In the Journals

One-third of children, teens use dietary supplements

Approximately one-third of all children and teenagers use dietary supplements, including multivitamins, researchers said. Additionally, the use of alternative medicines, such as melatonin supplements for insomnia, has nearly doubled.

These products are often associated with adverse cardiovascular effects, according to Dima M. Qato, PharmD, MPH, PhD, assistant professor in the department of pharmacy systems, outcomes and policy at the University of Illinois at Chicago College of Pharmacy, and colleagues.

“Dietary supplements are not required to go through the same FDA regulations and approval process as prescription drugs. As a result, we know very little about their safety and effectiveness, especially in children,” Qato said in a press release. “Many dietary supplements have also been implicated in adverse drug events, especially cardiovascular, which is a safety concern.”

The researchers used nationally representative data collected from the National Health and Nutrition Examination Surveys to examine how commonly dietary supplements — including nutritional products and alternative medicine — are used by children and teenagers in the United States.

Of the children and teenagers included in the analysis, 33.2% (95% CI, 30.4%-36.2%) used dietary supplements. Although similar rates were observed between 2003 and 2004, the use of alternative medicine in this population nearly doubled within the study period (3.7%; 95% CI, 2.8%-4.7% vs. 6.7%; 95% CI, 4.8%-8.3%; P < .001). Alternative medicines with the highest increases included omega-3 fatty acid supplements (0.4%; 95% CI, 0.2%-0.9% vs. 2.3%; 95% CI, 1.4%-3.5%) and melatonin supplements (0% vs. 0.9%; 95% CI, 0.5%-1.7%). 

Qato and colleagues noted that the age group that least frequently used dietary supplements was also the age group that most frequently used alternative medicine — teenagers aged between 13 and 19 years. This trend was observed for both boys and girls.

“Adolescents are using supplements to treat common health conditions or adverse effects of prescription medications,” Qato said in the release. “For example, we have seen an increase in use of melatonin, which is promoted as having cognitive and sleep benefits. At the same time, other studies have shown an increase in the use of ADHD medications, which we know are associated with the risk for insomnia.”

One-fourth of children and teenagers used multivitamins, making them one the most commonly used dietary supplements (25.1%; 95% CI, 22.3%-28.1%). Children and adolescents also used supplements targeting immunity (3.8%; 95% CI, 2.8%-5.2%) omega-3 fatty acids (2.3%; 95% CI, 1.4%-3.6%) and sleep aids (1.1%; 95% CI, 0.6%-1.9%).

According to the researchers, use of dietary supplements, including iron, calcium, multivitamins and single vitamins such as vitamin B products, was most prevalent among teenage girls. Teenage boys were more frequently using supplements such as omega-3 fatty acids and bodybuilding supplements.

“This suggests that supplement use among children may be targeting specific ailments, but the fact remains that common use of these products in otherwise healthy kids is potentially dangerous,” Qato said in the release. “Parents should be aware of the dangers, especially as many may be purchasing the supplements for their children. Health care providers working with children, especially pediatricians and pharmacists, should also take note of the prevalence of supplement use in this age group and ask patients and parents about such use regularly.” – by Katherine Bortz

Disclosures: Qato reports serving as a paid consultant for Public Citizen’s Health Research Group. Please see the study for all other authors’ relevant financial disclosures.

Approximately one-third of all children and teenagers use dietary supplements, including multivitamins, researchers said. Additionally, the use of alternative medicines, such as melatonin supplements for insomnia, has nearly doubled.

These products are often associated with adverse cardiovascular effects, according to Dima M. Qato, PharmD, MPH, PhD, assistant professor in the department of pharmacy systems, outcomes and policy at the University of Illinois at Chicago College of Pharmacy, and colleagues.

“Dietary supplements are not required to go through the same FDA regulations and approval process as prescription drugs. As a result, we know very little about their safety and effectiveness, especially in children,” Qato said in a press release. “Many dietary supplements have also been implicated in adverse drug events, especially cardiovascular, which is a safety concern.”

The researchers used nationally representative data collected from the National Health and Nutrition Examination Surveys to examine how commonly dietary supplements — including nutritional products and alternative medicine — are used by children and teenagers in the United States.

Of the children and teenagers included in the analysis, 33.2% (95% CI, 30.4%-36.2%) used dietary supplements. Although similar rates were observed between 2003 and 2004, the use of alternative medicine in this population nearly doubled within the study period (3.7%; 95% CI, 2.8%-4.7% vs. 6.7%; 95% CI, 4.8%-8.3%; P < .001). Alternative medicines with the highest increases included omega-3 fatty acid supplements (0.4%; 95% CI, 0.2%-0.9% vs. 2.3%; 95% CI, 1.4%-3.5%) and melatonin supplements (0% vs. 0.9%; 95% CI, 0.5%-1.7%). 

Qato and colleagues noted that the age group that least frequently used dietary supplements was also the age group that most frequently used alternative medicine — teenagers aged between 13 and 19 years. This trend was observed for both boys and girls.

“Adolescents are using supplements to treat common health conditions or adverse effects of prescription medications,” Qato said in the release. “For example, we have seen an increase in use of melatonin, which is promoted as having cognitive and sleep benefits. At the same time, other studies have shown an increase in the use of ADHD medications, which we know are associated with the risk for insomnia.”

One-fourth of children and teenagers used multivitamins, making them one the most commonly used dietary supplements (25.1%; 95% CI, 22.3%-28.1%). Children and adolescents also used supplements targeting immunity (3.8%; 95% CI, 2.8%-5.2%) omega-3 fatty acids (2.3%; 95% CI, 1.4%-3.6%) and sleep aids (1.1%; 95% CI, 0.6%-1.9%).

According to the researchers, use of dietary supplements, including iron, calcium, multivitamins and single vitamins such as vitamin B products, was most prevalent among teenage girls. Teenage boys were more frequently using supplements such as omega-3 fatty acids and bodybuilding supplements.

“This suggests that supplement use among children may be targeting specific ailments, but the fact remains that common use of these products in otherwise healthy kids is potentially dangerous,” Qato said in the release. “Parents should be aware of the dangers, especially as many may be purchasing the supplements for their children. Health care providers working with children, especially pediatricians and pharmacists, should also take note of the prevalence of supplement use in this age group and ask patients and parents about such use regularly.” – by Katherine Bortz

Disclosures: Qato reports serving as a paid consultant for Public Citizen’s Health Research Group. Please see the study for all other authors’ relevant financial disclosures.