Lemon-Flavored Cod Liver Oil and a Multivitamin-Mineral Supplement for the Secondary Prevention of Otitis Media in Young Children: Pilot Research

Abstract

We measured blood levels of fatty acids, vitamin A, and trace metals in children undergoing ambulatory surgery for placement of tympanostomy tubes and a comparison group having other ambulatory surgical procedures. We then performed a small, outpatient, secondary prevention study using nutritional supplements chosen on the basis of those blood levels. The study subjects had lower levels of red blood cell eicosapentaenoic acid (EPA) than did adult controls. Consistent with previous reports, the levels of vitamin A were < or = 40 microg/dL for 69% of our subjects, and the plasma selenium levels for children were lower than published values for adults. We then studied one otitis media (OM) season; 8 children (0.8 to 4.4 years of age) received 1 teaspoon of lemon-flavored cod liver oil (containing both EPA and vitamin A) and 1 half-tablet of a selenium-containing children's chewable multivitamin-mineral tablet per day. During this OM season, study subjects received antibiotics for OM for 12.3% +/- 13.4% (SD; p < .05) fewer days during supplementation than before supplementation. Larger, controlled trials are warranted to assess the utility of cod liver oil (of acceptable purity and taste) and a children's multivitamin-mineral preparation containing selenium, both for the prevention of OM and for the acceptance of delayed prescription of antibiotics for this disorder.

Nutritional supplements as adjunctive therapy for children with chronic/recurrent sinusitis: pilot research

“…The maximum dose of fish oil was 3 g per day, and the maximum dose of multivitamin-minerals was four half-tablets per day (providing 10,000 IU per day of Vitamin A and 800 IU per day of Vitamin D). The titrated doses of Vitamin A and Vitamin D were higher than those used in our previous study [15], but well below the lowest daily toxic doses of these vitamins [21] (19,860 IU per day for Vitamin A and 2800 IU per day for Vitamin D). The US Food and Drug Administration considers fish oil at dosages up to 3 g per day as safe for adults and children [22].…”

“…The starting dose of supplements in the current study was the same as in our previous research [15]: one teaspoon (5 ml) of Carlson's lemon-flavored cod liver oil and 1/2 tablet of Carlson's Scooter Rabbit chewable multivitamin-mineral per day (providing a total of 3750 IU per day of Vitamin A and 700 IU per day of Vitamin D). However, the Vitamin A content of the cod liver oil was lower than in our previous study (see below).…”

“…In a previous study [15], we obtained blood samples from 44 children undergoing ambulatory surgery (most of whom were undergoing placement of tympanostomy tubes). These children had lower levels than adults of eicosapentaenoic acid (EPA; an anti-inflammatory, omega-3 fatty acid), Vitamin A (the ''anti-infective'' vitamin, which also has anti-inflammatory properties), and selenium (a trace metal that is an intrinsic component of glutathione peroxidase, which decreases reactive oxygen species).…”

A case–control study of nutritional factors associated with chronic suppurative otitis media in Yemeni children

“…The prevalence of iron deficiency, based on the sTfR/ferritin ratio, did not differ between cases and controls. A beneficial effect of micronutrient supplementation, including Zn on recovery from acute otitis media (Dobo and Czeizel, 1998;Linday et al, 2002) and CSOM (Brooks et al, 2005) has been reported, although in these reports, the prevalence of micronutrient deficiency in study subjects was unclear. In the largest study from Bangladesh, a year's Zn supplementation (70 mg weekly) was associated, in children o2 years of age, with significant reduction in chronic suppurative ear disease (Brooks et al, 2005).…”

Time for an oil check: the role of essential omega-3 fatty acids in maternal and pediatric health

“…From development of intelligence in utero 10 to managing common pediatric problems such as recurrent ear infections, 11 from amelioration of hostility in young adults 12 to abating various psychiatric disorders 13 and from diminishing the risk of cardiac disease 14 to a role in preventing Alzheimer's, 15 it is evident that EFAs are necessary at all stages of life. In this paper, use of o3FAs in the gestational period and in pediatric health will be highlighted.…”