Not to put even more pressure on parents, but experts say starting too late can be irreversible in terms of cognitive development and lifelong health.
“A recent report by the American Academy of Pediatrics (AAP) emphasized the significant role adequate nutrition plays in a child’s physical and neurological development during their first thousand days of life, laying a foundation for long-term health,” says Susan Piergeorge, MS, RDN, nutrition education manager for Nutranext’s Rainbow Light, based in Sunrise, FL. “By age 2, a child’s brain has grown more than it will at any other time in their life. However, any setback in brain development resulting from malnutrition during this time cannot be recovered in subsequent years,” Piergeorge adds. “Thus, the nutrients they receive during their first thousand days are pivotal for helping them grow to their fullest potential. Insufficient nutrition during this period has been linked to a number of long-term health and economic challenges.”
“The brain of a growing child is the number one organ affected by smart nutrition. The smartest nutrient for growing a brighter brain is the Omega-3 fat, DHA. In my medical practice I get parents to remember this by telling them, you are feeling a little fat head, since your brain is mostly fat. There are over 20,000 medical journal articles on the brain health benefits of DHA. This is why expectant mothers and school age children need a DHA supplement. The brain grows fastest in the last trimester of pregnancy and the first five years of life,” says Dr. Bill Sears, a pediatrician on the advisory board of Smart Family Nutrition, based in San Diego, CA.
Choline Last year the American Medical Association (AMA) called for evidence-based amounts of choline to be put into prenatal vitamins. Research shows that choline is associated with a reduction in neural tube defects (2). In January 2018, the AAP issued a policy statement identifying choline as one of several key “brain building” nutrients critical to early childhood development (1).
“Choline is vital to fetal and early childhood brain development, but most pregnant and nursing mothers are not getting anywhere near the current recommended amounts of this essential nutrient in their diets,” says Tom Druke, director of VitaCholine brand development at Balchem Human Nutrition and Pharma, based in New Hampton, NY.
A big trend in maternal product development has been pre-conception supplements that can conceivably extend for years. So how vital are these nutrients at this stage? Perhaps more important than one would think.
“The Centers for Disease Control (CDC) reports that almost half of all pregnancies are unplanned. Regular use of this type of supplement would ensure intake of key nutrients, i.e. folic acid and others, when pregnancy does occur,” says Piergeorge. “To maintain an adequate vitamin and mineral status, consuming supplements on a consistent and ongoing basis vs. just for short periods may help optimize nutrient status and well-being.”
“Extensive research by the CDC (What we Eat in America, NHANES 2013-2014) determined that an alarming 90% of U.S. adults are not getting recommended levels of choline. Obviously all parents want their babies to have healthy, well-functioning brains, so it’s important this information be conveyed to the public. Natural product retailers can play an important role in helping expectant mothers pay attention to their choline intake,” Druke adds.
Authors of a 2017 study published in the journal Nutrients reported that only 8% of pregnant women are consuming the level of choline research says they should be getting (3). “This matters because research showed that only eight of the top 25 prenatal vitamins contained any choline, and none of them included enough,” Druke says. “Just 12% of the Dietary Reference Intake (DRI) for pregnant women was included in those eight formulas, at 55 mg per daily dose, when the daily intake should be 450 mg” (4).
A recent clinical study at Cornell University found a correlation between increased choline intake during pregnancy and improved information processing speed in infants (4).
“The science gets even more compelling on the importance of choline,” Druke says. “Epidemiological studies indicate a relationship between maternal choline intake and a child’s longer-term cognitive performance.”
A large study at the Harvard School of Public Health found evidence that more choline during pregnancy may positively impact visual memory among 7-year-old children (5). And it’s not just young children that benefit from choline: Swedish researchers found that plasma choline levels in 15-year-olds were significantly associated with academic achievement, independent of socioeconomic factors.
It’s not just pregnant women who need to pay attention to choline intake; nursing moms do too. Babies’ levels of choline at birth and in their first few weeks are significantly higher than a normal adult level, likely to meet the needs of rapid growth during this period (6). The DRI for lactating women rises to 550 mg in order to ensure that infants are getting adequate choline through breast milk. Choline is also required to be present in all non-dairy based infant formula, which is designed to closely match the nutritional composition of breast milk. Choline continues to play an essential role in toddlers and young children. It functions as a precursor to the essential neurotransmitter acetylcholine.
“Think of it as the brain’s ‘instant messenger’ speeding messages through the brain to the muscles and the entire body,” Druke says. “Adequate intake of choline for young, active children continues to be of great consequence, since research has made it clear that our bodies will sacrifice cell membrane phospholipids in the absence of adequate dietary choline, potentially leading to breakdown of muscle tissue in cases of prolonged inadequacy” (7).
“In a perfect world children would not need supplementation in the first two years of life,” says J.D. Dickinson, VP of El Segundo, CA–based ChildLife. “Nature set it up perfectly, so the newborn baby would receive all it needs through mother’s breast milk for at least the first six months of life. This becomes more obvious when you consider the newborn’s digestive system isn’t fully developed until around this age. It is also around this 6- month time period when the teeth start to come in. When you look at it from this angle, it all makes sense. “However, we are not living in a perfect world,” Dickinson acknowledges. “Soil depletion, food alterations, farming techniques, pesticides, water and air pollution along with environmental toxins have taken a toll on all of us, especially women who are bearing children.”
The lack of vitamins, minerals and nutrition is affecting the newborn babies across the board in major ways. For example, in the last few years the AAP has suggested newborn babies be supplemented with vitamin D and vitamin K. That’s quite significant, Dickinson adds. “The lack of these two supplements has resulted in complications leading to deaths in newborns.” Dr. Murray Clarke (ChildLife founder) was at the forefront on both of these and formulated organic vitamin D3 and vitamin K for babies.
“The Babies and Children category is the fastest growing segment in the natural products industry and retailers, buyers and owners who are ignoring this fact, are missing the boat,” Dickinson adds. Moms buy 80% of the groceries, which include supplements.
“Moms are brand buyers! Period,” Dickinson asserts. “Men are what’s called planogram buyers. Planogram is when store shelves are categorized by ‘product category,’ all multivitamins are together, all vitamin Cs are together and how you see products categorized in most stores. When a mom finds, or is recommended a good brand on her mommy blog she goes to the store and looks for, or asks for that particular product.
“In a planogram, the mom usually only sees the product she came in for and leaves the store with one product,” he adds. “When the products are categorized by brand, the mom sees the product she came in for, plus she sees all the other products that brand formulates and usually leaves the store with several products. Stores need to start focusing on moms.”
Vitamin K2 Another nutrient that’s often missing from the diet in the first five years is Vitamin K2. New research has shown a high prevalence of vitamin K deficiency, putting healthy bone development at risk. Vitamin K also supports cardiovascular health.
A new study on K2 deficiency in children was published by Nutrients, an international, peer-reviewed journal for studies related to human nutrition.
“The epidemiological evidence indicates a disturbing growth in the number of cases of low-energy fractures in healthy children and adolescents. There are multiple risk factors that may contribute to this growing health concern, and among the leading consideration are deficient or insufficient nutrition and nutrients, including calcium, vitamin D and vitamin K,” said Dr. Vladimir Badmaev, author of the paper and principal and founder of American Medical Holdings, Inc., in a statement announcing the findings.
Dr. Hogne Vik, NattoPharma chief medical officer, says this study is significant because it adds to evidence that vitamin K2 is beneficial for both adults and children.
In the paper, vitamin K2, particularly menaquinone-7 such as that manufactured by NattoPharma, is highlighted and differentiated from vitamin K1 in maintaining calcium levels. Vik says these findings are also significant for supporting NattoPharma’s existing research that children are the group most deficient in K2. Correcting this deficiency can have a positive impact on bone health.Vitamin D The prevalence of time spent indoors and use of sunscreen at the earliest ages has led to an epidemic of vitamin D deficiency, according to the Organic and Natural Health Association, (ONHA).
In 2014, OHNA’s research partner GrassrootsHealth embarked on a new nutrient field trial study with the Medical University of South Carolina (MUSC) to define the impact of vitamin D on birth rates. The result? Women who achieved a vitamin D level equal to or greater than 40 ng/ml had a 62% reduced chance of delivering a preterm baby as compared to women whose vitamin D level was under 20 ng/ml.
ONHA filed a petition with the U.S. Food and Drug Administration to approve a health claim for vitamin D that will raise awareness of the risks for pregnant women. It urges the FDA to recognize an association between higher serum vitamin D levels and a reduced risk of preterm birth.
21st Century Photo Stress Blue light has drawn increasing amounts of attention for its impact on adults who are chained to the computer screen, but children are equally at risk, says Trisha Sugarek MacDonald, BS, MS, senior director of research and development/national educator, Bluebonnet Nutrition Corp., Sugar Land, TX.
“A tablet, iPhone, video game or TV may be an easy distraction for a child, but to young eyes, 24/7 exposure to these high-tech devices can cause long-term, negative consequences on the health of their eyes because these devices emit blue light,” she notes.
“Since blue light has a very short wavelength, it produces a higher amount of energy. The constant bombardment of energy generated by blue light on the retina could cause serious long-term injury to the eyes since blue light penetrates all the way to the retina, damaging light-sensitive cells,” Sugarek-MacDonald adds. “This continual exposure to the blue end of the light spectrum over time is concerning many researchers who believe that the growth rate of age-related eye diseases like macular degeneration will exponentially increase over the next few generations unless consumers — starting in adolescence — do more to protect their eyes. “
Wearing sunglasses, turning on blue light filters on high-tech devices, getting regular eye exams, and taking eye care supplements are all helpful measures.
“At Bluebonnet, we are hearing that parents are now getting their teenagers onto eye support formulas as part of a holistic strategy to help protect their kids’ eyes, particularly the macula, from the photo stress of the 21st Century,” she says.
As more parents become aware of the damaging effects of blue light on eye health, as well as its effect on increasing the risk of age-related macular degeneration later in life, they realize the importance of starting their kids on formula based on research from the National Eye Institute’s AREDS (Age-Related Eye Disease Studies) to protect their eyes, particularly the macula, early in adolescence (13 years of age) instead of waiting until later after damage has already occurred.
“That said, it’s important for parents to find a product that is a natural fit to support eye health by looking for those that are wholesomely crafted and deliver the clinically studied nutrients recommended by the [NEI] based on the AREDS-2 study to help protect eyes from excessive exposure to blue light/LED screens, as well as improve visual performance and support optimal eye health as one ages,” Sugarek-MacDonald adds.
These studies found that taking high levels of antioxidants and zinc can reduce the risk of developing advanced age-related macular degeneration (AMD) by approximately 25%.
So, to address the clinically studied nutrients recommended by the National Eye Institute based on the AREDS-2 study, the nutritional scientists at Bluebonnet introduced Targeted Choice EyeCare Vegetable Capsules that are specially formulated with 500 mg of vitamin C, 200 IU of vitamin E, 40 mg zinc as zinc gluconate, 2 mg copper as copper gluconate, 10 mg lutein and 2 mg zeaxanthin.
When it comes to their families’ health — both physical and financial — moms are more likely to be in the driver’s seat with 80% or more in control of household spending. For natural products brands and retailers, it’s important to understand that where you put your focus will vary depending on what stage of parenthood the mom is at.
A study from Foursquare (1) based on location-based behavioral insights points to a diversity of moms.
New moms prioritize what they feed themselves and their family. Eager to get back in shape, they are 7% more likely to visit health food stores, 5% more likely to visit Whole Foods Market and 4% more likely to visit juice bars than U.S. women overall. But they also like to cut loose, and are 11% more likely to visit beer bars.
There’s opportunity if you get your message to them as part of their prenatal journey and soon after delivery.
Moms of young kids past the newborn stage are more likely to opt for convenience and are 12% more likely to visit fast-food restaurants than other U.S. women. They refuel on the go at convenience stores, gas stations and drive-thrus.
Moms of teens are more price-conscious with 44% more likely to go to discount stores. They’re also busy supporting their young athletes and attendance for this group is highest at stadiums, athletic fields and gymnasiums. They focus less on their own health and fitness at this stage with 33% less likely to visit cycling studios, 23% less likely to visit Pilates and 18% less likely to visit salad spots.
Tech-savvy moms spend more time outdoors. They’re 28% more likely to shop at health food stores, 28% more likely to stop at salad spots, and 25% more likely to visit juice bars. So look at what you’re doing digitally and consider supporting outdoor endeavors.
Moms of many are 40% less likely to shop at organic grocery stores, and 31% less likely to stop by vegetarian restaurants.
Millennial moms, meanwhile, enjoy active experiences. Look for them at climbing gyms, national parks and trails. They are also the most likely to cross into the new mom and tech-savvy mom category – making them a critical target.
With 53% of millennials already having children, they are the future. Indeed, 75% of millennial moms believe they pack healthier lunches for their kids than the ones they got growing up, with 37% opting for organic products.
“Instead of choosing their mother’s brands, they’re seeking out emerging brands whose values are aligned with their own,” says Andrea Van Dam, CEO of Women’s Marketing, based in Westport, CT.
“Women are educating themselves. They’re talking to other moms, reading product reviews, and connecting on social to learn about new products,” Van Dam adds. “Researchers (2) tell us that moms mention brands an average of 73 times per week. When we see studies that say that 79% of women learn about brands through word-of-mouth and almost 60% are influenced by online reviews and social media, it’s clear that this is an important place brands should be connecting with moms.”
Even if they’re not buying food online, 51% use their smartphones in-store searching for recipes, she adds. Another opportunity to get in front of them. LPReferences 1. “Mom’s the Word,” Foursquare, May 2018. 2. “21st Century Mom,” Babycenter, February 2015.
In addition, hyaluronic acid and sustainably harvested or wildcrafted super fruits (e.g. bilberry and wild blueberry) were integrated to help protect eyes from the growing concern surrounding blue light.
Probiotics and More “The gut is called the second brain, says Dr. Sears.“ Probiotics are the favoirite food for the child’s growing gut brain. Probiotics help grow a healthier microbiome, the community of healthy bacteria that grow in the intestines and help grow a healthier immune system to help feed the child well at school.”
Smart Family Probiotics has created science-backed supplements for children formulated by Dr. Bill Sears’ son pediatrician Dr. Jim Sears. Named for the areas they support, these include THINK SMART DHA Drops, THINK SMART DHA D3 chews, TUMMY SMART sprinkle packs and SEE SMART Digital Eye Health Melts.
Smart Family chews are sweetened with a natural sugar alternative and are formulated so they won’t stick to the teeth. The company’s probiotic powders mix with foods for picky eaters.
NOW, based in Bloomingdale, IL, is reformulating its Prenatal +DHA softgel to use 5-Methyl Folate (MTHF) instead of folic acid as the source of folate for improved bioavailability, according to Jim Ritcheske, NOW product marketing manager. The level of choline is being increased to 250 mg per 3 softgel serving now that choline has a recognized Daily Value of 550 mg. In addition, the lutein level is increased to 3 mg per 3 softgel serving. The improved Prenatal + DHA product should be available later this year.
Certain vitamins can be given shortly after birth, Ritcheske says. AAP now recommends all babies receive 400 IU per day of vitamin D. NOW offers a Liquid Vitamin D-3 Most children around the age of 2-4 are able to take a multivitamin and other nutrients, Ritcheske adds. NOW Kid Vits Chewables are berry flavored, taste great, sweetened with xylitol and provide supplemental vitamins and minerals to a child’s diet.
NOW also offers BerryDophilus Chewables delivering 2 billion CFUs of probiotics per berry-flavored chewable tablet. Each tablet contains 10 clinically validated probiotic bacterial strains designed to support gastrointestinal health and healthy immune system function. Growing children can also benefit from DHA and NOW has “fish-shaped” 100 mg DHA softgels with a lemon flavor making it easy for kids to take. WF
- Wallace TC and Fulgoni VL, Usual Choline Intakes Are Associated with Egg and Protein Food Consumption in the United States, Nutrients 2017, 9, 839.
- Bell and Aujla “Prenatal Vitamins Deficient in Recommended Choline Intake for Pregnant Women.”. J Fam Med Dis Prev 2016 2:048. https://www.clinmedjournals.org/articles/jfmdp/journal-of-family-medicine-and-disease-prevention-jfmdp-2-048.pdf
- Shaw, GM. et al. “Choline and Risk of Neural Tube Defects in a Folate-fortified Population” Epidemiology 2009; 20(5): 714-719. https://journals.lww.com/epidem/Fulltext/2009/09000/Choline_and_Risk_of_Neural_Tube_Defects_in_a.17.aspx
- Statement from American Academy of Pediatrics Food For Thought: AAP Aims to Ensure Kids Get Key Nutrients for Brain Development 1/22/2018
- Caudill MA, et al, “Maternal Choline supplementation during third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study” FASEB J, 2017 Vol. 32,000-000
- Boeke, et al, “Choline Intake During Pregnancy and Child Cognition at Age 7 Years” American Journal of Epidemiology, 2012 177(12): 1338-1347
- Nilsson, et al, “Plasma 1-carbon metabolites and academic achievement in 15-yr-old adolescents” FASEB J, 2016 30(4 )1683-1688
- Ilcol, et al, “Choline status in newborns, infants, children, breast-feeding women, breast-fed infants and human breast milk” J. Nutr. Biochem. 2005 16(8):489-99
- Wurtman, et al, in Handbook of Neurochemistry and Molecular Neurobiology: Neural Lipids, 2009.
- Da Costa, et al, “Elevated serum creatine phosphokinase in choline-deficient humans: mechanistic studies in C2C12 mouse myoblasts” Am. J. Clin. Nutr., 2004 80(1) 163-170