Promotions for Kids' Dietary Supplements Leave Sour Taste

Used to be that you couldn't expect a kid to stomach much more than a daily dose of cod liver oil or a multivitamin supplement. But lately, with the trend toward marketing herbs and other non-traditional dietary supplements for children's use, it's the Federal Trade Commission that's raising objections. The products are being advertised for maintaining kids' health as well as for treating their ailments.

"How these products are portrayed in ads is a concern," says Howard Beales, director of the FTC's Bureau of Consumer Protection. "There are many worrisome unfounded claims. A lot of these products have not been proven to provide any benefit and in some cases, may even present safety risks."

The FTC has noted an increase in dietary supplement advertising that promotes products as preventives or cures for a variety of childhood ailments, ranging from colds and ear infections to serious conditions like asthma and chronic bronchitis. In the past two years, the Commission has taken action against several marketers of kids' supplements for making unsubstantiated advertising claims. The marketers touted their products as safe, effective treatments for colds in children and attention deficit/hyperactivity disorder (AD/HD), which affects as many as 2.5 million school-aged kids in the United States.

Though the marketers charged in these cases agreed to stop making the fraudulent claims, there's no guarantee that similarly egregious claims about certain supplements for kids will not surface in the marketplace.

Supplements for Kids
Traditionally, the term dietary supplement referred to vitamins and minerals. But in the wake of a rapidly expanding market, it has come to mean herbs and other botanical products, enzymes, animal extracts and more.

The need for vitamins and minerals is well-established. These nutrients are necessary for life and are widely available in food. Sometimes, though, nutrients must be consumed as supplements to treat or prevent nutritional deficiencies. Other supplements, such as some herbs, may offer health benefits, too, but the science on that issue is still developing.

For most healthy children who eat a variety of foods, experts generally agree that dietary supplements beyond a daily multivitamin and mineral supplement are not necessary, let alone safe or effective. "I don't recommend dietary supplements for children under 12," says Varro Tyler, professor emeritus at Purdue University and a leading authority on herbal medicines. Many of the products being marketed for kids have not been adequately tested in children to determine their safety and value.

"We have no systematic scientific data," says Dennis Bier, a pediatrician and researcher at the Children's Nutrition Research Center in Houston. "Yes, some of these products may have been used for millions of years, but no one has ever systematically collected data on their use in children. We don't know if these products are safe."

Experts also advise against giving children dietary supplements because unlike medicines in this country, their manufacture is not currently held to any set of federal standards to ensure purity and quality.

"It's a crapshoot," says Susan Baker, a professor of pediatrics at the Medical University of South Carolina. "You have no idea what these products contain."

Professor Tyler believes that the risk of consuming substances not made according to any national standards is one that adults can weigh for themselves. "But," he says, "they shouldn't push that risk off on children."

Taking Aim at Disease Prevention Claims
Parents whose children suffer from chronic disorders may find it especially hard to resist dietary supplements promoted as effective treatments for their children's disease. Ads for these products promote them as safe, natural alternatives to prescription drugs, which some may view as having harsh side effects. But as the FTC has found, these claims often are unfounded.

"False claims exploit parents' fears about giving their children prescription drugs, " the FTC's Howard Beales says. "But these alternative therapies may actually do the children more harm than good."

Often, the deceptive ads describe the supplement products as "natural," a term that consumers generally take to mean as "safe," especially when compared with prescription medicines. But according to Michelle Rusk, an attorney in the FTC's Division of Advertising Practices, natural is not necessarily safe. "Botanical products, like drugs, can have potent pharmacological effects," she says.

In the FTC's experience, many deceptive ads have focused on AD/HD, a disorder whose diagnosis and treatment arouse controversy among parents and health care providers alike.

Kids with AD/HD usually display inappropriate activity for their age, are easily distracted and act impulsively. They often cannot sit still or pay attention in class, and their behavior often can lead to academic and social problems. The recommended treatment combines medicine, usually a stimulant such as Ritalin, with behavior management and parent training. Studies have found this regimen to be safe and effective.

"AD/HD is a difficult, frustrating problem," pediatrician Bier says. "It interferes with a child's growth...and with family lives. Parents want to find something that will work. They're looking for a magic bullet."

The traditional treatment is viewed as time-consuming and inconvenient, and many parents, concerned about long-term effects, balk at giving their children stimulants.

In three of the cases brought by the FTC, the marketers were promoting dietary supplements as safe and effective treatments for AD/HD. Ads for one product, Efalex, appeared in such national magazines as Parenting, Parade and People and on the Internet.

Ads for another product, called God's Recipe, claimed the product was a safe alternative to the prescription drug Ritalin. God's Recipe was widely advertised on the Internet.

Yet another product, Pycnogenol, a supplement derived from tree bark imported from France, was promoted as an effective treatment for AD/HD, as well as arthritis, diabetes, multiple sclerosis, heart disease and cancer. The promoters of Pycnogenol advertised through multilevel marketing.

Additional Concerns
The FTC also has objected to ads making unfounded safety claims. The Commission sought and received an injunction against the makers of so-called body-building supplements used by teenagers and athletes. The manufacturers, MET-Rx USA Inc. and AST Nutritional Concepts, were unable to substantiate their claims that the products could increase strength and muscle mass "safely and with minimal or no negative side effects." The products contain androgen and other steroid hormones known to have harmful effects, including unwanted changes to male and female sexual features.

"Children may take steroid hormone supplements to emulate popular athletes," the FTC's Rusk says. "But there's a potential for harm, especially considering that, as children, they're still growing and developing."

Some products that contain gamma butyrolactone (GBL) --  like Renewtrient, Revivarant, Blue Nitro and Gamma G -- are touted as performance enhancers. Taken orally, GBL is converted in the body to gamma hydroxybutyrate (GHB), an illegal drug that can cause unconsciousness, coma and even death.

Giving children dietary supplements raises still another concern: that products recommended for adults will be given to children. "Parents shouldn't assume that supplements work the same way in children as they do in adults," Rusk says. "What's safe for an adult may be risky for children."

Some dietary supplements are not deemed safe even for adults. According to the Food and Drug Administration, the following supplements are potentially dangerous: chaparral, comfrey, lobelia, germander, willow bark, ephedra (ma huang), L-tryptophan, germanium, magnolia-stephania preparations, dieter's teas, and excess amounts of some vitamins and minerals.

Because these substances are sold in products for kids, parents should always read the ingredient list on the labels of dietary supplements and avoid giving their children any that contain these potentially dangerous substances. But what about other dietary supplements? How can parents determine whether they are safe to give to their children?

Ask an expert -- for example, a pediatrician or other health care practitioner who is knowledgeable about herbal medicine and the disorder or condition for which the product might be used.

"Parents need to be careful," says New York City dietitian Wahida Karmally. "There are so many kinds of supplement products on the shelf, and none of them may be necessary or safe for their child."

Pointers for Parents

Before you give your child a dietary supplement, be aware that:

• Many dietary supplements, especially herbal products, have not been tested in kids to determine their safety or effectiveness.

• Dietary supplements in this country are not held to any set of federal standards for quality or purity.

• Your best advisor is your child's pediatrician or another health care provider. Be sure to check with them before starting your child on a supplement. And keep them informed of your child's continuing use of the product.

• Supplements advertised as "natural" are not necessarily safe. In fact, herbs, like other so-called natural products, can have powerful drug-like effects. Some of these effects can be especially risky for people who take other medicines or have certain medical conditions.

• Fraudulent promoters often fall back on the same claims to trick consumers into buying their products. Tip-offs that they're trying to fool you are:

  • Claims that the product is a "scientific breakthrough," "miraculous cure," "exclusive product," "secret ingredient," or "ancient remedy." Says Howard Beales, director of the FTC's Bureau of Consumer Protection: "Ask yourself, 'If a product is so amazing, why would I be reading about it for the first time in an ad?'"
  • Claims that the product is a quick and effective cure for a wide range of ailments.
  • Claims that use medical terms that sound impressive. This ploy is an attempt to cover up a lack of good science.
  • Claims that the government, medical profession and health care industry are in a conspiracy to suppress the advertised product.
  • Undocumented case histories of people who've had supposedly amazing results.
  • Claims that the product is available from only one source, and payment is required in advance.
  • Claims of a "money-back guarantee."