Evaluation of vitamin and mineral levels in children with poor appetite

Appetite disturbances in children may be linked to underlying micronutrient deficiencies, even in the absence of overt growth abnormalities. This study aimed to evaluate the association between caregiver-reported poor appetite and serum levels of select vitamins and minerals in children. A retrospective case-control study was conducted involving 200 children aged 2–16 years (100 with poor appetite and 100 age- and sex-matched controls). Serum levels of vitamin D, vitamin B12, folic acid, calcium, and phosphorus were compared between groups. There were no significant differences in age, sex distribution, or BMI between groups. However, children with poor appetite exhibited significantly lower serum concentrations of vitamin B12 (358.0 [244.25-465.25] vs. 440.0 [353.0-540.0] pg/mL, p<0.001), folic acid (8.0 [5.85-10.18] vs. 9.0 [7.08-11.53] ng/mL, p=0.007), and 25-hydroxyvitamin D [25(OH)D] (20.75 [14.15-26.13] vs. 25.0 [19.3-32.0] ng/mL, p<0.001). Levels of calcium (p=0.022), phosphorus (p<0.001), sodium, and potassium were also significantly reduced in the poor appetite group. BMI was negatively correlated with vitamin B12, folic acid, and vitamin D levels. Positive correlations were observed between calcium and both folic acid and vitamin B12, as well as between vitamin D and folic acid. Children with poor appetite may be at increased risk for multiple micronutrient deficiencies, particularly involving vitamin B12, folic acid, and vitamin D. Routine nutritional screening should be considered in pediatric patients presenting with appetite concerns, regardless of growth status.