背景:精神健康问题的患病率正在全球范围内增长,以及缺乏获得和接受所需治疗的机会。目前在提供治疗方面的差距导致探索替代预防方法,将营养和心理健康联系起来的研究,在低收入和中等收入国家特别相关,营养不良的患病率很高。
目的:研究危地马拉男性和女性在生命的最初1000d中接触蛋白质-能量营养补充剂与在1000d窗口之外接受低能量-无蛋白质补充剂或补充剂相比,是否降低了成年后精神困扰的几率。
方法:来自纵向队列蛋白质能量补充试验(生命早期,1969年至1977年的补充数据,0-7岁;生命历程,2017-2018年随访结果数据,40-57岁)分析了前1000天的营养与成年期的精神困扰之间的关联(WHO自我报告问卷20[SRQ-20]),控制早期生活变量和当前生活压力;生命过程变量(例如教育)被视为这种关系的潜在中介。利用广义线性混合模型和零膨胀泊松广义线性混合模型。
结果:在最初的1000天期间,部分和全部补充Atole与63%(95%CI:0.16,0.87)和56%(95%CI:0.19,1.03)较低的几率相关,分别,在成年后经历精神困扰。结果没有性别差异。在控制生命早期和生命过程变量后,这些反比关系保持相对不变(部分OR=0.34[95%CI:0.14,0.83];完全OR=0.38[95%CI:0.16,0.92])。包括生活压力。
结论:在危地马拉生命的最初1000天期间补充蛋白质能量,营养不良普遍存在的地方,可以减少成年后精神困扰的患病率。这种效果似乎是直接发生的,而不是间接地,通过生命过程变量的路径,如教育,财富,和婚姻状况。
The prevalence of mental health concerns is growing worldwide, along with lack of access to and receipt of needed treatment. Current gaps in treatment provision have led to exploring alternative methods of prevention, with research linking nutrition and mental health, of particular relevance in low- and middle-income countries, with a high prevalence of undernutrition.
To examine whether exposure to a protein-energy nutritional supplement during the first 1000 d of life decreased odds of mental distress in adulthood among men and women in Guatemala compared with receiving a low energy-no protein supplement or supplementation outside the 1000-d window.
Data from participants (n = 1249) in a longitudinal cohort protein-energy supplementation trial (early-life, supplementation data from 1969 to 1977, ages 0-7 y; life course, outcome data from 2017-2018 follow-up, ages 40-57 y) were analyzed for associations between nutrition in the first 1000 d and mental distress in adulthood (WHO Self-Reporting Questionnaire 20 [SRQ-20]), controlling for early-life variables and current life stress; life course variables (e.g. education) were examined as potential mediators of this relation. Generalized linear mixed models and zero-inflated Poisson generalized linear mixed models were utilized.
Both partial and full supplementation with Atole during the first 1000 d were associated with 63% (95% CI: 0.16, 0.87) and 56% (95% CI: 0.19, 1.03) lower odds, respectively, of experiencing mental distress in adulthood. Results did not differ by sex. These inverse relations remained relatively unchanged (partial OR = 0.34 [95% CI: 0.14, 0.83]; full OR = 0.38 [95% CI: 0.16, 0.92]) after controlling for early-life and life course variables, including life stress.
Protein-energy supplementation during the first 1000 d of life in Guatemala, where undernutrition is prevalent, may reduce the prevalence of later mental distress in adulthood. This effect appears to occur directly, rather than indirectly, through pathways of life course variables such as education, wealth, and marital status.