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>> From the Jama Network, this is Jama pediatrics author interviews. Conversations with authors exploring the latest clinical research, reviews, and opinions featured in Jama pediatrics [music].

>> Hi, This is Aaron Carol, and I'm the digital media editor for Jama Pediatrics. In this podcast I talk about interesting articles featured in the journal and what they might mean to you. This week I'm focusing on use of dietary supplements among children and adolescents in the United States by Dema Quato [phonetic] and colleagues. Dietary supplement use is really, really common. In adults, it's a multi-billion dollar business. It's also often of questionable value. In children and adolescents, it's also often implicated in preventable adverse drug events. We don't know as much about the use of supplements in this population as we might like. That's where this week's study comes in. The researchers use the National Health and Nutrition Examination Surveys, or NHANES to look at how many kids use dietary supplements. NHANES is done in waves, and the researchers used six recent cycles from 2003 to 2004, through 2013 to 2014. They also only looked at kids and adolescents through 19 years of age. When kids were younger than 16, parents provided the data for the surveys. Participants were asked if they had -- and I'm quoting here -- "used or taken any vitamins, minerals, herbals, or any other dietary supplements in the past 30 days. Those that answered in the affirmative were asked to show containers for the supplements that they took, so data could be entered and confirmed. Products that primarily contained vitamins or minerals are defined as nutritional products. Other products, like herbal supplements and those not containing mostly vitamins and minerals, were defined as alternative medicines. Data were also collected on the primary use of the supplements that were collected. Overall, about a third of children and adolescents used dietary supplements. Nutritional product use has remained pretty steady over time. But the use of alternative medicines went from 3.7% to 6.7%. Much of this increase was due to more people using Omega 3 fatty acids and melatonin. Overall, multivitamins were the most commonly used products, at about 25% of people, followed by those Omega 3fatty acids. Interestingly, adolescents were the least likely to use dietary supplements, and the most likely to use alternative medicines. Although I have a hard time understanding why adolescents, or any kids for that matter, are so eager to use Omega 3 fatty acids, let alone sleep aids. Female adolescents were more likely to use multi-vitamins, single vitamins, calcium and iron. Boys were more likely to use Omega 3 fatty acids and bodybuilding supplements. Bottom line, more than a third of children and adolescents are using dietary supplements. Many of them were potentially or actually involved in adverse drug events. The calcium, vitamin D and iron, not to mention the bodybuilding supplements, are increasingly associated with adverse cardiovascular events, especially arrhythmias. We often ask patients about the drugs they're taking. We don't do nearly as good a job asking them about the supplements that they're taking. We need to do better. Many more are taking them than we might think. Probing about why, discussing the fact that so many of them are unregulating, and highlighting the potential harms are also important. Especially, because there's often a belief that unlike drugs, supplements are somehow completely safe. They're not. We need to talk to our patients about them. The article's free this week, so please do go read it online at jamanetwork.com/journals/jamapediatrics.