In this exploratory study, two low-carbohydrate, low-volume vitamin and mineral formulations demonstrated favourable short-term acceptability, GI tolerability, and adherence in children and adolescents with IMDs, though the 7-day duration and lack of a control group limit interpretation.
Key Findings
Results
Thirty-one children and adolescents with IMDs were enrolled, and 29 completed the 7-day intervention with one of two novel vitamin and mineral formulations.
Median age was 7.2 years (range 2.1-16.6).
15 participants were allocated to product A and 16 to product B.
14 (product A) and 15 (product B) participants completed the 7-day intervention.
Design was prospective, single-centre, open-label, non-randomised; participants replaced their usual supplement for 7 consecutive days under usual home conditions.
Results
Most participants took the full dose of the study product during the 7 days.
Full-dose intake (always or mostly) was reported in 27/30 (90.0%) participants.
Adherence was recorded daily by caregivers.
Results
Gastrointestinal symptoms improved or stayed unchanged in most evaluable participants for both products.
Product A: GI symptoms improved or remained unchanged in 12/13 (92.3%).
Product B: GI symptoms improved or remained unchanged in 12/14 (85.7%).
GI symptoms were assessed at baseline and day 7 and monitored with daily diaries.
Results
Acceptability scores improved for both products after switching from the usual supplement.
Product A mean score improved from 2.4 to 1.
Product B mean score improved from 2.2 to 0.4.
Lower scores indicate greater acceptability; assessed with structured questionnaires.
Results
Most participants preferred the study product to their usual supplement, universally so for product B.
Product A: 10/14 (71.4%) preferred the study product.
Product B: 15/15 (100%) preferred the study product.
Results
Fewer than half of participants elected to continue using the study product at the end of the study.
Product A: 6/14 (42.9%) chose to continue.
Product B: 7/15 (46.7%) chose to continue.
Conclusions
The authors conclude that formulation characteristics and ease of administration may influence the feasibility of micronutrient supplementation in IMDs, but note important limitations.
The study lasted only seven days and had no control group.
The study was exploratory, single-centre, open-label, and non-randomised.
Larger, longer-term studies are needed to determine whether benefits are sustained and whether better acceptability and adherence translate into improved micronutrient status and clinical outcomes.
What This Means
Children with inherited metabolic disorders often follow strict diets that cut out many nutrient-rich foods, so they depend heavily on vitamin and mineral supplements. But these supplements can be hard to take because of taste, volume, or sugar content, especially for young children with feeding difficulties. This study tested two new low-carbohydrate, low-volume supplement formulations in 31 children and adolescents aged about 2 to 16 years.
Participants swapped their usual supplement for one of the two new products for 7 days at home. About 90% took the full dose always or mostly. Stomach and bowel symptoms stayed the same or got better in most children (about 86-92%). Acceptability scores improved for both products, and most children preferred the new product over their usual one (71% for product A and 100% for product B). At the end, though, only about 43-47% chose to keep using the study product.
This research suggests that supplements that are easier to take may be more practical for children with these conditions. However, the study was very small, lasted only a week, had no comparison group, and did not measure vitamin or mineral levels or health outcomes. Longer and larger studies are needed to find out whether these benefits last and lead to better nutrition and health.
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Tosi M, Evans S, Yilmaz Nas O, Daly A, Pinto A, Ackrill J, et al.. (2026). New Vitamin and Mineral Supplements: Acceptability, Tolerability, and Short-Term Adherence in a Paediatric Cohort with IMDs.. Nutrients. https://doi.org/10.3390/nu18203309