Dataset Information

Early life famine exposure and anthropometric profile in adulthood: a systematic review and Meta-analysis.

ABSTRACT:

Background

Previous famine studies reported the association between early life famine exposure and adulthood anthropometric profile. However, the findings were variable. Thus, a systematic review and meta-analysis was conducted to clarify the association of famine exposure in early life with the anthropometric profiles in adults.

Methods

Potentially relevant studies were searched through Scopus, Medline, Google Scholar and Google for gray literature and reference lists of previous studies. The random effects model (REM) and I² test was used to adapt the pooling method and assess heterogeneity, respectively.

Results

Prenatal famine exposure was associated with increased risk of body mass index [SMD = 0.10 (95% CI: 0.02, 0.18)], waist circumference [SMD = 0.21 (95% CI: 0.11, 0.31)] in adults. Likewise, famine exposure during prenatal life was associated with decreased adult height [SMD) = - 0.26 (95% CI: - 0.44, - 0.09)]. Moreover, famine exposure during early childhood was associated with increased risk of waist circumference [SMD = 0.09 (95% CI: 0.01, 0.16)] and decreased adult height [SMD = - 0.16 (95% CI: - 0.27, - 0.04)].

Conclusion

Our finding indicates that exposure to famine during early life was associated with the anthropometric profile of adults. In terms of public health significance, the results of the study further underscore the importance of improving the nutritional status of mothers and children to prevent adulthood diseases in the long run.

Systematic review registration number

PROSPERO CRD42020168424.

SUBMITTER: Arage G

PROVIDER: S-EPMC9028079 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

Early life famine exposure and anthropometric profile in adulthood: a systematic review and Meta-analysis.

Arage Getachew G Belachew Tefera T Abate Kalkidan Hassen KH

BMC nutrition 20220422 1

<h4>Background</h4>Previous famine studies reported the association between early life famine exposure and adulthood anthropometric profile. However, the findings were variable. Thus, a systematic review and meta-analysis was conducted to clarify the association of famine exposure in early life with the anthropometric profiles in adults.<h4>Methods</h4>Potentially relevant studies were searched through Scopus, Medline, Google Scholar and Google for gray literature and reference lists of previous ...[more]

PMID: 35459231

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Project description:BackgroundPrevious epidemiologic studies have reported famine exposure during early life association with overweight or obesity in adulthood, but a consistent perspective has not been established to date.PurposeTo determine, by conducting a systematic review and meta-analysis, whether exposure to famine could increase body mass index (BMI) in adult or not, and assess the association between famine exposure and the risk of overweight or obesity.MethodsPublished articles were systematically searched (until August, 2017) from PubMed, ScienceDirect, Cochrane, and China National Knowledge Infrastructure. Initially, comparing differences in BMI between exposed and non-exposed groups that weight mean difference (WMD) were used. Subsequently, the effect of famine exposure on overweight or obesity risk, which pooled relative risks (RRs), odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects model.ResultTwenty studies were included in this systematic review and meta-analysis. Compared with non-exposed group, famine exposure group significantly increased the risk of overweight (OR = 1.10, 95% CI: 1.04-1.16) and obesity (OR = 1.15, 95% CI: 1.05-1.24). Sensitivity analyses revealed no significant change in the famine exposure and BMI, the risk of overweight and obesity study when any one study was excluded. Subgroup analyses showed that age, gender, exposure type, study type, continent, famine cause and paper publication date were associated with BMI, the risk of overweight and obesity. Meta-regression analyses suggested that continent, famine cause could partially explain heterogeneity for famine exposure and BMI studies.ConclusionThe systematic review and meta-analysis indicates that famine exposure during early life may increase BMI, the risk of overweight and obesity, especially for female, fetal famine exposure or subject age less than 50. Furthermore, famine exposure group the risk of overweight and obesity in cross-sectional studies, Asian studies, famine cause by natural disaster or paper published from 2015 to the present studies are higher than that of non-exposed group.

Project description:BackgroundThe fast-growing literature suggests that the Chinese famine of 1959-1961 drives current and future type 2 diabetes (T2D) epidemics in China. This conclusion may be premature, as many Chinese famine studies have major methodological problems. We examine these problems, demonstrate how they bias the study results, and formulate recommendations to improve the quality of future studies.MethodsWe searched English and Chinese databases for studies that examined the relationship between prenatal exposure to the Chinese famine and adult T2D from inception to 8 February 2022. We extracted information on T2D cases and study populations of individuals born during the famine (famine births), before the famine (prefamine births), and after the famine (postfamine births). We used random-effects models to compare the odds of T2D in famine births to several control groups, including postfamine births, combined pre- and postfamine births, and prefamine births. We used meta-regressions to examine the impacts of age differences between comparison groups on famine effect estimates and the role of other characteristics, including participant sex, age, and T2D assessments; famine intensity; residence; and publication language. Potential sources of heterogeneity and study quality were also evaluated.ResultsTwenty-three studies met our inclusion criteria. The sample sizes ranged from less than 300 to more than 360,000 participants. All studies defined the famine exposure based on the participants' dates of birth, and 18 studies compared famine births and postfamine births to estimate famine effects on T2D. The famine and postfamine births had an age difference of three years or more in all studies. The estimates of the famine effect varied by the selection of controls. Using postfamine births as controls, the OR for T2D among famine births was 1.50 (95% CI 1.34-1.68); using combined pre- and postfamine births as controls, the OR was 1.12 (95% CI 1.02-1.24); using prefamine births as controls, the OR was 0.89 (95% CI 0.79-1.00). The meta-regressions further showed that the famine effect estimates increased by over 1.05 times with each one-year increase in ignored age differences between famine births and controls. Other newly identified methodological problems included the poorly assessed famine intensity, unsuitable study settings for famine research, and poor confounding adjustment.InterpretationThe current estimates of a positive relationship between prenatal exposure to the Chinese famine and adult T2D are mainly driven by uncontrolled age differences between famine births and postfamine births. Studies with more rigorous methods, including age-balanced controls and robust famine intensity measures, are needed to quantify to what extent the famine exposure is related to current T2D patterns in China.

Project description:BackgroundDyslipidemia is the major contributor to the global disease burden. Earlier epidemiologic research has linked early-life famine exposure to dyslipidemia and altered lipid profiles in adulthood, but a uniform perspective has yet to be established. In response, this systematic review and meta-analysis is aimed to investigate the association of early life famine exposure and dyslipidemia in adults.MethodsScopus, Medline and Google scholar databases were searched for articles published until October 2020. Studies of famine exposure during prenatal and early postnatal life and their association with dyslipidemia and lipid profiles in adults were included. Random effect model in the Meta-analysis and Mantel- Haenszel model was used to calculate odds ratios and their 95% confidence intervals to evaluate the strength of association between famine exposure and dyslipidemia. The lipid profiles of the exposed and non-exposed groups were compared using the standardized mean difference (SMD). Heterogeneity between studies were assessed using I2 values.ResultsWe identified 17 studies for assessing the association between early life famine exposure and risk of dyslipidemia in adults. About 11 studies were included for meta-analysis. Prenatal exposure to famine was associated with increased risk of dyslipidemia [OR = 1.74 (95% CI: 1.31, 2.31)], total cholesterol [SMD = 2.07 (95% CI: 1.40, 2.74)], LDL-cholesterol [SMD = 1.16 (95% CI: 0.25, 0.26)] and decreased HDL-cholesterol [SMD = -0.05 (95% CI: -0.10, -0.01)]. Likewise, famine exposure during early postnatal period was associated with increased risk of total cholesterol [SMD = 0.18 (95% CI: 0.11, 0.25), I 2 = 29%] and LDL-cholesterol [SMD = 0.15 (95% CI: 0.07, 0.23), I 2 = 61%].ConclusionsFamine exposure in early life was found to have an association with increased risk of dyslipidemia and altered lipide profile during adulthood. Our findings highlight the need for promoting better nutrition during pregnancy and infancy to prevent dyslipidemia during adulthood.Supplementary informationThe online version contains supplementary material available at 10.1007/s40200-022-01062-8.

Project description:ObjectivesFamine exposure in early life was associated with type 2 diabetes, non-alcoholic fatty liver disease and metabolic syndrome, etc. But evidence in early famine exposure and insulin resistance and beta cell dysfunction were limited. We aimed to investigate whether the association existed between famine exposure in early life and beta cell dysfunction and insulin resistance in adulthood.MethodsIn all, 7912 non-diabetic participants were included in this study, based on SPECT-China study. Participants with fetal or childhood famine exposure (birth year 1949-1962) were exposure group. Insulin resistance was estimated by the homeostasis model assessment index of insulin resistance (HOMA-IR). Beta cell function, represented by insulin secretion, was estimated by the disposition index. The associations of famine exposure with HOMA-IR and disposition index were assessed via linear regression.ResultsIn men, we did not observe a significant association between early life famine exposure and ln(HOMA-IR) in all three models (P > 0.05 for all). However, in women, early life famine exposure were found to have significant association with ln(HOMA-IR) after adjustments for urbanization, severity of famine exposure, current smoker, waist circumference, hypertension, and dyslipidemia (unstandardized coefficients 0.055, 95% confidence interval 0.021, 0.088, P = 0.001). Early life famine exposure was observed to be negatively associated with ln(disposition index) after adjustments for the above potential confounders, both in men (model 3: unstandardized coefficients -0.042, 95% confidence interval -0.072,-0.012, P = 0.006) and women (model 3: unstandardized coefficients -0.033, 95% confidence interval -0.058,-0.009, P = 0.008).ConclusionsIn conclusion, exposure to famine in fetal- and childhood- life period is associated with beta cell dysfunction in males and females without diabetes, but early life famine exposure was only associated with insulin resistance in non-diabetic females. These results indicate that malnutrition in early life period may offer a modifiable factor for type 2 diabetes development.

Project description:BackgroundNutritional insult in early life brings adaptive changes in body structure and functioning that could remain throughout the affected individual's life course. The long term impact of early life famine exposure on adulthood anthropometric measurements has been recorded in previous studies. However, the results were contradictory. Hence, we extend this study to examine the impact of famine exposure during early life on adulthood's anthropometry among survivors of the 1983-85 Ethiopian great famine.MethodsA total of 1384 adult men and women survived from 1983 to 85 Ethiopian great famine were included in the study. Famine exposure status was classified into five groups: early life-exposed, prenatal-exposed, postnatal-exposed, adolescence-exposed, and non-exposed based on self-reported age and birthdate of the participants. Prenatal, post-natal, and adolescence exposed groups were considered as early life exposed. Following a standard procedure, anthropometric measurements were taken. A linear regression analysis was used to analyze the impact of famine exposure on adult anthropometric measurements adjusted for all possible covariates. The effect of famine exposure on overweight, general obesity, and abdominal obesity was examined using multinomial and binary logistic regression analysis.ResultCompared to non-exposed groups, adult height was lower by 1.83 cm (β = - 1.83; 95% CI: - 3.05, - 0.58), 1.35 cm (β = - 1.35; 95% CI: - 2.56, - 0.14) and 2.07 cm (β = - 2.07 cm; 95% CI: - 3.31, - 0.80) among early life, prenatal and post-natal exposed groups, respectively. Likewise, famine exposure during early life (β = 0.02; 95% CI: 0.01, 0.03), prenatal (β = 0.03; 95% CI: 0.02, 0.03) and post-natal life (β = 0.02; 95% CI: 0.02, 0.03) was positively associated with increased waist to height ratio. However, none of the above exposures resulted in a significant association with body mass index (P > 0. 05). Additionally, exposure to famine during early stage of life was not associated with increased risk of overweight, general obesity and abdominal obesity in adults.ConclusionDecreased adult height and increased waist-to-height ratio were associated with early life exposure to famine, particularly prenatal and post-natal exposure. These results therefore underscore the significance of avoiding undernutrition in early life, which tends to be important for achieving once potential adult height and to minimize the increased risk of anthropometric markers of abdominal obesity such as waist to height ratio in later life.

Dataset Information

Early life famine exposure and anthropometric profile in adulthood: a systematic review and Meta-analysis.

Background

Methods

Results

Conclusion

Systematic review registration number

Publications

Early life famine exposure and anthropometric profile in adulthood: a systematic review and Meta-analysis.

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