Do Multivitamin/Mineral Dietary Supplements for young children fill critical nutrient gaps?

Authors: DWYER, JOHANNA - National Institutes Of Health (NIH); SALDANHA, LEILA - National Institutes Of Health (NIH); BAILEN, RICHARD - National Institutes Of Health (NIH); GAHCHE, JAIME - National Institutes Of Health (NIH); POTISCHMAN, NANCY - National Institutes Of Health (NIH); BAILEY, REGAN - Purdue University; JUN, SHINYONG - Purdue University; LONG, YUE - Abt Associates; CONNOR, EMILY - Abt Associates; ANDREWS, KAREN - University Of Maryland; Pehrsson, Pamela; GUSEV, PAVEL - University Of Maryland

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/18/2021
Publication Date: 3/1/2022
Citation: Dwyer, J., Saldanha, L., Bailen, R., Gahche, J., Potischman, N., Bailey, R., Jun, S., Long, Y., Connor, E., Andrews, K., Pehrsson, P.R., Gusev, P. 2022. Do multivitamin/mineral dietary supplements for young children fill critical nutrient gaps? Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2021.10.019.
DOI: https://doi.org/10.1016/j.jand.2021.10.019

Interpretive Summary: The Dietary Guidelines for Americans (DGA) 2015-2020 identified certain micronutrients as of public health concern, and others as underconsumed. Nearly a third of young US children take multi-vitamin -mineral (MVM) dietary supplements, but it is unclear how formulations compare to micronutrient intake recommendations. Our objective was to compare suggested amounts of micronutrients per day on MVM product labels for young children to Daily Values (DV). NIH’s Dietary Supplement Label Database (DSLD) as of March 2018 was used to identify the 288 MVM on the market labeled for children 1-4 yr. and a subset of 11 MVM meeting criteria in a bill before Congress in 2019 designating MVM for reimbursement under the Supplemental Nutrition Assistance Program (SNAP). Number of micronutrients in each MVM and amounts /day of each micronutrient on labels compared to appropriate % DVs were the main outcome measures. MVM varied greatly in the type and amounts of micronutrients they contained. No product provided > 50% DV of the micronutrients that the DGA 2015 denoted as of public health concern: 55% of the 281 products containing vitamin D; 4% of 144 containing calcium and 0% of 60 containing potassium. For micronutrients considered under consumed by the DGA 2015, percentages of products providing > 50% DV were: vitamin E 98% (n=279); vitamin C 99% (n=266); iron 84% (n=100); folate 62% (n=63); magnesium 13% (n=150), and choline 0% (n=140). MVMs with amounts > Upper Tolerable Intake Levels (UL) included 49% of 197 MVMs containing folic acid; 46% niacin (n=140); 17% vitamin A(n=48); 3% copper (n=85); 1% manganese (n=83), 1% selenium (n=80) and 1% vitamin C (n=298). Most MVMs provided many of the other micronutrients that were already abundant in children’s diets. In conclusion, it is time to reexamine amounts of micronutrients in MVMs and to consider reformulations that better fill critical gaps in intakes while avoiding excess.

Technical Abstract: The Dietary Guidelines for Americans (DGA) 2015-2020 identified certain micronutrients as of public health concern, and others as underconsumed. Nearly a third of young US children take multi-vitamin -mineral (MVM) dietary supplements, but it is unclear how formulations compare to micronutrient intake recommendations. Our objective was to compare suggested amounts of micronutrients per day on MVM product labels for young children to Daily Values (DV). NIH’s Dietary Supplement Label Database (DSLD) as of March 2018 was used to identify the 288 MVM on the market labeled for children 1-4 yr. and a subset of 11 MVM meeting criteria in a bill before Congress in 2019 designating MVM for reimbursement under the Supplemental Nutrition Assistance Program (SNAP). Number of micronutrients in each MVM and amounts /day of each micronutrient on labels compared to appropriate % DVs were the main outcome measures. MVM varied greatly in the type and amounts of micronutrients they contained. No product provided > 50% DV of the micronutrients that the DGA 2015 denoted as of public health concern: 55% of the 281 products containing vitamin D; 4% of 144 containing calcium and 0% of 60 containing potassium. For micronutrients considered under consumed by the DGA 2015, percentages of products providing > 50% DV were: vitamin E 98% (n=279); vitamin C 99% (n=266); iron 84% (n=100); folate 62% (n=63); magnesium 13% (n=150), and choline 0% (n=140). MVMs with amounts > Upper Tolerable Intake Levels (UL) included 49% of 197 MVMs containing folic acid; 46% niacin (n=140); 17% vitamin A (n=48); 3% copper (n=85); 1% manganese (n=83), 1% selenium (n=80) and 1% vitamin C (n=298). Most MVMs provided many of the other micronutrients that were already abundant in children’s diets. In conclusion, it is time to reexamine amounts of micronutrients in MVMs and to consider reformulations that better fill critical gaps in intakes while avoiding excess.