Exposure to the Chinese famine of 1959–61 in early life and long-term health conditions: a systematic review and meta-analysis

Li, Chihua; Lumey, L. H.

doi:10.1093/ije/dyx013

Cited by 184 publications

(182 citation statements)

References 52 publications

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“…The differences between our findings and those from famine studies 8–14 highlight the potential heterogeneity in the physiological response to severe acute versus moderate non-wasting undernutrition. The mothers in the original trial were short but not underweight.…”

Section: Discussioncontrasting

confidence: 97%

“…13 However, not all famine episodes have been found to produce adverse health effects in later life. A review 14 concluded that health effects commonly attributed to the Great Chinese Famine can be explained by uncontrolled effects of age. The Leningrad Siege Study10 found no association between exposure to early-life starvation and later-life hypertension, dyslipidaemia, or glucose tolerance.…”

Section: Introductionmentioning

confidence: 99%

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Exposure to improved nutrition from conception to age 2 years and adult cardiometabolic disease risk: a modelling study

Ford

Behrman

Hoddinott

et al. 2018

The Lancet Global Health

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Background Low-income and middle-income countries with populations that are chronically undernourished in early life are undergoing a nutrition transition and are experiencing an epidemic of cardiometabolic disease. These dual burdens are thought to be causally related; therefore, the extent to which improvements in early-life nutrition can offset adult-onset disease is important. The aim of this study was to examine whether improvement of protein-energy nutrition from conception to age 2 years can attenuate the risk of cardiometabolic disease. Methods We followed up a cohort of 2392 individuals born between Jan 1, 1962, and Feb 28, 1977, in four villages in Guatemala who had participated in a cluster-randomised protein-energy nutritional supplementation (Atole) trial. Of 1661 participants available for follow-up from Feb 26, 2015, to April 29, 2017, we studied 684 women and 455 men. We assessed cardiometabolic disease risk at ages 37–54 years using anthropometry, fasting and post-challenge glucose, fasting lipid concentrations, and blood pressure. We used generalised linear and logistic regression modelling to estimate the effect of Atole from conception to age 2 years (the first 1000 days) on cardiometabolic disease risk. Findings Exposure to Atole from conception to age 2 years was associated with increased fatness (body-mass index [1·29 kg/m², 95% CI 0·08 to 2·50], body fat [1·73%, 0·20 to 3·26], and obesity [odds ratio 1·94, 1·11 to 3·40]), diastolic blood pressure (1·59 mm Hg, –0·74 to 3·92), and blood lipids (total cholesterol [10·10 mg/dL, 0·80 to 19·40] and non-HDL cholesterol [10·41 mg/dL, 1·51 to 19·31]), reduced post-challenge glucose (–5·84 mg/dL, –12·51 to 0·83), and reduced odds of diabetes (odds ratio 0·46, 0·21 to 0·97). We found stratum heterogeneity by sex in pooled models for non-HDL cholesterol (4·34 mg/dL, 95% CI –6·86 to 15·55 for women vs 19·84 mg/dL, 5·86 to 33·82 for men) and post-challenge glucose (–0·19 mg/dL, –8·63 to 8·24 for women vs –13·10 mg/dL, –23·64 to –2·56 for men). p values for interaction of sex and exposure to Atole from conception to age 2 years were 0·09 and 0·04, respectively. Interpretation Improved protein-energy nutrition from conception to the 2nd birthday reduced the odds of diabetes at ages 37–54 years; however, this protein-energy supplementation also increased the risk of obesity and several obesity-related conditions. Our findings suggest a mixed ability of protein-energy nutritional supplementation in early life to prevent adult cardiometabolic disease incidence in the context of high childhood stunting and high adult overweight and obesity.

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Section: Discussioncontrasting

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Exposure to improved nutrition from conception to age 2 years and adult cardiometabolic disease risk: a modelling study

Ford

Behrman

Hoddinott

et al. 2018

The Lancet Global Health

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“…This result is broadly in line with the work of Li and Lumey () which finds that Famine exposure increased the risk of schizophrenia but had no other long‐term negative impact on mental health.…”

Section: Resultssupporting

confidence: 90%

Surviving the Famine Unscathed? An Analysis of the Long‐Term Health Effects of the Great Chinese Famine

Cheng

Shi

2019

Southern Economic Journal

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We study the long‐term health effects of the Chinese Famine of 1959–1961 on five cohorts of individuals exposed to it at different stages of their early lives. Based on a 2011 national survey, we use instrumental variables to estimate the impact of the Famine on various health and lifestyle indicators for the whole sample and for the female and male subsamples separately. We have found some negative effects of Famine exposure: (i) for the whole sample, Famine exposure reduced adult height for two out of five cohorts; (ii) for both the female and the male subsamples, Famine exposure reduced adult height in one cohort; and on the whole the reduction was larger for males. We have also found in the subsample that Famine exposure was associated with (i) a higher risk of having hypertension in one cohort for females; (ii) a higher likelihood of smoking in one male cohort; and (iii) a higher probability of consuming alcohol in one cohort for males. Finally, we have not found a statistically significant association between Famine exposure and the risk of being overweight or underweight, having diabetes or other chronic diseases, having depression.

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“…The subjects in the present study were born in the early 1960s, which maybe another reason for the apparent discrepancy between studies. In the early 1960s, China had just experienced severe famine, and some studies have found that experiencing famine or malnutrition in early life may increase susceptibility to diabetes …”

Section: Discussionmentioning

confidence: 99%

Effects of variants of 50 genes on diabetes risk among the Chinese population born in the early 1960s

Song

Wang

Fang

et al. 2019

Journal of Diabetes

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BackgroundGenome‐wide association studies have identified loci that significantly increase diabetes risk. This study explored the genetic susceptibility in relation to diabetes risk in adulthood among a Chinese population born in the early 1960s.MethodsIn all, 2129 subjects (833 males, 1296 females) were selected from the cross‐sectional 2010 to 2012 China National Nutrition and Health Survey. Fifty diabetes‐related single nucleotide polymorphisms (SNPs) were detected. Two diabetes genetic risk scores (GRSs) based on the 50 diabetes‐predisposing variants were developed to examine the association of these SNPs with diabetes risk.ResultsAssociations were found between diabetes risk and SNPs in the MTNR1B (rs10830963), KLHDC5 (rs10842994), GRK5 (rs10886471), cyclindependentkinase 5 regulatory subunit associated protein 1 (rs10946398), adaptorrelated protein complex 3 subunit sigma 2 (rs2028299), diacylglycerol kinase beta/transmembrane protein 195 (rs2191349), SREBF chaperone (rs4858889), ankyrin1 (rs516946), RAS guanyl releasing protein 1 (rs7403531), and zinc finger AN1‐type containing 3 (rs9470794) genes. As a continuous variable, with a 1‐point increase in the GRS or weighted (w) GRS, fasting plasma glucose (FPG) increased 0.045 and 0.044 mM, respectively (P < 0.001 for both), after adjusting for confounders. Both GRS and wGRS showed an association with diabetes, with a multivariable‐adjusted odds ratio (95% confidence interval) of 1.09 (1.00‐1.19) and 1.12 (1.03‐1.22), respectively, among all subjects. No significant associations were found between the GRS or wGRS and impaired fasting glucose or impaired glucose tolerance.ConclusionsThe data suggest the association of 10 SNPs and the GRS or wGRS with diabetes risk. Genetic susceptibility to diabetes may synergistically affect the risk of diabetes in adulthood.

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Exposure to the Chinese famine of 1959–61 in early life and long-term health conditions: a systematic review and meta-analysis

Cited by 184 publications

References 52 publications

Exposure to improved nutrition from conception to age 2 years and adult cardiometabolic disease risk: a modelling study

Exposure to improved nutrition from conception to age 2 years and adult cardiometabolic disease risk: a modelling study

Surviving the Famine Unscathed? An Analysis of the Long‐Term Health Effects of the Great Chinese Famine

Effects of variants of 50 genes on diabetes risk among the Chinese population born in the early 1960s

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