A new study published in JAMA Pediatrics shows that since 2003, the use of alternative medicines, such as herbal products and nutraceuticals, among children has doubled. The University of Illinois at Chicago researchers who conducted the study cite an increased use of Omega-3 fatty acids and melatonin among adolescents ages 13 to 18 as the primary driver of the change, despite clinical recommendations against use of such supplements in children.
Use of dietary supplements, of which herbal, non-vitamin alternative medicines are one type, remained high but otherwise stable, with approximately one-third of children using a dietary supplement.
Study author Dima Qato says the widespread use of supplements among children and the increased use of alternative medicines among teens is worrisome.
“Dietary supplements are not required to go through the same FDA regulations and approval process as prescription drugs. As a result, we know very little about their safety and effectiveness, especially in children,” said Qato, assistant professor of pharmacy systems, outcomes and policy at the UIC College of Pharmacy. “Many dietary supplements have also been implicated in adverse drug events, especially cardiovascular, which is a safety concern.”
“We simply do not know if there are any benefits to children that outweigh the potential harms, and this study suggests supplement use is widespread and therefore an important, yet often ignored, public health issue,” she said.
To study supplement use in children, Qato and her colleagues retrospectively analyzed six recent cycles — 2003 to 2004 through 2013 to 2014 — of data from the National Health and Nutrition Examination Survey. During the in-person survey, participants responded to a dietary supplement questionnaire.
If participants indicated supplement use within the last 30 days, they were asked to show the interviewers the containers for all supplements. Each supplement was classified as a nutritional product – those that primarily contain vitamins or minerals – or an alternative medicine and further classified by primary use.
In addition to the high prevalence of supplement use, the researchers observed that, when it comes to adolescents, supplement use varied by gender and use patterns may relate to other health issues.
“Adolescents are using supplements to treat common health conditions or adverse effects of prescription medications,” said Qato. “For example, we’ve seen an increase in use of melatonin, which is promoted as having sleep benefits. At the same time, other studies have shown an increase in the use of ADHD medications, which we know are associated with a risk for insomnia.”
The researchers also found use of Vitamin B products and folic acid were most popular among teenage girls. These supplements are promoted as having benefits against depression. For boys, use of Omega-3 fatty acids — which are marketed as having cognitive benefits — and body building supplements were popular.
“This suggests that supplement use among children may be targeting specific ailments, but the fact remains that common use of these products in otherwise healthy kids is potentially dangerous,” Qato said. “Parents should be aware of the dangers, especially as many may be purchasing the supplements for their children. Health care providers working with children, especially pediatricians and pharmacists, should also take note of the prevalence of supplement use in this age group and ask patients and parents about such use regularly.”
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