Long-term health implications of early life malnutrition: an umbrella review and anticipation of latent attributable disease burden

Introduction: Early life malnutrition is posing substantial health risks to the adulthood. This study comprehensively summarised the latent health outcomes after early life malnutrition and anticipated the attributable latent disease burden of the current humanitarian catastrophe in Gaza over the next five decades. Methods This umbrella review searched MEDLINE, EMBASE, and Web of Science for quantitative systematic reviews assessing the adulthood health risks attributable to early-life malnutrition exposure. Using re-analysed relative effects and the 2021 Global Burden of Disease (GBD) regional estimates, we projected population attributable fraction (PAF) and further anticipated the adulthood disease burden attributable to early life malnutrition among population under 20 years old in Gaza over the next five decades. Results The umbrella review, including 16 meta-analyses and 758,417 individuals, suggested that people experienced malnutrition in early life may be facing 34% elevated risk of cancers (95% confidence interval [CI] 8–66%), 25% of hyperglycaemia (95% CI 10–42%), 33% of type 2 diabetes (95% CI 8–64%), 38% of hypertension (95% CI 21–57%) and 21% of coronary heart disease (95% CI 9–35%) in their later years. Assuming 50% of the population younger than 20 exposed to malnutrition, the anticipated disease burden would be 29,587 disability-adjusted life years (DALYs) (95% uncertainty interval [UI] 17,401 to 40,769) including 25,344 years of life lost (YLL) (95% UI 14,754 to 34,941) and 4,247 years lived with disability (YLD) (95% UI 1,197 to 7,519) attributable to early life malnutrition in 50 years. The PAF for type 2 diabetes would range from 11.4–23.8%, contributing to up to 13,669 DALYs (95% UI 2,549 to 22,989); the PAF for ischaemic heart disease would range from 7.7–17.1% contributing to up to 14,917 DALYs (95% UI 6,420 to 22,805); the PAF for cancers would range from 11.7–24.4% contributing to up to 18,575 DALYs (95% UI 3,560 to 30,367). Conclusions Early life exposure to malnutrition is likely associated with increased risks of type 2 diabetes, hypertension, ischaemic heart disease, and cancers. The current malnutrition in Gazan young people will probably be associated with major disease burden in 50 years.