A daily multivitamin is a healthy basic for adults and kids alike, right? Maybe not. Late last year, the journal Annals of Internal Medicine deemed multivitamin and mineral supplements massive money drains that don’t deliver promised health benefits.

Though the supplement industry is robust — Americans spend nearly $27 billion on supplements annually — doctors and researchers aren’t sold on the value of vitamins. Per a 2009 study by researchers at the University of California, Davis, most kids and teens who pop a daily pill probably don’t need one because they get adequate nutrition from their diet. The same study found that kids with nutritional deficiencies are the least likely to take a supplement.

This leaves confused parents holding the bag — or, in this case, the bottle of brightly colored chewables. Read on to discover if nutritional help makes sense for your child.

The diet defense

As it turns out, deciding whether kids need a daily pill isn’t simple. If your child eats a varied diet that includes a few servings of fruits, vegetables, dairy, meat and plenty of whole grains (see sidebar), a multivitamin probably isn’t necessary, says Kristi King, MPH, R.D., L.D., senior clinical dietitian at Texas Children’s Hospital and clinical instructor of pediatrics at Baylor College of Medicine.

“We encourage parents to help kids meet their nutritional requirements through food, because the nutrients in food are better absorbed than those in supplements,” King says.

In fact, for kids already downing vitamin-rich foods such as leafy greens, milk, meat and fish on a daily basis, a pill could be overkill, she notes. That’s because certain fat-soluble vitamins (A, D, E and K) are toxic in very high doses.

Then there’s the challenge of finding a kids’ vitamin that’s not full of unwanted additives or worse: A 2008 study by the U.S. Food and Drug Administration reported that a significant number of popular children’s vitamins were contaminated with lead. And they may not contain the vitamins or doses promised — independent testing service ConsumerLab found labeling errors in 40 percent of the vitamins studied.

Tennessee mom Julie Gallagher ran into this very problem when she wanted a quality multivitamin for her 3-year-old, Will. “A good diet should cover everything, but I know I don’t prepare a perfect meal every night,” she says. But when she started looking, she found that nearly every kids’ vitamin contained a questionable ingredient: added sugar, artificial dyes (linked to behavior problems in children since the 1970s) or lead.

Is it safe to skip?

With all the questions surrounding supplements, some parents choose to bypass them altogether. But that may be a mistake, too. Picky eaters, exceptionally slow growers, chronically ill children or those who avoid certain food groups due to allergies or preferences may need added vitamins, King says: “It can be very hard on a restrictive diet to get everything kids need for growth.”

In those cases, King recommends a multivitamin and mineral supplement, as opposed to single-vitamin supplementation (with the exception of vitamin D — see below), because vitamins and minerals must be balanced appropriately to be effective. Too much of a single nutrient can be problematic: An excess of iron may cause abdominal pain, while too much magnesium may lead to diarrhea.

For some kids, a multivitamin might not be enough, says Pirayeh Pedarsani, M.S., R.D., a clinical dietitian at Cedars-Sinai Medical Center in Los Angeles. Multivitamin supplements are designed to complement a typical varied diet, so kids who avoid entire food groups — say, dairy or all animal products — may need a multivitamin plus other supplementation.

For example, dairy avoiders may need additional calcium and vitamin D for healthy bones and teeth, and vegans can benefit from supplemental B-12, a vitamin found mainly in animal foods that’s important for nerve function. Those who avoid grains or gluten might miss out on the magnesium or vitamin E found in whole grains.

Research shows that most Americans are deficient in vitamin D, so the American Academy of Pediatrics recommends 400 IU (international units) per day for babies and children via a nutritional supplement. Vitamin D isn’t readily available in food, so even an immaculate diet won’t provide enough, King says.

Supplement savvy

What’s a parent to do? If your child won’t drink milk or gets stuck in an “I hate veggies!” phase, or if your family follows a restrictive diet, King says that a daily multi is worth considering. Though food-based nutrition is ideal, she recognizes that it’s not possible or practical for all kids all the time. Multivitamins are probably safe for most children, she notes.

A few simple blood tests can eliminate nutritional guessing games. Your family doctor can easily check levels of nutrients such as D, B12 and iron, and offer customized advice about supplementation, says Kimberly L. Braly, R.D., a pediatric dietitian at Seattle Children’s Hospital.

But deciding whether to supplement is only half the battle; now you have to pick one. All vitamins aren’t created equal, and some manufacturers use cheaper ingredients that don’t absorb well, says Haylie Pomroy, a nutritionist, mom and author of The Fast Metabolism Diet. Go for one with folate (look for “5-methyltetrahydrofolate” or “L-methylfolate” on the label) instead of synthetic folic acid; methylcobalamin (the bioactive form of B12); and cholecalciferol (the most active form of vitamin D). If a vitamin contains these superstars, Pomroy says, it’s likely high-quality.

What about buzzy supplements such as probiotics and fish oil? While research is still emerging, it’s promising, says King. Probiotics have been linked to reduced colic in breast-fed babies, and fish oil may improve cognitive function. But because recommended dosages haven’t been established for children, be sure to check with your pediatrician before supplementing.

After spending a “ridiculous” amount of time reading labels, Gallagher settled on a natural gummy vitamin. Now the real challenge: finding a safe spot to stash them so Will doesn’t overindulge. “He loves them,” Gallagher says. “He’d eat a whole bottle if he could!”

Well rounded

If your kiddo downs most of the following foods on most days, a multivitamin might not be necessary. Check with your pediatrician to be safe.

                               Ages 2–3          4–8                  9–13               14–18

Whole grains*     3 oz.                  4–5 oz.            5–6 oz.            6–7 oz.

Fruits                     1 cup                 1–1½ cups      1–1½ cups     1½–2 cups

Vegetables           1 cup                 1½ cups          2–2½ cups     2½–3 cups

Dairy                      2 cups               2 cups             3 cups            3 cups

Meat & beans      2 oz.                  3–4 oz.             5 oz.               5–6 oz.

* At least half the grains children consume should be whole grains, such as oatmeal or whole wheat.

Source: U.S. Department of Agriculture

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