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Michael O'Brien, MD |
What is the current view on dietary supplements for children?
Studies suggest that approximately 30 percent of children under 18 use supplements, from multivitamins and vitamin C, to iron, gingko biloba, echinaciea and ginseng. Supplements can be divided into two major groups: complementary dietary supplements and ergogenic aides.
It's imperative that physicians give informed messages about supplements. For instance, telling an adolescent athlete that all ergogenic aides are ineffective is inaccurate. To cultivate a trusting relationship, we need to be able to give athletes accurate information on safety and effectiveness. On the other hand, they need to be aware that the supplement industry is not governed by the same regulations that the pharmaceutical industry is held to. There have been reports of contamination (including heavy metals) and inconsistent dosing, even from batch to batch within the same brand.
I tell athletes and parents to be wary of any product that claims "weight loss, increased energy or increased alertness," as these products may contain stimulants. These can have exotic or benign sounding names like ma huang, guarana, paullina cupana or zoom. There are thousands of supplements on the market and very few physicians can keep up with the safety or effectiveness profile for each one. In general, children and adolescents should be encouraged to get their vitamins and minerals through a balanced diet rather than supplements.
I'm frequently asked about calcium. Children ages 4 to 8 should have at least 800 mg per day and ages 9 to 18 should be taking in at least 1,300 mg per day. Children with chronic diseases or with a previous history of stress fractures may need higher levels of calcium, up to 1,500 mg per day. Calcium carbonate (like Tums) is a simple way to get calcium if the child isn't getting enough in her diet.
A fact sheet about nutritional abuse: childrenshospital.org/nutritionfacts
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