Ortiz-Prado Esteban, Reascos María Salome, Núñez Danna Fiorela, Pazmiño Jean Carlo, Gallardo Martin, Salazar Natasha, Castillo John Altamirano, Villacis Sofia, Acosta Esteban, Vasconez-Gonzalez Jorge, Izquierdo-Condoy Juan S
One Health Research Group, Universidad de Las Américas, Quito, Ecuador.
J Racial Ethn Health Disparities. 2025 Aug 27. doi: 10.1007/s40615-025-02609-0.
High-altitude environments present unique challenges for human physiology, particularly in Andean populations, where approximately 18 million people reside above 2,500 m in South America alone. These populations face not only the physiological stress of hypoxia but also socio-demographic challenges, including poverty, malnutrition, and limited access to protein-rich diets. Hypoxia at high altitudes, coupled with these socioeconomic factors, negatively impacts cognitive development, especially in children. The brain's high oxygen demand makes it particularly vulnerable to the effects of reduced oxygen availability, resulting in impaired cognitive functions such as memory, attention, and decision-making. Prolonged exposure to hypoxia can lead to structural changes in the brain, including alterations in white matter, neuronal damage, and compromised cerebrovascular regulation. In addition to hypoxia, malnutrition-especially the limited availability of vital nutrients-further exacerbates cognitive deficits in these populations. While Andean populations have developed physiological adaptations to mitigate some of these effects, such as increased vascularization and erythrocytosis, the combination of environmental and nutritional stressors continues to challenge cognitive health. This perspective explores the complex interaction between hypoxia, nutrition, and cognitive development in Andean high-altitude populations, discussing current findings and proposing future research directions to better understand these multifaceted challenges. It also compares adaptation strategies across highland populations and highlights the need for culturally contextualized and interdisciplinary approaches to guide future research.
高海拔环境给人类生理带来了独特挑战，在安第斯人群中尤为如此，仅在南美洲就有约1800万人居住在海拔2500米以上的地区。这些人群不仅面临缺氧带来的生理压力，还面临社会人口挑战，包括贫困、营养不良以及获取富含蛋白质饮食的机会有限。高海拔地区的缺氧，再加上这些社会经济因素，对认知发展产生负面影响，尤其是对儿童。大脑对氧气的高需求使其特别容易受到氧气供应减少的影响，从而导致记忆、注意力和决策等认知功能受损。长期暴露于缺氧环境会导致大脑结构变化，包括白质改变、神经元损伤和脑血管调节受损。除了缺氧，营养不良，尤其是重要营养素供应有限，进一步加剧了这些人群的认知缺陷。虽然安第斯人群已经发展出一些生理适应机制来减轻其中一些影响，如血管生成增加和红细胞增多，但环境和营养压力因素的综合作用仍然对认知健康构成挑战。本文探讨了安第斯高海拔人群中缺氧、营养与认知发展之间的复杂相互作用，讨论了当前的研究结果，并提出了未来的研究方向，以更好地理解这些多方面的挑战。本文还比较了不同高原人群的适应策略，并强调了采用文化背景化和跨学科方法指导未来研究的必要性。
