Journal Article

Famine Exposure in the Young and the Risk of Type 2 Diabetes in Adulthood

van der Schouw, Yvonne T., Elias, Sjoerd G., Roseboom, Tessa J., van Abeelen, Annet F.M., Grobbee, Diederick E., Bossuyt, Patrick M.M., Uiterwaal, Cuno S.P.M.

2012

Overview

The developmental origins hypothesis proposes that undernutrition during early development is associated with an increased type 2 diabetes risk in adulthood. We investigated the association between undernutrition during childhood and young adulthood and type 2 diabetes in adulthood. We studied 7,837 women from Prospect-EPIC (European Prospective Investigation Into Cancer and Nutrition) who were exposed to the 1944-1945 Dutch famine when they were between age 0 and 21 years. We used Cox proportional hazards regression models to explore the effect of famine on the risk of subsequent type 2 diabetes in adulthood. We adjusted for potential confounders, including age at famine exposure, smoking, and level of education. Self-reported famine exposure during childhood and young adulthood was associated with an increased type 2 diabetes risk in a dose-dependent manner. In those who reported moderate famine exposure, the age-adjusted type 2 diabetes hazard ratio (HR) was 1.36 (95% CI [1.09-1.70]); in those who reported severe famine exposure, the age-adjusted HR was 1.64 (1.26-2.14) relative to unexposed women. These effects did not change after adjustment for confounders. This study provides the first direct evidence, using individual famine exposure data, that a short period of moderate or severe undernutrition during postnatal development increases type 2 diabetes risk in adulthood.

• Publisher: American Diabetes Association
• Subject: Adolescent / Aged / Biological and medical sciences / Birth weight / Cancer / Cardiovascular disease / Child / Child development / Child malnutrition / Child, Preschool / Chronic illnesses / Cohort analysis / Diabetes / Diabetes Mellitus, Type 2 / Diabetes. Impaired glucose tolerance / Ecological studies / Endocrine pancreas. Apud cells (diseases) / Endocrinopathies / Etiopathogenesis. Screening. Investigations. Target tissue resistance / Famine / Female / Glucose / Health aspects / Humans / Hypotheses / Infant / Infant, Newborn / Insulin resistance / Malnutrition - complications / Malnutrition in children / Medical sciences / Medical screening / Metabolism / Middle Aged / Netherlands - epidemiology / Nutrition / Prospective Studies / Questionnaires / Risk / Risk factors / Starvation - complications / Starvation - epidemiology / Type 2 diabetes / Womens health / World War II / Young Adult / Young adults