Triple Harm of Malnutrition and Mental Health in Low- and- Middle Income Countries: After COVID-19.

Low- and- middle income countries (LMICs), particularly in Latin America, face a growing double burden of malnutrition, characterized by the coexistence of obesity and micronutrient deficiencies alongside high rates of mental health disorders. From the Developmental Origins of Health and Disease (DOHaD) perspective, maternal nutrition and mental health are critical determinants of offspring growth, neurodevelopment, and long-term health. The COVID-19 pandemic and subsequent global food crisis have exacerbated food insecurity, unhealthy diets, and symptoms of depression and anxiety, increasing the risk of maternal malnutrition in all its forms. Although most evidence on the interaction between maternal nutrition and mental health during early development comes from Asian and European populations, Latin America presents a particularly vulnerable context due to its high prevalence of obesity, micronutrient deficiencies, and perinatal mental health disorders. This work discusses the potential consequences of disruptions in maternal nutrition and mental health during early life on obesity and neurodevelopmental programming, with a focus on the role of micronutrient deficiencies in Latin America. We conclude that urgent action is needed to prevent and mitigate the long-term consequences of the COVID-19 pandemic on maternal nutrition and mental health in LMICs. Special attention should be given to children conceived and developing during and after the pandemic, as early-life exposure to maternal malnutrition, and poor mental health may adversely affect growth and future health outcomes. Strengthening food security programs, improving access to maternal mental health services, and implementing early-life interventions are essential strategies to reduce the potential intergenerational impacts of the pandemic on the offspring.