Vitamin intakes from supplements and fortified food in German children and adolescents: Results from the DONALD study

Frequent consumption of supplements is a common behavior in adults, as well as children and adolescents. We report on vitamin intake from consuming supplements, taking into account the vitamin intake from fortified and usual foods. A total of 5990 3-d weighed dietary records from 931 German subjects (452 males, 479 females, 2-18 y of age) between 1986 and 2003 from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study were evaluated. We identified 133 different vitamin-containing supplements in 451 records (7.5%). Slightly more males (8.0%) than females (7.1%) consumed supplements, with highest frequencies found between ages 15 and 18 y. For the majority (10 of 13) of vitamins (vitamin A, vitamin E, vitamin K, thiamin, riboflavin, vitamin B-6, vitamin B-12, niacin, biotin, and vitamin C), intake from usual and fortified food already reached or exceeded 80% of the recommended dietary allowances in all age groups. In the case of folate and pantothenic acid, intake from supplements was necessary to achieve at least 80% of recommended dietary allowances for half of the age groups, especially in females. Supplements with vitamin D considerably helped increase vitamin intake but failed to achieve 80% of references in almost all age groups. Intakes of vitamin A and folic acid exceeded the tolerable upper level most frequently in many age groups and were most pronounced in up to 32% and 13% of children aged 2-3 y. Intake of vitamin D, vitamin E, and vitamin C exceeded the tolerable upper level in single age groups only (< 7% of subjects). For the other vitamins, no exceeded limits were identified. The ubiquitous availability of supplements might indicate that even healthy children and adolescents profit by taking them. However, it is difficult to evaluate whether consumers receive more benefits or risks from the unrestricted consumption of supplements as they are marketed today.