Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
Nutrients. 2022 Feb 23;14(5):948. doi: 10.3390/nu14050948.
Complementing a recent systematic review and meta-analysis which showed that boys are more likely to be wasted, stunted, and underweight than girls, we conducted a narrative review to explore which early life mechanisms might underlie these sex differences. We addressed different themes, including maternal and newborn characteristics, immunology and endocrinology, evolutionary biology, care practices, and anthropometric indices to explore potential sources of sex differences in child undernutrition. Our review found that the evidence on why sex differences occur is limited but that a complex interaction of social, environmental, and genetic factors likely underlies these differences throughout the life cycle. Despite their bigger size at birth and during infancy, in conditions of food deprivation, boys experience more undernutrition from as early as the foetal period. Differences appear to be more pronounced in more severe presentations of undernutrition and in more socioeconomically deprived contexts. Boys are more vulnerable to infectious disease, and differing immune and endocrine systems appear to explain some of this disadvantage. Limited evidence also suggests that different sociological factors and care practices might exert influence and have the potential to exacerbate or reverse observed differences. Further research is needed to better understand sex differences in undernutrition and the implications of these for child outcomes and prevention and treatment programming.
在最近的一项系统评价和荟萃分析显示男孩比女孩更容易消瘦、发育迟缓且体重不足之后，我们进行了一项叙述性综述，以探讨哪些生命早期机制可能是这些性别差异的基础。我们探讨了不同的主题，包括母婴特征、免疫学和内分泌学、进化生物学、护理实践以及人体测量学指标，以探索儿童营养不足中性别差异的潜在来源。我们的综述发现，关于性别差异发生原因的证据有限，但在整个生命周期中，社会、环境和遗传因素的复杂相互作用可能是这些差异的基础。尽管男孩出生时和婴儿期的体型较大，但在食物匮乏的情况下，他们从胎儿期就开始经历更多的营养不良。在更严重的营养不良表现和更贫困的社会经济背景下，这些差异似乎更为明显。男孩更容易感染传染病，而不同的免疫和内分泌系统似乎解释了部分劣势。有限的证据还表明，不同的社会因素和护理实践可能会产生影响，并有可能加剧或逆转观察到的差异。需要进一步研究以更好地了解营养不良中的性别差异，以及这些差异对儿童结局以及预防和治疗规划的影响。
