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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Analizar si el hambre durante la Guerra Civil espa&#241;ola y la inmediata posguerra influy&#243; sobre la mortalidad por cardiopat&#237;a isqu&#233;mica de las personas que nacieron en este per&#237;odo&#44; seg&#250;n lo planteado en la hip&#243;tesis de Barker acerca de la posible programaci&#243;n fetal de enfermedades de la edad adulta&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Con los datos de mortalidad por edad y sexo por cardiopat&#237;a isqu&#233;mica en el per&#237;odo 1990-2002&#44; se calcularon las tasas anuales de mortalidad espec&#237;ficas y las tasas ajustadas por edad&#44; por el m&#233;todo directo&#46; Mediante an&#225;lisis de regression de Poisson se analiz&#243; el efecto de la edad&#44; el per&#237;odo y la cohorte anual de nacimiento &#40;1918-1957&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Durante el per&#237;odo de estudio&#44; la mortalidad por cardiopat&#237;a isqu&#233;mica ha disminuido un promedio anual de &#8211;2&#44;3&#37; en ambos sexos y para todas las edades&#46; En el descenso de mortalidad est&#225;n presentes los efectos cohorte y per&#237;odo &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#59; se observa un incremento del riesgo para todas las edades y ambos sexos en las muertes correspondientes a personas nacidas durante los a&#241;os reconocidos como de mayor escasez alimentaria de la Guerra Civil y la inmediata posguerra &#40;1937&#44; 1940&#44; 1943 y 1945&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los resultados obtenidos al estudiar anualmente la mortalidad por cardiopat&#237;a isqu&#233;mica son compatibles con la hip&#243;tesis de Barker sobre el efecto del estr&#233;s alimentario durante el embarazo en la g&#233;nesis de diversas enfermedades en el adulto&#46; La Guerra Civil espa&#241;ola&#44; adem&#225;s de costes humanos&#44; econ&#243;micos y pol&#237;ticos&#44; puede haber tenido consecuencias negativas para la salud de los nacidos en esas cohortes&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To determine whether the famine experienced during the Spanish civil war and immediate postwar period influenced mortality from coronary heart disease &#40;CHD&#41; in persons born in this period&#44; following the lines of Barker&#39;s hypothesis on fetal programming of chronic diseases in adult life&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Using CHD mortality data by age and sex for 1990-2002&#44; annual and age-adjusted rates were calculated by the direct method&#46; Poisson regressions were used to estimate period&#44; age and cohort effects by year of birth &#40;1918-1957&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">During the study period&#44; CHD mortality fell by a yearly average of &#8211;2&#46;3&#37; in both sexes and in all ages yearly&#46; This trend was influenced by both cohort and period effects &#40;p&#60; 0&#46;001&#41;&#59; an increased risk was observed for both sexes and in all ages in the deaths corresponding to persons born during the war and postwar years when the famine was most intense &#40;1937&#44;1940&#44; 1943 and 1945&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The results obtained by studying yearly CHD mortality are compatible with those expected by Barker&#39;s hypothesis of the effect of nutritional stress during pregnancy&#46; In addition to its human&#44; economic and political costs&#44; the Spanish civil war could also have had negative consequences for the health of persons born in this period&#46;</p>"
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El hambre en la Guerra Civil española y la mortalidad por cardiopatía isquémica: una perspectiva desde la hipótesis de Barker
Famine in the Spanish civil war and mortality from coronary heart disease: a perspective from Baker's hypothesis
Laura Inés González Zapataa,
Autor para correspondencia
laurag@pijaos.udea.edu.co

Correspondencia: Dra. Laura Inés González Zapata. Escuela de Nutrición y Dietética. Universidad de Antioquia. Carrera 75, 65-87 Bloque 44 Oficina 101. Medellín-Colombia.
, Carlos Alvarez-Dardet Díazb, Andreu Nolasco Bonmatíc, José Aurelio Pina Romeroc, María José Medranod
a Escuela de Nutrición y Dietética, Universidad de Antioquia, Medellín-Colombia; Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, España
b Observatorio de Políticas Públicas y Salud, Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, España
c Unidad de Investigación de Análisis de la mortalidad y Estadísticas Sanitarias, Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, España
d Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Analizar si el hambre durante la Guerra Civil espa&#241;ola y la inmediata posguerra influy&#243; sobre la mortalidad por cardiopat&#237;a isqu&#233;mica de las personas que nacieron en este per&#237;odo&#44; seg&#250;n lo planteado en la hip&#243;tesis de Barker acerca de la posible programaci&#243;n fetal de enfermedades de la edad adulta&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Con los datos de mortalidad por edad y sexo por cardiopat&#237;a isqu&#233;mica en el per&#237;odo 1990-2002&#44; se calcularon las tasas anuales de mortalidad espec&#237;ficas y las tasas ajustadas por edad&#44; por el m&#233;todo directo&#46; Mediante an&#225;lisis de regression de Poisson se analiz&#243; el efecto de la edad&#44; el per&#237;odo y la cohorte anual de nacimiento &#40;1918-1957&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Durante el per&#237;odo de estudio&#44; la mortalidad por cardiopat&#237;a isqu&#233;mica ha disminuido un promedio anual de &#8211;2&#44;3&#37; en ambos sexos y para todas las edades&#46; En el descenso de mortalidad est&#225;n presentes los efectos cohorte y per&#237;odo &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#59; se observa un incremento del riesgo para todas las edades y ambos sexos en las muertes correspondientes a personas nacidas durante los a&#241;os reconocidos como de mayor escasez alimentaria de la Guerra Civil y la inmediata posguerra &#40;1937&#44; 1940&#44; 1943 y 1945&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los resultados obtenidos al estudiar anualmente la mortalidad por cardiopat&#237;a isqu&#233;mica son compatibles con la hip&#243;tesis de Barker sobre el efecto del estr&#233;s alimentario durante el embarazo en la g&#233;nesis de diversas enfermedades en el adulto&#46; La Guerra Civil espa&#241;ola&#44; adem&#225;s de costes humanos&#44; econ&#243;micos y pol&#237;ticos&#44; puede haber tenido consecuencias negativas para la salud de los nacidos en esas cohortes&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To determine whether the famine experienced during the Spanish civil war and immediate postwar period influenced mortality from coronary heart disease &#40;CHD&#41; in persons born in this period&#44; following the lines of Barker&#39;s hypothesis on fetal programming of chronic diseases in adult life&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Using CHD mortality data by age and sex for 1990-2002&#44; annual and age-adjusted rates were calculated by the direct method&#46; Poisson regressions were used to estimate period&#44; age and cohort effects by year of birth &#40;1918-1957&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">During the study period&#44; CHD mortality fell by a yearly average of &#8211;2&#46;3&#37; in both sexes and in all ages yearly&#46; This trend was influenced by both cohort and period effects &#40;p&#60; 0&#46;001&#41;&#59; an increased risk was observed for both sexes and in all ages in the deaths corresponding to persons born during the war and postwar years when the famine was most intense &#40;1937&#44;1940&#44; 1943 and 1945&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The results obtained by studying yearly CHD mortality are compatible with those expected by Barker&#39;s hypothesis of the effect of nutritional stress during pregnancy&#46; In addition to its human&#44; economic and political costs&#44; the Spanish civil war could also have had negative consequences for the health of persons born in this period&#46;</p>"
      ]
    ]
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          "bibliografiaReferencia" => array:34 [
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