Early-life exposure to famine and the risk of general and abdominal obesity in adulthood: a 22-year cohort study

Abstract

Objectives: The aim of this study was to investigate how early-life exposure to famine affected the development of overweight, general obesity and abdominal obesity in Chinese adults.

Study design: This study was a 22-year cohort study.

Methods: Data were derived from the China Health and Nutrition Survey, which is a national prospective cohort study. All participants born between 1949 and 1966 were potentially eligible. Height, weight and waist circumference (WC) were measured by trained healthcare workers. Height and weight were used to calculate body mass index, which was used to define general obesity and WC was used to define abdominal obesity. Exposure to famine was defined using the birth date as follows: no exposure (participants born between 1962 and 1966); fetal exposure (participants born between 1959 and 1961); early childhood exposure (participants born between 1956 and 1958); mid-childhood exposure (participants born between 1953 and 1955); and late childhood exposure (participants born between 1949 and 1952).

Results: In total, 6957 participants were included in this study. Results indicate that exposure to famine was linked to a lower risk of being overweight. Exposure to famine in mid-childhood decreased the risk of general obesity in both males (hazard ratio [HR] 0.485, 95% confidence interval [CI] 0.292-0.807 [P = 0.005]) and females (HR 0.426, 95% CI 0.256-0.709 [P = 0.001]). Exposure to famine during any period of childhood decreased the risk of abdominal obesity (P < 0.001).

Conclusions: Exposure to famine in early childhood decreased the risk of overweight and abdominal obesity in adulthood; however, exposure to famine only had a weak role in the development of general obesity.

Keywords: Abdominal obesity; China; Famine; Obesity; Overweight.