Chicago—Despite clinical recommendations against the practice, about one-third of children and adolescents in the United States use dietary supplements, a new study revealed.

The report in JAMA Pediatrics pointed out that little data has been available on the extent of dietary-supplement use in the younger cohort, although those products are often implicated in preventable adverse drug events among that population.

The research was led by the University of Illinois at Chicago College of Pharmacy. The study team analyzed National Health and Nutrition Examination Survey (NHANES) data for 4,404 children and adolescents (aged up to 19 years) from 2003 to 2014.

Among the results was that, since 2003, the use of alternative medicines, such as herbal products and nutraceuticals, doubled among children. The researchers explained that the primary drivers of the increase were greater use of omega-3 fatty acids and melatonin among adolescents aged 13 to 18 years.

Otherwise, they said, use of dietary supplements—including herbal, nonvitamin alternative medicines—remained widespread but stable.

Study author Dima Qato, PharmD, PhD, MPH, suggested that the significant use of supplements among children, as well as increased use of alternative medicines among teens are troubling trends. “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,” explained 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 added.

In addition to reviewing NHANES data for six recent cycles—2003 to 2004 through 2013 to 2014—study authors also conducted in-person surveys, where participants responded to a dietary supplement questionnaire.

If supplement use was verified within the last 30 days, participants were asked to provide the containers. Based on that, 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.

That revealed more information on who was using the products and why, Qato said. “Adolescents are using supplements to treat common health conditions or adverse effects of prescription medications,” she noted. “For example, we’ve seen an increase in use of melatonin, which is promoted as having cognitive and 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.”

Teenage girls were found to be more likely to use vitamin B products and folic acid, which are touted as being beneficial against depression. Boys, meanwhile, were more apt to be taking omega-3 fatty acids for cognitive benefits or as body-building supplements.

“Parents should be aware of the dangers, especially as many may be purchasing the supplements for their children,” Qato advised. “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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