Comparative Study of Body Composition, Micronutrient Status and Hormonal Profiles in Undernourished Children With Feeding Difficulties

Malnutrition remains a global health concern, with feeding difficulties contributing to its development. This study is a cross-sectional analysis of baseline data from the MARVEL randomized controlled trial, which assessed the prevalence of feeding difficulties and compared nutritional and biological outcomes in children with and without feeding difficulties. 159 children aged 1–6 years with weight-for-height z-score between − 1SD to -3SD without diseases or medications affecting growth or appetite were recruited. Feeding difficulties were identified using the Montreal Children's Hospital Feeding Scale questionnaire. Dietary intake was evaluated via 24-hour dietary recall. Body composition was assessed using bioelectrical impedance analysis (aged ≥ 3 years). CBC, iron status, zinc,25(OH)D, IGF-1, IGFBP-3, and appetite hormones (ghrelin, leptin, peptideYY, insulin) were analysed. Feeding difficulties were present in 68% of the children. No significant differences in dietary intake, anthropometry, micronutrient status, or appetite hormones were found between groups. However, children with feeding difficulties had higher lean and skeletal muscle mass, significantly higher IGFBP-3, and a trend toward lower ghrelin. ID (Iron deficiency, transferrin saturation < 15%), ID anemia, and vitamin D insufficiency (25(OH)D < 20 ng/mL) were found in 18%, 4.7%, and 11% of children, respectively. Findings highlight the need for integrated nutritional and behavioral care in non-organic malnutrition.