Exposure to the Chinese Famine in Early Life and the Risk of Metabolic Syndrome in Adulthood

Department of Nutrition , Harvard University, Cambridge, Massachusetts, United States
Diabetes care (Impact Factor: 8.42). 02/2011; 34(4):1014-8. DOI: 10.2337/dc10-2039
Source: PubMed


To examine whether exposure to the Chinese famine during fetal life and early childhood is associated with the risks of metabolic syndrome and whether this association is modified by later life environment.
We used data of 7,874 adults born between 1954 and 1964 from the 2002 China National Nutrition and Health Survey. Famine exposure groups were defined as nonexposed; fetal exposed; and early childhood, midchildhood, or late childhood exposed. Excess death rate was used to determine the severity of the famine. The ATP III criteria were used for the definition of metabolic syndrome (three or more of the following variables: elevated fasting triglyceride levels, lower HDL cholesterol levels, elevated fasting glucose levels, higher waist circumference, high blood pressure).
In severely affected famine areas, adults who were exposed to the famine during fetal life had a higher risk of metabolic syndrome, as compared with nonexposed subjects (odds ratio 3.13 [95% CI 1.24-7.89, P = 0.016]). Similar associations were observed among adults who were exposed to the famine during early childhood, but not for adults exposed to the famine during mid- or late childhood. Participants who were born in severely affected famine areas and had Western dietary habits in adulthood or were overweight in adulthood had a particularly high risk of metabolic syndrome in later life.
Exposure to the Chinese famine during fetal life or infancy is associated with an increased risk of metabolic syndrome in adulthood. These associations are stronger among subjects with a Western dietary pattern or who were overweight in adulthood.

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    • "It is a catastrophe in human history , but now it is a valuable chance to investigate the relationship between famine exposure and MS in Chinese. In China, just two studies examined this association and revealed a significant association between famine exposure during fetus and infancy and higher risk of MS in adulthood [13] [14], though the only study Abbreviations: BP, blood pressure; IDF, International Diabetes Federation; GDP, gross domestic product; HbA1c, glycated hemoglobin; HDL, high density lipoprotein ; BMI, body mass index; HOMA-IR, homeostatic model assessment-insulin resistance; MS, metabolic syndrome; TG, triglycerides; FPG, fasting plasma glucose. * Corresponding author. "
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    ABSTRACT: Background & aims: Epidemiologic studies have revealed that early-life conditions influence later risk of chronic diseases. We aimed to explore whether exposure to Chinese famine between 1959 and 1962 during fetal and childhood period was related with metabolic syndrome (MS) in adulthood. Methods: 6445 subjects from SPECT-China study were divided into fetal-exposed (1959-1962), childhood-exposed (1949-1958), adolescence/young adult-exposed (1921-1948), non-exposed (1963-1974) and non-exposed (after 1975). MS was defined by the International Diabetes Federation criteria. Results: The prevalences of MS in the non-exposed (1963-1974), fetal and childhood-exposed were 16.4%, 20.1% and 19.1% in men and 13.5%, 23.7% and 33.5% in women, respectively. After adjustment for age, compared with non-exposed (1963-1974), fetal and childhood-exposed women had significantly higher prevalences of MS (P < 0.05), but not in men. Famine exposure during the fetal period (OR 1.47, 95% CI 1.05, 2.07) and childhood (OR 1.80, 95% CI 1.22, 2.67) was associated with higher risk of MS in women after adjusting for age (both P < 0.05). Further adjustments for age, smoking, rural/urban residence and economic status did not significantly attenuate this association. Conclusions: Exposure to famine in early life had sex-specific association with MS. It also suggests the adverse effects of malnutrition might extend beyond the 'first 1000 days' and last 9 years.
    Full-text · Article · Nov 2015 · Clinical Nutrition
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    • "The Chinese famine of 1959–1961 is the largest one in human history leading to approximately 30 million excess deaths [9,10]. Emerging findings suggested that exposure to Chinese famine in early life was related to elevated risk of diabetes [11], metabolic syndrome [4,5], hypertension [7], short height [12], and overweight [13] in adulthood. Anaemia is a common health problem especially in developing countries [14], with iron deficiency as one of the main causes [14]. "
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    ABSTRACT: Background Famine exposure during the early stage of life is related to a number of adulthood diseases. The objective of this study was to examine the association of early life exposure to the famine in China (1959–1961) with the risk of anaemia in adulthood. Methods We used the data of 2007 adults born between 1954 and 1964 in Jiangsu province from the 2002 Chinese National Nutrition and Health Survey. Anaemia was defined as haemoglobin concentration <12 g/dl in women and <13 g/dl in men. Results Prevalence of anaemia in adulthood in nonexposed, fetal-exposed, early-childhood, mid-childhood, and late-childhood exposed to famine groups were 26.0%, 33.8%, 28.1%, 28.2% and 29.7%, respectively. Overall, fetal-exposed to famine was associated with 37% increased risk of anaemia as compared with those non-exposed after adjusting for income, education, place of residence, smoking, alcohol drinking, job, hypertension and BMI; relative risk (95% confidence interval) (RR (95% CI)) was 1.37 (1.09, 1.71). In general, this association appeared to be stronger among men, those who were currently overweight or obese, or those of lower educational levels. Corresponding RR (95% CI) was 1.87 (1.21-2.87), 1.75 (1.20-2.56), and 2.07 (1.37-3.12), respectively. Conclusions Fetal exposure to the Chinese famine was associated with an increased risk of anaemia in adulthood.
    Full-text · Article · Oct 2013 · BMC Public Health
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    • "Exposure to famine in early life is associated with an increased risk of metabolic syndrome development in later life, which included hypertension [19-21], insulin resistance [22-25], central obesity [26-28] and dyslipidemia [29,30]. One current study provided further evidence that both fetal and infant exposure to severe famine increased the clustering of the metabolic risk factors that predispose a person to type 2 diabetes and cardiovascular disease [31]. To date, linkage of exposure to the Chinese famine with the risk of stomach cancer in later life has not been reported. "
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    ABSTRACT: The purpose of the study is to determine whether exposure to malnutrition during early life is associated with increased risk of stomach cancer in later life. The design protocol included analyzing the trend of gastric cancer mortality and nutrition and evaluating the association between nutrient deficiency in early life and the risk of gastric cancer by hierarchical age-period-birth cohort (APC) analysis using general log-linear Poisson models and to compare the difference between birth cohorts who were exposed to the 1959-1961 Chinese famine and those who were not exposed to the famine. Data on stomach cancer mortality from 1970 to 2009 and the dietary patterns from 1955 to 1985 which included the 1959-1961 Chinese famine period in the Zhaoyuan County population were obtained. The nutrition information was collected 15 years prior to the mortality data as based on the latest reference of disease incubation. APC analysis revealed that severe nutrition deficiency during early life may increase the risk of stomach cancer. Compared with the 1960-1964 birth cohort, the risk for stomach cancer in all birth cohorts from 1900 to 1959 significantly increased; compared with the 1970-1974 cohort, the risk for stomach cancer in the 1975-1979 cohort significantly increased, whereas the others had a steadily decreased risk; compared with 85-89 age group in the 2005-2009 death survey, the ORs decreased with younger age and reached significant levels for the 50-54 age group after adjusting the confounding factors. The 1930 to 1964 group (exposed to famine) had a higher mortality rate than the 1965 to 1999 group (not exposed to famine). For males, the relative risk (RR) was 2.39 and the 95% confidence interval (CI) was 1.51 to 3.77. For females, RR was 1.64 and 95% CI was 1.02 to 2.62. The results of the present study suggested that prolonged malnutrition during early life may increase the risk of stomach cancer mortality in later life.
    Full-text · Article · Jul 2012 · BMC Cancer
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