Frequency of nutritional supplement use in children, evaluation of influencing factors and relationship with hematologic and biochemical values

Objective: Today, dietary supplement consumption is increasing among all age groups. The increasingly widespread use of nutritional supplements also affects infants and children. Studies on pediatric age groups are limited and few in number in the literature. This study was conducted to evaluate nutritional status, growth, frequency of dietary supplement use, to elucidate the reasons for their use and to examine their relationship with hematologic and biochemical parameters in children. Materials and methods: This cross-sectional survey study was conducted with 565 volunteer participants with children aged 0-18 years who applied to Manisa Celal Bayar University Hafsa Sultan Hospital pediatric outpatient clinics for any reason between December 2021 and September 2022 after obtaining ethics committee approval. The questionnaire assessed the sociodemographic characteristics of the parents, their use of dietary supplements for their children, the purpose of using these products, the effects and side effects seen after the use of the products, and the level of knowledge of the parents about dietary supplements. Parameters indicating the growth and development of the child such as height, weight and laboratory tests performed in the last 1 month, if any, were recorded. The questionnaires were then recorded and statistically analyzed. Results: 565 parents participated in our study. Among the parents, 62.7% (n:354) were mothers and 37.3% (n:211) were fathers. The prevalence of dietary supplement use among the children included in the study was 39.1% (n:221). The most commonly used dietary supplement products were L-arginine and multivitamin 18.1% (n:40), omega-3 and multivitamin 17.6% (n:39), propolis 12.2% (n:27), chicory and multivitamin 10.4% (n:23), and multivitamin 7.2% (n:16). When parents were questioned about the reasons for supplement use, 21.7% (n:48) said to increase appetite, 19.9% (n:44) said to accelerate growth and development, 12.7% (n:28) said to increase weight gain, 11. 8% (n:26) to increase school success, 11.3% (n:25) to increase height, 9.5% (n:21) to provide additional benefit to treatment for any reason, and 5% (n:11) to increase immunity. It was found that 61.5% (n:136) of the parents who used supplements for their children were using supplements with the recommendation of a physician. Among all preparations, the most preferred preparation with physician recommendation was beta glucan-containing dietary supplement. When it was questioned from which source the participants learned about nutritional supplements and started to use them, it was learned that 76.9% (n:170) obtained information from other health workers, 73.3% (n:162) from social media, and 67.9% (n:150) from their physicians. The dietary supplement products for which social media played the most frequent role in providing information were a supplement containing pelargonium sidoides (90%) and a combined preparation containing ginkgo biloba, omega 3 and vitamin E. While 70.1% (n:155) of the participants stated that they benefited after the use of nutritional supplements, those who used combined preparations containing omega 3, ginkgo biloba and vitamin E were the most likely to benefit. While 24% (n:53) of the dietary supplement users reported side effects, the most common side effects were rash 71% (n:38) and nausea and vomiting 28.3% (n:15). Among the sociodemographic characteristics of the parents, educational level of the mother and father, age of the father, number of children, family type, place of residence, and income-expenditure status were found to be effective in the use of nutritional supplements. Children with lower weight percentile and SDS were found to use supplements more frequently. Parents with prophylactic iron and vitamin D use in the first year of life were more likely to use nutritional supplements. It was found that children who consulted pediatricians or pediatricians working in private practice for routine follow-ups used nutritional supplements more frequently. Laboratory tests taken within the last 1 month were available for 135 of the 565 children who participated in the study. 72 of the 135 children were taking nutritional supplements. The mean MCV, MCH, and hemoglobin (Hb) values of 77.42±8.80 fL, 25.59±3.58 pg, and 11.95±2.01 g/dl, respectively, were found to be statistically significantly lower (p<0.05). The mean platelet count of 312.31±84.75 103/µL and the mean absolute lymphocyte count of 3.22±1.22 103/µL were statistically significantly lower in the group using nutritional supplements. No significant statistical difference was found between the use of nutritional supplements and nutritional parameters. Conclusion: Nutritional habits are formed in childhood and establishing the right nutritional habits in this period will be effective in the whole life of the child. The use of nutritional supplements is increasing all over the world and is also increasing in our country. In our study, it was determined that there is a high rate of supplement use in our region. It has been found that there are children who experience side effects as well as benefits. In clinical practice, instead of getting used to the use of supplements for children, it is very important to educate families about balanced and adequate nutrition, to use supplements by examining the method, duration and reason for use, and to avoid unconscious use of supplements. Keywords: Dietary supplements, vitamins, minerals, nutrition