如今的加沙，有人用喂鸟的谷子来烤“面包”，有人给新出生的婴儿吸食椰枣，因为他们的母亲无法提供足够的奶水。在一份近期的报告中，90% 两岁以下儿童以及超过 90% 的孕妇和哺乳期妇女每天吃不满三餐，近三分之二的家庭每天只吃一顿饭。根据多家媒体报道，加沙的医院正在努力应对大量涌入的营养不良的儿童，其中包括蹒跚学步的幼儿。另一份报告发现，加沙北部每 6 名婴幼儿中就有一名严重营养不良。当然，不只是加沙，全世界有数百万人受到饥饿的影响，尤其是在索马里、阿富汗和苏丹。饥饿给人们带来的严重健康影响不仅限于当下，还会蔓延多年，甚至可能影响他们子孙后代的健康。在短期内，饥饿和营养不良可能会危及生命，包括引发严重贫血、腹泻或败血症等并发症；即使恢复了正常的营养，几个月或几年后人们仍然会出现健康问题，如心脏病、高血压和代谢性疾病。甚至出生前就遭受饥荒的人也会受到影响，一个典型案例就是荷兰大饥荒（Dutch Hunger Winter），这一事件发生在 1944-1945 年德国占领下的荷兰。1976 年有一项大型研究调查了 30 万名出生在这一时期的男性，结果发现，相比母亲没有遭受饥荒或在怀孕后期遭受饥荒的人，母亲在怀孕前半期遭受饥荒的人成年后更容易肥胖。其他研究还发现，饥荒期间孕育出的男性也更容易患心脏病，寿命也不及那些在饥荒后不久出生的男性。那么，是什么原因造成了这些长期影响呢？答案是表观遗传学（epigenetics）。简单来说，表观遗传学是指不涉及 DNA 序列变化的可遗传的基因表达调控，通常通过 DNA 甲基化、组蛋白修饰来实现。荷兰大饥荒的研究表明，相比饥荒后出生的兄弟姐妹，在妊娠期处在饥荒中的人 DNA 甲基化在 60 年后存在显著差异。还有一些研究表明，饥荒可能也会影响人们的后代，对 1959-1961 年中国大……[查看全文]
Hunger in Gaza Could Affect Survivors' Health for Decades
Tanya Lewis: The situation in Gaza right now is desperate. A large percentage of the population is experiencing hunger or even dying of starvation.Lewis: As of a report in December and January, nine in 10 children under two and more than nine in 10 pregnant and breastfeeding women were consuming two food groups a day or less.And nearly two-thirds of households were eating just one meal a day.Bose: Of course, hunger isn't limited to Gaza. Millions of people are affected by hunger, especially in Somalia, Afghanistan and Sudan.Lewis: While famine causes severe effects immediately, it can also affect people's health years down the road—and possibly even the health of their children and grandchildren. Science journalist Amanda Ruggeri wrote about this in an online news story for Scientific American, and today we're going to break down what that means.I'm Tanya Lewis, senior editor for health and medicine at Scientific American.Bose: And I'm Tulika Bose, senior multimedia editor.Lewis: And you're listening to Scientific American's Science Quickly podcast. Lewis: Gaza has a population of more than two million people. And right now, many of them are facing hunger, and some are dying—including children.Bose: Yeah— there's a viral photo and story going around about Yazan Al-Kafarna — a ten-year-old boy with cerebral palsy who died of acute malnutrition. The photos — some taken by his father — are shocking.Lewis: Yeah, those images are…really hard to look at.Bose: Some children with cerebral palsy have dysphagia — a condition where it's difficult to swallow food. The food he normally ate — blended fruit and milk — were no longer available, which exacerbated his condition. Ultimately, he passed away.Lewis: That just shows how hard this situation is for children with special needs. But I want to be clear that it's not just sick children who are facing malnutrition.Reuters and other outlets have reported that hospitals in Gaza are grappling with an influx of malnourished children, including toddlers. One report found that one in six babies and toddlers in northern Gaza are acutely malnourished.Of course, chronic hunger is a problem not just in Gaza, but for millions of people in multiple countries worldwide.So, one of our contributors — Amanda Ruggeri — has done some really powerful reporting on how starvation affects people's health, even years later—and possibly, even their descendants.Bose: I've heard of this.Lewis: In the short-term, starvation and malnutrition can obviously be life-threatening.Bose: What's the difference between starvation and malnutrition? I've seen this used interchangeably online.Lewis: Starvation is literally not getting enough food. Malnutrition is not getting an adequate amount of specific nutrients. So malnutrition can include starvation, but it can also include having an imbalance of different food groups.Malnourished children can also experience a number of different health problems, such as wasting and stunted growth.Bose: Are these effects permanent? What's the difference between stunting and wasting?Lewis: Wasting is basically an acute form malnutrition when your muscle and fat waste away. Stunting is a more permanent, chronic form of malnutrition.Bose: So it's not reversible?Lewis: It depends on the severity of the case, but generally stunting is not reversible.Malnutrition can also have life-threatening complications such as severe anaemia, diarrhoea or sepsis.Bose: Wow, that's sobering. [[Or something]] What about down the road - can it cause problems later in life?Lewis: Yeah, even after children return to normal nutrition, they continue to show health issues months or years later—such as heart disease, high blood pressure and metabolic disease.Bose: And even people who are exposed to famine before birth can be affected, right? There's something that I was reading about called the Dutch Hunger Winter.Lewis: Right, so the Dutch Hunger Winter was a famine in the Netherlands from 1944 to 1945, during German occupation in World War II. There was a major study in 1976 of 300,000 men who were born during that time. The study found that individuals who were exposed to hunger while in utero during the first half of pregnancy were more likely to be obese as adults than those who weren't exposed to hunger or those who were exposed later in pregnancy.Bose: Huh, so being exposed to hunger as a developing fetus actually made people more likely to be overweight later in life?Lewis: Yeah. Other studies have found that men who were in the womb during that famine were also more likely to develop heart disease and not live as long as those born soon afterward.Bose: So, what do scientists think could be responsible for these long-lasting effects?Lewis: Epigenetics. It's basically the set of processes that turn parts of the genome on or off. The way this normally happens is through something called DNA methylation.Studies of the Dutch Hunger Winter show that people who were exposed to famine during gestation had differences in DNA methylation 60 years later, compared with siblings who were born later on.And some research suggests being exposed to famine might affect people's children, too. Studies of the Great Chinese...[full transcript]
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