The use of dietary supplements has increased dramatically as our knowledge about the role of nutrients and other bioactive components of food in health has increased. Although much of the information about the diet and health connection that has driven this trend is related to the reduction of chronic disease risk in adults, belief in the prophylactic use of dietary intervention, including the use of dietary supplements, has been extended to consumers throughout the life cycle.
In response to a congressional mandate, the Office of Dietary Supplements (ODS) of the National Institutes of Health (NIH) organized a conference/workshop in January 2000, to explore the current state of our knowledge about the important issues related to bioavailability of dietary supplements. The conference, supported by a consortium that included organizations both within the federal research community (NIH, U.S. Department of Agriculture, the Food and Drug Administration, and the Centers for Disease Control and Prevention) and outside it, was intended to identify research needed to expand our knowledge about factors influencing the digestion, absorption, and biological activity of nutrients and other bioactive components of dietary supplements. One clear finding that emerged from these discussions was that the use of dietary supplements in children (infancy through adolescence) is increasing. However, little is known about either the evidence base to support appropriate indications, or the safety of these supplements for use by children.
To address this knowledge gap, the Office of Prevention Research and International Programs of the National Institute of Child Health and Human Development (NICHD) and the NIH ODS organized a conference to focus on dietary supplement use in children. In determining the scope of issues to be covered at the conference, the organizers utilized the definition of dietary supplements as provided by the Dietary Supplement Health and Education Act of 1994 (DSHEA) which specifies the following:
The Dietary Supplement Health and Education Act defines dietary supplements as: a product (other than tobacco) intended to supplement the diet that bears or contains one or more of the following dietary ingredients: a vitamin, mineral, amino acid, herb or other botanical; or a dietary substance for use to supplement the diet by increasing the total dietary intake; or a concentrate, metabolite, constituent, extract, or combination of any ingredient described above; and intended for ingestion in the form of a capsule, powder, softgel, or gelcap, and not represented as a conventional food or as a sole item of a meal or the diet. (DSHEA, Public Law 103-417, October 25, 1994)
The specific goals of the conference were to:
The conference consisted of presentations by a distinguished faculty of scientists, administrators and others involved research and activities related to dietary supplement use in children Six general topical areas included in the conference and reported in this supplement were:
The working group discussions dovetailed with the themes presented in the plenary sessions and provided opportunities for cross-fertilization of ideas from members of each stakeholder community. There were four working groups assigned the following topics:
The following is the summary of the recommendations from each working group.
After the conference, members of the conference organizing committee and representatives of various institutes and centers from within the NIH and the federal research community held a meeting to identify the following research priorities:
The organizers of this conference are particularly grateful for the support of all of the members of the conference consortium. Organizations providing support for this conference included: NICHD, ODS, CDC, National Center for Complementary and Alternative Medicine, NIH Division of Nutrition Research Coordination, International Life Sciences Institute, Mead Johnson Nutritionals, Whitehall Robbins HealthCare, Consumer Healthcare Products Association, and with additional support from SmithKline Beecham Consumer Healthcare LP.
Description of the conference