A Comparison of Labeled Nutrients with Respect to Recommended Amounts in Toddler Dietary Supplements.
Authors: Saldanha Leila , Brown LaVerne , Brasseux Charlotte , Bailen Richard , Dwyer Johanna , Ershow Abby 
Published: November 2023

The percent daily values (%DV), listed on product labels of dietary supplements in the United States, represent the recommended dietary intakes of vitamins and minerals at specific age groups [<12 months (infants), 1–3 years (toddlers), and ≥4years (adults)]. The DVs are intended to help consumers to make informed decisions regarding the nutritional value of food sources and dietary supplements with respect to individual needs. In this study, we focused our analyses on vitamins in dietary supplements labeled for toddlers. Our objective was to determine how dietary supplement product formulations compared with recommended amounts and recommendations from authoritative agencies. We identified and extracted label information from supplements labeled for toddlers available in the Dietary Supplement Label Database (DSLD) using the Advance Search features. We searched product labels for the labeled amounts and percent daily values (%DVs) of vitamins A, E, C, and D as well as folate and iodine, which all have been identified as shortfall nutrients in the 2015–20 Dietary Guidelines Advisory Committee (DGAC) report and are of concern to professional bodies. As of September 2016, the DSLD provided label information for 406 dietary supplements on the market in the US that targeted toddlers as the intended consumers. National surveys show that 45% of children 2–5 years use dietary supplements; and according to US census data, children under 5 years represent ~6.2% of the population. However, we found that only 1% of the dietary supplement products in the DSLD are labeled for children <4 years of age (0.1 % of the products were exclusively labeled for children <4 years of age and 0.9% of products contained dual labels for children and adults). More than 60% of the vitamin, multivitamin, or combination supplements for toddlers contained one or more nutrients with >100% of the current DV. Individual nutrients that were greater than the current recommended %DV tended to be 150–200% DV for children <4 years. However, some products contained individual nutrients, particularly vitamin C, as high as 625 %DV. The %DV on product labels are expected to reflect updated recommendations of dietary intakes by the year 2018. The new recommended %DVs for iodine and vitamin D have increased by ~30 and 50%. Thus, product labels will likely reflect normalized values of vitamin D and iodine by 2018. However, the new recommended %DVs for vitamins A, E, C, and folate have decreased by 40–60% for toddlers. If current formulations remain unchanged, product labels for these nutrients will have levels of 200–250 %DV in 2018. Published analyses of research data and clinical trials on healthy individuals do not support a benefit for the use of dietary supplements at amounts greater than the recommended dietary intakes. New or updated products that are specifically formulated for toddlers may need to better reflect the current recommendations and nutrient intakes for this population.Support or Funding InformationOffice of Dietary Supplements, NIH