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Providing perspectives on recent research into vitamins and nutritionals


Young Children can Benefit from Multi-Vitamin-Mineral Supplementation

By Michael McBurney

Scientific progress is much slower than the news cycle. So it is surprising when scientific studies create a media frenzy. After all, assembling the totality of the evidence isn’t  a matter of immediacy. The creation of regulations is even slower.

Last January, Madden, DeBias & Cook published a market analysis of vitamin supplements in JAMA Pediatrics.  They had analyzed products in the Dietary Supplement Label Database. TalkingNutrition discussed this paper. Frustrated with the insinuation that the dietary supplementation industry is irresponsible, Dr Eric Ciappio and I wrote a letter to the Editor. As noted above, scientific progress takes time – in this case 9 months to publish a letter.

In their response, Madden and colleagues do not acknowledge the central issue – there are multiple nutrient intake recommendations to consider when formulating products. It is ironic to be ‘commended’ for providing the concept of converting IOM recommendations to percent daily value. We did not present a novel concept. Years (actually decades) ago, the Food and Drug Administration (FDA) pre-emptively established Reference Daily Intakes (RDIs) and Percent Daily Values (DVs).  DVs which the food industry (yes, this includes dietary supplement industry) is required to use by law. Since Madden et al published their paper, the FDA has proposed labeling reform. We hope this labeling conundrum is rectified.

In response to their rebuttal, there is no issue with respect to analyzing IOM recommendations. Investigation is central to the scientific process. In fact, I wish the IOM and FDA would review Upper Levels (ULs) because several are too low. However, it is a disservice to create fear about the safety of multi-vitamin-mineral supplements, especially products adhering to labeling regulations.

Multi-vitamin-mineral supplements are safe. They are an important source of essential nutrients for many, young and old. As a member company of the trade association for the dietary supplement industry, the Council for Responsible Nutrition, , DSM endorses the its code of ethics, dosage limitations and good manufacturing principles.  The FDA should be given resources to enforce existing regulations and prosecute companies marketing products illegally.

In the meantime, most young children are missing essential vitamins and minerals from their diets. Recommending multivitamin-mineral supplements is consistent with the Hippocratic oath:

 “I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

Main Citation

Ciappio ED, McBurney MI. Multiple nutrient intake recommendations guide dietary supplements formulations. 2014 JAMA Pediatr doi: 10.1001/jamapediatrics.2014.426

Other Citations

Madden MM, DeBias D, Cook GE. Market analysis of vitamin supplementation in infants and children: Evidence from the Dietary Supplement Label Database. 2014 JAMA Pediatr doi: 10.1001/jamapediatrics.2013.4187

Madden MM, DeBias D, Cook GE. Multiple nutrient intake recommendations guide dietary supplements formulations - Reply. 2014 JAMA Pediatr doi: 10.1001/jamapediatrics.2014.429

Fulgoni VL, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: where do Americans get their nutrients? 2011 J Nutr doi: 10.3945/jn.111.142257

Berner LA, Keast DR, Bailey RL, Dwyer JT. Fortified foods are major contributors to food intakes in diets of US children and adolescents. 2014 JAND doi: 10.1016/j.jand.2013.10.012

Wallace TC, McBurney M, Fulgoni III VL. Multivitamin/mineral supplement contribution to micronutrient intakes in the United States, 2007-2010. 2014 JACN doi: 10.1080/07315724.2013.846806