Oral Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2024

The Long-Term Health Consequences of Early-life Malnutrition in Low- and Middle-Income Countries: A Systematic Review (#18)

Frehiwot Birhanu Zurga 1 , Catharine Fleming 1 , Haider Mannan 2 , Mirkuzie Woldie 3 , Evan Atlantis 1
  1. School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
  2. Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
  3. Fenot Project, Harvard T.H. Chan School of Public Health, Bole, Addis Ababa, Ethiopia

Background: Malnutrition in childhood and adolescence, encompassing both undernutrition and overnutrition, has been linked to long-term health consequences. However, the specific health risks associated with early-life malnutrition in low- and middle-income countries (LMICs) remain unclear. This study aimed to systematically evaluate the long-term health outcomes associated with childhood and adolescent malnutrition in LMICs.

Methods: We conducted a comprehensive literature search from 2019 to 2024 across four databases (Ovid Embase, Ovid Medline, Web of Science) and Google Scholar. The search strategy included longitudinal observational studies in participants aged under 18 years at exposure, published in English, peer-reviewed, and full-length articles.

Results: A total of 4,326 studies were identified, with 40 ultimately included for analysis in a narrative synthesis. The majority (78%) focused on childhood undernutrition and its association with future chronic diseases, particularly hypertension (75%), diabetes mellitus (60%), and cardiovascular disease (27.5%). The results showed an increased risk of hypertension (58%), diabetes (57%), and cardiovascular disease (80%) as a result of childhood undernutrition. Notably, some studies demonstrated that there is no association between childhood undernutrition and chronic diseases even a potential protective effect for hypertension. The remaining studies examined childhood overnutrition and its link to future chronic diseases, all reporting a statistically significantly increased risk for conditions like hypertension, cardiovascular disease, and diabetes.

Conclusion: This systematic review highlights the significant association between both undernutrition and overnutrition during childhood and adolescence with an increased risk of chronic diseases in adulthood within LMICs. These findings emphasize the critical role of promoting optimal early-life nutrition in LMICs to mitigate the future burden of chronic diseases.