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Malnutrition in Early Life and Adult Mental Health: Evidence From a Natural Experiment

机译：早期生命和成人心理健康的营养不良：来自自然实验的证据

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As natural experiments, famines provide a unique opportunity to test the health consequences of nutritional deprivation during the critical period of early life. Using data on 4,972 Chinese born between 1956 and 1963 who participated in a large mental health epidemiology survey conducted between 2001 and 2005, we investigated the potential impact of famine exposure in utero and during the early postnatal life on adult mental illness. The risk of mental illness was assessed with the 12-item General Health Questionnaire (GHQ-12) and eight other risk factors, and the famine impact on adult mental illness was estimated by difference-in-difference models. Results show that compared with women born in 1963, women born during the famine years (1959–1961) had higher GHQ scores (increased by 0.95 points; CI: 0.26, 1.65) and increased risk of mental illness (OR= 2.80; CI: 1.23, 6.39); those born in 1959 were the most affected and had GHQ scores 1.52 points higher (CI: 0.42, 2.63) and an OR for mental illness of 4.99 (CI: 1.68, 14.84). Compared to men in the 1963 birth cohort, men born during the famine had lower GHQ scores (decreased by 0.89 points; CI: −1.59, −0.20) and a nonsignificant decrease in the risk of mental illness (OR = 0.60; CI: 0.26, 1.40). We speculate that the long-term consequences of early-life famine exposure include both the selection of the hardiest and the enduring deleterious effects of famine on those who survive. The greater biological vulnerability and stronger natural selection in utero of male versus female fetuses during severe famine may result in a stronger selection effect among men than women, obscuring the deleterious impact of famine exposure on the risk of mental illness in men later in life.
机译：作为自然实验，饥荒提供了在生命的关键时期测试营养剥夺对健康的影响的独特机会。我们使用了1956年至1963年之间出生的4,972名中国人的数据，他们参加了2001年至2005年进行的一项大规模的精神健康流行病学调查，我们调查了子宫内和产后早期饥荒暴露对成人精神疾病的潜在影响。使用12个项目的《一般健康状况调查表》（GHQ-12）和其他八个风险因素评估了精神疾病的风险，并通过差异模型评估了饥荒对成人精神疾病的影响。结果表明，与1963年出生的妇女相比，在饥荒时期（1959年至1961年）出生的妇女具有更高的GHQ得分（提高了0.95分； CI：0.26、1.65），并增加了患精神病的风险（OR = 2.80； CI： 1.23、6.39）； 1959年出生的人受影响最大，GHQ得分高1.52分（CI：0.42，2.63），精神疾病的OR为4.99（CI：1.68，14.84）。与1963年出生队列中的男性相比，饥荒期间出生的男性GHQ得分较低（下降了0.89分; CI：−1.59，−0.20），精神疾病的风险无明显降低（OR = 0.60; CI：0.26） ，1.40）。我们推测，饥荒早期暴露的长期后果既包括选择最艰苦的饥荒，也包括对幸存者的持久有害影响。在严重饥荒中，男性和女性胎儿在子宫内的更大的生物脆弱性和更强的自然选择可能导致男性比女性更强的选择效应，从而消除了饥荒暴露对男性晚年罹患精神疾病风险的有害影响。

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