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Food & Nutrition

Vitamin Supplements

Vitamin Supplements - Does Your Child Need Them?

A look at the shelves in the pharmacy often reveals a bewildering range of vitamin supplements available on the market. Which one should you give to your child? But wait, does he need it in the first place?

The Facts And Fallacies …

  1. Vitamins are essential for growth as well as the normal functioning of our bodies. However, our requirements do not always increase with age. Certain vitamins like Vitamin D are actually needed in larger amounts by younger children, compared to older children, while the requirement for Vitamin C is constant from birth to adolescence. So, it is best to check with a dietitian on the requirements specific to your child's age.
  2. B vitamins such as thiamine (Vitamin B1), riboflavin (Vitamin B2), niacin and pantothenic acid, as well as biotin, are required to release energy from food. This then provides 'fuel' for your child to go about his daily activities. Hence, as your child grows older, his requirements for this group of vitamins DO increase with age to cope with his more energetic lifestyle. Tiredness and lethargy can also be due to anaemia caused by inadequate intake of Vitamins C, B12 or folic acid.
  3. While it is true that vegetables are good sources of vitamins, they are NOT the only source. Very often, fruits can supply the same types and amounts of vitamins as vegetables. For example, Vitamin A can be found in red/orange fruits such as papaya and mango, Vitamin C in citrus fruits, guava and strawberries, and folic acid in oranges and honeydew. Moreover, vegetables are not good sources of other vitamins such as Vitamin E, Vitamin D and the B vitamins. These vitamins can be found in higher concentration in other food groups like breads and cereals, milk and dairy products, meat and alternatives, and fats and oils.
  4. Contrary to popular belief, oranges have not been proven to cause asthma or increase the production of phlegm. However, your child may be sensitive to the sourness of the orange, thus precipitating an asthma attack. If this is the case, you can ensure that your child meets his Vitamin C requirement by giving him other fruits or fruit juices, as well as 2 servings of vegetables per day. Fruits like guava, strawberries, honeydew and kiwi, as well as vegetables like broccoli, spinach, cauliflower and cabbage are especially high in Vitamin C. But remember, Vitamin C is easily destroyed by heat and exposure to air. So, cut your fruits and vegetables just before eating, and lightly cook your vegetables.
  5. Although Vitamin D is essential for the absorption of calcium, in sunny Singapore, Vitamin D deficiency is rare as our skin manufactures Vitamin D in the presence of sunlight. So, it is good to let your child play outdoors daily for 10-15 minutes during the day to supplement his intake of Vitamin D from food sources. Apart from fortified milk, Vitamin D can also be found in liver, fatty fish like salmon, tuna and mackerel, egg yolk and fortified cereals.
  6. Vitamin B12 can only be obtained from animal food. However, if your child is taking egg, milk and dairy products, as well as yeast extracts like vegemite or marmite, he may not require a supplement. You can also give him Vitamin B12-fortified food like fortified infant soy formula or fortified breakfast cereals. Deficiency in Vitamin B12 results in anaemia, so if your child looks pale and complains of tiredness and lethargy, consult your paediatrician about a possible Vitamin B12 deficiency.
  7. It is possible to have too much of a good thing - excessive intakes of vitamins in the form of supplements, especially of fat-soluble Vitamins A and D, can lead to side effects and toxic reactions involving the liver, spleen, kidneys or bones. While in the past, water-soluble vitamins like Vitamin C were considered harmless even in high doses, recent reports suggest that it is prudent to limit intake of all vitamins to levels close to their Recommended Daily Allowances (RDAs), and to obtain them from foods, rather than from supplements.

Preventing Vitamin Deficiency

The rule of thumb is to first ensure that your child gets his nutrients through food sources. In instances where certain vitamins are lacking from the diet, you can then look to supplements. A growing child's daily diet should provide an adequate supply of vitamins A, B, C, D, E, K and folic acid.

To safeguard your child against vitamin deficiency, refer to the #table# for some guidelines.

In Conclusion

If you are still concerned that your child is not getting adequate vitamins from his daily diet, consult your paediatrician about prescribing a paediatric multi-vitamin supplement. Again, supplements should not be used as a substitute for a healthy and balanced diet.

However, if your child is on a special diet, say for food allergy or intolerance, specific vitamin supplements may be needed. Check with your paediatrician or the dietitian regarding which ones to give.

Types of Vitamins Food Sources
Vitamin C Fresh fruit or pure fruit juice daily e.g. orange, kiwi, honeydew.
Vitamins A, E, K and folic acid Dark green leafy vegetables or red/orange vegetable or fruit eaten at least every other day e.g. spinach, broccoli, carrots, tomato, papaya, mango.
Thiamine and riboflavin Cereal or grain products (preferably containing unrefined riboflavin) taken daily e.g. brown rice, oats, barley, breakfast cereals, muesli, wholemeal bread/biscuits.
Vitamin B Some meat, fish, chicken, liver, egg, milk or cheese daily. If your child is a vegetarian, substitute with beans and bean products such as tauhu, taukwa, tempeh, baked beans, chickpeas, or dahl.
Vitamins A, D and riboflavin Remember to include milk and dairy and riboflavin products in your child's diet. Milk is one of the best dietary sources of riboflavin and Vitamin A and if fortified, it will also be high in Vitamin D.
Vitamin E Allow some oil, margarine, nuts and seeds in your child's diet as these are good sources of Vitamin E.
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