OBJECTIVES: The developmental origins hypothesis proposes thatÂ undernutritionÂ during foetal life, infancy, or childhood is associated with an increasedÂ risk ofÂ cardiovascular diseaseÂ in adulthood. As data on postnatal developmental programming are scarce, we investigated whether exposure toÂ undernutritionÂ during childhood,Â adolescence, or young adulthood is related to coronary heartÂ diseaseÂ (CHD) and stroke in adult life.
METHODS: We studied 7845 women from the Prospect-EPIC cohort who had been exposed at various degrees to the 1944-45 Dutch famine when they were aged between 0 and 21 years. We used Cox proportional hazard regression models to explore the effect of famine on theÂ risk ofÂ CHD and stroke, overall and within exposure age categories (0-9, 10-17, â‰¥18 years). We adjusted for potential confounders, including age at famine exposure, smoking, and level of education as a proxy for socio-economic status.
RESULTS: Overall, stronger famine exposure was associated with higher CHDÂ risk. Among those who experienced the famine between ages 10 and 17 years, CHDriskÂ was significantly higher among severely exposed women compared with unexposed women (HR 1.38; 95% CI 1.03-1.84), which only slightly attenuated after adjustment for confounding (HR 1.27; 95% CI 0.94-1.71). We observed a lower strokeÂ riskÂ among famine exposed women (HR 0.79; 95% CI 0.61-1.02). Adjustment for potential confounders produced similar results (HR 0.77; 95% CI 0.59-0.99).
CONCLUSIONS: Exposure toÂ undernutritionÂ during postnatal periods of development, includingÂ adolescence, may affectÂ cardiovascularÂ health in adult life. Sony Michel Jersey