Not So Sure About Pediasure: Assessing the Relationship of BMI and the Incorporation of Nutritional Supplements in Ideal Meal Plans

Ruth Milanaik; Nallammai Muthiah; Kate Fruitman; Sharnendra Sidhu

doi:10.1542/peds.144.2_MeetingAbstract.208

Purpose: The American Academy of Pediatrics (AAP) recommends that nutritional supplements (NS), such as Pediasure (PS), only be used when children are unable to receive adequate nutrients from their diets. However, PS, a popular dietary supplement, is widely advertised as “clinically proven to help kids grow,” possibly convincing some parents that not consuming NS may put their child at a disadvantage. Excess calories from unneeded NS can lead to increased incidence of obesity. Nevertheless, the frequency with which parents use NS, when not medically necessary, is currently unclear. The objective of this study is to assess the frequency with which parents, when given the option, choose to offer their children NS when planning ideal meals. Methods: Parents of children aged 4-12 years were surveyed anonymously using Amazon Mechanical Turk. Parents who indicated that their child had medical conditions affecting food preferences were excluded. First, parents answered demographic questions, including age, height, and weight of their child. IOTF BMI was calculated using these measurements. Participants were then given a randomized picture list of 71 healthy and non-healthy foods, including PS, from which they were prompted to structure a 1-day ideal meal plan (IMP) for their child, even if their child would not actually eat these foods in reality. Results: A total of 630 effective parent responses were obtained. The mean age of the child sample was 7.25 years (SD= 2.69), with 82.5% of parents identifying as White, 11% identifying as Black, and 6.5% Other. Overall, 35.4% of parents included PS in at least one IMP for the day (breakfast, lunch, dinner, or snack). Parental PS choice was found to be associated with child’s BMI (Chi-square = 12.671, p<.001). Notably, the proportion of children whose parents chose PS was higher in the overweight and obese categories (44% and 43%, respectively), than in the thin and normal weight categories (31% and 29%, respectively). Conclusion: Despite AAP recommendations, over a third of parents chose to include PS in an IMP for their child. This percentage grew dramatically with increasing BMI, showing that children who fell within the overweight and obese categories had parents who chose PS for an IMP at a significantly higher rate. As pediatric obesity rates continue to climb nationwide, it is essential that pediatricians discuss misleading advertising and caution against excess calories associated with the non-medically necessary use of NS.