As much as we’d like to think of them as miniature adults, children and their nutritional needs are unique. It’s an ill-conceived notion that by simply halving the dose, adding tutti-frutti flavor, and tableting pills in the shape of cartoon characters, we can transform adult supplements into kids’ multis.
If only. Like children themselves, formulating supplements to satisfy their singular nutritional needs is far more complex. Just consider what a child faces during those first few years: The body is building a foundation of bone, muscles, and other structures; the brain and neural connections are knitting patterns that persist for a lifetime; and a naïve immune system grows wiser as it faces assault from all sides. These and other developments demand nutritional mediation, and if the growing child doesn’t get the right substances in the right amounts at the right windows of opportunity, the effects could reverberate well down the line.
But which substances, in what amounts, and when? The answers lie in the field of child nutrition research, which remains a reliable source of scientific ferment. Notes Duffy MacKay, ND, senior vice president, scientific and regulatory affairs, Council for Responsible Nutrition (CRN; Washington, DC), “The influence of nutrition on childhood health and disease continues to be an ongoing area of research that reveals new information on a daily basis.”
In fact, he says, “The federal government announced plans to include guidance on infants, from birth to two years, as well as on women who are pregnant as a group, in the 2020 Dietary Guidelines for Americans.” This would be a government first in providing such guidance, and it’s happening in no small part because “the available scientific evidence is sufficient to support science-based dietary recommendations,” says MacKay. And here’s a look at just what nutrition researchers have to teach us.
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Let the Sunshine Vitamin In
Vitamin D, the sunshine vitamin, has enjoyed a degree of celebrity status among adults who, either because they spend too much time indoors under a coat of SPF or don’t drink enough fortified milk, aren’t getting enough of it.
But the implications of insufficient intake on children are perhaps more alarming. “Vitamin D is very important because it plays a key role in bone development by helping the body to absorb calcium,” MacKay explains. “Thus, it’s crucial that kids, especially as they grow and develop, get enough vitamin D.”
Recent studies have shown that, like their folks, children shielded from the sun are frequently below quota, especially during winter. In response, Johns Hopkins Children’s Center recommends that pediatricians and healthcare providers screen all kids for vitamin D deficiency and order tests for those who could be at higher risk. “Increased screening of children would really help to avoid prolonged vitamin D deficiency and the health complications it can cause,” MacKay notes.
And if stronger bones aren’t selling point enough, a 2016 study published in JAMA found that supplementation with 4,400 IU/day vitamin D in pregnant women lowered the incidence of asthma and recurrent wheezing in their children—although not to a statistically significant level—compared to the reductions seen in children of women who supplemented with only 400 IU/day.
Reference: Litonjua AA et al., “Effect of prenatal supplementation with vitamin D on asthma or recurrent wheezing in offspring by age 3 years: The VDAART randomized clinical trial,” JAMA, vol. 315, no. 4 (January 26, 2016): 362-370
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The aforementioned vitamin D study affirms how important maternal nutrition and supplementation are to health outcomes in children. Such is also the case when it comes to iodine supplementation.
Though iodine is crucial for normal cognitive development in utero and in infants, MacKay explains, it’s “largely dependent on sufficient maternal intake.” Unfortunately, many women of childbearing age in the United States and abroad have a mild iodine deficiency. That leaves their children’s cognitive function at potential risk and has prompted CRN and other organizations to identify iodine deficiency as an emerging public-health crisis.
Groups including the American Academy of Pediatrics, the Endocrine Society, and the American Thyroid Association now recommend that pregnant and lactating women receive a daily supplement of 150 mcg of iodine. What’s more, says MacKay, “CRN developed voluntary guidelines to recommend that its members ensure multivitamin/mineral supplements intended for pregnant and lactating women in the U.S. contain at least 150 mcg of iodine.” The deadline for CRN member compliance with these guidelines is January 2017.
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In for the Long Haul
According to Harry B. Rice PhD, vice president of regulatory and scientific affairs, the Global Organization for EPA and DHA Omega-3s (GOED; Salt Lake City), one area of child-nutrition research that remains “very active” is on the role of omega-3 fatty acids—particularly the long-chain polyunsaturated fatty acids EPA and DHA—in childhood health.
The reason is elementary: these PUFAs support the growth and function of children’s brains—and, as a result, their cognitive development and performance. Yet “cognition is a difficult area to study,” Rice concedes, and in the wake of equivocal research results in recent years, we’ve seen some questioning of the cognitive benefits long attributed to omega-3s.
But, maintains Rice, “As with most things, the devil’s in the details.” Rather than a lack of beneficial effect, he believes, the so-so studies more likely reveal “a failure to detect an effect.” That might be because current methods for measuring cognition are insufficiently sensitive—Rice has hope that fMRI scans will be a more potent tool in the future—or because EPA+DHA’s benefits might not be detectable in young children and instead emerge only later on tests of “more specific tasks,” he says. “If true, then, this means that studies on omega-3s and cognitive development need to be powered to continue through early childhood and possibly even later.”
Consider one noteworthy study reporting a positive association between the omega-3 index—a measure of the EPA+DHA content of red blood cells—of 266 adolescent subjects and cognitive measures. The researchers said that the results suggested that those with a higher omega-3 index might exhibit higher information processing speeds and less impulsivity than their lower-omega-3-index peers.
Reference: Van der Wurff IS et al., “Association between blood omega-3 index and cognition in typically developing Dutch adolescents,” Nutrients, vol. 8, no. 1 (January 2, 2016)
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The Pros and the Pres
When asked to name which emergent focuses of early-nutrition research he’d be monitoring in the coming year, MacKay cited pre- and probiotics. “The science surrounding the impact of prebiotics and probiotics on children’s health is expanding and evolving quickly,” he says. “Several studies have explored the role of prebiotics and probiotics in reducing the risk for allergic disease, such as asthma and eczema.”
A 2013 Cochrane review evaluating the effect in infants of using prebiotics for the prevention of allergic disease and food allergy found “strong evidence” that certain prebiotics can prevent eczema in children during the first two years, MacKay says. “This is an area of research that’s building quickly and may expand into other allergic conditions, as well.” And while the review’s authors did caution that “further research is needed before routine use of prebiotics can be recommended for prevention of allergy in formula-fed infants,” MacKay remains bullish: “We’re really looking forward to see what becomes of this research and its potential effects on childhood nutrition.”
Reference: Osborn D et al., “Prebiotics in infants for prevention of allergy,” Cochrane Database of Systematic Reviews. Published online March 28, 2013.
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