About 34% of children between the ages of 2 and 17 use vitamin and mineral supplements, according to a study published yesterday in the Archives of Pediatrics and Adolescent Medicine.

However, researchers state that children who do not necessarily need vitamin and mineral supplements—those who are healthy, lead active lifestyles and have access to proper nutrition and healthcare—were more likely to take them. Conversely, children who may benefit most from vitamin and mineral supplements were less likely to take them.

Dr. Ulfat Shaikh of the University of California Davis School of Medicine and colleagues analyzed data from the National Health and Nutrition Examination Survey (NHANES), which evaluated 10,828 U.S. children ages 2 to 17. More than one-third took a vitamin and/or mineral supplement in the previous month.

Greater use of these supplements was associated with younger age, non-Hispanic white race/ethnicity, being born in the U.S., higher milk intake, lower total fat and cholesterol intake, higher dietary fiber intake, higher income, greater food security, lower media/computer use, greater physical activity, lower body mass index, health insurance coverage, better healthcare access and better self-reported health.

As for those children who don’t use supplements, “Poverty seems to be the overriding factor.” Dr. Shaikh told The New York Times. “Although supplements may not seem expensive to a middle-class family, the cost may be onerous for a low-income family. Parents who were poor were perhaps unable to afford supplements.”

Data showed that 22% of children in households below the federal poverty line used vitamins, compared with 43% in households above the poverty line.

Douglas MacKay, ND, vice president, scientific and regulatory affairs, with the Coucil for Responsible Nutrition, Washington, D.C., said, “It comes as no surprise that those individuals who use vitamin and mineral supplements also engage in other healthy behaviors, such as trying to eat a well-balanced diet and being physically active. Studies show that healthy individuals tend to engage in many healthy habits—not just one healthy habit—but an overall approach to wellness. Vitamin supplements are one component of a total health package and cannot be teased out of the overall wellness equation.

“It is also important to point out that the researchers rely on data from the National Health and Nutrition Examination Survey (NHANES),” he added, “but fail to point out that other data from the same survey show that many Americans, including children and adolescents, fail to consume recommended amounts of vitamins E, C and A, as well as calcium and magnesium. A daily multivitamin could affordably and safely help fill these nutrient gaps.”

It has become common practice for parents in the U.S. to give their children vitamins (such as a daily multivitamin) and minerals (such as calcium or iron) as supplements. Almost $2 billion is spent each year on these supplements in the U.S.

Many professional organizations, such as the American Academy of Pediatrics and the American Dietetic Association, do not recommend supplement use for children over one year who eat a healthy diet.

“The supplement industry agrees with the authors that the underserved population could benefit from a multivitamin,” said Dr. MacKay. “The supplement industry supports the need for vitamins to be available to all individuals, including those of a lower socioeconomic status, through a number of initiatives, including through organizations such as Nourish America and Vitamin Angels, who help provide vitamins to those in need. In addition, the dietary supplement industry has long lobbied for legislation to include multivitamins with folic acid in the Food Stamp Provision of the Farm Bill, as well as passage of bills that allow purchase of supplements through flexible spending accounts or health spending accounts, to ensure that all consumers have access to vitamins that can positively impact their overall health and wellness.

Dr. MacKay also said it is important to note “an error in the study authors’ comments.”

“The fact is that dietary supplements, including children’s vitamins, are regulated by the U.S. Food and Drug Administration,” he said.