Children's Multivitamin

Children's Multivitamins: A Nutritional and Natural-Health Reference

Definition and Conceptual Overview

A children's multivitamin/mineral supplement (MVM) is a dietary supplement product formulated to deliver two or more vitamins, typically combined with one or more minerals, in amounts intended to address the physiological micronutrient requirements of growing children. In the natural-health context, children's MVMs are understood not as remedies for disease, but as nutritional tools designed to bridge gaps between what children consume from diet alone and what their bodies require for optimal growth, immunity, neurodevelopment, and metabolic function.

Nearly a third of young US children take multivitamin/mineral (MVM) dietary supplements, yet it is unclear how formulations compare with requirements. The concept arises from the recognized reality that childhood malnutrition, which mainly includes protein-energy malnutrition and micronutrient deficiencies, not only affects children's growth and development but may also cause the development of many chronic diseases in adulthood.

Adequate intakes of micronutrients are essential for supporting the growth and development of children, as well as maintaining overall health across the lifespan. The supplementation approach reflects decades of epidemiological data showing that micronutrient deficiencies result in a broad range of adverse health consequences, including increased infectious disease, growth restriction, physical disabilities, and impaired neurocognitive development.

Body Systems Involved

Children's MVM use is relevant across multiple organ systems and physiological domains, all of which are subject to the influence of micronutrient sufficiency or deficiency:

• Skeletal system: Vitamin D helps the body absorb calcium, one of the main building blocks for strong bones; together with calcium, vitamin D helps protect against osteoporosis.
• Immune system: Deficiencies of certain vitamins and minerals—including vitamins A, B6, B12, C, D, E, and K; folate; and copper, iodine, iron, magnesium, selenium, and zinc—might adversely affect immune function.
• Nervous system and brain development: Vitamin B12 deficiency is one of the most common micronutrient deficiencies and is associated with poor cognitive development and growth. Vitamin B12 is crucial for normal cell division and differentiation, and it is necessary for the development and myelination of the central nervous system.
• Hematopoietic system: Iron deficiency is negatively associated with children's cognitive development; evidence shows that iron supplementation improves cognitive development. Nearly 50% of anemia is caused by iron deficiency.
• Musculoskeletal and metabolic systems: These micronutrients are essential for various biological functions in the body, including energy production, organ function, RNA and DNA synthesis, promotion of physical growth, sexual maturation, neuromotor development, and immune responses.
• Endocrine and thyroid system: Iodine is a critical mineral for thyroid hormone synthesis. The four nutritional deficiency subtypes modeled in GBD 2021 include protein-energy malnutrition, vitamin A deficiency, iodine deficiency, and dietary iron deficiency, as these represent the major nutrition-related risk factors for mortality and morbidity in children aged 0–14 years according to WHO and the Global Nutrition Report.

Global and Epidemiological Context

The scale of pediatric micronutrient deficiency globally is substantial. The global prevalence of deficiency in at least one of three micronutrients was estimated at 56% among preschool-aged children, equivalent to 372 million preschool-aged children. Regionally, three-quarters of preschool-aged children with micronutrient deficiencies live in south Asia, sub-Saharan Africa, or east Asia and the Pacific.

Vitamin A deficiency is still prevalent in South Asia and sub-Saharan Africa. Thirteen countries have a prevalence of iodine deficiency in preschool children of more than 50%, and in some countries in sub-Saharan Africa, the prevalence of iron deficiency and iron-deficiency anaemia exceeds 60% in the paediatric population.

Even in high-income countries, nutrient gaps persist. Inadequate calcium, magnesium, phosphorus, potassium, and vitamin A intake became increasingly common with age, particularly among adolescent girls, with approximately 78% of girls aged 9–18 years reporting inadequate calcium intake. Younger children reported adequate iron and folate intake; however, 29.9% of adolescent girls had serum ferritin concentrations indicating iron deficiency, and 19.7% had red blood cell folate concentrations below recommended thresholds. Vitamin D insufficiency also increased with age, affecting nearly 1 in 5 adolescent girls aged 9–18 years.

From NHANES data, an analysis of data from the 2015–2016 National Health and Nutrition Examination Survey (NHANES) found that average daily vitamin D intakes from foods and beverages were 4.9 mcg (196 IU) in children age 2 to 19 years. In fact, 2013–2016 NHANES data showed that 94% of people age 1 year and older ingested less than the Estimated Average Requirement of 10 mcg (400 IU) of vitamin D from food and beverages.

Contributing and Associated Factors

Picky Eating and Selective Food Behavior

Selective or "picky" eating behavior is a significant contributing factor to micronutrient inadequacy in children. Young children with picky eating behaviors and low weight-for-height have suboptimal dietary patterns and are at risk for significant dietary and nutrient insufficiencies. Picky eating behaviors are common in young children and may adversely affect dietary intake.

In a multicenter, randomized trial of 151 Chinese preschool children identified as picky eaters, median daily energy intake was 25% lower than the age-appropriate Recommended Nutrient Intake (RNI), while median intakes of calcium, iron, zinc, and vitamins C and E ranged from 52–73% of the RNI. Vitamin D intake was only 37% of the RNI.

A cross-sectional study of 321 school-age children aged 7–10 found that the picky eating group consumed significantly less protein, folate, magnesium, potassium, zinc, and vitamins B1, B2, B3, B6, D, and E than the non-picky eating group.

Dietary Patterns and Ultra-Processed Food Intake

Childhood obesity represents a serious public health burden. Despite excessive dietary consumption, children with obesity present high rates of micronutrient deficiencies, such as deficiencies in minerals and specific vitamins; micronutrient deficiencies may have a pathogenic role in obesity-related metabolic comorbidities. Iron; vitamins A, B, C, D, and E; folic acid; zinc; and copper deficiencies represent the most common deficient microelements in children with obesity.

Dietary supplement non-users had the highest risk of any deficiency (40%), compared to users of full-spectrum multivitamin-multimineral supplements (14%) and other dietary supplement users (28%).

Socioeconomic and Demographic Factors

Supplement use does not uniformly reach those most in need. Research from the 2016 Feeding Infants and Toddlers Study (FITS) found that the children who were most likely to use dietary supplements were not the most nutritionally vulnerable; they were non-Hispanic Whites from more affluent and highly educated families whose intakes were already high from foods alone.

The burden of child malnutrition was negatively correlated with sociodemographic index (SDI). Access to varied, nutrient-dense food—including animal-source foods rich in zinc, iron, and vitamin B12—remains unequal both globally and within high-income countries.

Special Dietary Patterns: Vegetarian and Vegan Diets

Children following plant-based dietary patterns face an elevated risk of deficiency in specific nutrients. Deficiencies in zinc may arise from the insufficient intake of foods containing zinc or insufficient absorption. Most foods high in zinc are of animal origin, such as meats, fish, and dairy products. Vitamin B12 is found almost exclusively in animal-source foods, making it a critical nutrient of concern for children following vegan diets.

Exclusive Breastfeeding and Infancy

Consumption of human milk alone does not ordinarily enable infants to meet vitamin D requirements, because it provides less than 0.6 to 2.0 mcg/L (25 to 78 IU/L). Accordingly, the American Academy of Pediatrics currently suggests that all children receive 400 IU of supplemental vitamin D daily — an amount that is typically found in multivitamin supplements.

Key Micronutrients in Children's MVMs: Roles, Traditional Use, and Scientific Evidence

Vitamin D

Role and Deficiency Context: Vitamin D is a nutrient needed for good health. It helps the body absorb calcium, one of the main building blocks for strong bones. Muscles need it to move, and nerves need it to carry messages between the brain and body. The immune system needs vitamin D to fight off invading bacteria and viruses.

Traditional Use: Historically, cod liver oil — rich in vitamin D and vitamin A — has been used for centuries in Northern European traditions to prevent rickets and support general robustness in children, especially through the winter months when sun exposure is minimal.

Scientific Evidence: Several risk factors are associated with vitamin D deficiency in children. Even if vitamin D deficiency remains a major public health problem, its symptomatic manifestations are less and less common in clinical practice, and pediatric age represents a "gray area" where vitamin D supplementation is often administered in the absence of an effective evaluation of status. The two supplemental forms, D2 (ergocalciferol) and D3 (cholecalciferol), are both effective at raising serum levels; both forms increase vitamin D in the blood, but D3 might raise it higher and for longer than D2. The Recommended Dietary Allowance (RDA) context is important: the RDA for vitamin D is 10 to 15 mcg (400–600 IU) for children, depending on age. Evidence strength for vitamin D and bone health in children is moderate; evidence for other pediatric outcomes (immunity, cognitive development) is preliminary and requires further RCT data.

Iron

Role and Deficiency Context: Iron is essential for hemoglobin synthesis, oxygen transport, and neurological development. Nearly 50% of anemia is caused by iron deficiency. Anemia affects more school-age children, at an age where their brain development continues.

Traditional Use: Iron-rich foods such as liver, red meats, and legumes have been emphasized in folk and traditional nutrition practices across many cultures for "blood building" and for treating pallor and fatigue in children — descriptions consistent with iron-deficiency anemia.

Scientific Evidence: A 2023 systematic review and meta-analysis (PubMed, EMBASE, Scopus, Web of Science, CENTRAL), including 13 RCTs of school-age children aged 6–12, found that iron supplementation improved hemoglobin concentration and reduced the incidence of anemia and iron deficiency in school-age children. Furthermore, iron supplementation was shown to be effective in improving cognition. However, longitudinal studies consistently indicate that children anemic in infancy continue to have poorer cognition, school achievement, and more behavior problems into middle childhood; the possible confounding effects of poor socioeconomic backgrounds prevent causal inferences from being made. Evidence is strongest for iron-deficient or anemic children; evidence for supplementation in iron-replete children is weaker. Over a quarter of children in the second year of life had usual iron intakes less than the RDA.

Zinc

Role and Deficiency Context: Zinc is an essential trace element required for maintaining intestinal cells, bone growth, and immune function. Severe zinc deficiency has been associated with stunting of growth, impaired immunity, skin disorders, learning disabilities, and anorexia.

Traditional Use: Traditional dietary systems in many cultures emphasized zinc-rich animal foods (oysters, red meats, organ meats, and legumes) for growth and wound healing in children, though zinc as an isolated nutrient was not recognized in pre-modern traditions.

Scientific Evidence: A 2016 Cochrane Review of 33 trials including 10,841 children aged 1 month to 5 years with acute or persistent diarrhea found that zinc supplementation shortens the duration of diarrhea by about half a day in children older than 6 months and reduces the likelihood that diarrhea will persist for at least 7 days by 27%. In addition, evidence deemed to have high certainty showed that zinc supplementation reduces the duration of diarrhea in children with signs of malnutrition by about a day. The RDA for zinc is 2–13 mg for infants and children, depending on age. Importantly, however, zinc is one of the nutrients most commonly exceeded in children who use MVMs combined with fortified foods: in the 2011–2016 NHANES, over 60% of children 1 to 3 years old were at risk of exceeding the UL for zinc and folic acid. Evidence for zinc in respiratory infections in children is mixed and context-dependent.

Vitamin A

Role and Deficiency Context: The role of vitamin A in the immune system is still debated. Multiple studies have demonstrated that vitamin A deficiency is associated with an increased incidence of infectious diseases and a consequent increased morbidity and mortality.

Traditional Use: Vitamin A-rich foods such as liver, egg yolks, and orange/yellow vegetables have historically been used across diverse cultures to support "night blindness" and promote growth and vitality in children — consistent with the modern understanding of vitamin A's role in retinal function and immune health.

Scientific Evidence: The WHO recommends vitamin A supplementation in all patients between 6 months and 5 years who are at risk of vitamin A deficiency (in all developing countries). This recommendation is based on the evidence that vitamin A supplementation determines an overall reduction in mortality (risk ratio 0.88; 95% CI 0.83, 0.93), a reduction in diarrhoea incidence (RR 0.88; 95% CI 0.79, 0.98), and a reduction in measles-related morbidity. In malnourished children, vitamin A supplementation improved measles vaccine seroconversion by 35%, especially among deficient children. Evidence is strong for vitamin A supplementation in deficient populations, but in nutrient-replete Western children, excess intake is a greater concern than deficiency: national surveys found that some toddlers and young children had total intakes from foods, infant formulas, fortified foods, and supplements exceeding the UL, especially for folic acid, vitamin A, and zinc.

Vitamin C

Role and Deficiency Context: Vitamin C plays an important role in both innate and adaptive immunity, probably because of its antioxidant effects, antimicrobial and antiviral actions, and effects on immune system modulators. Vitamin C helps maintain epithelial integrity, enhance the differentiation and proliferation of B and T cells, enhance phagocytosis, normalize cytokine production, and decrease histamine levels.

Traditional Use: Scurvy prevention with citrus fruits, rosehips, and fresh plant foods has a documented history in many seafaring and traditional populations, and vitamin C-rich preparations (lemon juice, berry preparations) have been given to children to prevent and treat symptoms of deficiency.

Scientific Evidence: The RDA for vitamin C is 15 to 115 mg for infants and children, depending on age. Evidence for vitamin C supplementation improving immune outcomes in vitamin C-replete, well-nourished children is weak. The bulk of evidence supporting vitamin C's immune role pertains to deficient populations or individuals under physiological stress. It remains one of the most consistently included vitamins in children's MVM formulations.

B-Complex Vitamins (B6, B12, Folate, and Others)

Role and Deficiency Context: B vitamins serve as coenzymes in energy metabolism, DNA synthesis, and neural function. Vitamin B12 deficiency is one of the most common micronutrient deficiencies and is associated with poor cognitive development and growth. Vitamin B12 is crucial for normal cell division and differentiation, and it is necessary for the development and myelination of the central nervous system.

Traditional Use: B12-rich animal foods (organ meats, dairy, eggs) have been recognized across traditional food systems as essential for vitality. Folate from green leafy vegetables has been valued in traditional diets as supporting healthy growth, though the explicit recognition of these nutrients is a modern scientific development.

Scientific Evidence: A double-blind, placebo-controlled RCT of 600 Nepalese infants aged 6–11 months (at risk of B12 deficiency) conducted over 12 months found that there were no effects of the intervention on the Bayley-III scores, growth, or hemoglobin concentration. This illustrates the challenges in demonstrating cognitive benefit from supplementation within a mixed-micronutrient background. Folate is one of the nutrients most commonly provided in excess through MVMs: the upper tolerable intake level was exceeded by 49% of 197 products with folic acid. The European Food Safety Authority (EFSA) has set age-specific ULs for folic acid; these are 200 μg/day for children aged 1–3 years, 300 μg/day for 4–6 years, 400 μg/day for 7–10 years, and 600 μg/day for 11–14 years.

Iodine

Role and Deficiency Context: Iodine is indispensable for the synthesis of thyroid hormones, which regulate metabolism and are critical for fetal and early childhood brain development. Thirteen countries have a prevalence of iodine deficiency in preschool children of more than 50%.

Traditional Use: Historically, coastal and seafaring populations used seaweed, kelp, and sea fish as sources of iodine. Many inland populations relied on iodine through salt fortification programs, which became widespread in the twentieth century.

Scientific Evidence: The body of evidence supporting iodine sufficiency for thyroid function and neurodevelopment is robust, primarily from public health-level fortification programs and observational data. However, use of dietary supplements gave rise to 21–73% of children in exceedance of the ULs for vitamin A, zinc, iodine, and iron. Excess iodine can suppress thyroid function, and this is of particular concern when children's MVMs are combined with iodized salt and fortified foods.

Product Formulation: What MVM Products Contain and Their Nutrient Gaps

A cross-sectional analysis of all 288 children's MVMs (for ages 1–4 years) in the NIH Dietary Supplement Label Database (2018) found that the 288 MVMs contained a mean of 10.1 ± 2.27 vitamins and 4.59 ± 2.27 minerals. The most common were, in rank order, vitamins C, A, D, E, B6, B12; zinc, biotin, pantothenic acid, iodine, and folic acid.

Critically, the nutrients most needed from a public health perspective are not always the ones most adequately provided. For micronutrients denoted by the Dietary Guidelines for Americans (DGA) 2015 and 2020 of public health concern, 56% of the 281 products containing vitamin D, 4% of the 144 with calcium, and none of the 60 containing potassium provided at least half of the Daily Value.

For nutrients where children already receive adequate or excess intake from the food supply, MVMs may compound the risk of exceeding safe levels. Most MVMs contained many of 16 other vitamins and minerals identified in national surveys as already abundant in children's diets. A reexamination of the amounts and types of micronutrients in MVMs might consider formulations that better fill critical gaps in intakes and avoid excess.

Calcium, magnesium, and phosphorus — all nutrients commonly inadequate in older children's diets — are systematically under-provided: for calcium, magnesium, and phosphorus, all studied products were labeled below the RDAs. This reflects practical constraints on tablet or gummy size, as these minerals require large amounts by weight.

Many children's multivitamin/mineral supplements on the market contain more than the RDA for several micronutrients when taken at the suggested dosage by age. Some even contain micronutrients (e.g., vitamin A, folic acid, copper, and zinc) at levels equivalent to the UL; this is of concern for children younger than 9 years old.

Safety and Tolerable Upper Intake Levels

A central nutritional concern with children's MVMs is the potential for cumulative intake from fortified foods, formula, and supplements to exceed the Tolerable Upper Intake Level (UL) — the threshold above which the risk of adverse effects increases. In the United States, national surveys found that some toddlers and young children had total intakes from foods, infant formulas, fortified foods, and supplements exceeding the UL, especially for folic acid, vitamin A, and zinc.

Among the measured content of actual products, overages (i.e., actual content exceeding labeled content) resulted in levels exceeding the UL for folic acid in 24 out of 29 products labeled at the UL, and for retinol in 10 out of 40 products labeled below the UL, including one of the three most highly consumed MVMs.

Dietary supplement use was common among 4–10-year-old Danish children and resulted in a considerable proportion of users exceeding the ULs for vitamin A, zinc, iodine, and iron. The long-term health consequences of exceeding these ULs for children are unknown.

The vitamin D UL context is also relevant: the tolerable upper intake level for children ages 4 to 8 years is 3,000 IU/day (75 μg/day) of vitamin D; the UL for boys and girls ages 9 to 13 years is 4,000 IU (100 μg/day).

For folic acid specifically, children aged 1–8 years, specifically supplement users, were the most likely to exceed their age-specific UL.

Scientific Evidence on Multivitamin Use and Child Outcomes

Cognitive and Neurodevelopmental Outcomes

The evidence for MVMs improving cognitive or developmental outcomes is mixed and context-dependent. In a randomized, 2×2 factorial, double-blind trial of 2,400 Tanzanian infants randomized to zinc, multivitamins (vitamins C, E, B-complex), zinc plus multivitamins, or placebo from 6 weeks of age, neither daily zinc nor multivitamin supplements, alone or in combination, had a significant effect on developmental outcomes at 15 months of age. The authors noted that there have been a limited number of randomized controlled trials that assessed the effect on development of direct multiple micronutrient supplementations to children.

In a follow-up to an RCT of 902 infants aged 6–17 months in Lima, Peru, brain growth and development are critically dependent on several micronutrients; during early development, cellular activity may be sensitive to micronutrient deficiencies, however the evidence from human studies is equivocal.

For iron specifically, which is one of the best-studied individual micronutrients in this context, iron supplementation improved hemoglobin concentration and reduced the incidence of anemia and iron deficiency in school-age children, and iron supplementation was shown to be effective in improving cognition. Evidence is strongest where baseline iron deficiency or anemia is confirmed.

Growth Outcomes

In picky-eating preschool children, oral nutritional supplementation alongside dietary counseling has shown benefits. A multi-center prospective randomized double-blind study conducted in 10 hospitals in India (N=321 children aged 24–48 months) found that oral nutritional supplements (ONS) along with dietary counseling, rather than dietary counseling alone, promoted growth among picky-eating Indian children aged 24–48 months with weight-for-height percentiles lying between the 5th and 25th over 90 days.

Immune Function and Infectious Disease

Consuming adequate amounts of several vitamins and minerals—including vitamin A, vitamin C, vitamin D, vitamin E, selenium, and zinc—is important for proper immune function, and clinical deficiencies of these nutrients weaken immunity and can increase susceptibility to infections. However, evidence that supplementing already-replete children with these nutrients further reduces infectious disease burden is limited. The strongest evidence for immune benefit from individual micronutrient supplementation pertains to deficient populations.

Vitamin A supplementation improved measles vaccine seroconversion by 35% among deficient children. Zinc enhanced responses to oral vaccines (rotavirus and OPV) by 20%. These findings come from studies in malnourished children in low- and middle-income countries and should not be generalized uncritically to well-nourished children in high-income settings.

Dietary and Lifestyle Factors

Dietary Quality as the Primary Determinant

Authoritative sources consistently position dietary quality, not supplement use, as the primary determinant of pediatric micronutrient status. Individuals consuming an adequate diet based on the Estimated Average Requirement had a lower risk of any deficiency (16%) than those with an inadequate diet (57%).

Consuming a nutritious variety of foods helps maintain overall good health and a strong immune system. Food-first approaches emphasize animal-source foods (iron, zinc, B12), leafy green vegetables (folate, vitamin K), fatty fish (vitamin D, omega-3 fatty acids), dairy and fortified alternatives (calcium, vitamin D), and orange/yellow fruits and vegetables (vitamin A precursors).

Fortified Foods and Cumulative Intake

The proliferation of fortified foods — breakfast cereals, dairy products, infant formulas, and fortified beverages — means that many children, especially in high-income countries, already receive substantial quantities of vitamins and minerals before any supplementation. Data from NHANES show that with the exception of vitamins D and E and calcium, dietary deficiencies of vitamins and minerals are rare among children 8 and younger in the United States. For young children, the problem is the opposite – the risk of too much intake of some nutrients from fortified foods and supplements.

Sun Exposure and Vitamin D

Obtaining sufficient vitamin D from natural (non-fortified) food sources alone is difficult. For many people, consuming vitamin D-fortified foods and exposing themselves to some sunlight are essential for maintaining a healthy vitamin D status. Factors such as geographic latitude, skin pigmentation, cultural clothing practices, and indoor lifestyles all modulate endogenous vitamin D synthesis and therefore influence children's risk of deficiency.

Obesity and Paradoxical Malnutrition

The nutritional status of children and adolescents with obesity represents a paradoxical malnutrition; despite excessive dietary consumption, children with obesity present high rates of micronutrient deficiencies, micronutrient deficiencies may have a pathogenic role in obesity-related metabolic comorbidities. This phenomenon highlights that caloric sufficiency does not equate to micronutrient sufficiency.

Equity and Access

Deficiencies in micronutrients contribute to impaired immune function, poor growth and physical development, and increased morbidity and mortality in children. Public health prevention strategies such as supplementation, fortification, and nutrition education are therefore strongly encouraged by the WHO and UNICEF in low-income and middle-income countries.

In high-income countries, however, the relationship between supplementation need and supplement use is inverted: supplement use is more common among children in higher-income, better-educated families who are least likely to be nutritionally vulnerable, while children in lower socioeconomic groups — who face greater nutritional risk — use supplements less frequently.

Nutrient Interactions Within Multivitamin Formulations

The co-formulation of many nutrients within a single product creates important considerations around nutrient-nutrient interactions. High doses of folic acid in synthetic form (as used in supplements) can potentially mask vitamin B12 deficiency by correcting megaloblastic anemia while neurological damage progresses. Iron can compete with zinc for absorption when both are present at high doses in supplement form. Calcium at high doses can interfere with iron absorption when taken simultaneously. Evidence suggests that while supplementation can be effective, interventions need to be tailored based on individual nutritional status and age-specific requirements.

Vitamin D, being fat-soluble, requires co-ingestion with dietary fat for optimal absorption. Because vitamin D is fat soluble, it is best absorbed when taken with a meal or snack that includes some fat. This is relevant for gummy and chewable MVM formulations often consumed as standalone snacks by children.

Evidence Summary and Research Gaps

The overall evidence base for children's MVMs as a nutritional intervention can be summarized as follows:

• Strong evidence (from systematic reviews and RCTs): Vitamin D supplementation for breastfed infants; iron supplementation in iron-deficient or anemic school-age children; vitamin A supplementation in deficient children in low-income countries; zinc supplementation for reduction of diarrhea duration in deficient children.
• Moderate evidence: Multiple micronutrient supplementation improving nutritional status biomarkers (hemoglobin, serum retinol, serum zinc) in nutritionally at-risk populations in low-income settings.
• Weak or preliminary evidence: MVM supplementation improving cognitive or developmental outcomes in generally well-nourished children; MVM use reducing infectious disease incidence in replete Western children.
• Areas of concern with evidence: Risk of exceeding ULs for folic acid, vitamin A, zinc, and iodine in children using MVMs alongside fortified foods; inequitable distribution of supplement use relative to nutritional need.

Brain growth and development are critically dependent on several micronutrients; during early development, cellular activity may be sensitive to micronutrient deficiencies, however the evidence from human studies is equivocal. Research gaps include long-term RCT data on MVM use in children who are not clinically deficient but consume suboptimal diets; studies on the impact of specific formulations (dose, form, matrix) on bioavailability; and data on the effects of long-term intake above ULs in pediatric populations.

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