[Time trends in the special dietary needs of preschoolers and schoolchildren: the case of a Brazilian metropolis].

This ecological study analyzed the temporal trend of special dietary needs in children aged 2 to 12 enrolled in the public school system of Belo Horizonte (MG) between 2014 and 2023. Secondary data from medical reports filed at schools, provided by the Municipal Department of Food and Nutritional Security, were used. Variables included year, gender, age, school location and type of dietary restriction. The analysis used descriptive statistics and Prais-Winsten regression. Among the 1967 children, 12.6% had some special dietary need, especially lactose intolerance (39.8%), cow's milk protein allergy (12.6%) and egg allergy (4.2%). From 2021 onwards, there was a significant increase, with 421 cases of intolerance in 2023. The annual increase rates were: 6.69% (intolerance), 5.51% (allergies) and 5.74% (selectivity). Around 43.4% of the reports did not specify the restriction. The high level of adherence to school meals (54.6%) highlights the role of the PNAE in food safety. The findings reinforce the need for intersectoral strategies to ensure inclusive and safe food in the school environment.