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March 20, 2020
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Fetal exposure to famine may lead to increased adiposity in adulthood

Rural Chinese women who were exposed to famine in utero between 1959 and 1961 have higher mean BMI, weight, waist circumference and hip circumference than those born after the famine between 1962 and 1964, according to a study published in Obesity.

“Famines can be used as natural experiments to test the link between fetal nutrition condition and later life outcomes,” Zhe Fang, a graduate student in epidemiology at the Research Center for Public Health at Tsinghua University in Beijing and the department of epidemiology at Harvard T.H. Chan School of Public Health at Harvard University, and colleagues wrote. “In the present study, we found that rural Chinese women who were exposed to famine in their fetal period had consistently higher BMI, weight, waist circumference and hip circumference in their adulthood.”

Researchers analyzed data from the China Kadoorie Biobank perspective cohort study from 76,912 Chinese adults born between 1959 and 1964 (29,402 men; 47,510 women; 34,001 urban residents; 42,911 rural residents). The group born between 1959 and 1962 was exposed to malnutrition during the Great Chinese Famine, and those born between 1962 and 1964 were in the post-famine group.

The researchers used local linear and parametric regressions to perform regression discontinuity analysis. Outcomes included height, weight, BMI, waist and hip circumference and body fat percentage.

Compared with the post-famine group, rural women who were exposed to famine had mean increases of 0.3 kg/m2 (P = .007) in BMI, 0.81 kg (P = .028) in weight, 8.57 mm (P = .004) in waist circumference and 5.07 mm (P < .001) in hip circumference. No statistically significant differences were observed for rural men or urban adults exposed to famine vs. those not exposed.

The researchers noted that survival bias may influence their findings.

“People who survived famine may have physiological characteristics that are prone to accumulate fat,” they wrote.

In addition, rural populations were more likely to experience more malnutrition than urban groups during the famine, according to the researchers.

“Malnutrition in the fetal period may result in developmental adaptations that permanently change the body construct and anthropometric structure, thereby predisposing individuals to potential cardiovascular, metabolic and endocrine diseases in adult life,” the researchers wrote. “As a result, nutritional intervention and support during pregnancy are an important public health issue to be addressed.” – by Erin T. Welsh

Disclosures: The authors report no relevant financial disclosures.