By Hansa Bhargava, MD
WebMD Medical Editor, Pediatrics
I still remember the 8-year-old girl who came to the emergency room with vomiting and drowsiness. She’d been complaining of headaches and abdominal pain for several weeks. The parents had brought her in that night because now she was acting strangely, not being able to talk properly and acting very lethargic.
She was admitted to the hospital that night with vitamin A toxicity and liver failure due to excess vitamin A in her body. Her parents had been giving her large doses of vitamin A supplements.
As a pediatrician, I see many parents who give their children vitamin supplements. Generally, this is okay, if the dosage is appropriate. It becomes a serious issue, though, if the dosage is excessive. This is where the issue of our foods being “fortified” with vitamins raises eyebrows. Could the vitamins in foods combined with supplements “overdose” our children with too many vitamins?
Today the Environmental Working Group released a report that raises concerns about the amounts of vitamins added to common foods, such as cereals. Many cereals contain up to 25% of the required daily amount of certain vitamins; unfortunately, these numbers are very outdated and based on adult requirements. This means that many of the added vitamins may exceed how much a child needs per day. What makes this issue even more worrisome is that if kids are taking vitamin supplements (such as the vitamin gummies) too, many of them may be at risk of overdosing on the vitamins. In fact, an analysis of data, published earlier this year, from the National Health and Nutrition Examination Survey 2003-2006 reported that just from food alone, 13% of kids get too much vitamin A and 45% take in too much zinc.
Too much vitamin A can lead to bone abnormalities, brittle nails, peeling skin, hair loss, and in rare cases, liver failure. Excess zinc can cause the blood condition anemia and may suppress your immune system. So what is a parent to do?
As a mom of twins, I think about the issue of nutrition for my kids every day. And I do want to tell you, all is not lost. First of all, you should know that most kids will not have overdoses of vitamins, especially if they eat a healthy diet based on the USDA’s healthy plate guidelines — i.e., mostly fruits, vegetables, and whole grains. The key is to be mindful of the ingredients that are in processed foods and to balance that with the vitamin supplements that you may give your children. It’s obviously important for our children to get the vitamins but equally important for them not to “overdose.” So here are a few tips that I use myself to walk that line:
1. Pay attention to the label. Look at cereal labels carefully to see what vitamins have been added. Maybe the day your child had a “fortified” cereal or waffle, he doesn’t need that gummy vitamin. Also, some cereals may not have vitamins added– these tend to be the organic brands.
2. Go back to basics: Serve simple, non-processed foods often. The more “real” food that is on the table, the less “added” ingredients there are. Fresh or frozen fruits and vegetables don’t have “added” vitamins. They’re the best sources of the nutrients for your kids. Fill those plates with veggies and fruits.
3. Cook at home as much as possible. Don’t groan — our grandmothers’ advice does turn out to be true in this case. I cook a lot on a Sunday — this way I have meals for a few days. Then, I cook on Wednesday so we have meals for 2 more days. This is good for my kids and my wallet.
4. Be a role model. I only eat cereal once or twice a week; usually we have smoothies, eggs, or on a Saturday, homemade pancakes.
And remember, be mindful about those vitamin supplements. It’s okay to have them, but most pediatricians, including myself, will remind you that the very best nutrients come from natural sources. So feed your kids a colorful plate with plenty of fruits, whole grains, dairy, and vegetables, and chances are they’ll get plenty of the vitamins that they need.