Hot, cold temperatures up risk of PEM-related deaths

Both heat and cold can elevate the risks and burden of protein-energy malnutrition (PEM)-related deaths, suggests a study.

Investigators obtained mortality and meteorological data from 2013 to 2022 in 31 China provinces and integrated logistic model with distributed lag nonlinear model, based on time-stratified case-crossover design, to explore the relations between nonoptimum temperatures and PEM-related mortality. They carried out subgroups analyses by age, sex, PEM type, and province to identify at-risk populations.

In total, 197,406 PEM-related deaths occurred from 2013 to 2022. Inverse J-shaped exposure–response curves were observed, with a greater effect for low vs high temperature. Nationally, 17.03 percent (95 percent confidence interval [CI], 14.59–19.17) of PEM deaths were driven by nonoptimum temperatures.

In subgroup analyses, the attributable fraction (AF) of PEM mortality due to nonoptimum temperatures was more pronounced in males (17.69 percent, 95 percent CI, 13.57–21.48), older adults (17.44 percent, 95 percent CI, 14.84–19.80), and nonsevere PEM (17.45 percent, 95 percent CI, 14.30–20.56).

Furthermore, the provinces with the highest AFs were Anhui (27.63 percent), Xinjiang (22.73 percent), and Hubei (22.05 percent).

“These findings underscore the necessity of targeted interventions to reduce the PEM-related mortality burden associated with ambient temperature,” the investigators said. 

“In the context of global warming, the health effects of nonoptimum temperatures have attracted increasing attention. Studies have shown that high temperatures increase risk of hospitalization for PEM,” they added.