{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T05:00:29Z","timestamp":1791608429812,"version":"4.3.4"},"reference-count":38,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,7,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVE:<\/jats:title><jats:p>Lifelong functional, adaptive, and economic outcomes of moderate to severe infantile malnutrition are not well known. We assessed social status and income at midlife in a cohort of Barbadian adults, hospitalized for protein-energy malnutrition (PEM) during the first year of life, with good nutrition and health thereafter, in the context of a 40-year longitudinal case-control study. We also examined to what extent childhood IQ mediated any group differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>Educational achievement, occupational status, and standard of living were assessed by the Hollingshead scales and a site-specific Ecology Questionnaire in Barbadian adults (aged 37\u201343 years) with a history of malnutrition (n = 80) and a matched healthy control group (n = 63), classmates of the index cases. Malnutrition effects, adjusted for childhood standard of living, were estimated by longitudinal multiple regression analyses, with and without childhood IQ, in the models.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>PEM predicted poorer socioeconomic outcomes with medium to large effect sizes (0.50\u20130.94), but childhood IQ substantially attenuated the magnitude of these effects (adjusted effect sizes: 0.17\u20130.34). The gap in weekly household income between the PEM and control groups increased substantially over the life span (P &amp;lt; .001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Moderate to severe PEM during the first year of life with adequate nutrition and health care thereafter is associated with significant depression of socioeconomic outcomes in adulthood, mediated in part by cognitive compromise in affected individuals. This finding underscores the potential long-term economic burden of infant malnutrition, which is of major concern given the continued high prevalence of malnutrition worldwide.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2012-0073","type":"journal-article","created":{"date-parts":[[2012,6,27]],"date-time":"2012-06-27T07:29:18Z","timestamp":1340782158000},"page":"e1-e7","source":"Crossref","is-referenced-by-count":63,"title":["Socioeconomic Outcomes in Adults Malnourished in the First Year of Life: A 40-Year Study"],"prefix":"10.1542","volume":"130","author":[{"given":"Janina R.","family":"Galler","sequence":"first","affiliation":[{"name":"Judge Baker Children\u2019s Center, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyralene","family":"Bryce","sequence":"additional","affiliation":[{"name":"Barbados Nutrition Study, St. Michael, Bridgetown, Barbados;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah P.","family":"Waber","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Children\u2019s Hospital, Boston, Massachusetts; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam L.","family":"Zichlin","sequence":"additional","affiliation":[{"name":"Judge Baker Children\u2019s Center, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garret M.","family":"Fitzmaurice","sequence":"additional","affiliation":[{"name":"Laboratory for Psychiatric Biostatistics, McLean Hospital, Belmont, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Eaglesfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2012,7,1]]},"reference":[{"issue":"9555","key":"2021120821255211200_B1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/S0140-6736(07)60032-4","article-title":"Developmental potential in the first 5 years for children in developing countries.","volume":"369","author":"Grantham-McGregor","year":"2007","journal-title":"Lancet"},{"issue":"5","key":"2021120821255211200_B2","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1542\/peds.2010-2231","article-title":"Early childhood stimulation benefits adult competence and reduces violent behavior.","volume":"127","author":"Walker","year":"2011","journal-title":"Pediatrics"},{"issue":"9609","key":"2021120821255211200_B3","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/S0140-6736(07)61692-4","article-title":"Maternal and child undernutrition: consequences for adult health and human capital.","volume":"371","author":"Victora","year":"2008","journal-title":"Lancet"},{"issue":"2","key":"2021120821255211200_B4","doi-asserted-by":"crossref","first-page":"348","DOI":"10.3945\/jn.109.112300","article-title":"Weight gain in the first two years of life is an important predictor of schooling outcomes in pooled analyses from five birth cohorts from low- and middle-income countries.","volume":"140","author":"Martorell","year":"2010","journal-title":"J Nutr"},{"issue":"4","key":"2021120821255211200_B5","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.jhealeco.2006.12.006","article-title":"The long-term health and economic consequences of the 1959\u20131961 famine in China.","volume":"26","author":"Chen","year":"2007","journal-title":"J Health Econ"},{"issue":"3","key":"2021120821255211200_B6","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.jhealeco.2011.03.001","article-title":"Effects of prenatal and early life malnutrition: evidence from the Greek famine.","volume":"30","author":"Neelsen","year":"2011","journal-title":"J Health Econ"},{"key":"2021120821255211200_B7","first-page":"63","article-title":"The behavioral consequences of malnutrition in early life","volume-title":"Human Nutrition: A Comprehensive Treatise","author":"Galler","year":"1984"},{"key":"2021120821255211200_B8","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1046\/j.1467-0658.2001.00109.x","article-title":"Children and famine: Long-term impact on development.","volume":"7(2)","author":"Galler","year":"2001","journal-title":"Ambul Child Health"},{"key":"2021120821255211200_B9","doi-asserted-by":"crossref","DOI":"10.3945\/jn.111.145441","article-title":"Infant malnutrition is associated with persisting attention deficits in middle adulthood.","author":"Galler","year":"2012","journal-title":"J Nutr"},{"issue":"1","key":"2021120821255211200_B10","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00004583-198301000-00002","article-title":"The influence of early malnutrition on subsequent behavioral development. 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