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Background. In high-income countries, shopping for non-prescription multivitamin-multimineral supplements has tremendously increased. Objective and Methods. The purpose of this labeling analysis is to inform on the daily elemental iron (with or without vitamin C) supply provided by multivitamin-multimineral supplements sold online by Amazon in Western and Southern Europe (amazon.es ® , amazon.de ® , amazon.it ® , and amazon.fr ® ). Results. We identified 298 iron-containing multivitamin-multimineral preparations sold by Amazon marketplaces: 153 preparations sourced from amazon.de ® , 68 from amazon.fr ® , 54 from amazon.it ® , and 23 from amazon.es ® . The daily iron dose provided by these preparations was 14 [5-14] mg (median and interquartile range), with no differences among the marketplaces. Approximately 90% (n = 265) of the preparations contained ferrous iron. Moreover, 85% (n = 253) of the preparations were fortified with vitamin C in a dose of 80 [40-100] mg daily. Conclusions. The median supply of iron (about 14 mg) and vitamin C (80 mg) in iron-containing multivitamin-multimineral preparations offered on Amazon platforms in Western and Southern Europe falls below that currently recommended for iron deficiency in review articles, namely 100 mg of iron and 500 mg of vitamin C per day. The iron supply of iron-containing multivitamin-multimineral preparations falls also below the dose of 30-60 mg advocated to prevent iron deficiency in menstruating women.

Multivitamins are commonly used by the general population, often without medical prescription. The purpose of this report is to inform on the daily vitamin D supply provided by multivitamins containing vitamin D that are commercialized online by Amazon in Western and Southern Europe. We surveyed multivitamins aimed at adults using the following marketplaces: amazon.es®, amazon.de®, amazon.it®, and amazon.fr®. We identified 199 vitamin D3-containing multivitamins sold by Amazon marketplaces: 77 from amazon.es®, 73 from amazon.de®, 33 from amazon.it®, and 16 from amazon.fr®. No multivitamin contained vitamin D2. The daily vitamin D3 supply ranged from 16 to 2000 IU: it was less than 400 IU daily in 108 (54%), 400−800 IU daily in 53 (27%), and more than 800 IU daily in the remaining 38 (19%) products. The vitamin D3 supply of products sold by amazon.it® was on average higher (p < 0.05) than that of products sold by amazon.de®, amazon.fr®, and amazon.es®. In conclusion, the vitamin D supply of multivitamins sold by Amazon may be insufficient, marginally sufficient, or adequate for subjects at high risk of hypovitaminosis D such as subjects 65 years or more of age, pregnant (or lactating) women, or patients on drug treatment or with an underlying disease, where a vitamin D supplementation is advocated.

Unlabelled: The European Food Safety Authority (EFSA) provides policy makers with scientific and technical advice in relation to food safety and human nutrition in an independent and transparent way, and communicates such advice to the general public. Requirements for the scientific substantiation of health claims referring to children's development and health are the same as for other health claims. However, children (particularly infants) have peculiarities which should be taken into account, because these may impair the extrapolation of results to other groups., Conclusion: Health claims used in commercial communications should be authorized only after a scientific assessment of the highest possible standard by EFSA. EFSA's negative opinions on rejected claims should not be read as a criticism to research studies published in paediatric nutrition but rather highlight their limitations in relation to the substantiation of specific health claims made on foods., (©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)