DNA Methylation Signatures of Early Childhood Malnutrition Associated With Impairments in Attention and Cognition.

BACKGROUND: Early childhood malnutrition affects 113 million children worldwide, impacting health and increasing vulnerability for cognitive and behavioral disorders later in life. Molecular signatures after childhood malnutrition, including the potential for intergenerational transmission, remain unexplored. METHODS: We surveyed blood DNA methylomes (~483,000 individual CpG sites) in 168 subjects across two generations, including 50 generation 1 individuals hospitalized during the first year of life for moderate to severe protein-energy malnutrition, then followed up to 48 years in the Barbados Nutrition Study. Attention deficits and cognitive performance were evaluated with the Connors Adult Attention Rating Scale and Wechsler Abbreviated Scale of Intelligence. Expression of nutrition-sensitive genes was explored by quantitative reverse transcriptase polymerase chain reaction in rat prefrontal cortex. RESULTS: We identified 134 nutrition-sensitive, differentially methylated genomic regions, with most (87%) specific for generation 1. Multiple neuropsychiatric risk genes, including COMT, IFNG, MIR200B, SYNGAP1, and VIPR2 showed associations of specific methyl-CpGs with attention and IQ. IFNG expression was decreased in prefrontal cortex of rats showing attention deficits after developmental malnutrition. CONCLUSIONS: Early childhood malnutrition entails long-lasting epigenetic signatures associated with liability for attention and cognition, and limited potential for intergenerational transmission.

Successes and challenges to implementing an early childhood supplemental feeding program in rural Honduras: a qualitative study.

BACKGROUND: Malnutrition is a major cause of childhood illness, stunted growth and death worldwide. A supplemental nutrition program for young children was implemented in Guachipilincito, Honduras. This study explores early successes and challenges to implementing this program. METHODS: We conducted a qualitative, semi-structured, key informant interview study in 2012. Two researchers analyzed interview transcripts using the immersion/crystallization method of qualitative analysis. RESULTS: The program evolved from addressing macronutrient deficiency in 2010, to targeting micronutrient deficiency. Successes include: consistent food distribution, positive community feedback and establishment of a Honduran community oversight committee. Challenges include: tracking growth data, sharing of food among family members, and long-term sustainability. Next steps include: obtaining stable funding, utilizing local food suppliers, and increasing crop diversity. Participants identified cultural and economic factors contributing to challenges with these steps. CONCLUSION: While the feeding program is having successes, it still faces many challenges. Additional interviews with Honduran-based staff, community leaders and program recipients may identify the best ways to address these challenges.

O papel dos eventos de vida em mães de crianças desnutridas: o outro lado da desnutrição / The role of life events in mothers of malnourished children: the other side of malnutrition

O objetivo deste artigo é descrever a história de vida de mães de crianças desnutridas e as possíveis relações com fatores sociodemográficos e psicossociais. Trata-se de estudo transversal realizado em unidade básica de saúde em Porto Alegre (RS) com 82 mães de crianças desnutridas. Usou-se um questionário estruturado com variáveis sociodemográficas referentes à gestação e relacionadas à história de vida das mães. Realizaram-se análise descritiva e o teste Qui-quadrado para verificar possíveis associações entre as variáveis selecionadas. As mães apresentaram baixa escolaridade, baixa renda familiar, são multíparas, sofreram maus-tratos, experiências negativas com familiar alcoolista (67 por cento) e privação afetiva infantil (65 por cento); rejeitaram a gravidez do filho desnutrido (70 por cento); faltou apoio do companheiro na gestação e pós-parto; 70 por cento relataram sintomas depressivos no período gestacional e em torno de 60 por cento destas apresentaram os mesmos sintomas no pós-parto. Verificou-se diferença na proporção de mães que sofreram maus-tratos na infância e rejeição da gravidez (p<0,001), sintomas depressivos na gravidez e pós-parto (p<0,001). O estudo identificou na história de vida dessas mães fatores que, além da situação de desvantagem social e financeira, apresentam elementos para a formação de fraco vínculo mãe-bebê, contribuindo para a desnutrição.

The objective of this article is to describe the life story of mothers of malnourished children and their possible associations to socio-demographic and psychosocial aspects. It is a cross sectional study carried out in a public health basic unit in Porto Alegre (RS, Brazil), with a total of 82 mothers. It was used a structured questionnaire with socio demographic, reproductive variables and mothers' live events. A descriptive analysis and chi-square were used to investigate possible associations among the selected variables. Mothers had low schooling, low income and were multiparous besides, suffered parental abuse, had negative experiences with alcoholic parents (67 percent), were neglect in infancy (65 percent), have rejected the undernourished baby during pregnancy (70 percent). They related depression symptoms during pregnancy (70 percent) and postpartum (60 percent). The study showed a difference of proportion between mothers who suffered abuse in childhood and those who not suffered according to pregnancy rejection (p<0,001), depression during the pregnancy and after delivery (p<0,001). This study associated mother's life stories with live events that, beyond the social and economic disadvantage, could develop a weak interaction between mother-baby that contribute to malnutrition.