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Dietary supplements for children, from probiotics to omega-3.
Dietary supplements for children, from probiotics to omega-3.
What are little girls made of?
NOT sugar and spice and everything nice.
What are little boys made of?
NOT frogs and snails and puppy-dogs’ tails.
These small human beings are made of skin and flesh, bones and blood. And organs. And hormones. And more. The care and feeding of these systems and the cells that comprise them is no easy matter.
While there is an almost perfect formula for creating a healthy child-exercise, adequate amounts of sleep, a healthy diet, and judicious supplementation-there is no foolproof way to get parents and kids to buy into the plan. Temptations from the dark side are too plentiful and provide too much instant gratification. Sticking to the recommendations means waiting years to see the rewards, and most people today-young and old alike-can’t project much further than a few hours at a time.
Julia Bird, associate scientist at DSM Nutritional Products (Parsippany, NJ), has an upbeat outlook. She says, “Kids today are very healthy in general. We have developed considerable research showing that evidence-based childcare has improved the health of children over the past century. Innovations such as childhood vaccines and sound nutritional practices have dramatically improved the quality of life and reduced sickness in millions of children.”
At the same time, Bird acknowledges, some concerns remain. One of the more troubling is the growing number of overweight and obese youth. “Childhood obesity has the potential to undo some of the good work done in reducing the effects of chronic disease. Our children enjoy good health, but we need to continue to give the best to future generations,” Bird says.
Echoing Bird’s optimism and misgivings, Gregory Leyer, PhD, global business development director, consumer healthcare/pharma, at Madison, WI–based DuPont Nutrition & Health, states, “Opportunities for great nutrition and healthcare exist, but the obesity epidemic is very troubling.”
Michael Shahani, COO, director of operations for Nebraska Cultures (Walnut Creek, CA), ruefully observes, “Today’s youths have never had so many health challenges. Leading the way, unfortunately, is the recent epidemic of childhood obesity. This has had a profound impact on the health of our children. Currently, about one of every three American children (including teens) is overweight or obese-nearly triple the rate in 1963.”
The Centers for Disease Control and Prevention (CDC) defines childhood overweight as a body mass index (BMI) “at or above the 85th percentile and lower than the 95th percentile for children of the same age and sex.” Obesity in children and teens means a BMI “at or above the 95th percentile.”
Richard Mihalik, director of innovation and product development at National Enzyme Co. (NEC; Forsyth, MO), cites CDC statistics showing that the obesity rate for children aged 2 to 19 is almost 17% and following an increasing trend. He warns, “Childhood obesity can result in psychosocial problems, high blood pressure, high cholesterol, and type 2 diabetes. All of these are very serious conditions in adults that can significantly shorten life spans and reduce quality of life. When they manifest in a child, this only magnifies the potential long-term health consequences. In short,” he laments, “the health of the American child is in decline.”
Noting that there will be breakdowns in the resolution to follow a healthy lifestyle, Bird asserts, “Dietary supplements can play a role when nutritional intake is inadequate.” She notes that DSM provides a full range of vitamins; nutritional lipids, including long chain omega-3 polyunsaturated fatty acids; and other nutritional ingredients that can be beneficial to children. DSM’s recently launched Tolerase L is an acid-tolerant enzyme capable of digesting lactose in the stomach. DSM developed Tolerase L recognizing that allergies are among the more common issues facing children and knowing that 90% of allergies are caused by just six foods, with cow’s milk heading the list (the others are eggs, peanuts, soy, wheat, and gluten).
Cathy Arnold, senior formulations scientist for Schenectady, NY–based Fortitech Inc., a developer and manufacturer of custom nutrient premixes, lays out a strategy covering a child’s nutrient needs from pregnancy onward. She says, “Clearly, a healthy mom has the best chance of having a healthy baby. On average, a pregnant mother will need about 300 kcal extra, each day, to meet the energy needs of the growing child.”
In addition, certain micronutrients are critical. Adequate folate (folic acid)-the Recommended Daily Intake (RDI) is 400 µg-has been shown to reduce the risk of birth defects such as spina bifida. Arnold also stresses the need for certain fatty acids, including DHA, which “accumulates in the brain and eyes of the developing fetus, especially during the last trimester.”
For newborns four to six months, Arnold says, breast milk is the best early diet. But the need for supplements doesn’t go away. She says the American Academy of Pediatrics and the CDC suggest that breastfeeding mothers also give their babies a vitamin D supplement (400 IU daily).
As the child transitions to solid foods, he or she should be receiving iron-fortified infant cereal diluted at first to a thin consistency with breast milk or infant formula and gradually increasing in thickness. When finger foods are introduced between six and eight months, attention needs to be paid to nutrients that support overall development, as well as cognitive function. Arnold says, “The most important period of development of the central nervous system begins before birth and continues until a child is three years old. During this period thousands of neuron connections are formed; 70% of the brain develops during the fetal stage and the remaining 30% during the preschool period.”
For toddlers, the Fortitech scientist recommends use of a “growing up” milk to supplement the baby’s diet. This specially designed milk-based formula is fortified with micronutrients and important long-chain fatty acids, as well as being an excellent source of protein. The nutrients needed by a child in this period include: iron, selenium, zinc, vitamin A, certain fatty acids, copper, folate, iodine, and choline.
Arnold continues, “Preschool is a good time to finish the transition of a child’s diet from the high-fat phase (50% of calories) during the first two years of life to a more adult-like fat intake (25 to 35% of calories). Most of the fats consumed should be ‘good fat,’ i.e., rich in mono- and polyunsaturated fatty acids. Fat is also important in the diet because it provides the fat-soluble vitamins A, D, E, and K and facilitates the absorption of carotenoids. Serving lower-fat meals will help control body weight and reduce the risk of heart disease and other chronic diseases later in life.”
Probiotics is another supplement category shown to be useful in keeping kids healthy. DuPont’s Leyer says, “Probiotic supplementation, with well studied organisms, has shown a benefit in growing children, ranging from warding off occasional cold/flu symptoms and helping reduce eczema incidence/severity, to reducing diarrheal episodes.”
DuPont’s branded product HOWARU Balance Kids contains two well-documented probiotic strains, Lactobacillus acidophilus NCFM and Bifidobacterium lactis HN019, in one pre-blended concentrate or consumer-ready finished format. Leyer says the product is “optimized to strengthen digestive and immune health for children aged 2 to 17.” It’s available as a bulk blend or flavored powder for dissolving in drinks or direct consumption.
Nebraska Cultures offers the DDS-1 strain of Lactobacillus acidophilus, discovered by the company’s founder, the late Dr. Khem Shahani, in the late 1950s. According to his son Michael, the DDS-1 strain offers the following benefits: produces B-vitamins and folic acid; prevents carcinogenesis; selectively prevents the adhesion of pathogenic coliform to the cell wall; aids in the alleviation of “traveler’s diarrhea” and constipation; inhibits stomach ulcer and cancer-causing Heliobacter pylori; relieves dermatitis and other skin disorders; has been shown to reduce serum cholesterol levels; inhibits the growth of 23 toxic microorganisms; reduces lactose intolerance; and stimulates the immune system.
Shahani says, “In children, probiotic supplements aid in recovery from acute diarrhea, and promote digestive health. Probiotics also help prevent the development of diarrhea when children take antibiotics.”
The DDS-1 strain can be found in many finished functional food and supplement products formulated especially for kids. One of these, the company’s own Pro-Flora Probiotic Chewables, is formulated with two complementary probiotic strains designed for optimal efficacy. Shahani says, “The DDS-1 strain of Lactobacillus acidophilus dominates the small intestine, and Bifidobacterium bifidum colonizes in large numbers in the large intestine and colon. This combination works to maintain the best possible health and protection for a child’s digestive system.”
Promoting the importance of long-chain fatty acids EPA and DHA is the principal mission of industry association Global Organization for EPA and DHA Omega-3s (GOED). Headquartered in Salt Lake City, UT, GOED reports, “A wealth of data supports the benefits of long-chain omega-3s for children’s health.”
Harry B. Rice, PhD, the organization’s vice president of regulatory and scientific affairs, cites the following two Article 14 health claims adopted by the European Commission: DHA maternal intake contributes to the normal development of the eye of the fetus and breastfed infants, and DHA maternal intake contributes to the normal brain development of the fetus and breastfed infants.
Rice says, “Globally, children are not consuming enough of the long-chain omega-3 fatty acids for optimal health. There is increasing evidence that there are relative deficiencies in the long-chain omega-3 fatty acids in children with ADHD and related behavioral and learning difficulties, including dyslexia, dyspraxia, and autism.”
According to Rice, a large body of scientific evidence supports a role of DHA in normal visual development of infants. He notes that the European Food Safety Authority (EFSA) has reviewed the science and provided a positive opinion on the following claim: “DHA intake contributes to the normal visual development of infants up to 12 months of age.”
In late May, at the ISSFAL (International Society for the Study of Fatty Acids and Lipids) 2012 Congress, Drs. Alex Richardson and Paul Montgomery presented data from the DHA Oxford Learning and Behaviour (DOLAB) study, a randomized controlled trial of DHA supplementation in healthy children. The data demonstrated that blood omega-3 concentrations are associated with reading, working memory, and behavior in that population.
At the same conference, positive results were reported from clinical trials exploring algae-based DHA supplementation. Susan E. Carlson, PhD, of the Department of Dietetics and Nutrition at the University of Kansas Medical Center indicated that prenatal algal DHA supplementation (600 mg from 14 weeks gestation until delivery) increased DHA blood levels in both the mother and newborn, as well as improved infant birth weight, length, and head circumference. A study led by Kelly Mulder, PhD, and Sheila Innis, PhD, both from the Department of Pediatrics, Child and Family Research Institute, at the University of British Columbia, suggested that DHA deficiency during pregnancy may limit infants’ development potential. And John Colombo, PhD, presented results from a study indicating that supplementation with algal DHA and arachidonic acid (ARA), an omega-6 fatty acid, provided developmental benefits up to six years of age. life’sDHA, used in the studies, is a vegetarian and sustainable source of DHA available from Martek Biosciences, a unit of DSM.
“One of the most challenging aspects of supplementing children is getting them to willingly take a supplement,” says NEC’s Mihalik. Therefore, he explains, NEC puts great effort into making sure its children’s products are pleasant tasting. “As a maker of numerous private-label children’s products, we have developed an expertise in designing highly palatable flavored formulations in many supplement categories for children,” Mihalik says.
NEC’s leading product for children is its BioCore Kids digestive enzyme chewable tablet. According to Mihalik, “It is designed to support healthy digestion in children by providing a broad range of digestive enzymes that address the common digestive needs of healthy children consuming a typical Western diet.”
Looking ahead, the NEC executive sees continued growth for the children’s health sector. And, he says, “The overwhelming trend toward increased childhood obesity will dominate the children’s supplement market. It is simply too big a health problem to ignore. Effective products that address prevention and that potentially delay or minimize the health consequences of obesity will come to dominate the children’s category, just as we have seen them dominate the adult category.”
Child UTIs: Cranberries Show Benefit in Study
New research indicates that cranberry juice can help reduce recurrences of urinary tract infections (UTIs) in children. The results, published in Clinical Infectious Diseases (Salo et al. 2011), show that the cranberry’s well-documented role in preventing recurrent UTIs in adult women also has the potential to benefit younger patients.
The study carried out by a group of Finnish researchers found that, compared to placebo, regular drinking of cranberry juice limited the number of UTI recurrences in children by 43% and reduced the need for antibiotics to be taken by 34%-the equivalent of six days per patient a year.
A June 28 press release from Ocean Spray’s Ingredient Technology Group (ITG), located in Lakeville-Middleboro, MA, quoted Dr. Tero Kontiokari of the University of Oulu, one of the scientists who carried out the study. He commented: “UTIs are one of the most common bacterial infections in pediatric medicine, and children with recurrent problems often face long-term antibiotic use. The cranberry is well known for preventing urinary tract infections in adult women, but this study shows that cranberry juice can be effective also among children in reducing the number of recurrences in children with multiple UTIs.”
In Gahanna, OH, integrative pediatrician Allen T. Lewis, MD, sees more than his share of children in distress. “No one supplement, no one diet, no one exercise program, and definitely no pharmaceutical is going to overcome all the challenges to children’s health,” he says.
He lists four fundamentals, none of which is easy to achieve-rest/exercise, nutrition, a minimized-stress environment, and fellowship. Kids should be engaged in 45 to 60 minutes of physical activity daily and get between eight and 10 hours of restful sleep each night. They should be eating fruits, vegetables, whole grains, nuts, beans, and fish. Organic, whole food is best, but at least avoid caffeine and, where possible, food colorings, preservatives, artificial sweeteners, nitrates, high-fructose corn syrup, and other additives.