Does my child need to take vitamins?" is a common question for dietitians during counseling sessions and even at holiday gatherings. A seemingly simple question has no simple answer. It depends on the child and his diet.
In an ideal world, minimally processed, wholesome food would provide all the nutrition a child needs. Trouble is, not every family is able to ensure that. Meals eaten on the run and all-too-common fussy eaters can contribute to nutrient shortages. At least three can be challenging to obtain even if a diet is well-planned: calcium, iron and vitamin D.
What they need
Children need between 500-1,300 milligrams of calcium, depending on their age. Calcium can be obtained from such foods as dairy products, almonds, broccoli and greens. Iron requirements can be satisfied by eating legumes, meats, spinach, fortified cereals, soy nuts and pumpkin seeds. But iron deficiency can occur when children gravitate toward a "milk diet"—when milk is meeting most of a child’s calorie needs. This results in eating few other iron-rich foods or the excessive milk’s high calcium interferes with iron absorption from the few foods he is consuming.
Vitamin D was in the news in October when the American Academy of Pediatrics raised its recommendation by doubling the amount needed—from 200 to 400 international units. One cup of milk—whether it’s whole, reduced fat or fat free—provides 100 units.
A study published in the October 2007 Archives of Pediatrics and Adolescent Medicine found that many parents felt taking vitamins provides children with extra nutrients they may not obtain in their daily diets. Children considered too thin were more likely to be given supplements than their average weight or chubbier peers.
But nutrition expert Dr. David Katz says, "There is no definitive evidence that a multi-vitamin improves health outcomes in children." Katz, director of the Yale Prevention Research Center and the father of five, contends that a multi-vitamin serves "as an insurance policy against inadequate intake of some important nutrients."
Food or supplements
The real thing usually trumps a supplement. Mother Nature provides just the right nutrient package in just the right proportions compared to man-made supplements. For example, dietary calcium, especially in dairy, is more easily absorbed compared to pills. Or pair iron-rich foods with ones rich in vitamin C, such as black beans and bell peppers. The vitamin C makes the plant form of iron better utilized.
Which children would benefit?
Some parents worry about their stick-thin children. Katz recommends these children eat when they want, with an emphasis on healthy snacks. If they have access to food, they won’t starve themselves (unless an eating disorder is present). "Create an environment of good choices, give this child a little space and I suspect things will turn out just fine," he says.
Children need the proper amount of nutrients for their growth and development, yet taking multi-vitamins may not be the best way. Some families justify frequent fast food runs and heavily processed foods at mealtime by popping vitamins, thinking they’re "covered." Your child’s pediatrician is the best judge as to whether he needs a supplement.
Katz reminds us, "A supplement is a supplement to a healthful diet, never a substitute for a healthful diet." He says the real answer is to have a home filled with only good dietary choices, in every category from soup to nuts, crackers to cookies. "Keep these at home and put nutritious items such as fresh or dried fruit within easy reach."
Christine M. Palumbo, RD, is a registered dietitian in private practice in Naperville. She can be reached at (630) 369-8495 or ChristinePalumbo.com.
Dear Good Sense Eating,
Is there such a thing as taking too many vitamins?
Kristie W., Alsip
Yes, there can be too much of a good thing. A child can overdo it by taking multiple supplements, such as a multi-vitamin plus separate supplements. Another way is by eating multiple fortified foods, such as cereals, nutrition or energy bars or vitamin-fortified waters, in addition to a multi-vitamin.
Pork Primavera Sandwiches
• 2 to 2 1/2 pounds pork loin or tenderloin, trimmed of all visible fat
• 1 large carrot, shredded (about 1 cup)
• 1 large red bell pepper, finely diced
• 1 medium onion, peeled and cut into thin wedges
• One 12-ounce jar all-natural barbecue sauce
• 8 whole wheat hamburger buns, toasted
Add the pork, carrot, red bell pepper, onion and barbecue sauce to the slow cooker and stir to combine. Cover and cook on low for six to eight hours.
When the meat is done, place it on a cutting board and, using a knife and fork, pull the meat into shredded pieces.
Place the meat back in the slow cooker and mix with the sauce (the vegetables virtually disappear into the sauce). Divide the pork mixture evenly between the hamburger buns and serve.
Makes eight servings.
Nutrition information per serving: 400 calories, 11g fat (3.5g saturated), 46g carbohydrate,
4g fiber, 570mg sodium, 30g protein, 60 percent vitamin A, 50 percent vitamin C, 15 percent iron.
See how it’s made at mealmakeovermoms.com/cooking-videos/main-dishes.