The vitamin aisle at your local drugstore is under assault. Call it the attack of the gummy bears.
The chewy treat made of gelatin and sugar was formerly known as candy, but now it’s a health product encapsulating everything from children’s multivitamins to supplements for seniors. It’s been estimated that nearly 70 percent of children’s vitamins come in gummy form, making them appealing to kids — too appealing, some critics say, noting that hundreds of parents rush to the emergency room each year with children who ate a whole bottle.
Then there’s the sugar — a gram or so in each vitamin — which troubles both nutritionists and dentists. “Ask any dentist if it’s OK to give sticky candy to a child every day, and they will say no,” said Dr. Roger Lucas, a pediatric dentist near Seattle.
The American Academy of Pediatrics discourages parents from giving children vitamins at all, saying they should get nutrients from food. Still, nearly half of American parents give their children supplements, believing they improve their health. The gummy-vitamin craze, however, troubles even some parents who buy them.
“It’s definitely scary, because when I give one to them, they always say, ‘We want more,’” said Jennifer Marquez, a California mother of two preschoolers who once got into a bottle of gummy vitamins and ate at least half a bottle.
Overdoses, while common, rarely cause significant health problems, poison-control officials say. But when considering whether to buy gummy vitamins, there are things every parent should know.
Child-proof? Don't believe it
When Marquez, a communications consultant in Orange, California, got home from work one day in 2015, she noticed that the vitamins that were normally in the bathroom were missing. She asked her daughter where they were, and her daughter, then 3, said, “Me and Zane ate them all today.”
Panicked, Marquez called her pediatrician and then a 24-hour help line at St. Joseph Heritage Medical Group, where she worked. Since the children, who were then ages 3 and 15 months, didn’t seem sick, she didn’t have to take them to the emergency room, and nurses assured her the children would be OK.
That’s the case with most overdoses reported to poison hotlines across the country.
In 2014, there were about 44,000 calls to the nation’s poison-control centers related to vitamins. More than half — 25,441 — involved children under the age of 6 who had consumed excessive gummy or chewable vitamins, said Dr. Toby Litovitz, director of the National Capital Poison Center in Washington D.C.
“It’s very common. Children eat lots of gummy vitamins and chewables,” Litovitz said, noting that not all overdoses are reported, so these figures represent “the tip of the iceberg,” the lowest possible number of cases.
“But most of these cases are not that serious,” Litovitz said. The main danger is an overdose of iron, which, if consumed in large amounts, can lead to nausea, vomiting, bleeding, shock and death.
Because of this, poison-control centers advise parents to be aware of whether any multivitamins contain iron and to keep all vitamins not only out of reach, but out of sight, from children. And those child-proof bottles? They’re not.
“Given enough time, toddlers can open child-resistant closures on medication bottles; nothing is really ‘child-proof,’” the poison-control website (webpoisoncontrol.org) says.
A bear market
The Gummi bear was invented in Germany in the 1920s and the gummy vitamin in Oregon in 1998.
There, two natural-foods advocates looking for a way to get their children to take vitamins came up with the idea to mix fruit crystals and echinacea, a herb that many people belief boosts their immune system.
It took Kate Jones and Marty Rifkin five attempts to get Walgreen’s to take a chance on their then-unusual product. A decade later, though, they sold their company for $650 million, and gummies now rule the vitamin aisle at drug stores across the country.
“The gummy delivery form grew out of my own desire to create a vitamin supplement for my children that was effective, but, most importantly, one that they would take,” said Jones, the co-founder of Northwest Natural Products who now runs a foundation with her husband.
“It was revolutionary in that it had no artificial colors or sweeteners and it tasted good. Once we saw people react with such a positive response to the taste, we continued our development in this area, eventually coming up with the gummy bear delivery form,” Jones said.
Jones’ children are now young adults, so she no longer has to worry about overdoses and she agrees that children should get their nutrients from wholesome food. But the product she and her husband pioneered helps parents whose children need supplementation but can't or won't swallow pills or capsules, she said.
“We always said food first to get your recommended daily dose of vitamins, but the reality is the American diet is deficient in many areas,” Jones said.
“Supplements fill the voids in our diet, but supplements are not medicine. So this goes back to safety and the need for clear labeling and instructions that direct consumers, for instance, to put the bottle on a high shelf. Parents should be very clear in talking to their children about what they are taking and why they are taking a supplement.”
When Jones and her husband owned the company, they never produced vitamins that contained iron. “We had toxicity studies that showed even if a child ate a whole bottle of one of our supplements, the worst reaction would be a tummy ache from the sugar,” she said.
When you chew a gummy — whether pure candy or vitamin — not all the sugar goes down your throat. Some clings to your teeth, where bacteria feeds on it and it converts to lactic acid. "That's what dissolves enamel," said Dr. Roger Lucas, also known as "the Dentist Dad."
Some sugar-free vitamins solve one problem, but create another. They're flavored with citric acid, and acid also weakens enamel.
"I think they're a bad idea. I don't think anyone should have them," Lucas said. "But not all gummy bears are created equal. Some are sticky and some are less sticky and some have sugar coated on the outside. Coating a sticky sugar with even more sugar is a really bad idea for teeth."
Lucas, who has three children, said if parents feel they must give their children vitamins, they should choose sugar-free, crunchy ones.
Others say skip the vitamins altogether.
“When you’re born, you need a shot of vitamin K. If you’re a child who is exclusively breast fed, especially a dark-skinned child, you would benefit from vitamin D. If you’re a strict vegan, you may benefit from vitamin B-12, and if you’re a woman of child-bearing age, you may need folic acid," said Dr. Paul Offit, author of "Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine" and director of the Vaccine Education Center at Children’s Hospital of Philadelphia.
"But do otherwise healthy children need supplemental antioxidants, like vitamins C and E? No, they don’t, and not only that, they’re potentially dangerous,” he said. “How many children with rickets do you know? None would be my guess."
Offit notes that vitamins and supplements don't require the approval of the Food and Drug Administration, and he contends that many of the manufacturers' claims are dubious. The American Academy of Pediatricians says vitamins are not necessary for "healthy, growing children who consume a varied diet," but about a quarter of toddlers and 40 percent of preschoolers take them.
Dr. Stephen Daniels, chairman of the AAP's Committee on Nutrition and pediatrician-in-chief at Children's Hospital in Denver, said some American children might need extra vitamin D because they're spending less time outside and consuming less dairy.
“That might be a rationale for some kids to get regular daily vitamins. Do they need to come in gummy-bear form? That’s complicated," Daniels said.
“I understand the argument that it might be important to make these things attractive to kids; on the other hand, it’s probably not a good idea to associate medication with candy,” Daniels said, noting that Colorado is having another issue with gummies: Since the legalization of marijuana, it’s being packaged in gummy bears.
For parents who believe their children need vitamins and supplements, Dr. Mary Hayes, a spokeswoman for the American Dental Association and a pediatric dentist in Chicago, offers some advice.
"Switch to chewables. Give them with a meal; don’t make them a treat,” she said.
And watch the sugar content. “We know that eating sugar promotes the growth of bacteria that causes decay. It may be only one gram, but the bacteria is happy, they don’t need a lot,” Hayes said.