中低收入国家营养不良与心理健康的双重危害：新冠疫情之后

摘要(中文译文)

中低收入国家（LMICs），尤其是拉丁美洲国家，正面临日益加重的营养不良双重负担，其特征是肥胖与微量营养素缺乏并存，同时精神健康障碍发生率居高不下。从健康与疾病的发展起源（DOHaD）视角来看，母亲营养和心理健康是子代生长、神经发育及长期健康的关键决定因素。COVID-19大流行及随后的全球粮食危机加剧了粮食不安全、不健康饮食以及抑郁和焦虑症状，增加了母亲各种形式营养不良的风险。尽管关于早期发育阶段母亲营养与心理健康相互作用的大部分证据来自亚洲和欧洲人群，但拉丁美洲因其肥胖、微量营养素缺乏和围产期精神健康障碍的高患病率而呈现出尤为脆弱的背景。本文探讨生命早期母亲营养和心理健康受到干扰对肥胖及神经发育编程的潜在后果，重点关注微量营养素缺乏在拉丁美洲的作用。我们得出结论，需要采取紧急行动以预防和减轻COVID-19大流行对中低收入国家母亲营养和心理健康的长期后果。应特别关注在大流行期间及之后受孕和发育的儿童，因为生命早期暴露于母亲营养不良和不良心理健康可能对生长和未来健康结局产生不利影响。加强粮食安全项目、改善母亲精神健康服务的可及性以及实施生命早期干预措施，是减少大流行对子代潜在代际影响的重要策略。

Abstract

Low- and- middle income countries (LMICs), particularly in Latin America, face a growing double burden of malnutrition, characterized by the coexistence of obesity and micronutrient deficiencies alongside high rates of mental health disorders. From the Developmental Origins of Health and Disease (DOHaD) perspective, maternal nutrition and mental health are critical determinants of offspring growth, neurodevelopment, and long-term health. The COVID-19 pandemic and subsequent global food crisis have exacerbated food insecurity, unhealthy diets, and symptoms of depression and anxiety, increasing the risk of maternal malnutrition in all its forms. Although most evidence on the interaction between maternal nutrition and mental health during early development comes from Asian and European populations, Latin America presents a particularly vulnerable context due to its high prevalence of obesity, micronutrient deficiencies, and perinatal mental health disorders. This work discusses the potential consequences of disruptions in maternal nutrition and mental health during early life on obesity and neurodevelopmental programming, with a focus on the role of micronutrient deficiencies in Latin America. We conclude that urgent action is needed to prevent and mitigate the long-term consequences of the COVID-19 pandemic on maternal nutrition and mental health in LMICs. Special attention should be given to children conceived and developing during and after the pandemic, as early-life exposure to maternal malnutrition, and poor mental health may adversely affect growth and future health outcomes. Strengthening food security programs, improving access to maternal mental health services, and implementing early-life interventions are essential strategies to reduce the potential intergenerational impacts of the pandemic on the offspring.

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