No magic pill
Gummy vitamins are becoming increasingly popular as dietary supplements for kids. But how good are they really?
Recently, particularly online, it's likely that you've come across advertising trying to convince parents to buy gummy vitamins for kids.
They have slogans like, "Veggie Gummy is delicious! And it gives you the vitamins you need, just like eating vegetables!", or "Boost your immunity with Gummy Vitamin C!".
Gummy vitamins are sugarcoated jelly sweets, made to look, feel and taste like regular candies to appeal to children. They have long been popular in the US. Now they are making inroads into Thailand, especially via e-commerce. The products offer a variety of dietary supplements, such as vitamin C, vitamin D, multivitamins, iron and zinc.
Given the increasing popularity of dietary supplements, particularly gummy vitamins, among Thailand's health conscious, it's worth asking: how effective are they really?
"They are similar to regular vitamin supplements, but each brand provides a different amount of nutrients in each tablet, which you can check from the labels," said Asst Prof Dr Worawut Choeyprasert, general paediatrician of haematology and oncology at Vejthani Hospital. "I would say to parents that if you and your children have a balanced diet, made up of the five main food groups, you don't need to take any vitamin supplements.
"People lacking in nutrition may need to take vitamin supplements, but they must first find out exactly what vitamins they are deficient in. If you want your children to take vitamins, you should consult a paediatrician."
But eating a balanced, healthy diet is often easier said than done, especially with so many people nowadays relying heavily on ready meals or frozen food from supermarkets. In 2013, a Southeast Asia Nutrition Survey by Royal Friesland Campina conducted a study about nutrition in 3,119 Thai children aged between six and 12. The results showed that 60% were lacking the requisite nutrition and had lower vitamin A, vitamin D, iron and zinc levels than the global average.
Popular in the US, gummy vitamins have been increasingly available in Thailand especially on e-commerce platforms.
So gummy vitamins are an attractive option to parents, as well as to children, given their sweet taste. However, that sweetness can encourage children to consume more than they should.
"Taking too many vitamins over an extended period of time can be dangerous. Excess vitamin A can lead to liver damage or skin problems. High doses of vitamin D can also cause liver damage as well as disrupt calcium absorption, weakening the bones," said Dr Worawut, who is also founder of the Facebook page Liang Look Tam Jai Mor, roughly translated as raising children, the doctor's way.
"Some gummy vitamins have high sugar content. Children shouldn't consume more than six teaspoons of sugar per day. When children are addicted to sweet things, it can lead to many problems, such as picky eating, obesity and tooth decay. Sugar free gummy vitamins can help eliminate these problems."
In order to avoid overdosing on vitamins, it is imperative that everyone strictly follow the consumption guides provided.
"If you take supplements according to the directions on the label, the amount won't exceed [the body's maximum requirement]. Children aged one to three should not consume more than 2,000 IU [International Unit] of vitamin A per day. Children aged four to eight shouldn't take more than 3,000 IU of vitamin A per day," Dr Worawut said.
"Vitamin supplements should be taken immediately after a meal because the fat from a meal aids absorption. Gummy vitamins should only be taken by children aged three and above. Children under two shouldn't take them at all because they may choke. If giving a child over two gummy vitamins, don't let them lie down or run around because the sweet can get caught in the throat, blocking the child's trachea. Children should only ever take vitamins under parental supervision," Dr Worawut advised.
There are several myths and misconceptions about dietary supplements which can encourage parents to allow their children to consume too much. One is that taking vitamins will increase a child's appetite. This might be true in the case of a child with iron deficiency, as they would lack energy, feel fatigued and have a poor appetite. But it is not always the case.
"Some parents will have bought multivitamins with iron and found that their child's appetite improved. But the vitamins didn't solve the root cause. When children stop taking vitamins, they lose their appetite again. The best solution, as always, is to eat a balanced diet."
Another myth is that vitamin C can prevent colds. There is no clear evidence to support this.
"Vitamin C supports the immune system and helps repair damaged tissue, but don't allow your children to take lots of vitamin C in order to be healthy. This is wrong. A balanced diet, exercise and vaccinations are what will keep your child healthy."
However, children are notoriously picky eaters and many parents find it difficult to get their children to eat everything they should. According to Dr Worawut, when babies are ready for solid food, after about six months, the first meal should contain various kinds of food.
"The first meal should have rice, egg yolk, meat and vegetables. The earlier you feed a baby a range of food, the healthier their appetites will be. There are those who delay feeding meat to their babies until the age of eight or nine months. They believe that if they feed their children meat too early, they are more likely to have food allergies. This is a misconception," Dr Worawut said.
This advice is great for parents with babies. But what about children who are already picky eaters? Dr Worawut suggested that parents should create a friendly atmosphere at the dining table and offer a range of food.
"Let them see a variety of food, but don't force them to eat everything," he recommended. "Try to convince them that each dish is tasty and show them how to eat. Keep it positive. Don't punish kids by forcing them to eat something. And don't scold them if they don't eat something. Teach by example, and eat foods like vegetables which you want them to eat. Children want to get involved in their parents' lives. Let food be a part of that. If they start to pick up food, even if they don't eat it, it is still a good sign."