Children and famine: long‐term impact on development

Abstract

The current and long-term effects of famine and malnutrition on cognitive and behavioral development are reviewed. The brain is vulnerable to the effects of insults during critical periods of brain development from the second trimester of pregnancy until 2 years of age. Malnutrition experienced at these ages will have lifelong consequences that are not reversed by adequate nutrition. Long-term effects of prenatal, postnatal and childhood malnutrition have been reported even after a long period of recovery from the illness itself. We summarize results of our longitudinal study in Barbados in which we followed individuals, now 28-34 years of age, who experienced moderate to severe malnutrition during their first year of life and a healthy comparison group from the same classrooms. Our studies showed that malnutrition had a negative impact on cognitive and behavioral functioning throughout childhood and adolescence, even after controlling for socioeconomic conditions and other factors in the home environment. The most striking finding in our series of studies was a fourfold increase from 15% to 60% in the frequency of attention deficit disorder following infantile malnutrition. Attention deficits persisted at least through adolescence and was closely associated with poor performance on a national high school examination at 11 years of age. We conclude that, under conditions of famine, it is important to include early and comprehensive interventions to reverse not only medical conditions resulting from malnutrition, but also cognitive and behavioral deficits arising from famine. In the absence of appropriate interventions, compromised behavioral function may continue long beyond the episode, may impact on the quality of life over the longterm of survivors, and increase costs to society.

Health of Children Adopted From Guatemala: Comparison of Orphanage and Foster Care

“…6,[21][22][23][24][39][40][41] In other populations, growth and cognitive performance in early life are related to later development. [42][43][44][45][46][47][48][49][50] Our results suggest that adoption professionals, governments, and other regulatory agencies should coordinate efforts to promote early placement of children who are identified for international adoption.…”

Socioeconomic Outcomes in Adults Malnourished in the First Year of Life: A 40-Year Study

“…5,6 Because nutritional insults typically occur in a context of poverty and social disadvantage, distinguishing the effects of malnutrition per se from of the more global impacts of poverty can be challenging. 1,7,8 Studies have typically used markers such as maternal schooling or father' s occupation near birth, providing only a limited estimate of childhood socioeconomic influences (although the Jamaica study, 2 which assessed crowding and household possessions, is an exception). Further complicating the interpretation of outcomes is the high prevalence of chronic undernutrition in severely impoverished environments.…”

Early malnutrition decreases contrast sensitivity to circular concentric gratings.

“…It represents the main environmental factor that contributes to mental retardation and permanent changes in fetal and neonatal development (Galler, 2001;Morgane, Mokler, & Galler, 2002). Malnutrition contributes as a latent cause to one in two deaths (53%) in children <5 years of age (World Health Organization, 2005), totaling over 6 million per year (United Nations Children 's Fund, 2007).…”