Dietary Intake and Consumption Characteristics of Children with Microcephaly Associated with Congenital Zika Syndrome (CZS)
Child Nutrition. Microcephaly. Food Consumption.
Congenital Zika Syndrome (CZS) was recognized as an important public health problem in Brazil during the outbreak of infections that occurred between 2015 and 2016. Zika virus is an arbovirus of the genus Flavivirus, family Flaviviridae, and its primary vector is the mosquito Aedes aegypti. Microcephaly is one of the main neurological conditions resulting from Zika virus infection. Children with brain lesions or malformations of the central nervous system, such as microcephaly associated with CZS, may present feeding difficulties that directly impact nutritional status. Considering the importance of adequate nutrition for proper child development and improved quality of life, the aim of this study was to evaluate the relationship between food and dietary intake and growth in children with microcephaly associated with CZS. This is a cross-sectional analysis of a cohort study including information on dietary intake and anthropometric data of children with microcephaly associated with CZS from Rio Grande do Norte, Brazil. Recruitment was carried out at the Child and Adolescent Health Care Unit
(UASCA) of the Onofre Lopes University Hospital (HUOL). Up to three 24-hour dietary recalls were collected to analyze information on foods consumed by the children on the day prior to the consultations. For the analysis of nutrient intake, data from the Brazilian Food Composition Table (TBCA) were used, and the prevalence of micronutrient inadequacy was calculated according to sex, age, and the Estimated Average Requirement (EAR). Foods were classified according to the degree of processing using the NOVA classification system to identify ultra-processed foods (UPFs). Regarding anthropometric data, weight was measured and height was estimated using tibial length. For evaluation and comparison, growth curves from the World Health Organization (WHO) and Brooks were used. High prevalences of micronutrient inadequacy were observed, particularly for magnesium (93.32%), vitamin E (73.24%), and selenium (71.23%). In addition, children consumed an average of 21.25% of their total energy intake from UPFs. When this energy intake was analyzed according to nutritional status classification, children classified as having high weight-for-age according to WHO criteria presented the highest
percentage of calories derived from UPFs (p = 0.006). It is concluded that children with microcephaly associated with CZS present a high prevalence of inadequate micronutrient intake, anthropometric alterations such as low
weight-for-age and short stature-for-age, as well as higher consumption of UPFs.