Vitamin and mineral supplements use in German children and adolescents between 1986 and 2003: results of the DONALD Study

Background/Aims: Dietary supplements may contribute to a considerable proportion to micronutrient intake. However, little is known about the consumption of supplements in children and adolescents, especially in Germany. We therefore examined patterns and time trends in supplement consumption in healthy children and adolescents. Methods: A total of 5,990 3-day records from 931 subjects 2-18 years of age from the DONALD Study between 1986 and 2003 were examined. Results: (a) Supplement type: A total of 166 different supplements were reported: 49% vitamin-mineral combinations, 31% vitamin, 13% mineral, 7% fluorine supplements. 12% (vitamin) and 13% (mineral) were single nutrient supplements. Vitamin C (72%), B1 (57%), B2 (54%), calcium (44%), magnesium (31%) and phosphorus (20%) were the most frequent added nutrients. (b) Users: In 25.8% (males 13.2%, females 12.6%) of the records, supplement usage was documented. Fluorine supplements were by far the most often consumed items (18.1%) followed by vitamins (4.5%), vitamin-mineral combinations (3.6%), minerals (2.4%), and multiple usage (2.6%). (c) Time trend: We found a marked time trend in supplement consumption in the past 18 years with a peak between 1994 and 1996 and lower usage before and after that time (independent of age and gender). (d) Associated factors: Supplement usage was influenced by age, year of study, season, smoking and number of persons in families, education level and employment of mothers, whereas gender or the number of children per family failed to have any effect. Conclusion: Supplement usage is a common behaviour in German children and adolescents and changing with time. Type and frequency of supplement usage is age dependent. Those nutrients found mostly in supplements are not the critical ones. In evaluations of children's diet it is mandatory to separate fluorine from other supplements.