Assessing Vitamins, Minerals and Supplements Marketed to Children in Canada.

Given the growth of supplements specifically designed for children in Canada, this study examines the nutrient levels of these products, and evaluates them in light of the US Health and Medical Division (HMD)-formerly the Institute of Medicine-and Health Canada's recommendations. Content analysis was used to document the nutrient levels of child-targeted vitamins, minerals and fish oils/omega-3s (n = 80) in Calgary, Alberta, Canada. Products were assessed according to HMD and Health Canada dosage recommendations for children, and the percentage of Estimate Average Requirements (EAR), Adequate Intakes (AI), and Tolerable Upper Intakes Level (UL) calculated. Median EAR/AI/UL percentages and quartiles were calculated for each nutrient, and estimates for the adequate intake recommendations plotted with box plots. Sixty five percent of the products assessed were multivitamins; the median dose was higher than AI recommendations for vitamins A, B6, B12, and C, as well as thiamin, riboflavin, pantothenic acid, and biotin. Substantial variation in vitamin, mineral, or fish oil dosage was found between similar supplements-with nutrients such as vitamin B12 ranging from 83% to 5557% of AI. Such findings matter because the very existence of these products suggests that children should be taking them, yet more research is needed on their potential (adverse) effects over both the short and long term. The substantial variation in dosages between products also raises questions about the (perhaps unnecessary) fortification of our children, as well as the expectations that parents know-or are even aware of-appropriate nutrient levels for their kids.

[Inventories of the Earth. Mineral resource appraisals and the rise of resource economics]. / Inventuren der Erde. Vorratsschätzungen für mineralische Rohstoffe und die Etablierung der Ressourcenökonomie.

How do the earth sciences mediate between the natural and social world? This paper explores the question by focusing on the history of nonfuel mineral resource appraisal from the late nineteenth to the mid twentieth century. It argues that earth sciences early on embraced social scientific knowledge, i.e. economic knowledge, in particular, when it came to determining or deposits and estimating the magnitude of mineral reserves. After 1900, assessing national and global mineral reserves and their "life span" or years of supply became ever more important, scaling up and complementing traditional appraisal practices on the level of individual mines or mining and trading companies. As a consequence, economic methods gained new weight for mineral resource estimation. Natural resource economics as an own field of research grew out of these efforts. By way of example, the mineral resource appraisal assigned to the U.S. Materials Policy Commission by President Harry S. Truman in 1951 is analyzed in more detail. Natural resource economics and environmental economics might be interpreted as a strategy to bring down the vast and holistically conceived object of geological and ecological research, the earth, to human scale, and assimilate it into social matters.

[Factors influencing on the Silesian University students' decisions concerning purchasing of vitamin and mineral food supplements]. / Czynniki decydujace o zakupie suplementów diety zawierajacych witaminy i skladniki mineralne przez studentów Slaskiego Uniwersytetu medycznego.

Correctly composed diet covers the demands of a healthy adult for nutrients, vitamins and minerals. Nowadays constant increase of vitamin and mineral supplements of diet intake is observed. Customers have a great choice of diet supplements on Polish market. They are diversified under the quality and quantitative accounts. The main aim of this study was to evaluate main factors of Silesian University students' choice while they are purchasing particular diet supplements. The questionnaire survey was conducted in a group of 208 students at the age of 19 to 24. 99.5% of them admitted that they have supplemented their diets with vitamin and mineral preparations until the moment of the experiment. The results indicate that main factors that influence the students' decisions on purchasing these preparations are: composition of the supplement, price and convenient dosing regimen. Respondents indicate the internet as a main source of information on the supplements being discussed in the following study.

The adult vitamin and mineral supplement maze.

OBJECTIVE: The content and daily cost of 14 popular multi-vitamin/ multi-mineral (MVMM) supplements promoted for adults 50 years of age or older in the United States were compared in order to provide pharmacists with objective information, enabling them to make more informed recommendations for these products. DATA SOURCES: The labeled ingredients for MVMM products contained on Drug Topic's "Top 200" over-the-counter product list and for several other popular brands were compared with the Institute of Medicine's (IOM) recommendations for the Dietary Reference Intake (DRI) of micronutrients. DATA SYNTHESIS: DRIs for micronutrients are generally the same for adults between ages 31 to 70. However, vitamin B6, vitamin D, and calcium have increased daily DRIs for adults 50 years of age or older, and the DRI for vitamin D for those 70 years of age and older is higher. All products reviewed met IOM's recommendations for vitamin B6 and vitamin D for individuals 70 years of age or older. No product contained the daily DRI for calcium, particularly products designed for men. The cost and number of tablets per daily dose for MVMM varies and may affect product selection. CONCLUSIONS: The most significant difference among MVMM products is the calcium content. IOM's recommendations for calcium are the same for both genders 50 years of age or older, but products developed for men contain very low amounts of calcium compared with products for women. Individuals who have a low dietary intake of vitamin D and calcium should take additional supplements with a daily MVMM. Formulations change frequently, and pharmacists should read labeling before making any specific product recommendations.

A cost-utility analysis of multivitamin and multimineral supplements in men and women aged 65 years and over.

BACKGROUND & AIMS: As people age there is a progressive dysregulation of the immune system that may lead to an increased risk of infections, which may precipitate hospital admission in people with chronic heart or respiratory diseases. Mineral and vitamin supplementation in older people could therefore influence infections in older people. However, the evidence from the available randomised controlled trials (RCTs) is mixed. The aim of the study was to assess the relative efficiency of multivitamin and multimineral supplementation compared with no supplementation. METHODS: Cost-utility analysis alongside an RCT. Participants aged 65 years or over from six general practices in Grampian, Scotland, were studied. They were randomised to one tablet daily of either a multivitamin and multimineral supplement or matching placebo. Exclusion criteria were use of mineral, vitamin or fish oil supplements in the previous 3 months (1 month for water soluble vitamins), vitamin B12 injection in the last 3 months. RESULTS: Nine hundred and ten participants were recruited (454 placebo and 456 supplementation). Use of health service resources and costs were similar between the two groups. The supplementation arm was more costly although this was not statistically significant ( pound15 per person, 95% CI-3.75 to 34.95). After adjusting for minimisation and baseline EQ-5D scores supplementation was associated with fewer QALYs per person (-0.018, 95% CI-0.04 to 0.002). It was highly unlikely that supplementation would be considered cost effective. CONCLUSIONS: The evidence from this study suggests that it is highly unlikely that supplementation could be considered cost effective.

Correction for errors in measuring adherence to prenatal multivitamin/mineral supplement use among low-income women.

Adherence to prenatal multivitamin/mineral supplement use is often measured by self-reports or pill counts. Although both measures were shown to overestimate adherence, measurement error is rarely considered. In this study, we examined measurement error in adherence to prenatal supplement use among pregnant women and demonstrated a calibration method to adjust for error. In a validation subsample (n=51) from a larger clinical study of supplementation, adherence was assessed by self-reports, pill counts, and a Medication Event Monitoring System (MEMS) bottle cap that recorded the date and time of each opening of the pill bottle. Mean adherence in the validation sample as measured by the MEMS (the gold standard) was 68%; thus, adherence measured by self-report (77%) and pill count (84%) reflected overestimation. The Pearson correlation coefficients of self-reports and pill counts to MEMS were 0.35 and 0.62, respectively. When adherence was defined as taking >or=75% of the pills prescribed, sensitivity and specificity were greater for pill counts (93 and 52%, respectively) than for self-reports (88 and 44%). The regression coefficient for pill count adherence from a linear regression on MEMS adherence was applied to pill counts from a larger sample (n=244). The adjustment significantly lowered the estimate of adherence from 74 to 64% (P<0.001) in this larger sample. In conclusion, our data show that both self-reports and pill counts overestimate adherence and that linear regression in comparison to an external standard such as MEMS can be used to correct for measurement error in adherence.

Vitamin and mineral supplement use and mortality in a US cohort.

OBJECTIVES: Vitamin and mineral supplementation is a common practice in the United States, yet little is known about the long-term health effects of regular supplement use. METHODS: To examine the relationship between reported use of supplements and mortality, we analyzed data from US adults 25 to 74 years of age who were examined in the First National Health and Nutrition Examination Survey (1971 to 1975), with vital status determined through 1987. RESULTS: At baseline, 22.5% of the cohort reported using supplements regularly and 10.0% reported irregular use. The risk of mortality for regular supplement users was similar to that for nonusers. No consistent mortality benefits or risks of supplement use were found across a number of population subgroups. The risk for those who reported supplement use at both the baseline and a follow-up interview approximately 10 years later was similar to the risk for those who reported not using supplements at either interview. CONCLUSIONS: We found no evidence of increased longevity among vitamin and mineral supplement users in the United States. Considering the wide use of supplements in the general population, the cost-effectiveness and the safety of supplement use need to be better defined.