Abstract
BackgroundWeight for height has been used in the past as an indicator of obesity to report that prenatal exposure to the Dutch famine of 1944–1945 determined subsequent obesity. Further evaluation is needed as unresolved questions remain about the possible impact of social class differences in fertility decline during the famine and because being overweight is now defined by a Body Mass Index (BMI: kg/m2) from 25 to <30 and obesity by a BMI of 30 or more.MethodsWe studied heights and weights of 371,100 men in the Netherlands born between 1943 and 1947 and examined for military service at age 19. This group includes men with and without prenatal exposure to the Dutch famine.ResultsThere was a 1.3-fold increase in the risk of being overweight or obese in young adults at age 19 after prenatal famine exposure in early gestation. The increase was only seen in sons of manual workers born in the large cities of Western Netherlands and not among those born in smaller cities or rural areas in the West. Social class differentials in fertility decline during the famine did not bias study results.ConclusionsThe long-term adverse impact of prenatal famine on later life type 2 diabetes and mortality through age 63 is already showing at age 19 in this population as a significant increase in overweight risk.
Highlights
Studies of the Ukraine famine of 1932–1933 [1], the Dutch famine of 1944–45 [2, 3], and three famines in 20th century Austria [4] show a relation between type 2 diabetes in later life with prenatal undernutrition
Dutch famine of 1944–1945. ● To avoid possible biases arising from the decline in conceptions during the famine we concentrated on births to women who were already pregnant during the famine. ● We found a 1.3-fold increase in being overweight at age 19 for men exposed in early gestation but not for men exposed later in gestation
The increase was limited to sons of manual workers, consistent with more limited access to food in this group. ● Our findings suggest that a body size increase in young adulthood foreshadows the long-term increase in later type 2 diabetes and mortality after early gestation famine
Summary
Studies of the Ukraine famine of 1932–1933 [1], the Dutch famine of 1944–45 [2, 3], and three famines in 20th century Austria [4] show a relation between type 2 diabetes in later life with prenatal undernutrition. Military induction records in the Netherlands have related prenatal exposure to the Dutch famine of 1944–1945 to increases in the weight for height ratio at age 19 [7]. Further examination of the military induction records could help clarify the relation between prenatal famine exposure, body size in young adults, and increased diabetes risk at a later age. This is important as prenatal famine studies were not included in the recent International Journal of Obesity review of the effects of prenatal stress on offspring obesity [8]. Further evaluation is needed as unresolved questions remain about the possible impact of social class differences in fertility decline during the famine and because being overweight is defined by a Body Mass Index (BMI: kg/m2) from 25 to
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