February 11/Washington, D.C./Medical Letter on the CDC & FDA -- A large number of U.S. children and teens age 2 to 17 appear to use vitamin and mineral supplements, although most may not need them, according to a report in the February issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Many Americans use vitamin and mineral supplements despite the fact that these products are largely deemed unnecessary for children and adults who eat varied diets, according to background information in the article. "Multivitamin preparations for older children and adolescents are not regulated by the Food and Drug Administration and may result in adverse effects ranging from nausea, vomiting and abdominal pain to increased cerebrospinal pressure, liver abnormalities and neuropathy [nerve damage]," the authors write. Supplemental vitamins are recommended only for certain groups of children, including those with chronic diseases, eating disorders, problems absorbing nutrients or liver disease, or obese children in weight-loss programs.

Ulfat Shaikh, M.D., M.P.H., of the University of California Davis School of Medicine, Sacramento, and colleagues analyzed data from 10,828 children age 2-17 who participated in the 1999-2004 National Health and Nutrition Examination Survey. As part of the study, parents completed questionnaires and participated in household interviews, and children and teens underwent medical examinations.

Approximately 34% of the children and adolescents had used vitamin and mineral supplements in the past month, with underweight children having greater intakes. "Our results supported our hypothesis that underweight children would have the highest use of vitamin and mineral supplements," the authors write. "However, in contrast to what we expected to find, children and adolescents with healthier nutrition, more active lifestyles, greater food security and greater health care access were more likely to use vitamin and mineral supplements."

This indicates that children at the highest risk for deficiencies including those with less healthy patterns of diet and exercise, greater obesity, lower income and food security, poorer health and less access to health care may be least likely to use vitamin and mineral supplements, the authors believe.

"Such supplements contribute significantly to total dietary intakes of vitamins and minerals, and studies of nutrition should include their assessment," the authors conclude. "Since vitamin and mineral supplement users report greater health care access, health care providers may be in a position to provide screening and counseling regarding dietary adequacy and indications for supplement use."

From the February 16, 2009, Prepared Foods E-dition