Feeding challenges faced by Brazilian children and adolescents with infantile neuroaxonal dystrophy (INAD) adversely impact nutrient intake and nutritional status

Abstract

ABSTRACT Objective: To evaluate the nutritional profile, dietary intake, and feeding characteristics of Brazilian children and adolescents with infantile neuroaxonal dystrophy, comparing exclusively orally fed and gastrostomy-fed participants. Methods: This retrospective cross-sectional study included 21 genetically confirmed patients with infantile neuroaxonal dystrophy between July 2023 and March 2024. Data collection involved 24-hour dietary recalls, anthropometric measurements, and assessment of dysphagia using the Functional Oral Intake Scale. Nutritional status and intake were compared using the Mann-Whitney U test (p<0.05). Results: Twelve participants (57%) received gastrostomy feeding. Among orally fed participants (n=9), 66.7% required food texture modifications and 88.9% exhibited symptoms suggestive of dysphagia. Weight-for-age Z-scores tended to be lower in the exclusively orally fed group than in the gastrostomy-fed group (−2.10 versus −0.34, p=0.072). Micronutrient intake, including vitamins A, D, E, folic acid, and B12, was lower in the exclusively orally fed group than in the gastrostomy-fed group. Ultra-processed foods were frequently consumed, leading to a monotonous diet. Conclusion: Feeding difficulties are common among patients with infantile neuroaxonal dystrophy and are associated with impaired nutritional intake and suboptimal growth, particularly in exclusively orally fed individuals. These findings underscore the importance of individualized nutritional strategies and multidisciplinary care to address dysphagia and optimize nutritional outcomes.