Abstract
A cross-sectional survey study was designed to gather information on the use of dietary supplements by Spanish pediatricians. The study questionnaire was completed by 433 pediatricians (62% men, mean age 52.5 years) throughout the country. They also provided data on 10 of their patients (n = 4304) in which synbiotics, immune stimulants, and omega-3 polyunsaturated fatty acids (PUFAs) had been prescribed. Synbiotics were used by 92% of pediatricians, immune stimulants by 80.4%, and omega-3 PUFAs by 75.1%. Synbiotics were mainly used combined with antibiotics (92.6%) and for gastrointestinal disorders (91.2%), immune stimulants to enhance defenses and cold prevention (87.1%), and omega-3 PUFAs to improve symptoms of attention-deficit hyperactivity disorder (ADHD) (84.8%) and concentration (80.1%). Confidence and previous experience with the product (51.6%), composition and indications of the product (43.1%), and tolerability (39.9%) were main factors involved in decision-making. Children treated with omega-3 supplements were significantly older (mean age 7.6 (3.0) years) than those treated with synbiotics (3.9 (3.9) years) or immune stimulants (3.4 (2.8) years) (P < 0.001). Short duration of treatment (<1 month) was significantly more common in the synbiotics group (90.5%), whereas longer duration of treatment (>3 months) was more frequent in the omega-3 group (79.1%). In the immune stimulants group, 60.4% of patients were treated for a period between 1 and 3 months. Clinical improvement was rated by participants as “a lot” in 39% of cases and as “quite” improvement in 50.6%. The overall level of satisfaction was rated as “very satisfied” by 52.1% of participants and as “quite satisfied” by 40.9%. The results show that the use of dietary supplements to improve different conditions, particularly minor disorders, is a widespread clinical practice among Spanish pediatricians. Administration regimens for the three types of supplements, synbiotics, immune stimulants, and omega-3 PUFAs, were consistent with guideline recommendations.
Highlights
Dietary supplements in children and adolescents have become very popular and are increasingly used in most industrialized countries
Ere is increasing evidence that some dietary supplements are beneficial for overall health and for managing some health conditions, such as omega-3 polyunsaturated fatty acids (PUFAs), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) on neurodevelopment of healthy children [7,8,9,10] and as a treatment option in attention-deficit hyperactivity disorder (ADHD) [11, 12], or the role of probiotic species to modulate the gut microbiota and interact with the immune system [13]
Probiotics/prebiotics/synbiotics were used by almost all pediatricians (91.9%) followed by immune stimulants (80.4%), vitamins and/or minerals (76.2%), and omega-3 fatty acids (75.1%)
Summary
Dietary supplements in children and adolescents have become very popular and are increasingly used in most industrialized countries. The increase in the use of dietary supplements in pediatric populations has not been associated with understanding of the properties of supplements and their ingredients, the risks of adverse events, and the potential interactions with drugs [20]. Ere is a need to inform the general population about the use of dietary supplements and for doctors to update and disseminate adequate knowledge of supplementation to their patients. Different studies have shown that community pharmacists’ level of the nutritional and dietary supplement knowledge and understanding of their therapeutic effects is generally poor [23, 24], which is consistent with inadequate physicians’ knowledge of dietary supplement regulation and adverse event reporting [25, 26]. Studies focused on vitamin D supplementation have shown that the knowledge of pediatricians and pediatric residents about the use of vitamin D supplement, time for prescribing, and duration of vitamin D supplement needs to be enhanced [27, 28]. is study was designed to collect information on dietary supplementation practices among Spanish pediatricians in routine clinical conditions
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