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Exposure to the 1959–1961 Chinese famine and risk of non-communicable diseases in later life: A life course perspective

Child undernutrition and later-life non-communicable diseases (NCDs) are major global health issues. Literature suggests that undernutrition/famine exposure in childhood has immediate and long-term adverse health consequences. However, many studies have theoretical and methodological limitations. To...

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Autores principales: Cheng, Mengling, Sommet, Nicolas, Kerac, Marko, Jopp, Daniela S., Spini, Dario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10431657/
https://www.ncbi.nlm.nih.gov/pubmed/37585364
http://dx.doi.org/10.1371/journal.pgph.0002161
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author Cheng, Mengling
Sommet, Nicolas
Kerac, Marko
Jopp, Daniela S.
Spini, Dario
author_facet Cheng, Mengling
Sommet, Nicolas
Kerac, Marko
Jopp, Daniela S.
Spini, Dario
author_sort Cheng, Mengling
collection PubMed
description Child undernutrition and later-life non-communicable diseases (NCDs) are major global health issues. Literature suggests that undernutrition/famine exposure in childhood has immediate and long-term adverse health consequences. However, many studies have theoretical and methodological limitations. To add to the literature and overcome some of these limitations, we adopted a life course perspective and used more robust methods. We investigated the association between exposure to the 1959–1961 Chinese famine and later-life NCDs and if this association depends on: life stage at exposure, famine severity, and sex. We conducted a secondary data analysis of a large-scale, nationally representative, longitudinal study—the China Health and Retirement Longitudinal Study (2011–2018, 11,094 participants). We measured famine exposure/severity using self-reported experience, life stage using age at exposure, and health using the number of NCDs. We performed Poisson growth curve models. We obtained three findings. First, compared with unexposed participants, those exposed before age 18 had a higher risk of later-life NCDs, particularly if exposed in-utero (IRR = 1.90, 95% CI [1.70, 2.12], p < .001) and in the “first 1,000 days” of life (IRR = 1.86, 95% CI [1.73, 2.00], p < .001; for 0–6 months group, IRR = 1.95, 95% CI [1.67, 2.29], p < .001). Second, the famine effects among participants moderately and severely exposed were similar (IRR = 1.18, 95% CI [1.09, 1.28], p < .001 and IRR = 1.24, 95% CI [1.17, 1.32], p < .001). Third, the famine effects did not differ between females and males (IRR = 0.98, 95% CI [0.90, 1.07], p = .703). In an individual’s life course, in-utero and the “first 1,000 days” are a particularly sensitive time period with marked long-term implications for NCDs if undernutrition/famine is experienced in this period. However, this window remains open until young adulthood. This highlights the need to invest more in preventing and treating child/adolescent undernutrition to tackle later-life NCDs.
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spelling pubmed-104316572023-08-17 Exposure to the 1959–1961 Chinese famine and risk of non-communicable diseases in later life: A life course perspective Cheng, Mengling Sommet, Nicolas Kerac, Marko Jopp, Daniela S. Spini, Dario PLOS Glob Public Health Research Article Child undernutrition and later-life non-communicable diseases (NCDs) are major global health issues. Literature suggests that undernutrition/famine exposure in childhood has immediate and long-term adverse health consequences. However, many studies have theoretical and methodological limitations. To add to the literature and overcome some of these limitations, we adopted a life course perspective and used more robust methods. We investigated the association between exposure to the 1959–1961 Chinese famine and later-life NCDs and if this association depends on: life stage at exposure, famine severity, and sex. We conducted a secondary data analysis of a large-scale, nationally representative, longitudinal study—the China Health and Retirement Longitudinal Study (2011–2018, 11,094 participants). We measured famine exposure/severity using self-reported experience, life stage using age at exposure, and health using the number of NCDs. We performed Poisson growth curve models. We obtained three findings. First, compared with unexposed participants, those exposed before age 18 had a higher risk of later-life NCDs, particularly if exposed in-utero (IRR = 1.90, 95% CI [1.70, 2.12], p < .001) and in the “first 1,000 days” of life (IRR = 1.86, 95% CI [1.73, 2.00], p < .001; for 0–6 months group, IRR = 1.95, 95% CI [1.67, 2.29], p < .001). Second, the famine effects among participants moderately and severely exposed were similar (IRR = 1.18, 95% CI [1.09, 1.28], p < .001 and IRR = 1.24, 95% CI [1.17, 1.32], p < .001). Third, the famine effects did not differ between females and males (IRR = 0.98, 95% CI [0.90, 1.07], p = .703). In an individual’s life course, in-utero and the “first 1,000 days” are a particularly sensitive time period with marked long-term implications for NCDs if undernutrition/famine is experienced in this period. However, this window remains open until young adulthood. This highlights the need to invest more in preventing and treating child/adolescent undernutrition to tackle later-life NCDs. Public Library of Science 2023-08-16 /pmc/articles/PMC10431657/ /pubmed/37585364 http://dx.doi.org/10.1371/journal.pgph.0002161 Text en © 2023 Cheng et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Cheng, Mengling
Sommet, Nicolas
Kerac, Marko
Jopp, Daniela S.
Spini, Dario
Exposure to the 1959–1961 Chinese famine and risk of non-communicable diseases in later life: A life course perspective
title Exposure to the 1959–1961 Chinese famine and risk of non-communicable diseases in later life: A life course perspective
title_full Exposure to the 1959–1961 Chinese famine and risk of non-communicable diseases in later life: A life course perspective
title_fullStr Exposure to the 1959–1961 Chinese famine and risk of non-communicable diseases in later life: A life course perspective
title_full_unstemmed Exposure to the 1959–1961 Chinese famine and risk of non-communicable diseases in later life: A life course perspective
title_short Exposure to the 1959–1961 Chinese famine and risk of non-communicable diseases in later life: A life course perspective
title_sort exposure to the 1959–1961 chinese famine and risk of non-communicable diseases in later life: a life course perspective
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10431657/
https://www.ncbi.nlm.nih.gov/pubmed/37585364
http://dx.doi.org/10.1371/journal.pgph.0002161
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