
size-fits-all’ answer – despite what the
vitamin packaging might tell us. What
is clear though, is that the supplement
industry is prone to wily marketing.
What parent doesn’t want to make
their child healthier? A lot of children
(and teenagers!) are picky eaters, but
that doesn't necessarily mean that
they have nutritional deficiencies.
Seek professional guidance if you are
concerned, don’t just be swayed by
clever marketing from supplement
companies. Essentially, supplements
should be used with care – just because
they are not mandated to have child-
proof lids, doesn’t mean they should
be treated like candy. Thousands of
children are treated in emergency
rooms every year in the US because
of dietary supplements, mostly due
to unsupervised ingestion of a vitamin
or mineral supplement. Keep them
out of reach of children, handle them
like medicine, and use only the best
quality supplements when advised by a
medical professional. Ideally, as Katie
says, “let food be thy medicine.”
References for statistics:
https://www.fda.gov/ForConsumers/
ConsumerUpdates/ucm050803.htm
https://www.hkhfa.org/en/health-
faq.php
https://www.consumer.org.hk/ws_en/
news/press/503/multivitamins.html
https://www.consumerlab.com/
reviews/multivitamin_review_
comparisons/multivitamins/
https://ods.od.nih.gov/factsheets/
iron-healthprofessional/
https://nccih.nih.gov/health/tips/
children
Spring 2019
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